Dental hygienist - is this normal??

[HappyMum123456]

I have a private dental plan and I moved to a new practice around 2 or 3 years ago, only because my dentist of many decades was retiring and the new one is more convenient.

I often require fillings and other treatment which is all covered in the (very expensive) plan.

My issue is with the 6 monthly hygienist appointments (which are separate to my normal checkups with my dentist). I expected this would be for a regular scale and polish. But no....these appointments are truly horrific and humiliating. She starts by measuring my plaque and bleeding score and compares this to my previous readings. I'm quizzed on my use of a "bottle brush" and expected to explain myself and my dental hygiene habits. If that wasn't bad enough, I then have the humiliation of having to sign a contract/treatment plan to promise I'll do better for next time.

Is this normal?? I had nothing like this with my previous dentist. They just advised where I needed to focus my brushing etc. Today she was especially brutal with my teeth and gums once she'd established my bleeding/plaque scores were worse than last time. She demanded to know why this had happened.

I'd change dentists if it was simple - but last time I moved I needed a load of treatment to get some kind of dental fitness certificate.

I realise this probably makes me sound like I have dreadful teeth (I really don't) and that I'm a complete lightweight (I'm not). I just wondered if this was normal. I very nearly cried during my appointment today and my mouth still feels so sore and bruised.

How do you know that, exactly?

Whenever anyone comes on here and asks about the behaviour of a professional, why are they always told they should be doing xyz better. OP didn't ask about her dental hygiene, she asked about the behaviour of a supposed professional - the two shouldn't even be linked.

But the way to make people do the "right thing" isn't to make them feel like a badly behaved toddler...

Her manner sounds awful - unpleasant, rude and belittling. As a professional, she should behave decently and treat all her patients with respect, regardless of the condition of their teeth.

This is such a trend on these threads and it's so unnecessary.

It is very difficult , because medico legally you have to give the patient all the information and the consequences of having gum disease and not controlling it . Not only is gum disease the number one reason for dentists being sued research says uncontrolled gum disease is linked to many other health problems from cardiac disease to Alzheimer’s to miscarriages to diabetes.

Unlike many other medical problems treatment of gum disease is 90% patient effort and 10% professional effort. There is no magic proceedure or medicine , it really is about showing someone how to clean more effectively and keep the biofilm down.

Unfortunately it is a very difficult art to get that information over in a way to protect all parties and remove the tartar effectively which can be uncomfortable when your gums are already inflammed.

Different people like different approaches so changing hygienists might help but the underlying message and getting rid of the tartar and the changes the patient has to make to remain healthy will remain the same.

Exactly.

I've been really lucky and have always had really lovely hygienists - they all manage to tell me what's necessary without being rude, unpleasant and demeaning.

Because the professional is telling the patient that whatever their oral routine is inbetween visits isn’t improving their gum health. Obvious questions would be things like vaping/smoking/food and drink intake etc. I would be listening very carefully to the hygienist and trying to implement necessary changes, not come of Mumsnet and feel aggrieved The professional is trying to help. I have seen so many hygienists over the years and none of them were known for their bedtime manner.

Well, I've had multiple hygienists over the years and none of them have left me feeling belittled or upset after a visit.

I don't think there's any reason to treat your patients poorly or to make them feel bad, even if their oral hygiene is awful. There are ways to get your point across that don't make people feel about an inch tall.

My Hygienists also never mentioned diet or the importance of vitamin C ,D and magnesium for tooth and gum health.
I started taking these a year ago regularly as well as a multi vitamin with iodine and my teeth and gums improved massively.

It's not just about brushing!

@sunsetsandboardwalks
The OP's plaque and bleeding scores have worsened since the last time they were recorded. Thus Oral hygiene has deteriorated. If the hygienist/therapist omits to inform the OP, this is negligence. The delivery of the message sounds dubious the way the OP describes it but the message itself is spot on in the circumstances described.

Yep, I'm not disagreeing about the message at all.

I'm just saying that there's no excuse for belittling people and making them feel awful for it. There are all kinds of reasons someone could be neglecting their oral hygiene - so patients should be treated with empathy and kindness, not like they're complete idiots.

I'm not sure why it seems to be accepted when it comes from doctors or dentists - if someone said a builder or other tradesman spoke to them like that, the answers would be completely different.

Unfortunately the vast majority is about effective cleaning. Hormonal changes , severe vitamin and dietary conditions can make the gums more susceptible to the inflammation caused by plaque and for a small amount of people alongside increased oral hygiene measures some supplements may help.
However the essential is to remove the biofilm and when 66% of the population have visible plaque on their teeth for the vast majority we are not doing a good enough job of cleaning.

I have never been to a hygienist, what do they exactly do? - have 6 monthly dental check ups but never realised this was a thing!

Do they only have 1 hygienist? I've changed to a different one at my dentist as the first was a rude fucker.

Proper in-depth cleaning of your teeth and gums, you're supposed to go every six months like with the dentist.

No not usual at all.

I have had several hygienists at my practice and whilst it's their job to educate you on dental hygiene, I don't think it's their job to bereft you like a child.

My hygienist is lovely and I look forward to seeing her more than the dentist. She will always tell me areas for concern, but she is kind about it and will advise me on products I might find more useful. Whilst it can be a little uncomfortable the following day, I'm never in pain.

I would let the practice manager know about your experience.

Is there another hygienist at the practice?

If you clean well and have healthy gums you should never need to see one. Well done.

I know that there are lots of wonderful hygienists and dentists treating patients. However I have come across a number of rude and patronising ones too. I think part of the problem is the fact that finding a new dental practice is so difficult if not impossible. They are a scarce resource and know it.

To be fair I think if you kept going back to the same tradesman with the same problem, and not taking care of the item they would be quite rude to you.

If you kept asking a plumber to unblock your drain and everytime there were more and more wipes/tampons down there I don't think they would be polite.

I don't really think that's an accurate or fair comparison.

Someone who is seeing a medical professional because they're struggling with something (be that oral hygiene, mental health issues, diabetes or whatever) deserves to be spoken to with respect and decency.

OP is doing the right thing by seeing the hygienist - if she didn't care at all, she wouldn't bother, I'm sure.

I'd also say that someone's dental hygiene only really impacts them, whereas a blocked drain can potentially cause expensive issues for other people. However, a professional should be professional regardless - if you don't want to keep unblocking someone's drains, you're free to turn down the job - you don't have to be rude.

I’m on the expensive sort of Denplan and don’t experience any of this at all. The hygienist is thorough but no interrogation and it doesn’t hurt (sometimes bleeds and is a bit sensitive).

I wouldn’t be going back!

The hygienist doesn't have the best bedside manner but they are doing their job.

By far the biggest cause of gum disease is poor oral hygiene. Second would be smoking and diabetes. It's the hygienists job to manage your gum health and the only way to do that is with good daily plaque removal. The hygenist job is not just to clean off calculus build up.

Plaque and bleeding scores are important in measuring your levels of gum disease and if this is related to oral hygiene, and again where needs focusing on. Technically you should not provide periodontal treatment if plaque scores are too high as it will fail.

If your on a dental plan and essentially an insurance company is paying for your work then presumably they don't want to keep paying for work that will fail, hence having to sign a treatment plan saying you will improve your oral hygiene

It would be worth speaking to the practice manager and saying you felt belittled by the hygienist and they can learn to adjust their bedside manner, but I would also say they sound thorough and what they have done is appropriate if handled badly

I think the idea might be to kind of shock people into action. I can remember getting such a telling off in my twenties that she literally told me I could lose my teeth at the bottom unless i listened to her. I’d never heard that before and it was a life changing moment. I am 50 now. No fillings. So for gum recession due to age that I am scrupulous about.

My evening routine involves floss and a water irrigator and I pay £110 to see a hygienist privately three times a year. She’s still not bloody polite to me and I’m still grateful.

What do you their you don’t mind me asking?

Was it a young dentist by any chance?

I went for a check up yesterday with a new one who looked fresh out of uni after seeing the same one for years. I haven't had a filling for years and although my usual one gives me a scale and polish and reminds me to clean the back of my teeth, this new one was brutal.

She poked all my gums with something sharp and made them bleed, and shoved a thing that was too big for my mouth in to take the x rays, which has left my mouth really sore. She's given me a list of things I need to be buying/doing and booked me a double appointment for intensive cleaning and a filling!

No of course people deserve to be spoken to with respect but also I don't think tradesmen are exactly the epitome of respect to their clients and tend to be pretty rude if someone isn't taking care of whatever they are working on

It also will impact the hygenist and the practice if their patients oral health worsens if they are on a payment plans, they need more work and time for the same price. Unlike a tradesman who charges for their time

The biggest cause of litigation in dentistry is patients not being informed about gum disease and how to manage it, and long term tooth loss because of periodontal disease.

Again the bedside manner is poor but the actual concept is the job of a hygenist

The person I saw was approaching retirement. Definitely old school in her approach. I'm sorry you had a rubbish time too.