Questioning a dental hygienist ?

Questions on how we spend our money and our time - consumer goods and services, home and vehicle, leisure and recreational activities
Post Reply
CFIT
Posts: 50
Joined: Mon Apr 07, 2014 7:57 pm

Questioning a dental hygienist ?

Post by CFIT » Fri May 22, 2015 6:31 pm

The thread on questioning a dentist reminded me of my current experience with a dental hygienist.

The dentist's office I started using two years ago is a bit quirky but I've generally been happy with the results. My only reservation concerns the hygienist who cleans my teeth every six months. For the last three visits (over 18 months) she has told me that I have several 5mm-deep periodontal pockets, that I should come back in 3 months for "deep cleaning" (which I take to be root planing and scaling), and to have the pockets treated with their laser. I'm not sure if my dental insurance would pay for the deep cleaning, but it would not pay for the laser treatment.

I take excellent care of my teeth, and even bought a WaterPik to help with the pockets. I'm not having pain, bleeding, or loose teeth. Looking at articles online it seems that the use of dental lasers in this application has not been proved beneficial.

After my last cleaning, and the hygienist's repeat of her recommendation, the dentist came in. He's a bit of an odd young guy but his work has been solid. He told me that in anything having to do with gums, the hygienist was the authority while he managed the tooth part of things. Since my approach to most things medical is to wait and see what happens, I asked him whether the 5mm pockets would suddenly blossom into 6mm pockets, whether there would be noticeable warning signs of that, and what the progression of the condition was normally like. I couldn't get a succinct answer from him but don't know if that was due to his communication skills (he seems painfully introverted) or the fact that they hygienist was in the room with us.

To my mind, the hygienist is pushing for treatments that would not be covered my dental insurance using a technology that has yet to prove itself. It feels like a scam.

Are the hygienist's recommendations standard for dental care?

Thanks.

User avatar
LadyGeek
Site Admin
Posts: 48024
Joined: Sat Dec 20, 2008 5:34 pm
Location: Philadelphia
Contact:

Re: Questioning a dental hygienist ?

Post by LadyGeek » Fri May 22, 2015 6:59 pm

CFIT, welcome! Here's the dentist thread: Questioning a Dentist?
Wiki To some, the glass is half full. To others, the glass is half empty. To an engineer, it's twice the size it needs to be.

John3754
Posts: 1289
Joined: Tue Mar 19, 2013 8:56 pm

Re: Questioning a dental hygienist ?

Post by John3754 » Fri May 22, 2015 7:14 pm

Go somewhere else and get a second opinion.

retire2044
Posts: 70
Joined: Sun Aug 31, 2014 12:17 pm

Re: Questioning a dental hygienist ?

Post by retire2044 » Fri May 22, 2015 7:24 pm

Not trying to give any medical advice and break any policies here, but I am a dentist and would recommend you search Google information on lasers and periodontal treatment. You seem to be reaching the same conclusion I have in regards to laser treatment. They may work great, but they really don't have much research backing up their effectiveness. This comes from a dentist that owns and uses a laser in his practice (Not for perio disease, but for routine restorative procedures). As discussed in the questioning a dentist thread, there is wide variation in treatment recommendations from dentist to dentist and also hygienist to hygienist. Maybe a second opinion from another office would be in line. They may suggest something totally different. There are other dentists on this forum, maybe someone that uses lasers for perio treatment and has a different opinion.

User avatar
LadyGeek
Site Admin
Posts: 48024
Joined: Sat Dec 20, 2008 5:34 pm
Location: Philadelphia
Contact:

Re: Questioning a dental hygienist ?

Post by LadyGeek » Fri May 22, 2015 7:32 pm

^^^ Perhaps, but please keep the opinions related to the financial aspects.

Medical advice is not permitted because 1) members may give incomplete or inaccurate recommendations or 2) readers may misinterpret the information. Since medical issues can do real harm, we avoid both issues by not allowing any advice to be provided.
Wiki To some, the glass is half full. To others, the glass is half empty. To an engineer, it's twice the size it needs to be.

derosa
Posts: 464
Joined: Wed Jul 24, 2013 5:18 pm

Re: Questioning a dental hygienist ?

Post by derosa » Fri May 22, 2015 7:35 pm

[OT medical advice removed by admin LadyGeek]

It is a little odd that the dentist is not in charge of the office staff. An "odd young guy" doesn't paint a high level of confidence on your part.

[OT medical advice removed by admin LadyGeek]

chrisdds98
Posts: 84
Joined: Tue May 19, 2015 9:55 pm
Location: Austin, TX

Re: Questioning a dental hygienist ?

Post by chrisdds98 » Fri May 22, 2015 9:27 pm

Do you go to a chain office (castle dental, aspen dental, etc)? Those offices tend to overdiagnose... avoid chains at all costs and try to go to an office owned by the dentist you see. you have much better odds of getting an accurate diagnosis. I'm a dentist who graduated in 2004 and worked in a few of those crappy offices. I was fired from a few because I didnt diagnose aggressively. I feel really bad for the new grads who are coming out with 400k in student loan debt. they have a tough time getting loans to start their own offices and are usually forced to work in the crappy "dental mills" for many years...

mhalley
Posts: 6064
Joined: Tue Nov 20, 2007 6:02 am

Re: Questioning a dental hygienist ?

Post by mhalley » Fri May 22, 2015 11:37 pm

I had some deep pockets, and after 6 months of improved flossing and a waterpik they improved markedly. I am concerned about a dentist that doesn't check the pockets himself and give you detailed instructions on how to improve the problem. There are lots of other treatments before deep cleaning and lasers. Are you doing the twice a day flossing? The thing about periodontal disease is that it can be silent until it becomes a problem. I would defintely seek a second opinion.
Mike

toofache32
Posts: 1324
Joined: Sun Mar 04, 2012 6:30 pm

Re: Questioning a dental hygienist ?

Post by toofache32 » Fri May 22, 2015 11:44 pm

My comments are only regarding the financial/insurance aspects. Remember how dental insurance works. The insurance company is not your friend, nor the dentist's friend. They want to get buy with the cheapest alternative. Just because they don't cover it, doesn't mean it's not needed. I see this all the time....."my insurance doesn't cover this so I must not need it." There are 3 parties involved.....you, the dentist, and the insurance company. Only 2 of those parties are actually interested in your health. I routinely see insurance plans that deny coverage for dental implants and crowns because a denture is a cheaper option. Don't mistake the insurance company for a friend.

2comma
Posts: 1241
Joined: Thu Jul 15, 2010 11:37 pm

Re: Questioning a dental hygienist ?

Post by 2comma » Sat May 23, 2015 1:37 am

I also find your dentists remark odd (like you said he's a bit odd). Not to dis dental hygienists but they go to school for 2 years, dentists need a Bachelors and a DDS degree program covers four years of in-class, pre-clinical and clinical instruction.

Like many said, get a second opinion and you might want get it from a periodontist - gum disease is what they do and gum disease I hear is no fun.
If I am stupid I will pay.

abner kravitz
Posts: 337
Joined: Tue May 05, 2015 7:42 am
Location: Beaufort County, SC

Re: Questioning a dental hygienist ?

Post by abner kravitz » Sat May 23, 2015 7:34 am

I have dealt with gum disease (as a patient) for a long time. I have a few comments. The fact that your gums aren't bleeding is good, and my periodontist told me a long time ago that a WaterPik was the best thing I could do for myself. However, you really won't "feel" gum disease until it is way past the time you should have it looked at. A good hygienest can certainly tip you off to the problem, but your next step should be to seek out a well-regarded periodontist. Dental insurance should cover that if you haven't hit what is typically a low annual maximum

CFIT
Posts: 50
Joined: Mon Apr 07, 2014 7:57 pm

Re: Questioning a dental hygienist ?

Post by CFIT » Sat May 23, 2015 12:10 pm

Thanks for the helpful advice and interesting discussion.

It crossed my mind that the dentist office would make more money on procedures that were not covered by insurance as opposed to those that were, and so had incentives to steer me towards more profitable procedures..

Not commenting and the pros or cons of dental lasers in this application, a quick Google search shows dentists' offices that use it in marketing their services. It has the feel of 'practice optimization' and that makes me wary.

My previous dentist would do the "sounding" (what I call the measuring of gums) himself, calling out the numbers to his assistant. In the current case, the hygienist does it herself and provides instructions and recommendations. While she gives me a feeling that my teeth on in imminent danger, I got none of that from the dentist.


Thanks again!

TRC
Posts: 1885
Joined: Sat Dec 20, 2008 5:38 pm

Re: Questioning a dental hygienist ?

Post by TRC » Sat May 23, 2015 4:50 pm

[Medical advice removed by admin LadyGeek. See my post earlier in the thread.]

User avatar
DesertOasis
Posts: 122
Joined: Mon Apr 13, 2009 8:55 am
Location: Boston, Massachusetts

Re: Questioning a dental hygienist ?

Post by DesertOasis » Sat May 23, 2015 6:02 pm

I recently went to a periodontist for a second opinion after my hygienist recommended a deep cleaning with antibiotic treatment. I have moderately deep pockets (some 4s, one 5). The hygienist scheduled all four quads to be worked on in only one visit. This was a red flag. How necessary is this costly and uncomfortable procedure if she can knock it off in visit? She has always told me that my pockets are stable, not inflamed and that my home care is excellent.

After the periodontist examined my gums and measured my pockets, she told me that the deep treatment was not necessary. She did, however, say that I should continue the quarterly hygiene visits, since my periodontal disease requires a more aggressive cleaning schedule than the usual twice yearly visits. The two extra cleanings are only partially covered by my insurance but I have no problem paying out of pocket for these (a very Bogleheads investment).

Mudpuppy
Posts: 5889
Joined: Sat Aug 27, 2011 2:26 am
Location: Sunny California

Re: Questioning a dental hygienist ?

Post by Mudpuppy » Sat May 23, 2015 6:41 pm

If the costs of the proposed plan seem high, why not just seek a second opinion? If you were getting an addition built onto your house, you wouldn't just get one estimate from a contractor, you'd get several. This matter isn't an emergency situation where you have to go with the first plan offered. There are no immediate or pressing time concerns on this matter, so spend the time to get a second opinion.

Post Reply