Utilizing your hygiene program for maximum wellness

By Douglas Cast, DDS

The most chronic inflammation occurs in the mouth in the form of gingivitis. While we were taught that we measure pocket depth to determine oral health, I am of the opinion that the rate and amount of bleeding upon probing is equal to or greater than the information of the pocket depth alone. Nearly all experienced dentists and hygienists have measured pockets of 4 mm to 6 mm and found the tissue was firm, pink, and stippled with little to no bleeding upon probing — or at worst, slight bleeding after a delayed onset. But what about 2 mm pockets with heavy bleeding?

Intraoral cameras have historically shown us the power of sight gets the patient to “own” his or her problem more than words do. A simple way to do so in your hygiene program is to instruct your hygienist from this day forward to use gauze sponges (preferably 4” X 4”) to remove the blood. In other words, do NOT irrigate and suction out the blood while doing any cleaning. Then, either place the used gauze on the patient bib or on the tray on which your instruments are placed. It is an important visual aid that reinforces the seriousness of the patient’s problem.

When I enter the operatory to do a check on a hygiene patient and see the amount of bleeding that he or she presents with, I take a few moments to just talk and listen to the patient. After a little small talk, I tell my patient that I noticed that he or she had more bleeding on the gauze than is healthy, and I follow it up with the question, “How are you feeling?” Then I inform — not lecture — the patient on what the bleeding does to his or her body.

I perform a clinical examination and use the intraoral camera — another visual aid tool — to examine the patient’s mouth and existing restorations. I always stay on topic about bacteria. If old restorations are leaking and gums are swollen, it all is a breeding place for bacteria ... and chronic bacteria leads to chronic inflammation. Chronic inflammation leads to higher levels of CRP, and hence increased risk for expensive and deadly diseases. Remember, we are taught that many diseases are first detected by dentists during routine dental examinations. But the truth is, dentists and hygienists are in the best position to diagnose potentially high levels of CRP and as such. We can play a role in prevention of some of the most expensive and deadly diseases we see in our country today.

Author bio
Douglas Cast, DDS, practices in Murrieta, Calif. He is a former clinical instructor at LVI as well as an international speaker. For more information, you can contact Dr. Cast at [email protected] or call his practice at (951) 698-1700. Send a text message to Dr. Cast at (951) 760-3590.