04.10.09 Issue #370 Forward This Newsletter To A Colleague

Angie Stone
Angie Stone RDH, BS
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Candy Can Save The Day

An elderly patient is seated in the dental chair waiting for Suzie the hygienist to begin treatment. As Suzie enters the operatory, she says, “Hello, Mr. Smith. It is very good to see you. Are you ready to get started?” The hygienist begins with a review of Mr. Smith’s medical history. She notes medications the patient is taking. Many of the medications cause dry mouth. During their conversation, Mr. Smith reports the arthritis in his hands continues to worsen as the days go by. It is becoming difficult for him to hang on to small objects. He even believes his jaw is becoming affected by the arthritis.

When the update is complete, Mr. Smith is tipped back so that hygiene treatment can begin. Suzie, the hygienist, is mortified by the amount of plaque clinging to the patient’s teeth. “Oh, no, not this again!” she is thinking. “I know I discussed his poor brushing habits at his visit 6 months ago. I just wish he would listen to me. I am sick of scrapping this junk off of his teeth every time I see him.” She proceeds with the prophy while struggling to refrain from scolding Mr. Smith.

At the completion of the prophy, as she is waiting for the doctor to come in for Mr. Smith’s exam, Suzie again tells Mr. Smith how important it is that he is brushing and flossing his teeth. This is the exact same discussion she has been having with him every 6 months for the last 10 years! What is the frustrated hygienist to do?

It is the responsibility of the dental hygienist to offer more options to a patient in this situation than just brushing and flossing. Though there are mechanical aids other than traditional brushes and floss, these items may not offer much more assistance than traditional items. Mr. Smith’s health issue of arthritis in his hands is a good indicator as to why he is not brushing or flossing effectively. Patients with the inability to execute adequate oral care, no matter what the reason, need to be given achievable options.

An option that fits this situation and description is xylitol. This naturally occurring sugar alcohol had been proven to reduce plaque levels in people who consume the substance on a daily basis. Xylitol is found in the fibers of many fruits and vegetables, including various berries, corn husks, oats and mushrooms; it was first derived from birch trees. The beauty of xylitol is that it is a food substance for harmful bacteria that populate the human mouth. Bacteria ingest xylitol, but they do not have the ability to digest it. Without digestion, the bacteria die off and leave room for more friendly bacteria. Plaque cannot grow in the presence of xylitol.

Xylitol is available in many products, including gum, candy, toothpaste and mouth spray. It is also available in bulk and individual packets much like other sugars. The recommended daily dose to achieve an oral health benefit is 6–10 grams, although benefits have been noted at lesser amounts. If interested in reaping the benefits of xylitol, people should assess the labels of products containing the product. Xylitol should be at least in the top three on the ingredient list, and products with xylitol listed first on the list are preferable. Some company’s market gum and candy sweetened only with xylitol. This sugar substitute does not alter blood glucose levels in diabetics. An adverse side effect of xylitol usage is GI upset, but research suggests adults typically are not adversely affected with diarrhea until xylitol consumption exceeds 100 grams daily.

Consider Mr. Smith’s appointment again. Envision Suzie educating him about the dental benefits of chewing gum or eating candy sweetened with xylitol instead of discussing brushing and flossing again. Imagine the relief Mr. Smith feels knowing there is a way he can improve his oral health other than struggling to brush and floss. Of course, Suzie tells him to still attempt to brush as well as he can, but to incorporate xylitol as well.

Imagine the next visit after that. Suzie is elated because Mr. Smith’s mouth is healthier. Mr. Smith is thankful for not hearing about brushing and flossing again. He is also thankful to Suzie for finding an achievable alternative method which has allowed him to improve his oral health. Suzie is the hero!

Suzie has not only assisted Mr. Smith, she could also increase hygiene production if you sell xylitol products in the office. In today’s economy, the incorporation of any product that assists patients and the office is a must!

Need help with implementing new systems and products in your hygiene department? Email hygiene@mckenziemgmt.com. Interested in having Angie speak to your study group or at your next seminar? Click here.

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