Dental Hygienists: A Key Provider in healthcare

By Lacy Walker, RDH, BS, CDA, FAAOSH

Dental hygienists, also called prevention specialists, play a vital role in healthcare, and their impact on oral health and overall systemic health cannot be understated. They are responsible for preventing and treating oral diseases and educating patients on optimal oral health. They use various tools and techniques to clean teeth and remove biofilm (plaque) and calculus (tartar) from the surfaces of the teeth.

Hygienists provide counseling on diet, tobacco use, and the prevention of gingivitis and periodontal disease. In addition, dental hygienists often work with other healthcare professionals to diagnose and treat oral diseases, such as gum disease and oral cancer, and provide referrals when needed. Ultimately, dental hygienists are essential to the healthcare system, helping ensure people have healthy mouths and bodies.

History

1906 - The role of a dental hygienist has evolved over the years and the official role of a dental hygienist started when Bridgeport, Connecticut, dentist Alfred C. Fones trained his assistant, Irene Newman, to scale and polish teeth. (1) Irene’s title changed from dental nurse to dental hygienist.

1917 - Irene Newman became the first licensed dental hygienist, and within the next three years, six more states followed and licensed dental hygienists. (2)

1952 - All fifty states had licensed dental hygienists. (2)

1959 - Wilkins wrote the cornerstone text in almost every dental hygiene education program in the United States and worldwide, “Clinical Practice of the Dental Hygienist.” (3)

Education

Dental hygienists learn a plethora of information in college, including these courses:

Embryology & Histology Radiology Human Anatomy Biochemistry Pharmacology Medical & Dental Emergencies Microbiology Nutrition Oral Pathology Periodontology

Oral Systemic Health

Oral health affects systemic health and vice versa. As trained, licensed professionals, hygienists are responsible for cleaning and maintaining patients' teeth and educating them on proper oral hygiene. Dental hygienists also work to promote oral-systemic health. Oral systemic health refers to the connection between oral health and overall wellness. Dental hygienists know how the mouth's health can affect the rest of the body.

Dental hygienists review medical histories and obtain a blood pressure reading prior to dental procedures because high blood pressure can lead to increased bleeding or prompt a heart attack or stroke. Dental hygienists are knowledgeable about the effects of poor dental health on things like diabetes, heart disease, and stroke. Periodontal disease has been associated with diabetes, metabolic syndrome, obesity, eating disorders, liver disease, cardiovascular disease, Alzheimer's disease, rheumatoid arthritis, adverse pregnancy outcomes, and cancer. (4)

Oral pathogens associated with periodontal disease can translocate into the bloodstream and affect your heart, kidneys, brain, lungs, joints, and pregnancy outcomes. Scientific literature reports that the presence ofFusobacterium nucleatum and Porphyromonas gingivalis are associated with the onset and/or worsening of a wide range of systemic diseases, such as osteoporosis, cardiovascular diseases, rheumatoid arthritis, and neurodegenerative diseases such as Alzheimer’s and Parkinson’s. (5) These bacteria can be identified through salivary testing, which a dental hygienist can perform

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Dental hygienists are more than just “teeth cleaners,” “toothpickers,” or “mouth maids”; they are an integral part of the healthcare team to provide patients with optimal oral care in the office and recommend home care products based on their specific needs.

References

1. Dental hygienists: The evolution of the profession (no date) Fortis Colleges & Institutes: Accredited Career Training Programs. Available at: https://www.fortis.edu/blog/healthcare/dental-hygienists--the-evolution-of-the-profession.html

2. Remembering Esther Wilkins, Dental Pioneer (2016) Tufts Now. Available at: https://now.tufts.edu/2016/12/14/remembering-esther-wilkins-dental-pioneer

3. Heather Hakes, R.D.H. (2022) The history of Dental Hygiene: Development through the years, Today's RDH. Available at: https://www.todaysrdh.com/the-history-of-dental-hygiene-development-through-the-years/

4. Kapila, Y. L. (2021). Oral health’s inextricable connection to systemic health: Special populations bring to bear multimodal relationships and factors connecting periodontal disease to systemic diseases and conditions. Periodontology 2000, 87(1), 11-16. https://doi.org/10.1111/prd.12398

5. Contaldo, M., Fusco, A., Stiuso, P., Lama, S., Gravina, A. G., Itro, A., Federico, A., Itro, A., Dipalma, G., Inchingolo, F., Serpico, R., & Donnarumma, G. (2021). Oral Microbiota and Salivary Levels of Oral Pathogens in Gastro-Intestinal Diseases: Current Knowledge and Exploratory Study. Microorganisms, 9(5). https://doi.org/10.3390/microorganisms9051064