Dental Tribune USA

‘The Last Flossing’

By Patricia Walsh, RDH, Editor in Chief, Hygiene Tribune
August 07, 2017

I came across Ed Sorel’s illustration “The Last Flossing” in a round-about way. Sorel is one of those artists whose work might be immediately familiar to you from popular magazines, but his name likely isn’t. Such is the fate of illustrators. Their hand-colored drawings are usually just an adjunct to a nationally syndicated story — unless, of course, the artist has been at it for about six decades and is considered an institution.

Best known for his political cartoons and caricatures in The New Yorker and Vanity Fair, Sorel has iconic murals adorning the walls of the landmark Waverly Inn in Greenwich Village. The Waverly has been dubbed one of the worst restaurants in New York City by the newly elected U.S. president, so you can easily guess on which end of the political spectrum the establishment’s owner lands.

The last time I had heard the Waverly mentioned was when a childhood friend gathered a group of Yale grads there to host a charity event. The place is more “old-English-pub-meets-Sardi’s” than a hotbed of radical leftist anarchy. In fact, I think one of the folks among the Yale group was married to a Standard Oil heiress.

These Sorel-inspired thoughts had been prompted by my vacation read over the holidays: a book about Mary Astor, the Hollywood actress who first gained fame in the 1920s. Fortified by festive gourmet chocolates, I plowed through “The Purple Diary: The Great American Sex Scandal of 1936.” Published late last year, the book was written and illustrated by old Mr. Sorel himself, who is now pushing 90.

“The Purple Diary” shouldn’t be confused with “The Purple Guide,” by Shirley Gutkowski, RDH, whose book I also highly recommend (Shirley’s book, a lovely stroll through the realities of the dental hygiene profession, is ideal for the newly minted registered dental hygienist).

But back to Sorel. Apparently, when this then-relatively-unknown illustrator was pulling up the linoleum in his Upper East Side kitchen in 1965, he came across some yellowed newspapers from 1936. The rest of us would have found bits of blue kitty litter, coffee grounds and a coupon for Cheerios. But Sorel found the basis for an obsession that five decades later manifested itself as a book. All of the old newspapers’ headlines were about Astor’s scandalous divorce and custody trial. The unfolding details were so sensational, Astor had knocked Hitler and Franco off the front pages.

I thought of this recently when I was interviewed by The New York Times after our profession’s dear Esther Wilkins, DMD, RDH, passed away. It took a few days longer than I expected for the newspaper’s thoughtful obituary to appear in print. Perhaps the piece was bumped by Zsa Zsa and her nine husbands. The more things change with mass media, the more they stay the same.

Just before the holidays, my boss handed me four pages of information about the new ADA code for hygiene. I glanced at the information, didn’t immediately understand its relevance, and promptly tucked it into a drawer. My mind was on shopping, wrapping, cleaning, cooking, clothing and hair. ADA dental terminology was not at the top of my list.

When I casually mentioned the code update to another hygienist, who seemed equally unaware, I had an “aha” moment: I would check with Patti DiGangi, RDH. She wrote the book on codes. Literally. Before I even got the shipping boxes out with the trash and the last Christmas package wrapped, there was already an article online by DiGangi explaining D4346. She seems to know what we need to know before we conclude we need to know it. I’m not sure if Dr. Wilkins had 12 apostles or not, but she certainly has two good disciples in Gutkowski and DiGangi. They work diligently to make our profession better even when the rest of us are thinking about shopping, wrapping, baking — and decades-old sex scandals.

Most likely 2017 will bring along with it a bumper crop of patients ready to use newly acquired dental benefits. There will be plenty of people who have taken a vacation from the dentist for years who will suddenly appear on our doorsteps. They may not have any bone loss, but they sure as heck aren’t traditional re-care appointments either.

Hence the need for D4346. Prior to this code, we would be looking at a wall of calculus but no bone loss to back up the need for additional visits when submitting a claim. Giving us a little wiggle room for oral-health assessment humanizes the health care provider. It adds value to our diagnostic abilities. It allows us to emphasize the mouth/body connection to the patient. If we’ve assessed that the patient presents with at least 30 percent of his or her gingivae exhibiting moderate to severe inflammation, the code can then be correctly used.

When The New York Times reporter called me to do research on Esther’s life, the initial questions were about Esther’s classic dental-hygiene textbook. The 12 editions in multiple languages are impressive enough on their own. So I tried to steer the reporter away from the text, hoping the tribute might focus more on the wonderful, energetic woman Esther was. When Esther was 89, she was out on a Chicago dance floor at a Hu Friedy party at 10 p.m. The rest of us, decades younger, were yawning into our decaf.

I can see why someone who isn’t a hygienist would wonder why people would stand in line for two hours for an autograph from a professor. This is what made Esther so special and unique. She really was our True North.

Esther was our link to another era. A living, breathing connection to the beginning of our profession. The rest of us can only pray that, in time, the shadows of our own professional reputations stand bigger than ourselves.

I’ve been collecting lithographs for 30 years. Stumbling upon Sorel’s “The Last Flossing” around the same time that Esther passed away led me to believe that divine provenance had met divine providence. Considering Sorel’s nontheism, I’m not so sure he would agree. But then, he’s not a hygienist.

For more information on the updated dental hygiene code, visit DiGangi’s website,

Find “The Purple Guide: Developing Your Clinical Hygiene Career” on Gutkowski’s site,

At press time, a signed print of Sorel’s “The Last Flossing” could be seen for sale at


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