Dental hygienists do not all practice dental hygiene care at the same level just as different dentists provide different levels of dental care. You may have your thoughts in regard to these different levels but I think you will agree that not all hygienists provide care in the same manner.

•LEVEL 1 Dental Hygiene Care – Managed Neglect

Level I hygienists are practicing managed neglect. Every 6 months they scale away at the same teeth that had calculus the last visit. They feel there is no hope for a change in patient behavior so why bother. The attitude of the hygienist is ‘I just do my job and go home.’ Most of these hygienists are not probing or if they are there is no protocol for active disease so the periodontal exam has little meaning. The cause of disease and true prevention are non-existent with no regard for the future health of the patient. This type of practice pushes patients through the hygiene department as fast as possible. You might call this a prophy mill. The hygienist must see as many patients as possible so as to increase the production numbers. The patients in this type of hygiene department have little or no value for their dental health. They rely on the hygienist to “clean” their teeth every 6 months with not much thought of care in between appointments.

•LEVEL II Dental Hygiene Care – Body Parts Care

Level II hygienists have some higher technical training and are interested in providing higher levels of care that will generate more production dollars in the practice. The focus is more on advising patients of treatment options based on ‘what the insurance will cover’ rather than a comprehensive treatment plan. Success is measured based on production. The periodontal exam does have meaning for this level of hygienist to the extent that patients agree to the treatment presented. The patient’s future dental health, and general overall health are not the focus in this practice. This level of hygiene treatment may provide care that will slow the disease process but it doesn’t address the cause of the problem. Instead of looking at the entire system, this level treats only one aspect of the body, the gums and supporting structures. Patients in this type of hygiene department may end up with a host of dental problems in the mid to later adult life despite having visited the dentist regularly their entire life. We wonder, “How can that happen?” yet we observe it and watch it happen right before our eyes.

•LEVEL III Health Centered Dental Hygiene Care – Cause of Disease Care

The level III hygiene department has moved to be ‘health-centered’ and strives to treat the patient as an entire system. Everyone in the practice understands the ideal of dental health and realizes the importance of conveying that message to their patients. The examination process is engaging for the patient, comprehensive, and includes the protocol necessary to restore health to the highest level for the patient. The patient is a true partner in health as we create together long-range goals for dental and overall health. The hygienist is motivated to life-long learning while growing and developing their technical and communication skills. They understand that to behave differently, they must think differently. The cause of disease is the primary concern so that true healing can occur. The patients are motivated to care for themselves because they understand the consequences of neglect. It is hard work to become a level III hygienist but the rewards are high as service to others becomes the top priority.

•LEVEL IV Health Centered Dental Hygiene Care – Systemic / Total Body Wellness

The Level IV hygiene department has everything described in level III and has now moved to include protocols that provide systemic care. Nutritional counseling related to overall health and testing procedures to identify precursors to disease are implemented. A high level of trust exists between the patient and the hygienist. Level IV hygienists are highly educated in the link between systemic diseases and oral health and continue to educate themselves as new information becomes available. Level III and Level IV hygienists are concerned about the health of themselves as well as their patients thus serving as a model to those around them.

Barb Stackhouse, RDH, M.Ed.

There is a call for higher learning and the quest for a better way to care for people. Because of this request from dentists like you, we have put together a very special one day event at The Schuster Center on May 1, 2009. For anyone who truly aspires to higher patient care and understanding, this offering is for you.

Graduate and mentor of The Schuster Center, lecturer Dr. Tony McRedmond has studied with Dr. Pankey, Bob Barkley, FACE and OBI, among others. His unique holistic approach led him to in-depth study with other healthcare professionals as well as those in the field of research.

If you are looking for different ways to contribute to the overall health of your dental patients or you are concerned about the possible negative effects of some commonly used dental materials, attend this special continuing education seminar.

This dental seminar will cover:

• Biocompatibility of dental materials
• Recurring infections
• Depression, memory loss and/or fatigue for no apparent reason
• Chemical sensitivity in chronic illness
• Improve dental systemic health

If you miss this lecture and wish to speak to someone regarding this or other continuing education opportunities, call The Schuster Center toll free 1-800-288-9393 or visit our website