“Why do my gums bleed after I brush my teeth?”
Dentists and dental hygienists hear questions like this almost every day in the office. The answer usually involves dental plaque, and the result of inconsistent or inadequate oral hygiene habits. The solution is usually simple, but as every frustrated hygienist knows, actually getting patients on board with better oral hygiene practices can be extremely difficult!
Despite energetic oral hygiene instruction, dental hygienists will often find that the advice they give their patients doesn’t quite stick. There may be a brief honeymoon period at first, but subsequent visits will often show that the patient has fallen back into old routines. Why is this and what can we do about it?
We are creatures of habit, and the habits we learn at a young age tend to stick with us forever — for better or worse. Oral care is no exception, and if a patient has never developed good habits, it can take time to build them up.
RDH Magazine notes that setting a goal creates tension, motivating the patient to work towards it in order to achieve resolution. To start, then, clearly identify the problem, set an end goal with your patient, and agree on the best way to achieve this.
For example, your patient may wish to work towards having no bleeding when they brush. Set the baseline by asking your patient how often their gums bleed, and then use this to measure progress towards their goal.
Today’s RDH cautions against diving straight into oral health instruction. Instead, they recommend gaining “buy-in”, or permission, from your patient first. Asking if they would mind you giving them a step-by-step walkthrough — even if they’re already sure they know what they’re doing — will make them feel like an active partner, rather than a passive listener.
Another trick is to let the patient demonstrate their own style of oral hygiene with a toothbrush, floss or both, and offering them gentle pointers on technique if the opportunity arises. You can make it more engaging by challenging the patient to spend two full minutes brushing and another one full minute flossing.
RDH Magazine suggests that hygienists use the “learning ladder” tool to help their patients make small but impactful steps towards their end goal. At the top of the ladder is habit, where your hypothetical patient brushes twice daily and flosses once a day.
Your patient won’t reach the top overnight and may even be discouraged by such a big task. Therefore, your goal is to gently move your patient up the ladder one rung at a time. If they’re starting with only brushing once a day, the next rung may be brushing twice a day. If they brush twice a day, the next rung might be adding daily flossing. After that, the next rung may be maintaining a two-week flossing streak. And so on…
Set your patient up for success by recommending the best tools and products they can use at home. Whatever your patient’s goals, you’ll want to ensure they’re using a toothpaste for Whole Mouth Health, such as Colgate Total which is scientifically proven to fight plaque-causing bacteria on 100% of mouth surfaces. Your patients may also benefit from following up with an antibacterial mouthwash, such as Colgate Total Advanced Pro-Shield Mouthwash.
You may also wish to recommend a smart toothbrush, such as the Colgate hum. Not only are power toothbrushes shown to achieve greater plaque and gingivitis reduction than manual toothbrushes, the Colgate hum also comes with a handy smartphone app to keep your patient motivated between visits. The app tracks their brushing habits so they can see their improvements in real time, and offers them points for good habits that they can exchange for rewards.
One way you can motivate your patients to keep climbing is by celebrating small wins. Today’s RDH says that by giving credit where it’s due, you’ll steadily build your patient’s confidence in their ability to achieve oral health.
At each follow-up visit, compare your patient’s progress to their baseline and to their previous visit to show them how far they’ve come. When patients see positive results, especially early on, they see confirmation that their efforts are paying off, inspiring them to keep going.
Colgate’s Gum Health Physical (GHP) is a great tool for monitoring progress and celebrating wins. The chairside assessment tool highlights areas of the gums that need attention and creates a custom report for your patient to take home. You can perform a GHP assessment at each session and use it to show your patient areas of improvement.
Recall visits are key to keeping patients on track. Schedule regular follow-ups so that you can celebrate your patient's wins, praise their hard work, and reinforce the importance of their new habits. This also gives you the opportunity to address any issues before they throw your patient off-course. With patience and consistency, your patient will be climbing the ladder towards great oral health before they know it!