Jamie Collins, RDH
Jamie has been in the dental field for nearly 20 years, both as an assistant and hygienist. In addition to clinical practice, she is also an educator, speaker, and has contributed to multiple textbooks and curriculum development in addition to being a frequently published author.
Just like fingerprints, no two patients are ever the same in terms of oral health. Sure, we basically do the same things day in and day out, but digging a little deeper might uncover some surprising factors that could relate to oral health.
Think of yourself as a dental detective and ask the following five questions of each and every patient.
1. Have there been any changes to your medical history?
If you’ve practiced for any period of time then you will at some point have a patient tell you “NO,” only to later tell the doctor about a surgery or heart attack they seemingly forgot about when you asked.
Or they tell you they take medication but can’t remember the name. We even have the select few that can’t tell you what they’re taking the medication for! Take this a step further and ask, “Have there been any changes to your medical … including, medications, surgery or anything different?” You’ll be shocked how many say no until you elaborate, and then will state they take a new medication.
Always ask your patient if they have a list of medications on them that you’re able to scan or copy for the record. It takes the guesswork out of trying to spell medication names and risking error. This should be updated each and every dental visit no matter how long it’s been since you’ve last seen the patient.
2. Do you smoke or vape?
E-cigarettes and vaping devices are often advertised as a safer alternative to traditional cigarettes. That’s still up for debate, but they are NOT harmless. When a patient who smokes is in your dental chair, they’re usually easily identifiable from either stain or cigarette odor. In comparison, it’s incredibly difficult to recognize an individual who vapes unless you see a device or ask pointed questions.
Patients who use vaping devices are prone to periodontal disease, and studies show that they're more prone to caries than those who don’t use. If your patient doesn’t have a strong caries history until recently and you’ve wracked your brain trying to figure out what has changed, maybe – just maybe – it’s a new vaping habit.
3. When was your last physical?
Throughout many years of dentistry, I’ve seen plenty of patients who come regularly for dental appointments, but haven’t seen a medical doctor in years or have only seen a “doc in the box” for urgent care needs.
For example, I had a patient who was in his 60s who had not had a physical since he was drafted into the military at age 18. With chronic illnesses such as diabetes projected to increase over the next decade, you likely see many patients with underlying health conditions, whether they’re diagnosed or not. Many symptoms of systemic diseases show in the oral cavity. If you have any concerns, refer your patient for a medical consultation – it may even save a life.
4. What are your goals for your teeth?
Finding out what motivates an individual to seek out oral health care is essential in optimizing your care plan. If a patient is reluctant to shove fingers in their mouth to use floss, or struggles with using a toothbrush due to dexterity limitations, then maybe the old “brush and floss” adage isn’t ideal.
Consider floss picks, interdental brushes, water flossers and power brushes as alternatives to string floss. Think outside the box and understand it may be trial and error to find the right combination for each individual.
5. Ask about them!
Having a stranger poke around in your face is a very personal and often stressful event for many. Learn a little about your patients and make it personal and friendly. Asking about family and work will give you something to reflect on in the future. It also helps distract and put patients at ease by breaking up the monotony of dental hygiene.
You’ll find that you’ll benefit just as much as your patients! Many of my patients have then become friends both in the practice and in life.
Dentistry is one of the most underestimated professions when it comes to health. Asking your patients direct and pointed questions not only helps you uncover potential health risks, it allows you to make necessary referrals.
Plus, general human compassion makes you a great caregiver. It not only helps put your patient at ease, it helps both you and your patient to create a plan together to optimize their dental health. When you’re a friendly face, patients will be more open to honest discussion and suggestion. Have conversations about life, habits and motivation and you may just learn something new!