Oral Hygiene Coaching 1 medium

Oral Hygiene Coaching 1

• Presented by Julie Watson and Rhona Mann
• Part of Foundations in Clinical Skills and Practice Year 1
• At Eastman Dental Hospital, LSBU Education Centre
• GDC Learning Outcomes were listed

GDC Learning Outcomes

• 1.1.1, 1.1.2, 1.1.4, 1.1.11, 1.2.1, 1.2.2, 1.2.3, 1.2.4, 1.5.3
• 1.7.1, 1.7.3, 1.7.8, 1.9.1, 1.10.2, 1.10.3, 1.10.4, 1.10.5, 1.11.1, 1.11.2, 1.11.3, 1.11.4, 1.11.5
• 3.2, 6.3, 10.1

Intended Learning Outcomes

• Explain why Oral Hygiene Coaching is needed
• Explain the principles of a Preventative Programme
• Demonstrate the delivery of appropriate Oral Hygiene advice, including tooth brushing techniques and interdental cleaning
• Tailor techniques and advice to adapt to diverse patients' needs

Outline

• Session 1: Overview of why Oral hygiene coaching is important in the role, review of available products, use of products, and advice for patients.
• Session 2: Practical session with case studies of adapting the approach.

Assessment

• Formative: Demonstrations in activities
• Summative: Year 1 OSCE, Year 1, 2, & 3 Clinical placements
• Future career effectiveness as a dental hygienist and therapist.

Why?

• Dental biofilm is directly involved in dental caries and periodontal disease, increasing risk.
• Effective and regular removal of biofilm is crucial for prevention and maintaining oral health.

Steps in a Preventive Programme

• Gather all information: referred from which department, previous treatment and outcomes, patient perception, verbal history, radiographic evidence.
• Gather new information: identify presence and severity of disease, identify risk factors, carry out baseline charting (BPE, 6PPC, BS%, PS%)
• Provide coaching for self-care: identify current OH routine, ask patient to demonstrate current techniques, identify needs and build motivation and assess readiness, select appropriate measures.
• Evaluate changes in oral health: ask patient how they feel, support and correct, provide further advice, check if ID brush sizes need adjusting, complete new indices and compare to previous findings.

Tooth Brushing

• Manual: Lower 3-3 use circular and side-to-side motion. Recommended sensodyne 3.5 manual brush
• Electric: 1-2 teeth at a time, use in the mirror, slow technique, 45-degree angle to gingival margin, check size of head, consider battery brushes are not recommended.

Manual VS Electric

• Both are effective if used appropriately (Grender et al 2020)
• Adapt to patients' needs.

Interdental Cleaning

• Brushing alone is not sufficient for interproximal areas.
• Ensure brush fits snugly and provides resistance on medial and distal surfaces.
• Various tools and methods discussed, including floss, interdental brushes, and superfloss.

Flossing

• Use interdentally.
• Use 1x daily.
• Place small piece of tightened floss between contact points.
• Wrap round tooth in a C shape.
• Slide between tooth and gum.
• Place subgingivally as possible.
• Wipe up and down approximately 3 times.
• Remove from contact point.
• Reassure patient about bleeding.

Superfloss

• Single units.
• Daily use.
• Under bridges, implants, orthodontic appliances.
• Push stiffened end through normally from buccal side.
• Grasp on lingual/palatal side, work towards gingivae, wipe under pontic, once back and forth, pull out, and reassure if gums bleed.

Interdental Brushes

• Use interdentally.
• Use 1 x daily
• Used in larger gaps
• Need to be sized correctly.
• Need snug fit without causing trauma.
• Push between teeth at gum level.
• Usually from buccal side.

Single Tufted Brush

• Very versatile.
• Use around implants, distal to last molar, around orthodontic appliances.
• Partial erupted teeth, after surgery, patients with gag reflex.
• Inexpensive and long-lasting.
• May need to run under hot tap to soften.
• Single standing teeth, inclined teeth.
• Tooth with recession, into pockets.
• Awkward areas include: orthodontics, impacted wisdom teeth, single standing teeth, and gag reflex.

Removable Retainers & Appliances

• Need to be kept clean as they can harbor bacteria, food, and biofilm.
• Cleaning methods discussed.

How To Do It:

• Use a soft toothbrush or similar brush to clean appliance surfaces.
• Soaking in a cleaning tablet can loosen debris, rinsed, and then brush.
• Do NOT use toothpaste since it is abrasive.
• Clean fitting surfaces thoroughly.

When to Adapt Advice

• Consider additional needs, comorbidities, and carer involvement.
• Adapt to individual patients' needs (children vs adults).

Summary

• Why OH coaching is necessary
• Steps in a preventive program
• How to demonstrate techniques for different products
• Need to adapt techniques for patients' diverse needs

Final Thoughts

• Preventative dentistry is effort to promote, restore, and maintain oral health
• Program composed of preventative steps, patient and operator collaboration, preserving dentition and supporting structures by preventing onset, progression, and recurrence.

Next Time

• Bring toothbrushes
• Be dressed for a clinical session.

Thank You

• Thank you for your attention.