Dr. Heff’s Health Hero Project – Dental Hygienist
Dr. Heff's Health Hero Project interview with award-winning Dental Hygienist Jennie Haywood-Hull.
Jennie is a clinical teaching fellow at the University of Portsmouth Dental Academy. Thank you for sharing your knowledge, Jennie!
On a personal note, I think you are spot on with your last point about the future of Dental Therapy.
We understand there are different standards of care within the Covid protocol, and it would be great to learn about your particular method. So, how have you been coping with Covid?
Covid has positively impacted day-to-day life to some extent; I now have full-time chairside support, which has benefitted my working life immeasurably. I have had good support from
colleagues both on reception and clinically with diary planning, allowing for a fallow time at the end of sessions and longer appointments (45mins) to allow for effective hand scaling. The increased cross-infection measures and pre-appointments have meant that I have felt my personal safety has not been a concern.
In the UK, many hygienists are still hand scaling - do your patients feel they are getting the benefits of hygiene therapy, or should we all be ultrasonic?
I think the studies show ad feel from my own experience that hand scaling is equally effective. However, this is only the case if the correct variety and quality of hand instruments are available. The appointment lengths are adequate to allow gold standards treatment to be completed. Therefore, we have treatment planned ultrasonic sessions for patients with needs exceeding a realistic expectation of hand scaling within an appropriate time scale.
What is the best way your practice has integrated your skills to assist the patients and your working environment?
I think my role is integrated throughout the patient journey, from achieving baseline health at the start of a treatment plan for new patients to ensuring that correct monitoring and support is given throughout. The best thing is that the patients are made aware of this requirement from the outset, so the hygienist is viewed as an important part of their dental journey.
Please, take me through a patient’s journey that has moved you and explain your part in it.
I have been very fortunate to work with a wonderful patient who has very aggressive periodontal issues coupled with systemic health problems, namely severe Rheumatoid arthritis. The patient comes from a clinical background herself as she is a Professor in physiotherapy, despite some intensive periodontal treatment. She has lost all her upper teeth and moved to a full upper denture, and we are now trying to maintain her periodontal status on the lower arch. The impact that was even reducing the degree of periodontal infection around the upper teeth before extraction made to both the patient’s confidence by stopping the spontaneous bleeding and reducing mobility and the patient’s systemic health was really beneficial to the patient.
She felt better socially, medically, and professionally. It was a privilege to make such a difference in such a lovely woman’s life. Since starting treatment with myself, she has also referred her daughter to me via direct access, who is already showing signs of susceptibility to periodontal disease despite only being 18 years old, so hopefully, I will also be able to make a positive impact on her daughter's life by helping her to put the correct prevention in place before its too late!
Should hygienists have dental nurses? Are you working with a dental assistant, and how has that changed your system?
I have worked with and without a nurse in the past 20 yrs, and now for the first time, I have a full-time nurse. It has massively changed my system as I can now monitor and record patients'
periodontal status in line with the BSP guidelines, spend more of the appointment time on treating patients and discussing their care with them. I feel less stressed as it has impacted the time
pressures of the appointment in several ways. I feel my clinical notes are more thorough as I have time to complete them effectively. It is also lovely to work collegiately with another person day-to-day as being a hygienist can be quite isolating.
Is there anything you would alter or add to the training pathway?
As a clinical teaching fellow, I would love to see an element of direct access being added to the training pathway at the University of Portsmouth Dental Academy. We have an element of this from external general dentists’ referral which means the student is responsible for treatment planning, prescribing radiographs under the patient group directive of their clinical tutor, and carrying out treatment. I would love for whitening, fluoride application, and LA to be within our prescribing powers as I feel it limits our application of these areas despite them being part of our scope of practice.
We appreciate the benefits of guided biofilm therapy - can you explain your favourite long-term change from this process?
The best results I have had from guided biofilm therapy have been around implants placed a long time ago. Quite often, these implants are long and difficult to remove despite strictly being classed as failing. This leaves the responsibility of maintaining them to the hygienist, and the results from using Guided Biofilm Therapy outstrip those with conventional methods. I also love the patient's response to this treatment as it is very motivating, the disclosing helps to monitor OH, and the patients can see the changes and feel the difference.
Do you think long-term use of agents such as chlorhexidine harms the oral microbiome?
I tend not to recommend the long term use of CHX for many reasons
Do you think that the oral bacteria can travel through the placenta of a pregnant mother? What do you think the implications of this would be?
A low birth rate is a potential risk for mothers with periodontally involved teeth.
Where do you see the future of hygiene therapy?
I think the NHS should utilize Dental therapists more effectively. Dentistry is one profession that refers/triage from the top (dentist/consultant) down. If the necessary prescribing rights were added to the scope of practice, then Therapists could run NHS clinics and refer more complex work or private work to the dentist. This would require an overhaul of the NHS's current remuneration system but would help make NHS treatment accessible to a larger number of people, which is very important to help close the poverty gap.
Lastly, a cheeky final question - do you recommend Dr. Heff’s?!
Of course!!! Seriously, they are a beneficial product, I treat many patients who suffer xerostomia due to polypharmacy, and they are invaluable to these patients.
Clinical teaching fellow
University of Portsmouth Dental Academy
William Beatty Building
University of Portsmouth
+44(0) 23 9284 8308
(Tuesdays, Wednesdays and Fridays 08:30-17:00)
Website - www.port.ac.uk/dentalacademy
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