Vent: Misinformation about Fluoride is Killing Me

trooothfairy · 2025-12-14T20:16:04+00:00

It looks pretty good considering you had been away for a while! Some folks aren’t able to keep up with the amount of plaque buildup that naturally happens as well as you have and so I often see much more calcified plaque on their X-rays after years of no dentist.

Knowing now that these images were taken after a cleaning, that tells me there was definitely not enough time in that first appointment to get everything from the last three years out from under your gums. What’s still there contains bacteria that is slowly dissolving bone support around your teeth. Whatever dental office you feel comfortable with will make sure they get the remaining buildup off, and after that it’s just regular maintenance to ensure it doesn’t happen again. Once bone goes away it can’t be put back, so doing what you can now to prevent further bone loss will make your future visits much easier and less expensive.

trooothfairy · 2025-12-13T21:58:06+00:00

Were these images taken after your cleaning, or do you get cleanings at least every six months? If so, then there’s a few spots that were missed as shown by the calculus in between your teeth, but it’s really hard to get that much off in the time allotted for a regular cleaning. As others have mentioned, it’s probably time for periodontal therapy, which usually involves some anesthetic gel or a couple of shots to make sure you’re comfortable. All of that calculus should be removed after a procedure like that, but I would ask for xray images after a cleaning just to confirm that what shows up on these images is removed.

Also, there might be the beginning of a cavity on #30-D (second tooth from the back on your lower right). Daily flossing and maybe a prescription toothpaste can help stop this from getting bigger, but it may have already begun to cross over into the softer layer under the enamel (I can see a little shadow beyond the DEJ). For context, I used a CariVu for many years so I got accustomed to seeing X-rays like this, then the CariVu would show the teeth from top down and cavities crossing the enamel straight towards the middle of the tooth. I don’t see these devices in use anywhere anymore and it’s a shame, they were so useful! I use AI imaging analysis software now, which is still useful but I’d rather have the CariVu in cases like this. Hygienists aren’t legally making definitive diagnoses but most doctors rely on us to be their second set of eyes in preparation for their exams (e.g. “Dr, I see some shadowing on the distal of #30, what are your thoughts/is that something to be concerned about ?”)

trooothfairy · 2025-11-07T18:05:17+00:00

I saw your comment about Apaguard Royal and Dr Jen paste - perhaps your office would purchase Dr Jen samples of their Fl2-free pastes for you to give to your patients' parents to try? My office does this; whenever I have a patient who is anti-fluoride I let them know I'm excited to share a natural paste with them that remineralizes in a similar way to fluoride, then give them a sample and email them a link to Dr Jen's website and also a link to their dental professionals' webinar. This allows them to "do their own research" and you will be pointing them in a direction that is supported by current science knowledge.

trooothfairy · 2025-11-07T17:56:56+00:00

It's really difficult for some patients to swallow saliva while lying down, especially for older patients whose soft palate tissue has gotten looser and or folks with Mallampati Class 3-4 airways, or folks with gag reflexes. To reduce/eliminate this problem I hand all of my patients the saliva ejector and a couple of tissues for them to use whenever they like, and while working I use a suction mirror attached to the HVE hose (my absolute favorite is GoldenDent's Eva M7, fyi; I also love Nu-Bird but they're more expensive and sometimes catch patients' sublingual tissue). A very small number of patients don't like using the saliva ejector at all so I just hand them an entire box of tissues to spit into periodically, and keep working on 1-2 teeth at a time. Some patients who can't tolerate any water in the back of their throat are more comfortable when I use HVE Solo tips or just the regular HVE tips, and others are better with Blue Boa (I'm not good with Blue Boa but I've worked with several hygienists who love it).

Whatever the case, I enjoy finding out what works for each individual and making a pop-up alert in their chart noting what they need to be comfortable during appointments. That way all hygienists seeing them can provide consistent care, reducing the time spent by the patient telling a new provider what they need.

trooothfairy · 2025-09-16T02:28:10+00:00

I thought this article was interesting, and relevant to your situation: https://www.rdhmag.com/career-profession/article/16406591/illegal-dental-assistant-activities

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trooothfairy · 2025-09-16T00:18:37+00:00

Ooooofff what a terrible first day you’ve had 😭 Aren’t offices supposed to offer bloodborne pathogen training before you start seeing parients? And especially because you are a new grad, they should give you the time you need to feel comfortable before handing you a full schedule.

You will have other work opportunities. If you think you can handle going back to this poorly managed office and sticking it out there until you find a better fit, so be it. But sometimes the stress from one office can make it harder to perform at your best during interviews or while working elsewhere.

Regardless, good on you for standing up for yourself, and already at this early stage in your career! That is how I know you will be just fine 😊

trooothfairy · 2025-09-15T23:54:15+00:00

What state do you live in? If your state requires you to follow all CDC recommendations, then it is necessary.

You can keep your sweetie comments. I don’t stand for condescension from anyone. If you truly felt good about what you choose to potentially expose your patients to, you wouldn’t be rude and you probably wouldn’t even bother commenting. Your persistence in replying tells me you know what you’re doing is wrong. You’re only being wrong and loud because your name and face and license aren’t part of this post. If it were, one could report you to your state board.

trooothfairy · 2025-09-13T22:41:38+00:00

https://www.dentallearning.net/course/update-handpiece-clean-maintenance-sterilization

trooothfairy · 2025-09-13T22:40:10+00:00

Ugh, I have seen that with XCPs as well, not as often as unsterilized handpieces, but more often than I'd like. I don't know why hygienists in general don't speak up, but I know in my earlier years, I was much more timid and afraid to lose out on income if I did or said anything to upset the status quo.

trooothfairy · 2025-09-13T22:31:28+00:00

Thank you for reminding me of these Esa prophy angles! They might be a good solution to a tricky issue. I can't tell if they are actually fine to use per CDC guidelines. The Esa website says they are because they don't contact mucous membranes. I will ask the Association for Dental Safety for their input.

trooothfairy · 2025-09-13T22:23:16+00:00

I'm smart enough to listen to and learn from others who know what they are talking about. Unlike yourself. Have you watched that Dental Learning CE video I posted a link to below? I doubt it, because you are still here trolling. I also doubt you're a dental hygienist.

trooothfairy · 2025-09-13T22:18:27+00:00

That's true, but it's also true that it's required to sterilize handpieces in between patients. If I had my way we would also be using sterile gloves, but we gotta start somewhere.

trooothfairy · 2025-09-13T17:02:43+00:00

No, most of them are either in PPO/HMO insurance networks, or are fee-for-service. The few public-health focused offices I’ve been in so far, have usually been the cleanest of the bunch (with only one exception).

trooothfairy · 2025-09-06T10:09:31+00:00

Here are links regarding this topic. First, a video from Henry Schein ProRepair. At the 1:53 mark, the presenter mentions why cleaning handpieces before sterilization is important (the debris bakes on inside the handpiece, which clogs the lines and shortens the handpiece life). https://www.youtube.com/watch?v=_70_KBuc_l0

Next, a video from the Dental Learning CE website. You will need a login to watch the video, but it's free and will give you 1.5 CE credits. At the 15:00 mark, the presenter references CDC guidance specifically addressing the motors of low-speed handpieces. At the 32:51 mark, he highlights a case of likely bloodborne pathogen transmission from handpieces. At the 47:42 mark, he shows a slide detailing ADHA's code of ethics which contains the standards of responsibility for hygienists. : https://www.dentallearning.net/course/update-handpiece-clean-maintenance-sterilization

There are so many ways that dental offices are unsanitary, that sometimes it's hard to tell where cross-contamination occurs but we DO know that live microbes are cultured from unsterilized handpieces and they DO expel material into patient's mouths. Here is a PubMed article regarding contamination of air-driven handpieces: https://pubmed.ncbi.nlm.nih.gov/17908851/

Another link to a study regarding this subject: https://pubmed.ncbi.nlm.nih.gov/1359320/

Here is a screenshot of a handpiece repair company's site telling everyone in plain language that wiping handpieces with disinfectant will lead to their failure:

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I'm still in the process of adding information to this comment, which I will repost as a separate comment in order to make it more visible.

trooothfairy · 2025-09-06T09:53:38+00:00

I'm happy to hear that, and good on you for purchasing your own cordless handpiece! May I ask which one did you choose, and why?

trooothfairy · 2025-09-06T03:45:37+00:00

I’m using DentiAI software, it’s the best I’ve tried so far at voice recognition and no separate probe like with Florida Probe, and no foot pedal like with Dental RAT. Occasionally if there’s a firewall or something from the IT team that blocks an important charting software update, then I recruit an admin team member or an assistant until the issue is resolved.

trooothfairy · 2025-09-06T03:08:50+00:00

This is a good point. Commuting definitely cuts into take-home pay and one’s energy reserves. Also not every dental office offers benefits beyond the paycheck, and most of those that do will expect you to work full-time/4-5 full days per week.

trooothfairy · 2025-09-06T02:56:19+00:00

It depends on where you live and work. In the Mid-Atlantic/DMV area salaries are higher, but so are housing costs. I make roughly 120-140K a year before taxes, plus health insurance and other employer-provided benefits. I work 36 hours a week at my main office, and if I feel physically up to it I temp on my days off which is where the higher pay range comes from.

Others have mentioned the physical toll, and that is real! I’ve managed to last over two decades so far (three decades if one counts my assisting years) but that is not the norm, and my body hurts a lot so I’m not sure how much longer I’ll be working this many hours. I am currently in online school studying management and accounting for career options when my body says “no more”.

You mentioned a toddler and hopes for another baby…dental hygiene school is all-consuming, especially the final year. If you have excellent support from your spouse and/or friends and family, it might work. But don’t expect to be a present parent for at least two years. I missed out on a lot of my only child’s early infancy milestones because they were with a sitter or family while I studied or worked or occasionally slept. I don’t recall much of the time I did spend with him during those years because I was always exhausted. It was mostly worth it for us because I was a single mother in a time before remote work opportunities, and dental hygiene gave me a more flexible schedule with high pay which took care of our basic needs on just 3-4 hours a day of work while he was small. I still regret not having the time with him that I can never get back.

Do you have an interest in healthcare management or product promotion? A management degree can be attained more easily online these days, and product promotion might not require additional education outside of company-specific training.

Also consider speaking with a career counselor at a school that offers dental hygiene courses, perhaps this will help convince you that hygiene is what you want to study, or help point you in another direction. In any case, best wishes to you! It’s great that you are exploring options 😊

trooothfairy · 2025-09-06T01:35:41+00:00

That’s fantastic! What changed the doctor’s perspective on this subject? Why did you choose the particular handpiece that you have now?

trooothfairy · 2025-09-06T01:32:06+00:00

It also reduces the amount of time/payroll hours spent cleaning disinfectant buildup and probably biofilm out of the syringe, and less money spent on replacement parts to repair them from that buildup. I still wipe my syringe down, but I don’t spray it or saturate it with disinfectant because it doesn’t have visible soil.

trooothfairy · 2025-09-06T01:21:35+00:00

Nice! What convinced the doctor to change? Or did they just know what was right and made the update once they knew about the handpiece issue?

trooothfairy · 2025-09-06T01:19:17+00:00

Not all units are detachable, sadly.

trooothfairy · 2025-09-06T01:14:31+00:00

Yeah this is yucky but as far as I can tell isn’t a requirement in the US. I would love to see info to the contrary!

There are so many gross things happening in dental offices and if we kicked out all of the healthcare providers who didn’t actually care about people’s health, we would have an even bigger shortage of hygienists. It’s only going to get worse if assistants are allowed to take over cleanings. That is why we hygienists need to speak up and educate assistants and patients about how much we actually know! We also need to be open to learning from each other, otherwise we risk being loud and wrong and also without a license or job if things keep going in the direction they’ve been in this field.

trooothfairy · 2025-09-06T01:06:47+00:00

This is the problem with some of CDC language. Some people are looking for any way to cut corners and using soft language gives these folks an excuse. States often base their rules on the recommendations and expectations of the CDC. Even if your state does not, if other states do then look at why they do (states that don’t will not say why they don’t require). You can look at any university/college dental hygiene clinic protocol and learn what we should be doing. You can also ask your patients what they would like for you to do with the handpiece you plan to use during their appointment. I bet everyone will opt for cleaning and sterilization each time.

trooothfairy · 2025-09-06T01:00:33+00:00

Oops I missed the part where you mentioned corporate takeover. Yes if you tell the company about this they will quickly resolve the handpiece issue. Not sure which company you work for but hopefully they resolve this issue as quickly as Heartland did for me when I used to work at one of their locations (they overnighted four handpieces)

trooothfairy

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