Dental hygienists brush up on skills

When Maria Sorrentino tells people she’s a dental hygienist, she gets one of two reactions: “people either stop smiling, or they cover their mouth with their hands.” It probably doesn’t help that Sorrentino, who is a dental hygienist in the office of Dr. John J. Caravolas, has a set of perfectly straight white teeth, that yes, she brushes three times a day.

In her four years as a dental hygienist, Sorrentino has peered into countless mouths. She is one of five dental hygienists assisting three doctors at the Waltham-based adult and pediatric practice. She’s seen all types of patients, from a 95-year-old with a full set of teeth, to a child with such bad tooth decay that the front teeth and molars are rotting. Her job as a licensed oral health professional is not just to clean teeth, take and read X-rays, and assist the dentist, but also to educate patients. “It’s great when you give someone advice about their teeth, and they come back in six months and did everything you told them, whether it’s not letting a baby drink apple juice from a bottle, or flossing their teeth.”


Sorrentino, a graduate of Massachusetts College of Pharmacy and Health Sciences, says that the dental hygiene curriculum is grueling. “They drill things into your head,” she says – no pun intended, since a dental hygienist needs to be able to remember and use all sorts of dental instruments – angles, chisels, hatchets, excavators – to water syringes, sterilization systems and dental dams. Ouch. “Let’s face it, no one wants to be at the dentist. Someone is inside your mouth and scaling (or cleaning) your teeth. It feels invasive. The noise of the tarter coming off has been compared to the sound of nails against the chalkboard,” says Sorrentino.

Registered dental hygienists like Sorrentino have to successfully pass a national written exam and a state clinical exam. Dental hygienists are among the fastest growing occupations, and are expected to grow 30 percent through 2016, as the crucial role of preventative dentistry grows in importance. The career offers flexible scheduling, with more than half dental hygienists working part-time.

Q: All those metal hand tools on the tray – isn’t it difficult to remember which ones to use?
Once you get the hang of it, you can feel how each instrument – we call them scalers – have different angles, and fit into the tooth in a different way. You wouldn’t be able to go at the back side of the tooth with a front angle, for example, or clean teeth with an explorer – it’s a pointy tool that probes for cavities.
Q: How long before you work on a real patient?
In school, we practice on a fake mouth that is screwed to a chair as if it were a real patient. The clinical instructor watches everything that you do, and there is a test after every instrumentation. Then you practice on the teacher. When you finally do a real patient, it’s nerve wracking. You have to factor in the cheeks and tongue, and the fact that, unlike a fake mouth, a patient has feelings.
Q: What sort of skills do you need to be a good dental hygienist?
You need to have fine motor hand skills, the discipline to finish and complete school, and of course, great people skills. Ninety-nine percent of the population doesn’t want to be at the dentist, and it’s our job to make the feel comfortable.
Q: How many cavities do you have?
I didn’t get any as an adult, but as a child, I was a so-called ‘frequent flyer.’ I had a lot of decay because I was a big apple juice drinker. Back then, my mom didn’t know any better.
Q: And you really do brush your teeth three times a day?
Yes, I do. And I’m not just saying that because I’m a dental hygienist.

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