the Waterpik®Water Flosser, we would be creating a dental problem versus our goal of becoming part of the solution. The use of antimicrobial agents such as cetylpyridium chloride, essential oils and chlorhexidine may benefit some patients. To varying degrees, they have demonstrated reductions in plaque, bleeding and/or gingivitis. Some products contain alcohol and have side effects that may cause a burning sensation or stain the teeth. This may impact recommendation based on patient age and expectation of compliance due to the undesirable side effects of reversible staining, tissue response and taste alterations. Toothpastes containing antimicrobial agents plus fluoride can also be considered. A Successful Prevention Program In my practice (Dr. Idiculla), we have implemented the use of the Waterpik®Water Flosser as the key home care device. At the first appointment, when patients receive their removable or fixed appliances, we spend 10 minutes on oral hygiene alone. Every patient who starts treat- ment receives a Water Flosser at that appointment, free of charge. We do not want finances to get in the way of an ideal clinical result. This not only improves our orthodontic treat- ment, but also shows our patients and referring offices just how focused our practice is on oral hygiene and the prevention of oral disease. We put over 40 patients in braces each month, and the numbers are only increasing. Without a proper oral hygiene regimen and an aid such as 44 May/June 2010 JAOS If we come across a patient with less than ideal oral hygiene, a letter goes home with the parent that same day, along with a picture of the patient’s teeth indicating areas needing improvement. The next appointment made for the patient is an oral hygiene instruction appoint- ment, where we do not reactivate wires, but rather go over oral hygiene with their Water Flosser. If this happens twice, another letter is generated, and this time sent to the parent as well as the referring office with yet another oral hygiene appointment. A third time requires us to generate a final letter with the removal of wires for easier access for hygiene. A fourth time would result in the termination of orthodontic treatment. I am proud to say that we have never had to generate the second letter. The Water Flosser will virtually eliminate the problems seen in everyday orthodontics. We always promote our hygiene program to our referring offices. This is a unique way to distinguish ourselves from other offices. We hope to not be so unique in the future, since this is in the best interest of our patients and their health. We have come to realize many offices have a choice to refer to us exclusively because of this program. Too many doctors are complacent about poor oral hygiene in orthodontics. It seems to be almost expected in today’s world. We refuse to let that happen in our prac- tice. We are dentists first, and we must never forget that and proper oral hygiene is the foundation for success of any office in the world. Implementing an oral hygiene program is easy. It is a team effort A good oral hygiene program is a team effort between the front desk staff, office manager, treatment coordinator, assistants, dental hygienists and dentist. that includes the front desk staff, office manager, treatment coordina- tor, assistants, dental hygienists and dentist. Everyone who works in the practice should contribute to making it a success. Start by scheduling a staff meeting to discuss the benefits of your current program and areas for improvement. Then, make the changes that will benefit both you and your patients. Good communication is impor- tant and shared goals are impor- tant within the practice, between the hygiene department, dentist, staff or with the referring dentist. A consistent message will have a positive impact on the patient. They will appreciate your efforts in providing them with the best tools available to maintain their beautiful smile. (Editor’s note: Click here for references.)
Journal of the American Orthodontic Society May-June 2010: Page 44
