Delgado Scaling

Dental hygiene is more than just scaling

Aug. 21, 2019
Are we really only as good as the last piece of calculus we removed?

We spend the majority of our academic careers learning the techniques and skills needed to assess our patients’ oral health status, remove hard and soft deposits, and return patients to health. Instrumentation is a very technique-sensitive skill and requires many years to master, but we focus much of our success in school on how well we can perfectly debride a patient’s mouth of all calculus. The current model for licensure includes a clinical board examination that is primarily focused on how well the candidate can remove moderate to heavy calculus.

All of this focus on calculus removal poses the question: Are we really only as good as the last piece of calculus we removed? This way of thinking will get you on the fast track to job dissatisfaction, burnout, and feeling incompetent in clinical skills. Just as there are many factors that can influence the disease process in our patients’ oral status, there are many factors that contribute to a clinically competent and successful dental hygienist.

It is important to continually improve clinical skills and debride local irritants that can cause or perpetuate the disease process. Graduates of accredited dental hygiene schools are deemed competent in instrumentation and calculus removal, but only after years of practice do we reach the mastery or expert knowledge of these skills. But there is more to dental hygiene practice than just that.

More than scaling machines

We learn about the complex disease processes that can be present in the mouth and the many risk factors associated with the development of periodontal disease. These risk factors include systemic, environmental, and behavioral factors. With an understanding of the various risk factors that influence the progression of disease, we become empowered to treat our patients beyond simply removing calculus and local irritants. We are more than scaling machines and have the capacity to practice dental hygiene at a higher level.

Technology advances over the last decade have dramatically changed the way dentistry is accessed and practiced. These advancements give clinicians the ability to treat and assess many of the factors that influence the disease process and improve patient outcomes. Screening for medical conditions including high blood pressure, diabetes, HIV, and HPV are some areas in which we can utilize technology. Establishing this standard of care enforces a holistic approach to caring for our patients’ systemic health and its relation to their oral health.

Changing patients’ lives

Utilizing our expertise in different ways can greatly impact clinical outcomes and could change our patients’ lives. When clinical signs or symptoms present at a dental appointment, making appropriate referrals to primary care physicians or medical specialists could quite possibly save someone’s life. Intraoral cameras can track minor changes in suspicious lesions in the head, neck, and mouth and can be included in medical or surgical referrals. Over my years of clinical practice as a dental hygienist, I have had numerous experiences of screening for uncontrolled hypertension, recognizing the signs of severe sleep apnea, and catching cancerous lesions at an early stage.

As we continue our careers in dental hygiene, we can be confident in our clinical abilities in all facets of patient care. When we focus on only one particular aspect of treatment, we can become discouraged or frustrated when treatment or patient outcomes are not what we expected. Our patients’ overall health, as well as their oral health, is worth so much more than just scaling teeth. We often begin a career in dentistry to help those in our communities, and it is important to remember what fuels our passion for dental hygiene. Dental hygienists are so much more than scaling machines, and I would even go so far as to say we save lives one smile at a time.