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Hygienist appointments: Pain vs non pain

Sir, I have written to many dental bodies regarding the subject of 'pain vs non pain' caused by the dental hygienist. I have worked in dentistry for 23 years, 13 of these as a dental hygienist. The same complaint keeps getting raised and I think it must be dealt with.

There were always issues when I was a dental nurse that the hygienist was 'brutal or a butcher' and now as a hygienist I have to deal with these issues on a daily basis. I was never taught in my training that pain and force was considered good practice. It should be down to technique. Every week when dealing with new patients I get the same story that the patient hasn't come back to the dentist due to a bad hygiene visit or dreads coming back so puts the appointment off. This is not good for either the practice or the patient.

I pride myself on tailoring each appointment to the individual and this is even on a 15 minute NHS appointment. If a patient is very nervous then less is more; it is no use pushing treatment onto the patient when you know they cannot cope with it. Build the patient's confidence up by doing a little scaling at a time. Sensitive patients you can hand scale or use local anaesthetic and with patients with perio then they will have pockets so there will be plenty of room to debride the area and disturb the biofilm. If you are hurting the patient then you will be ripping into the attached gingivae. Many a time I get patients saying to me it was a terrible experience. When I examine the patient's mouth they may have a BPE of 1s and 2s with very little calculus so I am totally shocked and very annoyed as this should not be the case. I think many hygienists feel they are not considering the patient's needs and only trying to fulfil their own of what they think is expected of them. It is very clear to see if a patient is uncomfortable. I would hope that if this subject is discussed then it would make hygienists reflect on their own manner and how they perform their treatment on the patient.

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Kennedy, L. Hygienist appointments: Pain vs non pain. Br Dent J 223, 67 (2017). https://doi.org/10.1038/sj.bdj.2017.601

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