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HYGIENE TRIBUNE The World’s Dental Hygiene Newspaper ·U.S. Edition April 2013 — Vol. 6, No. 3 www.dental-tribune.com their overall physical and mental health needs. Three of the most likely mental illnesses that hygienists and other dental professionals should have a basic aware- ness of are schizophrenia, bipolar disor- der and major depression [explained a more detail on page E2]. Correct diagnosis often a challenge The most important aspect for treatment of an SMI is getting the correct diagnosis. Because of overlapping symptoms, the stigma of receiving a diagnosis, medical privacy laws, civil rights protection for the mentally ill, and a continuing lack of insight by patients, families and society as a whole, individuals developing an SMI may go without treatment — or re- ceive ineffective treatment for years. At times medication is used to control symptoms before a correct diagnosis can be made. Understand medication side effects The health history is the biggest clue for the dental hygienist to consider to gain awareness regarding the possibility that a client is being treated for mental ill- ness. Some clients diagnosed with mental illness will neglect to state the nature of their illness but will list the medications that they are currently using. These med- ications will consist of antipsychotics, antidepressants, mood stabilizers, anti- anxieties, anti-epileptics and sleep aids. Other clients might have an SMI that has not been diagnosed, or they might have received a diagnosis, but they are not taking medications. Clues here might include a somewhat disheveled appear- ance, odd behavior and consistently poor oral hygiene. People being treated for mental illness often are on several medications, which can cause severe xerostomia, resulting in high caries, erosion, tooth loss, mouth infections, loss of taste and difficulty in chewing and swallowing. Other side ef- fects include bruxism and metabolic cravings for foods high in carbohydrates. The plaque index in patients with an SMI is often quite high, causing decalcifica- tion and severe sensitivity. Smoking, substance abuse common The need for thorough oral cancer screening is great because statistics show that SMI correlates with tobacco use, substance abuse and other high-risk behavior. General health disorders such as diabetes, high cholesterol, cardiac dysfunction, movement disorders and agranulocytosis are serious side effects that can be attributed to medications. O ne in four families in the Unit- ed States is affected by severe mental illness (SMI), a life- altering disease that can be especially difficult when it emerges just as an individual is beginning to discover the freedoms of adulthood — a common age at which symptoms first present. In addition to the psychosocial chal- lenges faced by this population, many of these individuals also must confront a myriad of oral health issues that often end up being largely ignored — because individuals and families become over- whelmed by the chaos the illness typi- cally brings into their lives. With basic awareness of the unique needs of patients with an SMI, dental hygienists can play an important role in the effort to better meet not just the oral health care needs of this particu- larly vulnerable population — but also The severely mentally ill are severely underserved Dental hygienists have unique opportunity to provide high-value care By Lisa Stillman, RDH LiSa StiLLman, RDH, BS, is a clinical dental hygienist and the Northeast Xylitol Educator for Wasatch Sales Force. She creat- ed the organization “Dental Voice for Mental Health” to help mental health care recipients address their oral health needs though awareness and educa- tion. She presents courses to fel- low dental professionals, mental health pro- fessionals, advocacy groups and mental health facilities. Stillman is a member of American Dental Hygienists Association and the National Alliance of the Mentally Ill. She is a founding member of the American Acad- emy of Oral Systemic Health. Stillman earned the 2008 Sunstar/RDH Award of Distinction. She can be contacted at lisa91156@aol.com. ” See UNDERSERVED, page E2 Clinical has always preferred a manual tooth- brush. I have made him switch be- cause I know the benefits of using a power brush. However, even with a power brush, he still brushes in a back- and-forthmovement.WhatIlikeaboutthe new Deep Sweep brush head is that it com- binespulsationsandsweepssoitfeelslikea more traditional manual brushing motion. Now, I don’t have to correct him when he brushes as if he was using his old manual toothbrush. While I have always liked using power brushes, the new Oral-B Deep Sweep Tri- action 5000 has shown me that I haven’t been brushing as properly as I thought. This brush comes with a separate piece, the wireless Smart Guide, to place onto the sink to guide brushing and warn the user if they’re brushing too hard or not long enough. The Deep Sweep Triaction 5000 also has a red light built into the handle that indicates when you are using too much pressure. I had never realized before that I brush too hard until my handle start- ed lighting up like a disco ball! Having the wireless Smart Guide feature feels like you have your own personal dental hygienist observing you while you’re brushing. I now feel compelled to share my new preference of the Oral-B Deep Sweep with my patients, especially since studies show the effectiveness of plaque removal. Like with my saw analogy, I must now come up withametaphorfortheOral-BDeepSweep, demonstrating how the power brush has advanced even further. By Liz nies, RDH-Ea, aS When I introduce new products and tech- nologies to my patients, I often use analo- gies to help them understand how they work. For example, I compare a manual to a power toothbrush as a hand saw versus a chain saw. I start off by explaining that toothbrushes have been around for more than 5,000 years in much of the same de- sign. You could never move your brush fast enough to break through the cell walls of oralbacteriaasyoucanwithapowerbrush. Just like if you were going to cut down a tree, which tool would you use to do it: a hand saw or a chain saw? Recently I noticed that many of my pa- tients who use Oral-B power brushes had improved oral health. I was quite surprised because that has not always been the case. This piqued my interest, so while attending a continuing education retreat, CAREERfu- sion,IobtainedtwonewOral-BDeepSweep Triaction 5000 power brushes — one for me and one for my husband. I was skepti- cal at first to try it out, but have been im- pressed with the results. Like many of my patients, my husband Changing my power brush preference Industry opinion CDA BOOTH NO. 1166 The Oral-B Deep Sweep brush head combines pulsations and sweeps so it feels more like a traditional manual brushing motion; but it cleans deep between teeth and gets to places that manual toothbrushes normally miss. Photos/Provided by Crest Oral-B