Trisha O’Hehir: Oral Health Detective By: Regina Dreyer Thomas, RDH, MPA

Dental hygiene’s very own Trisha O’Hehir reveals still another dimension of her many talents as she becomes the mainstay of Hygienetown magazine. Have no fear, Perio Reports lives on…same author, different publisher. The story of how Trisha arrived at this point is an appealing one. Read further.

Parlaying her skills as a clinical hygienist into periodontal therapist, educator, researcher, international speaker, instrument designer, inventor, author, publisher and businesswoman, this forward-thinker is a perfect example of how curiosity, hard work, and figuring out easier ways to solve problems can lead to a fulfilling career in oral health care.

There’s probably no one more surprised by her accomplishments than wide-eyed Trisha is. As she recounts her professional history she says, “I’m absolutely amazed as I was at the bottom of the class in hygiene school!” One wonders why this smart woman was, as she says, “in the half of the class that made the top half possible,” not-so-smart in her student days. Her explanation lies in the prevailing educational philosophy of the late 1960s–memorize, and don’t ask questions; be seen and not heard. Trisha claims she just couldn’t memorize, yet was driven by the need to have things make sense, “I was trying to figure things out by myself and couldn’t.”

She claims she graduated hygiene school not really knowing how to “clean teeth,” yet had the courage, after a short stint in private practice in Minnesota, to make her way to Switzerland where she stayed for four years.

“I was sure my new employers in Switzerland would soon find out I had no idea what I was doing. Each day I walked into the office sure that would be the day they found out and sent me back to Minnesota. It took me nearly two years to realize I must be doing okay, and stop worrying about being ‘found out’ and sent back to the States.”

That said, at what point did she gain enough confidence and self-worth to call herself an honest-to-goodness dental hygienist? “It happened when I decided to leave Switzerland,” she says. She had been asked to teach at the first dental hygiene school in Zurich. Surprised and pleased to have been asked, she decided that before accepting the position she would return to Minnesota to earn a teaching degree.

While working on her degree in higher education and practicing as a clinical hygienist, Trisha was asked to teach dental students in the school’s periodontal clinic. Another big surprise. “I was the first hygienist at the University of Minnesota to be on faculty and teach in the dental school,” she says. “Quite a revolutionary thing back in 1973. This enticed me to forego the teaching position in Zurich.”

What Trisha underplays is her receiving the Teacher of the Year award from the dental students after only one year of teaching. Why? Because she encouraged her students to ask questions–not memorize. This episode in her life strengthened her resolve to help people understand the why of dental hygiene, above and beyond the how of “cleaning teeth.”

When asked about people who helped her along the way, Trisha mentions one periodontist in particular she knew from both the University of Minnesota and the University of Washington where she taught after completing the Periodontal Expanded Functions Program in Arizona. “He liked to debate me all the time on research,” she says. “He wanted to make sure I knew what I believed in and could substantiate it with science.”

Could this encounter be one of her first steps toward her endless fascination with research? Or is research simply an extension of her need to have things make sense? The story continues to unfold.

During her last year at the University of Washington she conducted an educational research project that compared traditional autocratic teaching to inquiry learning, a method centered on solving problems and answering questions instead of the established focus on requirements and competencies. Was it this project, coupled with the periodontist’s provocations, that drove Trisha to choose research as her primary approach to “figuring out how things work?” Maybe yes, maybe no.

“My dad was a police chief,” she says, “and I always wanted to be a policewoman. I wanted to be the one solving the mysteries, taking the evidence apart, finding all the clues.” That goal did not sit well with her father. Hmm.

 

So how did law enforcement’s prospective loss become dental hygiene’s future gain? “I was in love with my orthodontist and when I asked him what I had to do to work in an office like his, he replied, ‘Go to hygiene school.’ NaÔvely, I thought he meant for me to be a dental assistant.” Despite her mistaken belief, her professional life in oral health care now began to take root.

This Type B mover-and-shaker moved on to pioneer, with other RDHs, the position of periodontal therapist in the state of Arizona.

“It was a challenging time,” she says, “and exciting to be able to provide an alternative to periodontal surgery, but we all lived under a microscope of scrutiny. We were eventually called before the state board of dentistry and sanctioned for using the term ‘periodontal therapist’.” Fifteen years and more research have changed that thinking.

It was during these days as a periodontal therapist and teaching the expanded functions courses in Arizona that spawned her well-known publication, Perio Reports, now in its 17th year.

“I know I must have a screw loose to find research interesting reading,” she laughingly says, “but I do. I subscribed (and still do) to several periodontal journals.

“Other hygienists knew I read the research and often called me for answers to their questions. Becoming a resource to the hygiene community happened gradually and easily, but soon took a great deal of time each evening to answer phone calls and look up answers. The idea of a research newsletter was born of an attempt to share the research with other hygienists and free up my evenings! Little did I realize at the time how the Perio Reports project would influence my career path.”

Research and education seem to be inextricably linked to dental hygiene for Trisha. She is a firm believer in their power to overcome disease and improve one’s quality of life.

“When I learned about disease on a cellular level,” she claims, “I was able to take it to a clinical level and make a difference.”

That’s exactly where Trisha lives professionally: integrating scientific research into clinical practice. And not just for oral health care professionals. The first in a series of colorful cartoon books for consumers with research at its core has been available for over a year. The Toothpaste Secret is based on a dry brushing pilot study published in the Journal of the American Dental Association in 1998 that showed a 63 percent reduction in calculus and a 55 percent reduction in bleeding on the lower lingual surfaces when patients were instructed to “Dry brush inside first, brush till the teeth feel and taste clean, and then add toothpaste.”

(See www.ToothpasteSecret.com for more information.)

This research was conducted in clinical practice by readers of Perio Reports, with the findings presented in a poster in 1997 at the International Association for Dental Research. (Trisha is 2004-2005 president of the Oral Health Research Group within this organization.)

“This group is perfect for me,” she says, “as I can go to the meetings to see what’s new, what the researchers are doing, and where the trends in research are.” Trisha makes the case that as important as randomized, controlled clinical trials are, there is a definite need for more practice-based research on the products and procedures being offered today.

The newest chapter in the Trisha O’Hehir story is the integration of Perio Reports’ research summaries into the free, monthly Hygienetown magazine, which is available both in print and online. The contents of Hygienetown magazine will come from the discussions on the website among practicing hygienists with Trisha at the helm.

Still under her own umbrella are Trisha’s continuing education ventures, The Toothpaste Secret book, and the other Perio Reports products. These include the 400-page Perio Reports Compendium of Current Research, which is the first eight years of Perio Reports, and a compilation of the first 16 years of the research summaries in searchable format on CD. (For further information on these products, see www.PerioReports.com)

When asked what advice she would give to the hygienists reading this article, her careful answer reflects her philosophy of care: setting goals and determining how to accomplish them. She says, “Ask yourself how healthy is this person now and how healthy does he or she want to be? What steps do I need to take to get them there? How will I know when I’ve reached that level of health the patient and I want to achieve?” Trisha asserts it’s much more rewarding, challenging, and easier to embrace this philosophy of care than just going through the routine of procedures.

The enthusiasm and passion that Trisha brings to her professional life is clearly evident in her accomplishments, but now what?

“I must be here for a purpose,” she thoughtfully replies, “and that could be the elimination of dental disease in a simple and easy way. We say we want to help people get healthier, but how do we measure that? Part of the answer lies in how much disease we can prevent. We’ve got this idea that dental disease is inevitable. It’s completely preventable, but we haven’t looked at it as a detective might, unraveling clues based on the scientific evidence. We have to ask ourselves, what are the quickest and easiest ways to prevent disease?

Maybe we’re telling patients the wrong things! We need to ask more questions and be more curious. That’s the best way to discover ways that are predictable to prevent dental disease.” From the almost-bottom-of-the-class position to one of the top guns, this dynamic woman has come a long way with her inquiring mind and need to “figure things out.”

Police work never looked so good.

Regina Dreyer Thomas, RDH, MPA, a consultant at the UMDNJ-New Jersey Dental School and author of Career Directions for Dental Hygienists, is a highly-organized, goal-oriented manager of information committed to helping oral health care practitioners identify and achieve their professional goals.