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Finding the Hidden Treasure: Prevention = Treatment + Motivation + Compliance by Barbara Vugteveen, RDH

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by Barbara Vugteveen, RDH

I have no idea why I used to check Urban Dictionary almost daily. Maybe I wanted to get my "word of the day" and catch my kids using some inappropriate slang I'd be unfamiliar with otherwise. Or maybe a part of me wanted to know the jargon just in case I was ever in the situation where I could use it. It offers the craziest (and sometimes the crudest) new words and phrases!

Then it happened: I finally got the ultimate Urban Dictionary definition. It was the best phrase any dental hygienist could ever ask for—"dental swag"!

"Dental swag" is defined as the complimentary stuff with which you leave your dentist's office: toothbrush, dental floss, etc. I think the hygienist likes me; she always loads me up with dental swag.

Since then, I rarely check my Urban Dictionary Word of the Day, as I feel my urban vocabulary is now complete.

A rich haul
Why is this so important and why do your patients need to get their dental swag on? Patients need motivation—through instruction—to make all your efforts in the office work over the long-term. They need the right tools for the job to make this happen, and more important, they love the individual, case-specific oral-hygiene instruction you give them. When a hygienist gives a patient a proxy brush, end tuft, Stim-U-Dent or any tool that targets a specific problem area, the patient loves the hygienist for it and will often stay with the practice for life.

We all know periodontal disease isn't cured; it's maintained. We also know that proper treatment—a prophy, a debridement with reevaluation for scaling, or quadrants of scaling and root planing—won't be successful without the patient's compliance with home-care and daily plaque-removal instructions. Educate your patient about the disease process and how critical it is that he or she participates in the treatment. Education empowers your patient to take ownership of the disease. Ownership should be a desire for overall oral and systemic health. Without patient ownership, there will never be an adequate level of compliance.

You can scale and educate your patients about the disease process. You can motivate them to follow through with home care and give them the tools they need, yet there is only so much the hygienist can do to prevent disease without all of the steps coming together. In short, prevention = treatment + motivation + compliance.

When all three are in place and working together, your patients hit the jackpot.

The hidden gems
Every patient has different motivations, and you must gauge what these are before treatment and hygiene instruction can be successful. Does he want to save his teeth? Are cosmetics her main drive to see you? What is her concern when she walks into your operatory? Understanding a patient's motivation gears you toward the conversation you will have about overall oral and systemic health, in addition to the patient's participation in successful treatment. If a patient's main concern is not addressed at every appointment, you will lose the motivation and compliance components to successful treatment.

For example, how do you educate and motivate the patients in your chair who have bleeding on probing, with light to moderate gingivitis? Most hygienists would tell these patients that "healthy gums don't bleed" and give oral-hygiene instruction. Most patients, in turn, will respond that their gums always bleed and that is normal for them. Take it a step further and motivate them to own their disease. Tell these patients that chronic gingivitis will lead to periodontal disease. Be direct and show them how to disrupt the bacteria that cause their chronic infection.

Get out the mirror and the swag and show them the target areas. Bleeding is a sign that all patients should recognize as chronic disease. It's a symptom that they can see—it's concrete, so they will be able to gauge how well they are doing with their home care. Let them know that it takes only a few days to see results, so they will be rewarded for their efforts. This keeps them engaged and motivated. Now, it should be that easy, but unfortunately not all patients understand it after the first explanation.

Following the treasure map
Offer your patients a follow-up appointment in two weeks if their bleeding is not under control. That will not only get their attention but it will also help them take ownership of their disease by being participants in their treatment. If they are compliant with their home care and don't have bleeding, there is no need for them to come back until the next scheduled recare appointment. If there is still inflammation and bleeding, this return appointment gives you an opportunity to reevaluate the problem areas for additional scaling, or decide if a simple change of swag is needed before their next recare appointment.

In either case, it is also the perfect time to take a tour of your patient's mouth with the intraoral camera and take pictures of these problem areas so you both can see any improvement at the next appointment. Review overall oral-hygiene instruction in the mirror and watch your patient's technique, as well. Be encouraging and kind. It can often take several times to "show and tell" something that we, as dental professionals, find simple—such as proper flossing—before the patient can properly execute and/or understand the importance of daily plaque removal. Don't look at it as being repetitive; look at it as being consistent. This will help your patient not only with technique but also with compliance.

A treasure chest of swag
I know some offices only give out the toothbrush, floss and paste that come in their bundled order. But don't be stingy with your swag. Having several samples of different home-care supplies on hand to demonstrate and send home with patients really helps customize their home-care routine and meet their specialized needs. If the patient wants a tongue scraper every time she walks in the door, give it to her.

Always ask if there is anything else your patients need, and if you don't have it, order it for them. You're not just promoting successful treatment through motivation and compliance—you're also creating lifelong relationships with the patients in your practice. Trust me: they love it that you care.

And they love the dental swag—just ask Urban Dictionary.



Barbara Vugteveen is a registered dental hygienist. She has 20 years of experience in private practice and currently works in Tucson, Arizona. Vugteveen believes making a personal connection and motivating her patients to be active participants in their overall health is just as important as restoring and maintaining periodontal health.


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