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BS: Dental Hygienists.

Acorn4 24 Jun 08 - 01:23 PM
Wesley S 24 Jun 08 - 01:43 PM
Little Hawk 24 Jun 08 - 02:29 PM
katlaughing 24 Jun 08 - 04:51 PM
Rapparee 24 Jun 08 - 05:38 PM
Little Hawk 24 Jun 08 - 06:14 PM
jimmyt 24 Jun 08 - 06:21 PM
Mrrzy 24 Jun 08 - 06:47 PM
Gurney 24 Jun 08 - 07:49 PM
Q (Frank Staplin) 24 Jun 08 - 07:55 PM
Amos 24 Jun 08 - 07:57 PM
frogprince 24 Jun 08 - 08:07 PM
Joe_F 24 Jun 08 - 08:40 PM
Bobert 24 Jun 08 - 09:13 PM
jimmyt 24 Jun 08 - 09:27 PM
Little Hawk 24 Jun 08 - 11:12 PM
Moses 25 Jun 08 - 03:38 AM
Mooh 25 Jun 08 - 09:17 AM
Donuel 25 Jun 08 - 10:27 AM
Stilly River Sage 25 Jun 08 - 10:57 AM
JohnInKansas 25 Jun 08 - 11:53 AM
Little Hawk 25 Jun 08 - 11:58 AM
JohnInKansas 25 Jun 08 - 01:22 PM
the lemonade lady 25 Jun 08 - 06:53 PM
Sandra in Sydney 26 Jun 08 - 09:00 AM
the lemonade lady 26 Jun 08 - 06:29 PM
Sandra in Sydney 26 Jun 08 - 09:14 PM
katlaughing 26 Jun 08 - 10:00 PM
Little Hawk 26 Jun 08 - 10:11 PM
jimmyt 27 Jun 08 - 09:27 AM
jeffp 27 Jun 08 - 11:05 AM
jimmyt 27 Jun 08 - 04:49 PM
JohnInKansas 28 Jun 08 - 04:13 PM
Stilly River Sage 28 Jun 08 - 10:19 PM
Alice 28 Jun 08 - 10:40 PM
Jeanie 29 Jun 08 - 02:10 AM
Bonzo3legs 29 Jun 08 - 04:18 PM
Dave Roberts 29 Jun 08 - 07:41 PM
jimmyt 30 Jun 08 - 12:00 PM
jimmyt 30 Jun 08 - 03:57 PM

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Subject: BS: Dental Hygienists.
From: Acorn4
Date: 24 Jun 08 - 01:23 PM

I'm just wondering if anyone else has had problems after visiting a dental hygienist.

The story

I thought that after not having visited a dentist for some time that I'd better go and have a check-up. Big mistake.

I was advised that it would be a good idea to go to the dental hygienist who works in the practice - I duly folowed advice and was told that I had gum problems and that the teeth needed a good clean and polish, which then took place and the next half an hour was spent with various scrapings and pokings with assorted instruments.

If I had gum problems before I went there this was nothing to what was to follow - I had painful ulcers appearing on both sides of the mouth which made it uncomfortable to eat. Worse than this one of my front teeth had developed a wobble, which it still has slightly, and at one stage I thought that I was going to lose it. The gap between my two front teeth has widened and this looks like being permanent.

A month's treatment with Corsodyl helped clear up the ulcers but it took a while before I could sing properly as the gap affected how I formed words.

Is this just to make dentitst moer money?

Has anyone else had bad experiences of this type?


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Subject: RE: BS: Dental Hygienists.
From: Wesley S
Date: 24 Jun 08 - 01:43 PM

No - It sounds like you had a crappy dentist and picked up up an infection.


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Subject: RE: BS: Dental Hygienists.
From: Little Hawk
Date: 24 Jun 08 - 02:29 PM

I'm not sure what to say about it. In my own case, I've had no problems following such treatments.

My grandmother, however, came to North America when in her mid-30's or early 40's, and had never had her teeth cleaned by a dental hygeinist in her life. She followed the advice of her new Canadian dentist and got her teeth cleaned by the dental hygeinist...and they all went into some kind of state of shock, and she lost them all in the months following!

So it may depend on the individual...or it may depend on the particular skills and care of the dental hygeinist who does the work.


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Subject: RE: BS: Dental Hygienists.
From: katlaughing
Date: 24 Jun 08 - 04:51 PM

I agree with Wesley. I've never had a problem and I get mine down every six months. Infection in one's gums is not to be messed with as it gets into the blood stream very easily and can get into one's heart if their heart health is in any way dicey. In that case one takes pre-meds of antibiotics before a visit to the hygienist and dentist. Whatever you do, I wouldn't go back to the same dentist or hygienist!


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Subject: RE: BS: Dental Hygienists.
From: Rapparee
Date: 24 Jun 08 - 05:38 PM

Never had a problem like that! I get my teeth done every six months, need it or not. It helps forestall problems, messy and expensive problems, later.


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Subject: RE: BS: Dental Hygienists.
From: Little Hawk
Date: 24 Jun 08 - 06:14 PM

Pardon me for saying so on this thread, Rapaire, but that's sort of how Shane approaches the problem of bathing.

And you may now all return to your regulary scheduled programming.


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Subject: RE: BS: Dental Hygienists.
From: jimmyt
Date: 24 Jun 08 - 06:21 PM

SOrry to rain on your parade, but the only logical explanation is pure coincidence. Dental hygienists, at least in the US, are trained to deliver excellent healthcare and mostly what they do is appreciated by the mass majority of patients. If you had a tooth that was loose, the highest liklihood is that you have (and had prior to the DH visit) periodontal disease. Treating this is sometimes an unpleasent albiet necessary experience. Just like the physician that diagnoses hypertension or diabetes didn't cause these diseases in their patients, your dentist or dental hygienist did not cause your periodontal disease. Perhaps sitting down with your dentist or another one, preferably a periodontist, and having a thorough discussion on the severity of your problems and how to solve them would enable you to keep your teeth. Otherwise, untreated periodontal disease ultimately causes the teeth to loosen up and fall out. I have 3 dental hygienists that work for me, and over a month period, they probably see 400 patients. If I had one patient a month that felt like you, it would be rare.   I am not trying to protect your dentist or dental hygienist. Maybe they are real jerks and are in fact not competent. I just wanted to share the more likely possibilities for your own good.


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Subject: RE: BS: Dental Hygienists.
From: Mrrzy
Date: 24 Jun 08 - 06:47 PM

My only problem is that I am so terrified of dentistry, way beyond the norm, that I *have* to have a hygienist who will CHAT, and take my mind off what s/he's doing and cover up that terrible noise. I actually had to change dentists when my old one got a new hygienist who couldn't chat and work at the same time...

Sounds like a horror story, though! But it was the right decision on your part to go, and get it done, good for you!


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Subject: RE: BS: Dental Hygienists.
From: Gurney
Date: 24 Jun 08 - 07:49 PM

I've done the six-monthly visit thing for 50 years, and the last time I went, my dentist DIDN'T give a scrape-and-polish for the first time.
However, he did charge the usual fee and recommend a visit to the hygienist. So, I make that to be a de-facto price rise from him, a reduction of service, and the shuffling-off of part of his job to a less-qualified individual.
How long has this been going on?


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Subject: RE: BS: Dental Hygienists.
From: Q (Frank Staplin)
Date: 24 Jun 08 - 07:55 PM

I once had a dentist who had a hygienist, apparently on low salary, who was allowed to keep a good portion of the fee for gum treatments, etc., over and beyond what he himself did. While she cleaned my teeth, she told me my gums were receding, and needed to be 'scarified,' and treated over several visits. This scared me (also fearful of dentists). I went to a walk-in dentist in a strip mall near me and asked about it. He laughed, and said it wasn't needed, and that the woman was just extracting money.
Apparently there were several hygienists in the city who made extra money this way, and the dentists let them do it.

I can see where this sort of treatment could cause infections unless extreme care was exercised.


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Subject: RE: BS: Dental Hygienists.
From: Amos
Date: 24 Jun 08 - 07:57 PM

The cleaning, especially if you have gum conditions allowed to develop over time, can cause a lot of irritation, which gradually succumbs to salt-water rinsing.

Prices are hell alll over, anyway.


A


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Subject: RE: BS: Dental Hygienists.
From: frogprince
Date: 24 Jun 08 - 08:07 PM

My hygenist is a sweetheart. I hadn't had any dental care for close to twenty years, have now been with her for about twenty, and things look and feel much better in my mouth than back when.


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Subject: RE: BS: Dental Hygienists.
From: Joe_F
Date: 24 Jun 08 - 08:40 PM

My dental hygienist badmouths my dentist (a terrible thing to do, you will agree) & disagrees with his diagnoses. However, she seems to know her business.


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Subject: RE: BS: Dental Hygienists.
From: Bobert
Date: 24 Jun 08 - 09:13 PM

My dental hygientist is mean!!! She complains that my teeth need cleaning and that I should floss them 5 times a day and that I should use this stuff the she tries to sell me that looks and tastes like Listerine, 'cept it's 5 times a s expensive...

Now here is my question...

...if everyone flossed 5 times a day and used $18 a bottle anti-plack crap then what would my dental hygientist do for a living???

Huh??? I mean, what a crock... Thats what these folks do and to complain because you happen to need to have yer teeth cleaned is down right stupid...

Plus, she has terrible breath even with the mask on... She is mean and as bad breath, too... And she is lecturing me??? Hey, awwwww, nevermind...

Bet she is a Barry Manilow fan...

B~


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Subject: RE: BS: Dental Hygienists.
From: jimmyt
Date: 24 Jun 08 - 09:27 PM

Bobert, I can see how this would affect you, what with your box set of Neil Sedaka in the Miata.


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Subject: RE: BS: Dental Hygienists.
From: Little Hawk
Date: 24 Jun 08 - 11:12 PM

The hygeinist at the dental facility I go to in Toronto is wonderful, and so is everyone else in the place. I think they may be the best dental clinic in Canada. No fooling. They are as good as it gets.

But, DANG! Is dental work ever expensive!


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Subject: RE: BS: Dental Hygienists.
From: Moses
Date: 25 Jun 08 - 03:38 AM

I have always visited my dentist every 6 months and had the usual scrape and polish at the end of each periodic visit.

In my ignorance I ignored his advice when some ten years ago he suggested I visit the hygienist. I thought it an attempt to extract more money out of me and I continued to brush my teeth as I had always done morning and night without fail.

About five years ago one of my front teeth suddenly became wobbly and within 3 weeks so did most of the others.

I was found to have gum disease which necessitated expensive and painful periodontal treatment followed by very expensive orthodontal work (because the wobbly teeth had gone out of alignment).

I now see the hygienist every three months and, of course, have to do my own extensive brushing/flossing (not just the normal once-over with a toothbrush for a minute or so) at least twice every single day.

If your dentist says you need to see a hygienist it is probably for a very good reason and the chances are that problems are already there but you are (as I was) not aware of them.

I could have bought a small car with the cash I've spent in the last 5 years on my teeth.

But what price is a smile?

Christine


BTW Low-level infections caused by poor dental hygiene can be the cause of heart problems. I don't know much about this but someone else can probably enlighten me.


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Subject: RE: BS: Dental Hygienists.
From: Mooh
Date: 25 Jun 08 - 09:17 AM

I had one who bitched and complained about everything, including me and my teeth, plus she was rough on my mouth. Eventually, after tolerating her for three or four visits, I requested a change and was rebooked with another in the office. The new one is more thorough, personable, and relatively easy on my mouth. She also seems to remember me from one visit to another. It is a job where personality can mean a lot.

Peace, Mooh.


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Subject: RE: BS: Dental Hygienists.
From: Donuel
Date: 25 Jun 08 - 10:27 AM

Yipes

Don't ever go for the free treatment at hygenist schools.
When I was young I tried that once to my dismay.

They didn't turn me into a newt but the mark she made on my front tooth never went away.


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Subject: RE: BS: Dental Hygienists.
From: Stilly River Sage
Date: 25 Jun 08 - 10:57 AM

I find it surprising that you have separate visits with hygienists vs dentists. I've always gone to a dentist office where the hygienist in the office cleaned my teeth, then the dentist took a look. In one case the dentist sometimes did the cleaning if she was looking for something in particular (or had reduced hours and staff when her kids were small so did more of that work herself). The dentist I see now is a character, but has done his environmental research regarding treatments and fillings and has in place a plant that allows for some of these procedures to take one visit instead of two. I had a partial crown (I think that's what it is), a form put on the top of a molar that was cracked. Before, any time I bit wrong it hurt, but it hadn't broken completely. When I was able to get the co-pay (thank George Dubya for providing the "incentive" this spring) I had that work done. It took over 3 hours, it wasn't fun, but that tooth doesn't bother me any more.

I didn't go in often, I didn't have cavities for most of my life, but in my late 30s, after having a couple of kids, the dynamics of my mouth changed and I now have a few fillings. I try to remember to go in every six months. They always have useful information (Bobert, switch to a mouthwash that doesn't have alcohol and it won't dry your mouth out so much. I was using a mouthwash to soak my brace/retainers and they said that was causing dryness. Switching made a big difference.)

SRS


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Subject: RE: BS: Dental Hygienists.
From: JohnInKansas
Date: 25 Jun 08 - 11:53 AM

I am firmly convinced that I might still have teeth if I hadn't gone to the dentist several years ago.

The normal practice was to have a hygeinist in the dentists office, and for the dentist to insist that your teeth must be "cleaned" prior to his/her examination.

The hygeinist in this case was quite obviously fresh out of "hygeinist school" and had not learned that not all dental enamel is pearly white. Being raised where there was a rather high fluoride content in the local water, possibly supplemented by some antibiotics that were popular when I was a kid, my own teeth were naturally a bit on the "yellow" side.

The hygeinist attempted to clean down to the white, and since there wasn't any white to be found she literally removed the enamel from several large areas of my teeth (mostly right at the gum line, of course). When she figured out that what she was doing wasn't working, she called the dentist in, he looked and muttered "oh f**k" and my visit was over.

At a rescheduled appointment for "the regular dental work" the dentist would not say what had been done, but said quite emphatically that there was "nothing that could be done about it."

And consultation with other dentists (plural) got the same opinion that my (undescribed, since it was obvious what had happened) problem could not be fixed by any remotely affordable procedures, and even the too expensive ones offered little hope of improvement.

I had constant, although not quite excruciating, pain for the next three years, before all my teeth spontaneously removed themselves. With the bone exposed, the gum could not bond to the tooth and there was no barrier to infection, and I must assume that it took hold rapidly once it got a starting point.

(But the dentist who attempted to provide dentures to fit what was left of my jaw bones was even less competent. So who needs teeth? I can still nibble.)

John


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Subject: RE: BS: Dental Hygienists.
From: Little Hawk
Date: 25 Jun 08 - 11:58 AM

Good lord.

Well, that is one more horror story to add to the list that I have heard already about people's dental mishaps due to certain incompetent practitioners.

And I've heard some doozies, let me tell you.


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Subject: RE: BS: Dental Hygienists.
From: JohnInKansas
Date: 25 Jun 08 - 01:22 PM

LH -

I don't have more than normal reservations about the competence of the dentist. He just got suckered by the "credentials" of an inexperienced hygienist who hadn't quite learned everything needed out of the schoolbooks.

(Incidentally, she was no longer working for him when I went back a week later - which is somewhat unfortunate, since with proper/appropriate supervision until her abilities were confirmed in practice shouldn't have been a necessary outcome.)

Surprisingly, the best dental surgeon I ever encountered was in the Army. It took about four months to get in to see him, since his "senior medical officer" figured that reservists should wait 'till they got out to get anything significant done; but when I did get in the chair he was %!$!@^* GOOD!

I'd also have picked the post Vet (in preference to the MDs) if I'd needed any other surgery, but that's another story.

John


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Subject: RE: BS: Dental Hygienists.
From: the lemonade lady
Date: 25 Jun 08 - 06:53 PM

Go steady with Corsodyl it'll stain your teeth! Honestly it will.

Sal


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Subject: RE: BS: Dental Hygienists.
From: Sandra in Sydney
Date: 26 Jun 08 - 09:00 AM

I've never come across Dental Hygienists before, so I checked google Australia - & we do have them! The profession started in 1976 in Australia & universities train them. Hygienists work under supervision of a dentist, doing the kind of things folks mentioned above.

I've consulted at least 7 different dentists over the past 30 years, & as far as I;m aware none ever included Dental Therapists in their practices. Some were single practitioners, one was Professor** at the local teaching hospital others worked in group practices, naturally all had dental nurses.

All these dentists cleaned & scaled my teeth, maybe I was lucky not to need more specialised help from Hygienists, but I've had lots of holes fixed in my younger days (I hated going to the dentist & avoided it wherever possible, tho now I go regularly twice a year!) & have since had crowns & a bridge, too.

sandra

(**In Oz universities, Professors are relatively rare - one per department/school, the other teaching staff have different titles)


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Subject: RE: BS: Dental Hygienists.
From: the lemonade lady
Date: 26 Jun 08 - 06:29 PM

Hey Sandra, have you come across a dental technician in Sydney called Dave Haine? He was a good mate of mine once.

Sal


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Subject: RE: BS: Dental Hygienists.
From: Sandra in Sydney
Date: 26 Jun 08 - 09:14 PM

Sal I don't remember the names of past dentists or technicians, however
there is only one likely Haine in the
NSW White pages that might be him - D S Haine

sandra


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Subject: RE: BS: Dental Hygienists.
From: katlaughing
Date: 26 Jun 08 - 10:00 PM

MY dentist does like SRS's...one automatically has a cleaning done by the hygienist, then he comes in to check one's teeth, look at the xrays, and ask if one has any questions. They also have a tv mounted in the ceiling for those who need distraction. They think I am funny because I always request that they turn it OFF!:-)


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Subject: RE: BS: Dental Hygienists.
From: Little Hawk
Date: 26 Jun 08 - 10:11 PM

I also request TVs to be turned off. Heh! We may be kindred souls, Kat.

I want to get one of those remote things that you can quietly turn all the TVs off with in stores and restaurants, and no one knows who did it. ;-) (Anyway, they usually don't even notice when it stops babbling.) I always turn off the TV at the waiting area in my local car dealership and at Canadian tire...providing no one is sitting there already and deliberately watching the stupid thing, that is.


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Subject: RE: BS: Dental Hygienists.
From: jimmyt
Date: 27 Jun 08 - 09:27 AM

I find it odd that the comments on this thread have continued to berate the dental profession and talk about how they would still have their teeth if it weren't for the dental visit, how incompetent, how dishonest, how "all the enamel was scraped off, etc." and not one person has seemed to notice that a board certified dentist with 30 years of experience has made some logical explanations, and they have beem apparently dismissed as being not valid.
John from Kansas, I seem to remember you know a lot about knives and I have read with great interest about your expertise. Any idea how much harder enamel is than carbon steel? you cannot "scrape off the enamel " with dental hand instruments. The steel will dull before any damage can come to the tooth. This thread, with a few intelligent comments thrown in here and there, ( rapaire as usual, you are the voice of reason" is about as valid as reading National Enquirer for your current events.
I know I don't know much about music and I try to leave the comments to people who do know, but, darn, this is one chance to sort of provide some valid education and I might as well be invisible.   Oh well, go figure...


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Subject: RE: BS: Dental Hygienists.
From: jeffp
Date: 27 Jun 08 - 11:05 AM

You have unfortunately chosen a profession that, while honorable, is greatly despised and feared. I blame myself alone for my dental problems, which have now resulted in me not having a tooth in my head. I am in the process of having snap-in dentures installed, a process which will have taken nearly a year by the time it is completed. The dentist and periodontist that I have been working with all this time have been wonderful. I must say that having all your teeth pulled is not fun, but the drug "cocktail" that they gave me for the extraction was a lot of fun. I am currently wearing regular dentures while the implants take hold. I can eat foods that I hadn't been able to eat for a few years and am enjoying it immensely.

Hang in there, jimmyt! At least one of us respects you.


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Subject: RE: BS: Dental Hygienists.
From: jimmyt
Date: 27 Jun 08 - 04:49 PM

Thank you, Jeff, for the kind words. I, too, was a dental phobic prior to getting over it and figuring out that the dentist didn't cause the problems, he only fixed them. I am used to people having an aversion to dentistry, i was only surprised that no oner seemed to place any validity on what I had said, but shose to buy in to every other "conspiracy theory," related to their visits to the dreaded dentist. SOrry to be sensitive.


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Subject: RE: BS: Dental Hygienists.
From: JohnInKansas
Date: 28 Jun 08 - 04:13 PM

jimmyt

I believe that you will find that I was sympathetic to the unskilled hygienist, and I think I indicated that she was inexperienced. I did intend the reference to her being new at the job as an indication that a "normally skilled" hygienist would be unlikely to make the mistake she made.

As to:

you cannot "scrape off the enamel " with dental hand instruments

You most certainly can bore a hole entirely through a tooth with the high frequency ultrasonic (tungsten tipped) tool that the hygienist used on me (and that appears to in common use in US dental offices).

The tool usually is a great improvement over scraping with "knives and axes" since when properly used it is nearly impossible to nick the soft tissue. Properly used, with a cusioning slurry of abrasive paste between the tool and the tooth, only the softer tartar will be removed. If you bear down and make solid contact with a hard surface it is quite easily possible to cut (not scratch and break - but bore a hole through) TEMPERED GLASS.

Perhaps you might contribute some suggestions for how to find the good dentists and their hygienists. I'm sure that the majority are quite capable, but as with any profession where most people require services infrequently, I've found "peer referrals" to be less than satisfactory. I have also found that the diploma on the wall is not necessarily good assurance that the person whose name is on it will recognize unusual conditions and adjust procedures appropriately even where they may be quite adept at handling "the usual cases."

While you're about it, a similar advice on how to find a good lawyer, accountant, psychiatrist/psychologist, electrician, auto mechanic etc. would also be helpful. (board certifications exist in all these fields of course) In all such cases, as with dentists and hygienists, it's necessary to commit to receiving services, and your only way of evaluating a provider is by how much you've been injured (or not) by the time you get done.

Your personal reputation is, obviously, the thing that really counts. If you've figured out a way to make people talk about a good reputation, please clue us all in. Only the bad ones seem to get discussed.

John


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Subject: RE: BS: Dental Hygienists.
From: Stilly River Sage
Date: 28 Jun 08 - 10:19 PM

I talked about a good dentist! Two of them, in fact! You didn't go unnoticed, jimmyt!

SRS


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Subject: RE: BS: Dental Hygienists.
From: Alice
Date: 28 Jun 08 - 10:40 PM

the tv at my dentist's is a video running of an aquarium of tropical fish


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Subject: RE: BS: Dental Hygienists.
From: Jeanie
Date: 29 Jun 08 - 02:10 AM

As others have said here, I think in all professions you will find people of varying degrees of experience and expertise, and sometimes you have to shop around to find the best one for you. After moving house, I changed dentists and for the first time have one who has a hygienist on the premises. She certainly makes my teeth look and feel better than they have since I can remember.

By the nature of their work, certain professions demand that the people carrying them out necessarily come across as being a bit "bossy". I put dental hygienists and physiotherapists in this category. Part of their job, if they are doing it properly, is to nag people to change their habits. It takes a certain kind of person to want to do a job like that.

- jeanie


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Subject: RE: BS: Dental Hygienists.
From: Bonzo3legs
Date: 29 Jun 08 - 04:18 PM

Floss and brush your gums really hard with Ozone toothpaste at least 3 times a day, no snacking between meals, and you will have no problems!


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Subject: RE: BS: Dental Hygienists.
From: Dave Roberts
Date: 29 Jun 08 - 07:41 PM

I've had no real problems, but on the whole would rather have an extraction or a filling than the scraping, grinding and general GBH of the teeth which my dentist always cheerfully calls a 'quick clean and polish'.
My partner Lynne, who's from Yorkshire and therefore no fool, insists on a local anaesthetic for this procedure.


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Subject: RE: BS: Dental Hygienists.
From: jimmyt
Date: 30 Jun 08 - 12:00 PM

My apologies to anyone who thought I was not reading the whole of your responses and noting the good things done by our profession rather than the customary bashing that is common. I still seem to miss making my point that dentistry and dental hygiene services by and large, does not create or exacerbate the problems, but merel;y are an attempt to help the patient get a healthier mouth. I will go into this more later, but by and large, "a quick clean and polish," does not constitute the way we deal with periodontal disease. We do what is a normal prophylaxis on a healthy mouth. If there is disease present, it is a different procedure. It is more comprehensive, and normally requires local anesthesia.

John, the instrument you refer to is an ultrasonic scaler. It works on ultrasonic vibrations. It does not use a slurry of abrasive at all. If a hygienist or dentist uses this improperly it would cause pain. It could even damage the cementum surface which is below thwe gumline and below where there is enamel. COuld it bore a hole in the tooth? Well, it is unlikely. If it is placed against the enamel, I still say it would not do any damage at all. All this is academic at best. The fact is a hygienist who is board certified is not unskilled. If she is she should never have passed the licenising requirements in the US. I am not saying this is impossible, but if she were to use this improperly, it would hurt like hell and most patients would simply not stand it. Are there incompetant people in healthcare? SUre. Once my wife got an injection in the thigh that directly hit the bone and was very painful. THe nurse should not have used that angle for the injection. Are the vast majority of nurses like this? I think not. I do think there is a significant difference between the training of Registered Dental Hygienists in AMerica with their counterparts in the UK. There is also a significant difference between the training of dentists in the US over their counterparts in the UK. Maybe we have developed a little better patient skills in dealing with all of the patients dental issues because we are all private practice dentists. If I displease a patient, they simply do not come back. I hope to write my approach to dealing with a new patient, how this techinque seems to give patients and dentists a better approach to dealing with the problems patients present with. If time allows I will write another note in a few hours. RIght now, however, I am working on a patient who is delighted to have a dentist who sat down, developed a plan of attack with the patient, we decided how to approach her problems and are now proceeding as a team.


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Subject: RE: BS: Dental Hygienists.
From: jimmyt
Date: 30 Jun 08 - 03:57 PM

NOt to belabor a point here, but let me discuss the way I practiced dentistry for 2 decades, then the way I do now.

1982-2002. Patient calls for an appointment, usually in pain, we schedule them that day, see them, deal with their pain, try to reappoint for a "cleaning" Repeat the above, year after year, with my patients using my services as they needed, or felt they needed.

2002-present. Patient calls for an appointment. Either they are a new patient or they are an existing patient. We ask what prompted the phone call. Patient responds, either they have a problem they want fixed, or they want to schedule for a cleaning an xrays, etc. If they are a new patient with an acute problem, we try to schedule them for a comprehensive examination, full mouth of radiographs, check every tooth, every area of their gums, their bite, their soft tissue for oral cancer, etc. We also provide palliative treatment for the problem they called in for. If it is an established patient, we obviously schedule for whatever necessary work they need which we have documented in their charts since they will have been through a comprehensive exam within the last 2 years. If they are a patient of record, but have been out of treatment for 2 years, we schedule them as a new patient in order to know exactly what we are dealing with.

By doing this, we systematically diagnose each and every issue in their mouth and develop a plan to solve their problems. I find that my old way of treatment gave the patient the quick fix but in no way did we have any idea what the big picture was as we were only treating the immediate problem, (putting out the fire).

My comprehensive examination is scheduled for 1 1/2 hours where the staff and I carefully go over the case item by item, prioritize, and discuss with the patient the "battle plan" for their treatment. If thie patient doesn't follow through, I still see them, I take care of them as best I can, I do not try to hustle them for treatment, I don't beg and coax and leap through fire hoops to get them to accept treatment. I am merely there to help. Most follow through, some don't. I am not frustrated because I have done my best and the rest is up to my patient.

my plan:


1 Treat the disease. Bacterial issues of the gums first, decay second. If we can get the cavities fixed with simple fillings we go ahead. Otherwise we frequently go through and " put out fires" by removing decay and placing temporary fillings. at no time do I jump ahead and do "secondary" dentistry, (Crowns, bridges, implants partials etc) until we have done the primary disease removal first.

2 treat the rest of the case as per a co-decision based on the patient's wants, needs and desires, at the speed that they dictate. (ie some people want everything done in one visit. We will sedate them, do 4-5 hour case, then 2 weeks later place the crowns, bridges, etc as per the wishes of the patient. Other people want us to only max out their dental insurance on a year by year basis which I am happy to do,provided the patient realise that this decision is theirs and may create need for mor expensive dentisty as a result of delay.)

3 We aggressively treat periodontal disease ( gums) and push hard for patients to follow through with this treatment as it is the one area that at some point all we can do is forstall the inevitable, loss of the teeth. U find most patients over 35 have some manefestation of gum disease when they present, Smokers nearly a hundred percent.


Now a point about dental hygienists: In America, most dental hygienists have 3-4 years of college and the difficulty in getting accepted into the DH program creates a situation where only the cream of the crop become registered dental hygienists. A couple states are the exception where they have a different criteria ( much less education) In the use of Ultrasonic scalers, piezo scalers, abrasive polishing systems and the use of hand instruments for the removal of calculus form the teeth, the dental hygienist has much more education than the dentist. I do not clean teeth, I never have, now will I ever. I know 25 years ago it was normal for dentists to provide this treatment, but that has pretty much gone the way of the horse and buggy. Every patient is scheduled for one hour with my dental hygienist. Any less time and it is doubtful that a patient is given a thorough cleaning. In the presence of disease, the treatment can and does take several appointments and require local anesthesia.

I am only relating this so we have a level playing field to discuss from if you would like. I am not going to criticise anyone's dentist, nor will I support the profession as being without charletans and rogues that are out to cheat you out of money. By and large, though, most pentists I know want to take good care of their patients, make a good living, and pay for their investment.

_


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