Most dental offices have one or several hygienists. Hygienists are deemed dental auxiliary personnel who help the dentist to deliver appropriate dental care. The training varies for hygienists from different areas. In Ontario the dental hygiene course is currently two years, with a possibility of it being extended to three years. During their training they study the biological sciences including bacteriology, chemistry, anatomy, ( Both dental and general), dental sciences including materials, fluoride applications among other disciplines.
As well, programs include courses on psychology, aimed at patient education and motivation. A major part of a hygienist’s role is to motivate patients to carry on with excellent home care. This of course involves demonstrating how and why a patient can engage in home care. Hygienists are also given courses on physiology and medical conditions. Medical conditions can affect the way a hygienist treats a patient. For example a patient who has had recent heart or joint surgery may require anti-biotic coverage. It can be the responsibility of the hygienist to inform the dentist of any such conditions. Any medical changes or concerns should be relayed to the dentist when it is time for the intraoral examination. As well a properly trained hygienist can often detect needed dental work through the contact they have with the oral environment during the cleaning procedures.
The cleaning of the teeth is more involved than may at first appear. The gum tissues around the teeth are carefully evaluated and any debris such a bacterial plaque and calcifications called, calculus, are removed by the hygienist. Plaque is a bacterial film that forms within 20 minutes of a good thorough cleaning. It is a protein precipitation from the saliva. The film forms on the teeth and over three days normal oral bacteria will bind in the film. After three days it will have gone from a basic bacterial plaque to a mature plaque. At this stage it can cause damage. Plaque on teeth can break down sugars in the diet forming acids, which can cause decay. Plaque that gathers in the gum pockets around the teeth can cause the formation of toxins which can result in gum disease.
The hygienist will remove plaque, which is an invisible film, from the teeth along with any stain. As well the hygienist will remove the plaque and calculus which is in the gum pocket. An important part is to demonstrate what is being done and to motivate the patients. This is a very challenging procedure as some reports state that it can take 21 days to acquire a positive lifestyle habit. At subsequent examinations the hygienist can reiterate the motivational aspects of encouraging home care.
The key to long lasting restorations ( Fillings) is in fact plaque removal. A well fitted crown, for example, will have a small 50 micron gap ( A micron being 1/1000th of a millimeter. But dental bacteria can be as small as 6 microns. In a patient with proper oral hygiene this is taken care of. But, in some cases very extensive and expensive dental treatment can fail due to poor home care.
The hygienist is an important part of the dental care group. The physical aspects of oral care and the motivational aspects, which are in the long term, more important.