Why I love dental hygienists — they "get" biofilms

The Silent Role of Biofilms in Chronic Disease Forums Biofilm Community The DENT Connection Why I love dental hygienists — they "get" biofilms

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    • #3250 Score: 0
        2 pts

        Product Insights by Shirley Gutkowski

        Hygienist Profile: Shirley Gutkowski, RDH, BSDH, FACE

        Author: Shirley Gutkowski
        Date: 12/10/2012 08:06pm
        Other posts from Shirley Gutkowski

        The vital stats…..

        I received my BSDH from Marquette University. I am currently specializing in developing the idea of a Risk Factor Manager in the office and providing dental hygienists with the skills they need to work outside of clinical. I’m also co-creator of The Stonkowski Project a company that focuses on raising the awareness of the oral health problems of dependent people and how dental hygienists are here to help solve the problem. I also have a small publishing company that publishes books by/for clinicians.

        What initially attracted you to dental hygiene as a career?

        I intended to go to dental school and become an orthodontist. I had to shift because I kept having babies. Then I really loved the positive changes I could make on people as a dental hygienist. The base level, I didn’t have to wait for disease to break something down before I could help someone.

        Dental hygienists have some autonomy, they’re licensed and the education is grueling. It wasn’t until later that I realized the thick glass ceiling that dental hygienists face. Regardless of your degree, a clinical dental hygienist has no way to move up a corporate ladder and still be a clinician. For example, even with a Master’s degree, you can’t take on more patient responsibilities for a higher level of care, you cannot write a prescription for fluoride, use other tools like lasers–or anything really.

        How and why did you decide to expand your professional activities beyond the operatory and clinical practice?

        There were two defining moments that happened for me that made me want to get out of the treatment room. The first was my being reprimanded for talking to a patient about his increased risk for heart attack and stroke etc in 1997. He didn’t have gingivitis, he had an advanced case of periodontal disease (which I wasn’t allowed to diagnose), loose teeth, exudate, the whole spiel. The dentist said there wasn’t enough evidence to scare his patients like that. I left that office soon after that incident.
        The second was when I saw a patient after the dentist did an initial exam and had to call him back to my room because the patient had frank decay big enough for a full raison to live in the hole. He didn’t want to come into my room to take another look because he had just looked. I still cannot shake the chest crushing frustration that he was overseeing me in the big scope of things, and he wasn’t careful enough to take basic care of a patient.

        By then I had learned enough about caries risk assessment from Dr. Benn of UF Gainesville and how important xylitol was to healthy mouths. I was lucky enough to have a husband who insisted that I learn the computer and was daintily becoming aware of the Internet and had joined some of the online dental groups that had formed. The most important thing I learned from the Internet is that I wasn’t alone. I was right about caries management and treatment, other hygienists were treating patients the way I was taught to treat patients. Dentists were supportive of my thinking and I started writing articles about how things can/should be.

        Today I’m helping other hygienists find ways of using their passion and frustration to create new income streams for themselves. Through CareerFusion, I meet hygienists with all kinds of degrees, from Associates to PhD, who are looking for alternative ways of using their education, their passion, and their drive to find ways to be comfortable in what they know and share. Some want to do sales, some want to do better chairside, some want to learn to write. I’ve matched my two career choices from second grade: teacher or actress!

        What are the three top advancements/innovations that have impacted your professional life or the practice in general?

          [*]The idea of biofilm and how important it is to know what a biofilm is and how it’s different from our traditional model of plaque. Which ties in directly to the oral systemic link, and products that interfere with biofilm growth, like oral probiotics.
          [*]Early detection devices that allow dental hygiene interventions to work earlier (eg., bioluminescence, saliva testing and health, DNA, oral cancer)
          [*]Products that replace missing enamel at an early breakdown (eg., CPP ACP, bioactive glass, TCP, HA – nano technology)

        What is your message to fellow hygienists about how they can learn about and inform patients about the role of probiotics in maintaining good oral and systemic health?

        The exciting thing about oral probiotics is how they fit into the biofilm science. In order to grow a biofilm you need early colonizers of a certain type. They need to expel copious amounts of a matrix that allows others to join in and protects the bunch from harm. Once that biofilm establishes a foothold in the mouth, the body tries to eradicate it, and cannot. The inflammatory cascade goes into an overdrive situation that stimulates all that is linked to oral health.

        Oral probiotics from healthy mouths don’t allow a biofilm to form, or they at least take up the space that the other early colonizers would use. I learned the this really exciting term a few years ago: Domesticate Bacteria. That term still gets my heart to flutter. With xylitol we kind of do that, but it doesn’t work like probiotics. Oral probiotics, taken once a day, flood the mouth with health promoting bacteria. The biofilm isn’t allowed to grow and, presto…a decrease in disease.

        As this is a newish product for oral health, the studies rightly started looking at decay rates and that’s where we’re at right now. Ongoing studies are looking at periodontal health, cytokine expression, CRP measurements, mother/child transfers. And other studies that haven’t been developed yet are being thought up. The reach of this technology is as yet not totally measured.

        In your role as lecturer/educator, what is the most important thing YOU have learned while teaching other dental hygienists?

        I’ve learned that everyone has a limit to the amount of new information they can let in. I once spoke to an audience about xylitol for three hours–yes it’s possible! I showed picture after picture of disclosed teeth that looked 100% better after using xylitol gum for a short time, a few weeks even. A VIP in the crowd raised her hand and asked if teaching better brushing and flossing wouldn’t get the same results. I was a little flabbergasted, knowing that teaching brushing and flossing got us into this mess and that not everyone can brush and floss to dental hygienist standards. We have to come up with better options for reducing dental biofilm and we have some better options now.
        So my goal is to push my audience members beyond the edge of their comfort. Remind them that everything old is new again, and we have ways of implementing what we learned in college, even stuff we put away for long time. Companies have provided us with products and services to help us with our most difficult cases, we shouldn’t be afraid of them we should be relieved that someone did it! Then let them find a way to feel safe implementing new thinking, new products, new services.

        Anything else you like to tell your fellow dental hygienists about yourself?

        I like to let people know that I’m a member of some really important groups. Groups that are spear heading dental hygiene without knowing they are.

      • #3514 Score: 0

          Dental hygienists are swimming in biofilm all day long. And not just on the teeth. The waterlines in dental offices are dirtier than the Chicago river. Biofilm can and does come from sterile water. ASK what your dental office is doing about the water in the water lines. Ask how old the hoses are, you’ll be shocked that no one in the office has any idea that the hoses have a life span.

          Ozoneated water is safe, find out how long they’ve been using the ozonated water. it should be made every hour and if they just started reschedule for a month out.
          There is also a brand I’m suddenly exposed to called Monarch, it was a Canadian company that is now available in the US. It’s been tested against waterline biofilm and shown to remove it as well as stop it from growing.

          Dang there’s so much to know!!

          Shirley Gutkowski, RDH, BSDH
          America’s Dental Hygienist

        • #3251 Score: 0
            2 pts

            Shirley, you are SO right.

            My last dentist had an ozone system to clean his water lines — it was broken for over a year. A YEAR! I wonder how many of his patients gargled with less-than-clean water!? Got their teeth rinsed with biofilmy H2O?

            I moved on to a better dentist who stays current on anti-biofilm therapies for his practice. The last cleaning I had was actually much “nicer,” in that:

            – it took less time;
            – my RDH used ozonated water;
            – used xylitol instead of fluoride (that everyone knows is injurious to the thyroid, adrenals, etc.);
            – did not seem uncomfortable at all.

            Who helped me find this great DDS and RDH 15 minutes from my house? An RDH named Shirley! 😉

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