Dental Hygienists Discuss Importance of Oral Health

Good oral health is essential for good overall well-being. Diseases in your mouth can lead to other health problems, and an oral or dental infection can cause sepsis. But, according to the Centers for Disease Control and Prevention (CDC), over a quarter of adults in the United States have untreated tooth decay. In addition, 80% of all people in the U.S. have some evidence of periodontal (gum and bone) disease. Sepsis Alliance would like to spotlight National Dental Hygiene Month, celebrating the healthcare professionals who can identify problems in the mouth and empower their patients with the tools and knowledge to maintain their oral health.

Meet Two Dental Hygienists

Dental hygienists are the best healthcare professionals to help you maintain a healthy mouth. Sepsis Alliance spoke with two dental hygienists who helped explain their role and their credentials.

Dianne L. Sefo, RDH, MEd, is a clinical professor and chair in Dental Hygiene & Assisting at New York University Dentistry. Deborah Manne, RDH, RN, MSN, is an adjunct instructor and oral health specialist at Saint Louis University in Missouri. Manne also continues to work with patients in a public health clinic for people who can’t afford to go to a dental office.

What do dental hygienists do?

Dianne Sefo: A dental hygienist is part of the dental team and focuses on dentistry’s preventative aspects. This means we provide treatments and education on preventing oral diseases like tooth decay and periodontal disease. We also do scaling and root planing – this is the really deep cleaning. Sometimes we have to apply chemotherapeutic agents (drugs that treat bacteria in the mouth), or we use lasers to reduce the bacteria and allow for better healing. We can also apply sealants and do some cosmetic services.

But a lot of what we do is an overall assessment. We look at the head and neck, the medical history, and anything that could affect a patient’s care. Is the patient prone to infection, or are they immunocompromised in any way? We collect data and take measurements and x-rays. We do visual inspections and then share our findings with the dentist, who makes the final diagnosis.

Deborah Manne: In addition to what Dianne said, dental hygienists with additional education can give infiltration and block local anesthesia and administer nitrous oxide/oxygen analgesia.  In Missouri, we can also practice under general supervision, which means we do not need to have a dentist physically present in the office. However, the patients still need to be a patient of record with the dentist and have to have had an exam within a year of seeing us.

It wasn’t always like that, though. I went to nursing school after 16 years of working as a dental hygienist because our practice was very restricted in Missouri at that time. I also work as a head/neck oncology nurse as well. (Sepsis Alliance: The American Dental Hygienist’s Association lists the scope of practice for dental hygienists, according to state.)

What education do dental hygienists need to practice?

Sefo: The entry-level to be a registered dental hygienist in the United States is an associate degree in dental hygiene from an accredited program. There are bachelor’s and master’s degrees in dental hygiene as well.

What is a common misconception you hear about dental hygienists?

Manne: You’re the tooth cleaner; all you do is just clean teeth. There are many misconceptions, even among other healthcare professionals. And it’s amazing to me sometimes. I have heard colleagues in the nursing world say they didn’t know dental hygienists had a license.

Many people don’t realize the level of education we have to undergo and the exams we must take for licensure. We relicense every two years in the state of Missouri, and we also have to take 30 hours of continuing education credits that meet certain criteria, including maintaining basic life support/CPR certification.

Dental care isn’t cheap – and that’s often one reason people don’t see dental professionals routinely. What can people do if they can’t afford the preventative care offered by dental hygienists?

Manne: I recommend looking for federally qualified health centers and community health centers with dental clinics. Those are typically less expensive. They also offer sliding scale fees based on your income. Also, look for dental schools and dental hygiene schools. We have a dental hygiene program here in St. Louis that sees patients. There is a dentist faculty there that can do an exam and pretty much do everything.

Dental practices don’t tend to see sepsis because these patients go to the hospital, so how much do dental hygienists learn about sepsis?

Sefo: It’s definitely pressed upon dental hygienists that there is a link between oral and systemic health. There’s a big emphasis on periodontal disease, for example, and its association with several health conditions like heart disease and diabetes. We talk about bacteremia, even when just conducting a cleaning or prophylaxis. It can become sepsis. Some patients have conditions and need antibiotics before treatment to prevent infective endocarditis.

Manne: Unfortunately, there have been some very sad cases of sepsis that started in the mouth as a preventable oral infection. It’s tragic because there’s absolutely no reason for that to happen.

What made you want to be a dental hygienist?

Sefo: I went into the field because of my parents. They were both nurses (mom – RN in the OR, dad – nurse anesthetist). Hearing their stories inspired me to go into healthcare, but I didn’t want to work in a hospital. My dad then recommended dentistry. My initial plan was to be a dentist, but I did my undergrad in dental hygiene and fell in love with the preventative aspects of dentistry. I wanted to be a part of the team that helped patients prevent diseases and not always deal with the major problems afterwards. I also didn’t want to be concerned about the business side of dentistry and truly be able to just focus on patient care.

Manne: My uncle was a dentist, and he kind of planted that seed when I was younger. But I think probably the big thing was working one-on-one with people and just wanting to help them. When I was younger, I didn’t really understand all that was involved or the importance that I as a dental hygienist, could bring. I always saw the dental hygienist every six months while I was growing up. I liked the dental hygienist, and I liked the way she worked with people and got to know people. I just thought that might be a good fit for me to work to help people out.

What do you want people to know most about your profession?

Sefo: I try to be very thorough with my medical history review with the patients. And sometimes, unfortunately, you get some patients who get a little annoyed and wonder why I’m asking so many questions. I try to explain that I’m doing all of this to ensure their safety, and that the care I provide will not harm them in any way. So I need to make sure what conditions they potentially have or have signs or symptoms so we can ensure that overall they are healthy.

But overall, I think what’s really important is for people to stay on top of their preventative care, to not wait for problems to happen. See a dental hygienist a minimum twice a year, if not more. Some patients need to go more often.

Manne: Just the fact that dental hygienists are an essential member of the interprofessional team who makes sure that people have good overall health. We want to bring our skills and our education to help people achieve that through good oral health.

To learn more about sepsis and oral health, visit Sepsis and Dental Health, part of the Sepsis and… library.