Sunday, 10 July 2011

Bad breath in the workplace

Fresh Breath for the Workplace

Being physically near to someone in the workplace can have certain consequences.
For instance, offensive mouth odour (halitosis) cannot be contained and may be extremely offensive to spouses, friends, acquaintances and, or co-workers.
Society uses odours as a means to define and interact with the world. The intimate emotionally charged nature of the olfactory/smelling experience ensures that value coded odours such as bad breath are interiorized by people in a deeply personal way. Thus bad breath odour becomes a very public issue in the workplace. Like it or not smells and odours affect us physically, psychologically and socially.
Unfortunately, individuals are unaware of their own odour as it cannot  be smelled by oneself. The  sinister thing about bad breath is that  the odour can be most repulsive and
cause distress to people nearby.
Since smells and odours have such a high ability to produce emotional responses, defense tactics such as negative body language may be used  around people with bad breath. These  defensive behaviours can erode an individual’s self image. Thus breath odour can have devastating social and employment consequences.  It is a difficult but important issue to approach with co-workers. Sometimes breath odour indicates an untreated systemic medical condition.

Sociology Oral health behaviors & dental hygienists

Gallagher and Moody wrote an article in 1981 Dentists and the Oral Health Behavior of Patients: A Sociological Perspective. They state:
Dentistry has long had an interest in the prevention of oral pathology, but without remarkable effect and without widespread professional consensus as to how this interest is to be implemented. [i]
Dentistry  developed in the mid to late 1800s. Dentistry arose out of the public health movement. Adams (2000)[ii] tells us that in Canada the public health movement centered around the belief that there was direct connection between physical health, cleanliness and morality. Dentists were very active in these movements and they worked to improve the health, cleanliness and morality. Nettleton’s (1992) genealogical study looks at the relations between dental power and the establishment of dental knowledge.[iii]  In her text Nettleton examines the circumstances, techniques, and events such as regular 2x daily tooth brushing, professional cleaning, that led to the mouth and the teeth becoming the focus of a distinct discipline called dentistry. She demonstrates how in Britain, the dental profession established its object,- teeth subject to decay, by allying itself with public health. Public health helped dentistry justify the need for monitoring children’s mouths to ensure the prevention of infectious disease.
Dental hygiene was created in the early 1900s as ‘dentistry’s agent’ to provide education and ‘mouth keeping’ to ensure the prevention of decaying teeth and infectious disease. “ Dental hygienists it was suggested, could work either in schools or dental offices, performing the unremunerative  but important public health and preventive dental work, for a fraction of the cost and with little training” (Adams 2000)[iv] Dentistry was more interested in extracting and  filling teeth than teaching children or treating gums. So dentistry assigned the ‘mouthkeeping’ tasks to the female dental hygienists.

In a 1981 article Gallagher and Moody state that: “Many dentists delegate most of their prophylactic and preventive work to dental hygienists and assistants” They pose several questions for researchers. ‘Does the dentist’s role become diluted if he delegates to paradental personnel those preventive functions where his own influence and prestige might be most effective?’ And 'Who can best influence the patient’s oral behavior in the long run?'[v]

Dentistry became an official profession in Canada in 1867. Society gave to dentistry the authority and professional autonomy to be the dominant profession in oral health care delivery. Dentistry views itself, as does much of society, as the profession that has control over professional oral care, the restoration and   maintenance of the teeth and tissues in the mouth.  Dentistry possesses power as expressed in the social organization of oral health care delivery, power they worked hard to establish.
 The mouth, and the practices that surround the mouth, are   ordinarily mundane and academically unexplored areas. However, the oral cavity provides an opportunity for sociologists to examine multiple processes.  These various processes create the conditions for the possibility of reorganization of oral health care delivery.  As networks of professions, consumers, bureaucrats, and politicians oscillate between the curative, medical treatment model and the preventive wellness model of health, new knowledge of oral health should emerge.  
Dental hygienists have been part of oral care delivery for more than 50 years in Canada. Primary prevention seeks to maintain a healthy mouth and functional dentition, a healthy mouth for healthy living.  Dental hygiene was created to meet these needs, to encourage primarily young children to adopt and maintain healthy behaviors.
Dental hygiene appears to be occupationally stabilized in 2011.  Dental hygiene is self regulating in most of Canada, and self initiating in many provinces. Dental hygienists are recognized by many as the professional who provides consistent preventive care and education in healthy behaviors.
Now that the profession is ‘stabilized’ do dental hygienists improve the oral health behaviors of patients/clients? 
Examine the social landscape of oral health care, beyond the confines of the dental hygiene cubicle in the dental office to take a different perspective of the world of dentistry, oral care, and evolution of dental hygiene. The mouth, and its multiple processes often taken for granted, considered  mundane topics provide opportunities for sociology researchers.
L McKeown July 2011          

[i] Gallagher, E. B.  Moody, P.M. (1981) Dentists and the Oral Health Behavior of Patients: A Sociological Perspective
Journal of Behavioral Medicine  4(3) 283-295.
[ii] Adams, T. L (2000) A Dentist and a Gentleman Toronto University Toronto Press p90
[iii] Nettleton, Sarah (1992) Power, Pain and Dentistry.  Great Britain: St. Edmunsbury Press.  p123-4  
[iv] Adams, T. L (2000) A Dentist and a Gentleman Toronto: University Toronto Press p.122
[v] Gallagher & Moody (1981)p295

Friday, 1 July 2011

Dental Hygiene education

Following are some thoughts about dental hygiene gaining degree education. It is important that dental hygienists are able to obtain a degree, not as a matter of  a ‘credential’ to carry out the role of dental hygiene. A degree will not improve opportunities for employment or financial gain for dental hygienists in dental private practice. Additional knowledge  gained from a degree program will benefit dental hygienists.
The problem as I see it now is, if  dental hygiene college graduates   become dissatisfied in private dental practices (dentists the primary employer) dental hygienists do not have the credentials to easily change jobs.
I believe it is important to have the ability to complete a degree though/after the present dental hygiene diploma programs.
Recently, I have seen and heard the term, ‘creeping credentialism’. ( Physiotherapy  and respiratory  therapy now require an MA for entrance to practice.) DH has been caught in this entry to practice issue as several Universities were about  to implement  degree programs.
I  wondered what ‘creeping credentialism’ meant although I did not give it much thought  until I began to read  Jane Jacobs  book  In Dark Age Ahead   chapter 3, titled ‘credentialing versus educating’  Jacobs speaks to  credentialing and education.
“Credentialing, not educating , has become the primary business of education of North American universities.” .. “the credential is … a passport to a consideration for a job.”
Today, young people recognize that post secondary education is a key to a good job.
Her words provoked my thought.
From her comments I don’t think DH fits in the category of ’credential’ rather we are presently in the ‘training’ category. Credential as I understand it now, refers to a degree. It seems to me that we are encouraging DHs to obtain a degree so dental hygienists have a greater understanding of social issues, a broader general knowledge than they can gain in the present diploma structure. With increased knowledge dental hygienists can provide oral health care in areas of society beyond the private dental practice. If  dental hygienists are dissatisfied with private practice they have a means to move to another career without having to start all over again.
The degree is not going to increase DHs ability to obtain jobs in private practice. Most dental practices won’t pay for the university ‘credential’. However without a degree in CA society today the majority of DHs are ‘dead ended’
On the dismal side of things perhaps the students won’t get an ‘education’ in a degree program. Another note of Jacobs:
Expansion of first rate faculty … has not kept pace with expansion of enrollments and courses offered; professors lack the time and energy they could once devote to personal contact with students. … so many papers to mark, relative to numbers and qualities of mentors to mark them, changed the nature of the test papers. Some came to  consist of True or False? and  which of the following is correct?” types of questions, fit for robots to answer and to rate rather than stimulants and assessments of critical thinking and depth of understanding…
Ever the idealist, I still believe that a student does gain a broader range of knowledge in a general degree program, despite Jacob’s comments.
Perhaps DHEC and CDHA can be influential at the Federal level to release the ‘hold’ on dental hygiene degree programs, and to encourage more degree completion linkages.  Dental hygienists with  a degree, the ‘credential’ will have more ‘knowledge’ about various social issues, and  hopefully more respect as oral health care providers. In my opinion oral health providers need greater visibility throughout society if the health of the mouth is to be taken seriously.