Straight From a Patient’s Mouth: A Patient’s Perspective on Hygiene

by Janice Wheeler, President, The Art Of Management Inc.

There are two types of hygienists, and it’s not whether they are partnered with a dentist or independent. Let me explain from my own experience as a patient what the two types are.


I never saw a hygienist until I was about 21 because our family dentist always did a bit of “tidying up” in our mouths. We never knew that we should actually have been having proper cleanings done by a hygienist because we never knew such a person existed.

At 21, I saw a dentist who had this lady called “a hygienist” who the dentist asked me to see. She cleaned my teeth and it hurt like “*&^%**” and bled a lot, and I didn’t know why she was even doing this procedure. My husband saw her too as a patient and he said she was really nice and gentle and he had no bleeding. I jumped to the conclusion that either she didn’t like women or she had it in for me. Regardless, from there on I avoided hygienists and only saw a random dentist if I had a toothache or broke a tooth for many years after that. No more discussion of cleanings.

When I was 40 and had entered the world of dentistry as a practice management expert, I broke a tooth and chose to see a dentist who was one of my clients who we had trained on treatment plan presentations. He enlightened me on what my years of neglect had done to my gums and teeth, and explained very thoroughly why my gums bled. The light was dawning on me that I had not been right in my neglect and that I had been a bad dental patient. I was sent to his hygienist who he explained was going to do deep scaling to clean out my deep pockets.


This hygienist educated me on what scaling was all about and told me that it was probably going to hurt because of the deep pockets. (NOTE: I don’t take freezings.) However, when it did hurt this time, I understood that it meant she was actually doing a really thorough job and helping me save my teeth, not that she hated me. I had three visits the first time around because of the bleeding and pain, but I stuck to it because I now understood, thanks to the hygienist’s explanations. My gums gradually healed up over the next year and we saved my teeth. I felt satisfied and was with that hygienist and dentist for about 7 years till I moved away.


The next hygienist was Matilda. She was friendly and chatty and talked about her no-good husband, my daughter and grandson who were patients, the weather, politics, vacations, and so on. I was not that interested but it passed the time – I just hated that it was mostly a one-sided monologue that I couldn’t contribute to with my mouth open. She must have been doing a good technical job because I didn’t have bleeding gum problems particularly (this patient’s measuring stick to judge what is “good” hygiene care). However, there was neglect going on silently in the background as you will see from lack of education. Whenever I went to the front desk to pay after my appointment with Matilda, I would think to myself that it seemed like a lot of money being charged for an hour of chit chat.


Then Matilda retired and I was switched to Angela who had just graduated. She had been a dental assistant in this office before and I also knew her because we had gone out as friends to a theatre production or two. Did she chit chat with me when I came in to see her the first time? No, she did not. She welcomed me warmly and invited me to jump up in the chair and asked me what I thought was happening in my mouth.

She then did a very thorough exam while explaining some things she was seeing happening in my mouth – a couple of deep pockets and a loose tooth. She asked me to show her how I was brushing (not so well) and especially around a particularly crooked tooth that was getting loose and then to show her how I was flossing it (not quite right either). She spotted the need for a change in my techniques (the patient is never wrong, just needs to learn “new techniques”), and proceeded to show me another way to do those things. A deal was made that if I did it the new way, we would probably see the gum around the tooth tightened back up the next time I came. (And it was!)

And when I went to pay my bill at the front desk, I felt she had undercharged me for all that wonderful care. Yet it was the same dollar amount as before. I felt edutcated and serviced!


I got interested in learning about how I could maintain my teeth and gums and be proactive. I had never been proactive about it before. This was a great lesson I learned. They are my teeth and gums, and I am responsible for them and I need to be good at it.


(NOTE: Angela had done my company’s Treatment Presentation Workshop when she was the Dental Assistant because she was working in the practice of one of our clients.)

The next time I came in, I had phoned ahead to say I had broken off the whole side of a tooth while in Florida. It was time for my next cleaning anyway, so I saw Angela first. She took a picture to put up on the monitor to show me what had happened to my tooth and proceeded to start cleaning my teeth.

As she cleaned, she presented that I needed a crown and core build-up. She cleared up what those things mean as I had never personally had a crown before and had no idea what a core build-up was nor why one was needed. I asked why it couldn’t be an onlay or inlay like I have in my other teeth. She explained everything in simple English and made sure I truly understood.


Then I asked Angela how much it was going to cost and she told me, which freaked me out a bit, cash-flow being a bit low after my Florida trip. So, we discussed the consequences of not taking that path and what the other, less desirable options would be and I got my head around the ideal option. We discussed payment methods and, with her help, I came up with a way I could pay for it. I felt very comfortable talking to her about all these things. I would never have asked half as many questions if it had been the dentist presenting because we wouldn’t have had all that time afforded by a hygiene appointment.


When the dentist came in to do the check-up, he said that he could see from the monitor that Angela had presented the treatment and asked if I had any questions. I had two: can we do it without freezing (yes) and can’t it be an onlay (no). And that was it. The hygienist had saved him from all my questions and money issues. What a help she was! I could tell by his smile that he appreciated her!


As a patient, I clearly saw that there are two types of hygienists: the first just does the cleaning but not much education and mostly fills the silence with chit chat. They may have once cared but as time went on have forgotten how important they are in the journey of a patient’s teeth and gums.

The second type really cares about the patient being proactive and doing their part in maintaining the health of their teeth and gums. This hygienist is an important part of the practice that has the goal to help patients keep their teeth until they don’t need them anymore. I am thankful I was treated by one of these!

About the Author

Janice Wheeler, is the President of The Art Of Management Inc. which has grown more than 700 Canadian dental offices over the last 32 years. She is an international speaker, has written over 500 management articles (, regularly contributes to various Canadian healthcare journals, wrote a book “Practical Advice for Practice Owners”, and has an awesome team who love helping dentists reach their practice goals.