Traditional Hygiene and Hygiene "Wellness"
In over 30 years of dentistry, I have learned a lot. Following are a few of the most fundamental truths I have learned:

• people, as well as their mouths, are not at all alike
• 85 - 90% of the patients I have seen have had some form of gum disease. (This is supported by American Dental Association statistics)
• developing oral health occurs within a sound relationship involving high trust, and time to assess individualized needs and responsibilities. (See our Purpose and Mission Statement under "Introduction" and Core Values under "We Build Relationships")

The more traditional, "usual and customary" (dental insurance term) view of dental hygiene and dentistry is based on the dentist "selling" cleanings, fillings and crowns with set fees. These fees are presented to the patients as if they were exact commodities to be dispensed, without any consideration for individual differences. Patients have been trained from this viewpoint and it is not uncommon for a person to call our office and ask, "How much is a cleaning?" or "How much is a filling?" Most dentist's fees are influenced by insurance companies whose policies are based on "average" values that allow benefits for "average" service. I have yet to come across an "average" patient. My patients are very individual and have individual needs, especially when it pertains to their periodontal health.

All dentists, including periodontists (gum specialists) agree that one of the more demanding procedures in dentistry is the thorough scaling under the gums of the hard tartar or calculus which is the material resulting from bacterial plaque on the root surfaces of the teeth. This material builds up daily. In many offices the hygienist is not afforded the time and opportunity to have the patient learn the true nature of their periodontal status and their responsibility and accountability in the equation. The hygienist ends up cleaning off the same old tartar each visit with little or no gain in health and this can become very demoralizing. (see "Cleanings" under "About Our Services"). Add to the mix the possibility of a blood chemistry imbalance that may be a factor in gum inflammation. It is important for the patient to have the trust to work as a partner with the hygienist and office in the continuing diagnosing, prevention and treatment of gum disease.

When individual responsibilities are not able to be defined, the responsibility for the patient's health is shifted mostly to the dental office, rather than within the mutual responsibilities that should evolve. (see "Dental Health and Wellness"). One of our core values is fairness, and this is definitely not fair, although quite common due in part to this heavy influence of the insurance industry (no fee allowance for the time it takes to educate the patient). This is very frustrating for the hygienist and no doubt one of the reasons there is such a short supply of hygienists. Many of them work only part time or leave the profession.

Attempts by dentists to "buck the system" are often met with patient attitudes based on "usual" care. Many dentists are fearful that if their hygienists offer patients not only their great teeth cleaning dexterity, but the time and fee exchange to allow the patient to learn what they need to know to get healthy, they may be rejected and lose the patient. (See "About Fear & The Dentist").

In our office we do not compromise our standards by offering mediocre, "usual and customary" care. Since we know that true health requires mutual responsibilities, we choose to allow the time it takes to educate our patients. We want to work with people who value wellness and want to gain and maintain their oral health though long-term committed relationships, rather than those who may be more interested in the traditional, insurance based, approach.