Orthodontics: A Straight Perspective, From a Dental Hygienist’s Eyes

by Amy Currie, BSc, RDH

When my journey as a hygienist began over 15 years ago, never did I believe I would find myself fulfilled in a career as an orthodontic clinician.

As a fresh graduate with a suction in my left hand and a scaler in the right, I was going to save smiles, one tooth at a time! Soon after my hygiene career began it took me to the other side of the world – New Zealand– allowing me to not only explore new land and way of life, but also share knowledge and teach the benefits of good oral hygiene. Within this year, a new passion was ignited
in me while working on and creating hygiene care plans alongside the dentist. New Zealand is by no means a third world country, but routine hygiene care was still in the early developing days (and was anything but routine)!

After my time was up (aka expired work visa) I returned to Canada determined to change the world, again one tooth at a time. I scaled here and there between my maternity leaves still searching to find my groove, my niche to make a difference. As the saying goes “good things come to those who wait” and just over three years ago I had the opportunity to join forces at an orthodontic office that completely changed my life. I was no longer trying to “save” smiles one tooth at a time; I was helping create them… one tooth at a time!

From the outside, one may not fully understand the depths of knowledge that we as dental hygienists have; we are seeing this now more than ever, with collaboration within the medical field to the public eye. In the profession we understand the importance we make in people and for people through routine hygiene debridement appointments. But have you ever wondered what happens behind the scenes of those brackets, wires and elastics? What does a dental hygienist within the orthodontic realm really do? We are tracing the ceph, creating complex treatment plans alongside the orthodontist, collaborating not only with the general dentist, but perhaps having perio or endo clearance, maybe even surgeons for complex extractions or orthognathic surgery. There is no “typical” day in the ortho world and that excites me. In the clinical setting, we are not just powerchaing/o-tieng and changing wires; we are fitting bands to create various appliances, taking impressions and scanning for 3D models to fabricate retainers or appliances, including clear aligners, taking models for surgeons to use to hand articulate before jaw surgery, bonding and removing brackets, placing buttons and lingual wires, and, of course, photo shoots, cephs and pans to document progress to highlight a few.

Most orthodontists have an interactive observation program allowing young children to become familiar with the office while coaching not only the little smiles, but the parents/caregivers on what to expect or watch for in the coming years. When the last baby tooth is lost and the magic is about to happen, we have an inside track on their values and concerns with not only their smile, but their motivation, comfort level and confidence! This can make the process so much easier for the family and the team.

Early intervention can be key, be it a removable retainer to correct an anterior crossbite, an expander for posterior crossbite, or perhaps removing primary teeth to encourage positive eruption which can all help little problems from becoming “bigger” problems as the dentition continues to erupt. Oftentimes diagnosing congenitally missing teeth or “pegged” (Bolton Discrepancy/small) laterals can help the family create a plan while they still have options. Is their ideal treatment creating or maintaining space for future implant with bone preservation from the
primary tooth or extract and allow natural drift to aid in closing all space? These are treatment plan discussions that can begin the foundation of the smile into perspective and reality.

Once the smile and individual are ready for treatment, from both a dental and emotional readiness, there are many options to get the most optimal individualized results from bracket choices to clear aligners. This includes both the perspective, expectations and values of the patient, to the ideal treatment recommendations from the orthodontist and any consulting specialists. Expectations from all involved parties have to be managed and understood. Examples include aligners that are wonderful and convenient for tooth movement, but only work when they are in the
mouth! Thus, compliance needs to be understood.

As an orthodontic clinician I can see the smiles honestly being created one tooth at a time, both figuratively and literally. I have found my niche! Motivating and creating positive change in values is so rewarding. If you have found yourself reflecting in your career and looking for more, I encourage you to explore the opportunities within the orthodontic world! Seeing things unfold into a straight perspective, may be exactly what you need!

About the Author

Amy Currie is a Registered Dental Hygienist and Treatment Coordinator based in Kingston, Ont. She is a graduate of John Abbott College where she received her diploma for Restorative Dental Hygiene. She recently graduated from O’Hehir University with a Bachelor of Science in Oral Health Promotion.

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