Dental News - Reflections on the ADHA meeting

Patricia Walsh, USA

Thu. 29 August 2013

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I ﬁrst met Esther Wilkins quite by accident. It was early in the morning at a Chicago convention. Marginally awake after 12 hours of convention festivities the previous day, I walked onto a hotel elevator. No badge, no makeup and in search of strong coffee. I glanced at the person I shared the lift with and did a double take.

I tilted my head to one side and said, “Aren’t you ...?” There she was, our Florence Nightingale. I was all alone with Dr. Wilkins for a whole glorious eight ﬂoors. The love we have for this hygienist is palpable. You see it at every book signing. We wish to hold her hand, feel her genuine warmth. Just being near her makes us feel like we are somehow connected to the original intention and purity of our profession.

One of the highlights of the American Dental Hygienists Association annual meeting was a morning speaker who opened with an unofﬁcial “benediction” taken from “The Book of Esther.” About a thousand dental professionals got the joke immediately and burst into wild applause. When Dr. Wilkins spoke to us this year, not onstage, but via the Jumbotron screen, you could have heard a pin drop. She is the “true north” on our professional compass.

Technology sometimes leaves me scrambling to keep up. I would be lost without regular continuing education courses even if they weren’t a licenser requirement. This was not the case for the ﬁrst 20 years of my career. But in more recent years, there has been an explosion of change in our profession. My ofﬁce was one of the ﬁrst in the state to go digital. Since then, the improvements that have been made with panorex clarity and deﬁnition are amazing. Its capabilities astound me: a concise, full head shot with all the radiation of one set of bite-wings.

A pan review course was at the top of my list for the Boston meeting. In other words, we’re seeing so much more detail that it amounts to information overload.

A helpful website to assist in lesion identiﬁcation is www.0rad.org. A clinician can be guided along by answering simple questions about the abnormality. You’ll be asked to enter age, gender, borders, loculation and location. The website will give you a list of the most probable or typical lesions that match your entries. I hope I never see evidence of metatastic breast cancer show up on one of my pans, but it’s entirely possible. The radiographic improvements that have transpired increase our responsibilities as clinicians. Technology has furthered our role as holistic health care providers.

I have an old-school physician who was never much for vitamins other than Calcium and D when I turned 50. Now and then I’ve read something on a dental blog about an exciting new oil or a vitamin combo that has left me scratching my head. If so-and-so is this excited about it, then it must be great. One year I sat intrigued by a hygienist pushing “gingival” vitamin powder rubs ¬— after her lecture on lasers. The more high-tech the subject, the more credible the educator? When I wrote to a top nutritionist — a professor emeritus at a prestigious dental school — his response was chilling. Not only was it a profound, “No. It doesn’t do anything,” but he followed it up with a scoulding: “Patty, you’re a smart girl, stop reading the blogs. Read PubMed.” His mantra seemed to be if they are selling their book after the lecture, take what they say with a grain of salt.

His words were resounding in my head when I went on a hunt for an antioxidant gel at the ADHA convention booths. A well-respected periodontist I know had been using it to ﬁght inﬂammation in patients who did not seem to respond to traditional treatment. If it’s good enough for him, it’s good enough for me. The hygiene blogs were all buzzing about it as well. The company did not have a booth at the convention, and I was disappointed. I was ready to put their reps’ feet to the ﬁre and ask about clinical trials. As they said in Dragnet: “Just the facts ma’am, just the facts.” Perhaps the product will turn up in another year, at another big meeting.

My ﬁrst hygiene textbook, “The Clinical Practice of the Dental Hygienist” (AKA, The Book of Esther) may be “old testament,” but it is the foundation of a vibrant and growing profession. Recently, California approved self regulation for hygienists, who will now dictate their own education and licenser requirements and control the profession's ethical standards. Californians have always been trendsetters. If it is a left-of-center fashion statement, it probably got its start in California. (The jury is still out on wearing Uggs boots with short shorts, but my perpetually cold feet do appreciate the introduction of soft fur.) Our professional meetings allow us to collaborate and compare. I no longer discount the blogs. Sometimes a grass-roots effort or product takes a little longer to catch on. A rumor might just have you hold off on buying a loupe if you know it may go cordless soon. Clinical trials and documentation can take years. Dental corporations compete with one another; dental publications compete with one another. The information highway can sometimes be a one-way, one-lane street. We use our education to take what we need for the time being, and leave the rest.

I try to tell my patients not to believe everything they read or see on TV. Not only are hygienists bombarded with professional information on a daily basis, it’s that much worse for the patient. The patient never reads peer-reviewed dental journals. I heard one well-educated lecturer disparagingly use the phrase “bogus journals” at a dental meeting. I think there’s a place at the table for everyone. Only a small percentage of us are in research — and writing our doctoral thesis.

The vast majority of hygienists just want to know what works and what doesn’t. Not necessarily what is fast and easy — but what actually works. We learn so much from each other’s clinical experiences in “the trenches.” There is an understanding in the military that if you really want to know what’s going on, ask a master sergeant. Don’t ask an ofﬁcer. They’re too busy with the bureaucracy. Your doctor isn’t going to be up to date on which sensitivity toothpaste is the least abrasive. (Hint: It’s not the one you think.) He’s too busy trying to get his state income tax software to work properly. We, the hygienists, are the prevention specialists of the ofﬁce.

The Oscar-winning actor Geena Davis spoke to us at the end of our ADHA session about a woman’s worth — the value of our integrity, the beauty of our intellect. Davis reminded us that we still have a long way to go to change how women as a whole are perceived. To change the Hollywood misrepresentation of women, she started the foundation called Seejane.org. I walked away from the convention hall feeling empowered and as tall as Davis in heels. She is an actor, not an actress; just as I am a hygienist, not a hygienistess.

As a profession, we were slow off the mark when it comes to diversity. I wonder sometimes if our female-oriented profession is both our greatest strength and our greatest weakness. We have evolved and diversiﬁed. I hope our individual information-gathering processes continue to evolve and diversify.

Some of us are astute to changes in technology and research, while others have ears to the ground via local meetings and the Internet. We go forward together in this new information age — free from information prejudice — with an open mind and a common goal.

(Note: This article was published in Hygiene Tribune U.S. Edition, Vol. 6 No 6, August 2013 issue.)

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