What does a Dental Hygienist do?

A Dental Hygienist is a trained and registered health professional that primarily deals with the health of the gums. They are focused on the prevention of oral diseases and helping people to establish better oral hygiene practices. They are usually found at the dental practice in a separate room and may work with or without a dental nurse.

Using special instruments and techniques, a Dental Hygienist will clean the teeth thoroughly to remove bacteria that causes problems in the mouth, like tooth decay and gum disease. They will use a variety of methods to do this, for example: hand instrumentation, ultrasonic scaling (with a water jet), airflow and prophy polishing. In order to get your oral health at its best they will go over your home regime like toothbrushing and interdental cleaning. In addition to this, they will educate you on your oral disease risk factors like smoking or tobacco habits, links to your medical history and to any medications you might be taking. Trained in pharmacology and systemic health conditions it is important to discuss these things with your dental professional so they can tailor your care appropriately.  

So, who should visit a Dental Hygienist?

Everyone! Most people should see their Dental Hygienist every four to six months. Sometimes people need to go more often, for example if they have gum disease, recurrent problems with gum inflammation, struggle with their home oral hygiene routine or have had complex dentistry done like implants and bridges.

Your Dental Hygienist will want to work on the three main pillars of oral health, these are toothbrushing, cleaning in between the teeth and a healthy, low sugar diet. 

Toothbrushing

An electric toothbrush is the best way to achieve a thorough clean because they get far more strokes per minute than you can with a manual brush. There is a great range of electric brushes on the market that are suitable for everyone’s budget; often great deals can be found online too! The brushes with a pressure sensor and a two-minute timer are the best; these are features which help to keep brushing on track. It is also important to remember that a toothbrush will only be as good as the hand that uses it- it is really important to get a 45-degree angle into the gum line as this is where the plaque tends to build up first. Using a pen like grip on the handle, spend a few seconds with the brush still, on each surface of each tooth, with an even pressure. It is a great idea to take your own brush to your dental hygiene appointment so the Hygienist can demonstrate all these aspects with you, in person. Many Hygienists will also use an electric tooth brush called a “test drive”, which is a demonstration brush specifically to use in the surgery.

Sometimes people really don’t like electric toothbrushes, in which case a manual brush is still okay to use, provided you use the correct technique and are very thorough. It is the same 45-degree angle into the gum line that is needed but small circular movements should be made with the brush. This mimics the action of an electric brush, having been found that this is the best way to remove plaque. A manual brush doesn’t have a timer so it is a good idea to use a watch, sand timer or, my personal favourite, to put on a song to brush to!

The best toothpastes are the ones with fluoride in; this is because fluoride strengthens the teeth, making them more resistant to decay. Toothpastes should contain 1350-15000ppm of sodium fluoride and a pea sized amount should be used on the brush. Some pastes prescribed by a dentist can contain up to 5000ppm if someone is particularly susceptible to decay.

Cleaning in between your teeth

The other very important stage in an oral hygiene routine is to clean between the teeth.

If we miss the interdental cleaning part of our routine, we actually miss 40% of the tooth surface! That’s why your dental hygienist will encourage you to floss or use interdental brushes at least once a day. Floss tends to be better for tighter gaps and the interdental brushes are better for bigger ones. Most people find the interdental brushes easier to use because they are less technique-sensitive. Occasionally people can use floss picks - the ones that are pre-strung floss on a stick - if they really struggle to use the other aids, or if they are completely new to interdental cleaning.

It is important to be consistent with your interdental cleaning, if inflammation starts to occur then the gums may bleed when you clean them. People often think this means they are doing it wrong or they should stop doing it, when in actual fact it means the gums are unhealthy and need to be cleaned more! If you persist through this initial stage of bleeding you will notice that this subsides as the gums get healthier again.

Additional aids in an oral hygiene routine include water flossers and mouth washes. Water flossers are usually only for those who have very complex dentistry like implants and bridges or those with impaired manual dexterity; traditional mechanical techniques, like those mentioned above, tend to be much more effective.

Mouth washes can be an addition to your routine but should not be relied upon or used as a replacement for manual cleaning. There are multiple reasons for this. Firstly, the bacteria that cause problems in the mouth are chemically resistant and mechanically vulnerable, meaning that they are more effectively targeted with proper toothbrushing and interdental cleaning. Secondly, and many people are unaware of this, we should not be rinsing after we brush our teeth, instead just spit out the excess toothpaste and leave the rest on the teeth. Therefore, each time we use mouth wash after brushing, we are undoing much of the good work yet to be done. Similarly, the ingredients within mouthwash are less concentrated to those in toothpaste, so often we are just better off using the latter.

Healthy diet

The final pillar is a healthy diet. The sugars that we eat breakdown to produce acids in the mouth that bacteria thrive on and it is these bacteria that cause dental decay and gum disease. Reducing our sugars in terms of total consumption and frequency will help keep our oral health at its best. Healthy snack swaps are an easy way to do this, for example, instead of chocolate or biscuits in the afternoon try hummus and vegetables or rice crackers and peanut butter. In drinks, try reducing the sugar added in tea and coffee, and swapping out fizzy drinks for water; this will really help in the long term!

Want to keep learning? Find more articles from Frances Robinson:

• Meet the Expert - Frances Robinson, Dental Hygienist
• Understanding The Relationship Between Your Diet and Your Oral Health
• Bleeding Gums: Why It Happens and How To Treat and Prevent It
• HealthHubble Podcast: Introducing Frances Robinson, Dental Hygienist