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The Dental Hygienist
730
The Journal of the American Dental Association
wield a great influence in molding pub lic opinion as regards public dental serv ice. Examples of the results of this in fluence are: The Rochester'Dental In firmary, The Forsyth Dental Infirmary and many other similar activities where the philanthropically inclined wealthy citizens willingly supplied sufficient funds to work of this kind, as a result of their contact with some member of the profession. The obligation of all local dentists, then, is to seek a local Eastman or Forsyth, and win him to the idea of community dentistry. In Pennsylvania, we have a volun teer organization made up of ethical practitioners of the state, which has been described. This plan is functioning beyond the expectations of its originators, and, by means of this group, it is planned to hold a state-wide dental health week, beginning February 22, 1925. The suc cess of dental health weeks in Milwaukee and Detroit in previous years, and also in Reading and York, Pa., last year, has been our incentive to try to put over such a plan in every city, borough and hamlet in the state. W e believe that the
time has passed when it should be con sidered unethical for members of the profession to broadcast the importance of mouth hygiene, and we believe that every dentist in the community, both in groups and individually, should do everything in his power to disseminate proper in formation to the public. In Pennsylvania this year, there are more than 100 dental hygienists serving, in seventy-five communities, and about as many more dentists engaged in school clinic work. There are, in round num bers, 1,800,000 children of school age in Pennsylvania, and it is estimated that approximately 300,000 of these children are receiving preventive and corrective service at the hands of these workers. The adopted slogan of the state dental society and the state department of health is “ A clean mouth for every inhabitant of the commonwealth.” Actually, this slogan will never be realized, but, within a very few years, it will not be the fault of the health department authorities or the dental profession if there is an un clean mouth in the state, for the message will have reached the remotest corner.
THE DENTAL HYGIENIST By ANNA V. HUGHES,* D.M.D., New York City TRAN G E as it may seem, there are many people, including dentists, who do not understand the special field of the dental hygienist. Many of them think she is a highly trained office assistant, while, in reality, she is pri marily an educator. Conservative statistics show that 95 per cent of the adult population have
S
^Professor of Preventive Dentistry, Colum bia University.
carious teeth. Such teeth are not only potential sources of pain and discomfort, but are also sources of disease, and with every mouthful of food they send into the system a supply of dangerous bac teria. Decayed teeth, moreover, are not able to do the work of biting, chewing, thoroughly masticating and preparing the food for the intestinal tract, and thus they are instrumental in bringing about the digestive troubles with which so many people are afflicted.
Department of Dental Health Education The harm has already been done to the adult; he is in the hands of the den tists, and it is his good luck that dental art is improving so rapidly. The dental profession has made great advances in knowledge and skill during the last few years. Still, they cannot control the sit uation and correct the bad habits already established among both adults and chil dren. Nothing can absolutely replace the original sound tooth. Fillings and the other artificial means of restoring decayed teeth to usefulness are admira ble, but at best they are makeshifts. A profession has been created to take care o f the necessary educational work and to furnish the prophylactic service that helps to prevent tooth decay. Here the dental hygienist enters the field of active service, and oral hygiene is rapidly gaining in favor as a field of professional work peculiarly adapted to women. The only hope of relief from the present situation is to take care of the rising generation, and it is for this service that the profession of oral hygiene has been created, a profession of educators and teachers of mouth hy giene and diet. Their aim is preven tion. They begin by teaching the ex pectant mother how to provide sound teeth for her child as a consequence of her own intelligent dieting. The really important work is with mothers and babies, preschool children and school children. The first five grades are the most important since there the dental hygienist can keep in good condition the deciduous teeth until their period of usefulness is over and the per manent teeth take their place. Big in dustries are taking advantage of this new opportunity for increasing efficiency among employes. Department stores, telephone companies, the Army, the Navy, banks and large social organiza tions are including dental hygienists
731
among their personnel. Within the past eight years, oral hygiene work has de veloped rapidly. Typical of the professional training required is the course at Columbia Uni versity, where a full academic year in the school of oral hygiene equips the dental hygienist for effective work. The professional curriculum is approved by the regents of the State of New York, and students cannot be matriculated until they file with the university evi dence of four years of high school work or its equivalent. This precaution in sures the necessary educational basis for the advanced technical studies that ac company the training in manual dex terity and skill in the handling of in struments. During the winter semester, the dental hygienist is instructed in the following theoretical subjects, calculated to give her an intelligent grasp on the importance of her calling and its rela tion to the work of the dentist: anatomy and physiology, dental anatomy, dental histology, oral hygiene, child and school hygiene, elementary chemistry, dentophysics, oral surgery (assisting), bacte riology and sterilization, pedagogy. And in the latter half of the college year, or second semester, she has courses in nutri tion and dietetics, anatomy and physiol ogy, comparative dental anatomy, dentochemistry, oral pathology, oral prophy laxis and pharmacology. Additional special lectures include roentgenology, occlusion and malocclusion, current den tal literature, nursing ethics, clinical re cording, public service and lay educa tion. Armed with this preparation, and with the technic of oral prophylaxis, the dental hygienist is prepared to render valuable service. The expectant mother needs the dental hygienist; for it is in the prenatal period that the greatest good can be accom plished for the baby’s teeth and for the
732
The Journal of the American Dental Association
mother’s in the prevention of premature decay. At this period, mothers must have lime-producing foods. The kind of food a child receives after its birth is not so important as the kind it receives from the maternal food supply before birth, and it is hoped that a few years o f emphatic dietary education will make mothers understand that children do not “ inherit” soft teeth from their parents, but that poorly developed teeth may be traced to improper diet during the pre natal period and infancy. For this reason, not only is the dental hygienist’s mission fulfilled through friendly counsel while the patient is in the dentist’s chair, having the teeth cleaned, but also through lectures, lan tern slides, motion pictures, toothbrush drills, poster exhibits, and dental litera ture is the message broadcast. The habits of the child, such as thumb suck ing, use of pacifiers, mouth breathing, etc., which cause malocclusion; the care of the child’s deciduous teeth, and the importance of the first permanent molar are a few of the many things mentioned in her talks. Not so many years ago, we accepted a great many things as necessary evils that we now know to be preventable. The deciduous teeth, for instance, used to be regarded as of no consequence. They were allowed to decay and the child’s mouth was allowed to continue in a far from healthy condition. The result was that the soft bones of the child’s mouth were malformed, and when the perma nent teeth came, there was not room for them, and they were pushed out of line and rendered almost useless for biting and chewing. This condition can be avoided by caring for the deciduous teeth as conscientiously as the permanent teeth must be cared for later. The dental hygienist calls attention to the value of the coarse foods, which
strengthen the jaws and exercise both gums and teeth, shaping them to do their work effectively while they are still soft. She tells mothers and children that the foods that contain their natural minerals are best because they are prepared by Nature for easy assimilation. Among the lime-bearing foods that children need is milk, and they are taught to use a sufficiency of this growth-promot ing food. These are some of the points on which the dental hygienist is trained to educate the people. If these points are neglected, the child’s health is impaired before it has a start. If the child is in a school where den tal hygienists attend regularly to the cleaning of the teeth, he is sent to the dental clinic or to his own dentist at the first suspicion of decay, and thus the first permanent molar and many of the deciduous teeth are saved. Give us the children of the first five grades in all the schools! That is the plea of the experts, who realize the importance of oral hy giene. In this first five years of public school life, the dental hygienists can establish in the children habits of mouth hygiene and also give the regular pro phylactic treatment necessary to keep the first teeth from decaying. Eternal vigilance is necessary to keep down the bacterial plaque, so-called, without which no tooth can decay. This plaque is a thin glue-like accumulation or deposit which is soft, slimy, and very adhesive. The dental hygienist is trained to polish it away, for it is almost impossible to remove it with a tooth brush. What has been done for the chil dren of the Bridgeport public schools can be done elsewhere. More and more schools are being founded, and more dental hygienists are being trained each year, but so far, the demand for their services far exceeds the supply of gradu ates ready to carry on the work.
The Journal of the American Dental Association
wield a great influence in molding pub lic opinion as regards public dental serv ice. Examples of the results of this in fluence are: The Rochester'Dental In firmary, The Forsyth Dental Infirmary and many other similar activities where the philanthropically inclined wealthy citizens willingly supplied sufficient funds to work of this kind, as a result of their contact with some member of the profession. The obligation of all local dentists, then, is to seek a local Eastman or Forsyth, and win him to the idea of community dentistry. In Pennsylvania, we have a volun teer organization made up of ethical practitioners of the state, which has been described. This plan is functioning beyond the expectations of its originators, and, by means of this group, it is planned to hold a state-wide dental health week, beginning February 22, 1925. The suc cess of dental health weeks in Milwaukee and Detroit in previous years, and also in Reading and York, Pa., last year, has been our incentive to try to put over such a plan in every city, borough and hamlet in the state. W e believe that the
time has passed when it should be con sidered unethical for members of the profession to broadcast the importance of mouth hygiene, and we believe that every dentist in the community, both in groups and individually, should do everything in his power to disseminate proper in formation to the public. In Pennsylvania this year, there are more than 100 dental hygienists serving, in seventy-five communities, and about as many more dentists engaged in school clinic work. There are, in round num bers, 1,800,000 children of school age in Pennsylvania, and it is estimated that approximately 300,000 of these children are receiving preventive and corrective service at the hands of these workers. The adopted slogan of the state dental society and the state department of health is “ A clean mouth for every inhabitant of the commonwealth.” Actually, this slogan will never be realized, but, within a very few years, it will not be the fault of the health department authorities or the dental profession if there is an un clean mouth in the state, for the message will have reached the remotest corner.
THE DENTAL HYGIENIST By ANNA V. HUGHES,* D.M.D., New York City TRAN G E as it may seem, there are many people, including dentists, who do not understand the special field of the dental hygienist. Many of them think she is a highly trained office assistant, while, in reality, she is pri marily an educator. Conservative statistics show that 95 per cent of the adult population have
S
^Professor of Preventive Dentistry, Colum bia University.
carious teeth. Such teeth are not only potential sources of pain and discomfort, but are also sources of disease, and with every mouthful of food they send into the system a supply of dangerous bac teria. Decayed teeth, moreover, are not able to do the work of biting, chewing, thoroughly masticating and preparing the food for the intestinal tract, and thus they are instrumental in bringing about the digestive troubles with which so many people are afflicted.
Department of Dental Health Education The harm has already been done to the adult; he is in the hands of the den tists, and it is his good luck that dental art is improving so rapidly. The dental profession has made great advances in knowledge and skill during the last few years. Still, they cannot control the sit uation and correct the bad habits already established among both adults and chil dren. Nothing can absolutely replace the original sound tooth. Fillings and the other artificial means of restoring decayed teeth to usefulness are admira ble, but at best they are makeshifts. A profession has been created to take care o f the necessary educational work and to furnish the prophylactic service that helps to prevent tooth decay. Here the dental hygienist enters the field of active service, and oral hygiene is rapidly gaining in favor as a field of professional work peculiarly adapted to women. The only hope of relief from the present situation is to take care of the rising generation, and it is for this service that the profession of oral hygiene has been created, a profession of educators and teachers of mouth hy giene and diet. Their aim is preven tion. They begin by teaching the ex pectant mother how to provide sound teeth for her child as a consequence of her own intelligent dieting. The really important work is with mothers and babies, preschool children and school children. The first five grades are the most important since there the dental hygienist can keep in good condition the deciduous teeth until their period of usefulness is over and the per manent teeth take their place. Big in dustries are taking advantage of this new opportunity for increasing efficiency among employes. Department stores, telephone companies, the Army, the Navy, banks and large social organiza tions are including dental hygienists
731
among their personnel. Within the past eight years, oral hygiene work has de veloped rapidly. Typical of the professional training required is the course at Columbia Uni versity, where a full academic year in the school of oral hygiene equips the dental hygienist for effective work. The professional curriculum is approved by the regents of the State of New York, and students cannot be matriculated until they file with the university evi dence of four years of high school work or its equivalent. This precaution in sures the necessary educational basis for the advanced technical studies that ac company the training in manual dex terity and skill in the handling of in struments. During the winter semester, the dental hygienist is instructed in the following theoretical subjects, calculated to give her an intelligent grasp on the importance of her calling and its rela tion to the work of the dentist: anatomy and physiology, dental anatomy, dental histology, oral hygiene, child and school hygiene, elementary chemistry, dentophysics, oral surgery (assisting), bacte riology and sterilization, pedagogy. And in the latter half of the college year, or second semester, she has courses in nutri tion and dietetics, anatomy and physiol ogy, comparative dental anatomy, dentochemistry, oral pathology, oral prophy laxis and pharmacology. Additional special lectures include roentgenology, occlusion and malocclusion, current den tal literature, nursing ethics, clinical re cording, public service and lay educa tion. Armed with this preparation, and with the technic of oral prophylaxis, the dental hygienist is prepared to render valuable service. The expectant mother needs the dental hygienist; for it is in the prenatal period that the greatest good can be accom plished for the baby’s teeth and for the
732
The Journal of the American Dental Association
mother’s in the prevention of premature decay. At this period, mothers must have lime-producing foods. The kind of food a child receives after its birth is not so important as the kind it receives from the maternal food supply before birth, and it is hoped that a few years o f emphatic dietary education will make mothers understand that children do not “ inherit” soft teeth from their parents, but that poorly developed teeth may be traced to improper diet during the pre natal period and infancy. For this reason, not only is the dental hygienist’s mission fulfilled through friendly counsel while the patient is in the dentist’s chair, having the teeth cleaned, but also through lectures, lan tern slides, motion pictures, toothbrush drills, poster exhibits, and dental litera ture is the message broadcast. The habits of the child, such as thumb suck ing, use of pacifiers, mouth breathing, etc., which cause malocclusion; the care of the child’s deciduous teeth, and the importance of the first permanent molar are a few of the many things mentioned in her talks. Not so many years ago, we accepted a great many things as necessary evils that we now know to be preventable. The deciduous teeth, for instance, used to be regarded as of no consequence. They were allowed to decay and the child’s mouth was allowed to continue in a far from healthy condition. The result was that the soft bones of the child’s mouth were malformed, and when the perma nent teeth came, there was not room for them, and they were pushed out of line and rendered almost useless for biting and chewing. This condition can be avoided by caring for the deciduous teeth as conscientiously as the permanent teeth must be cared for later. The dental hygienist calls attention to the value of the coarse foods, which
strengthen the jaws and exercise both gums and teeth, shaping them to do their work effectively while they are still soft. She tells mothers and children that the foods that contain their natural minerals are best because they are prepared by Nature for easy assimilation. Among the lime-bearing foods that children need is milk, and they are taught to use a sufficiency of this growth-promot ing food. These are some of the points on which the dental hygienist is trained to educate the people. If these points are neglected, the child’s health is impaired before it has a start. If the child is in a school where den tal hygienists attend regularly to the cleaning of the teeth, he is sent to the dental clinic or to his own dentist at the first suspicion of decay, and thus the first permanent molar and many of the deciduous teeth are saved. Give us the children of the first five grades in all the schools! That is the plea of the experts, who realize the importance of oral hy giene. In this first five years of public school life, the dental hygienists can establish in the children habits of mouth hygiene and also give the regular pro phylactic treatment necessary to keep the first teeth from decaying. Eternal vigilance is necessary to keep down the bacterial plaque, so-called, without which no tooth can decay. This plaque is a thin glue-like accumulation or deposit which is soft, slimy, and very adhesive. The dental hygienist is trained to polish it away, for it is almost impossible to remove it with a tooth brush. What has been done for the chil dren of the Bridgeport public schools can be done elsewhere. More and more schools are being founded, and more dental hygienists are being trained each year, but so far, the demand for their services far exceeds the supply of gradu ates ready to carry on the work.