tag:blogger.com,1999:blog-32878833206512487702024-02-20T03:19:49.347-08:00L. Lynda McKeownL Lynda McKeownhttp://www.blogger.com/profile/11983607867026839508noreply@blogger.comBlogger10125tag:blogger.com,1999:blog-3287883320651248770.post-76895470723140011672020-04-16T09:26:00.001-07:002020-04-16T09:26:26.990-07:00Mary Otto's book TEETH <span style="font-family: Calibri, sans-serif; font-size: 26pt;">Mary Otto Teeth</span><br />
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<span style="color: #666666; font-family: Arial, sans-serif; font-size: 26pt;">For those of us who lived through the fight for dental hygiene self regulation Chpt 7 'Adventurers& Auxiliaries' in Mary Otto's book stirs memories-not all good. <o:p></o:p></span></div>
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<span style="color: #666666; font-family: Arial, sans-serif; font-size: 26pt;">For those of you who did not, it may be a 'wake up' call about the importance of prevention, and need for dental hygiene to teach and provide therapies. Diet (refined sugars and CHOs) and Dirt (harmful bacteria) cause most dental disease-preventable. Yet dental hygiene struggles to transfer knowledge. Too often dental hygiene is handmaiden in the dental practice, directed by insurance codes, and /or need to sell dentistry. The art of dental hygiene--working with clients to change to healthy behaviours is lost. Fone's initial vision of dental hygiene bringing knowledge and skills for oral health by educating children in community has 'fallen by the wayside' <o:p></o:p></span></div>
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<a href="https://www.goodreads.com/author/show/15515379.Mary_Otto"><span style="color: #600090; font-family: Arial, sans-serif; font-size: 26pt;">Mary Otto (Author of Teeth) - Goodreads</span></a><span style="color: #666666; font-family: Arial, sans-serif; font-size: 26pt;"><o:p></o:p></span></div>
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<span style="color: #006d21; font-family: Arial, sans-serif; font-size: 26pt;">https://</span><a href="http://www.goodreads.com/"><span style="color: blue; font-family: Arial, sans-serif; font-size: 26pt;">www.goodreads.com</span></a><span style="color: #006d21; font-family: Arial, sans-serif; font-size: 26pt;">/author/show/15515379.Mary_Otto</span><span style="color: #767676; font-family: Arial, sans-serif; font-size: 26pt;"><o:p></o:p></span></div>
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<span style="background-color: white; background-position: initial initial; background-repeat: initial initial; color: #666666; font-family: Arial, sans-serif; font-size: 26pt;">Mary Otto. “The teeth are made from stern stuff. They can withstand floods, fires, even centuries in the grave. But the teeth are no match for the slow-motion catastrophe that is a life of poverty: its burdens, distractions, diseases, privations, low expectations, transience, the addictive antidotes that offer temporary relief at usurious rates</span></div>
L Lynda McKeownhttp://www.blogger.com/profile/11983607867026839508noreply@blogger.com0tag:blogger.com,1999:blog-3287883320651248770.post-21224007085755645062020-04-16T09:19:00.002-07:002020-04-16T09:19:20.421-07:00This was posted recently on IP CDHA site April 2020. Worth keeping and worth sharing<br />
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<span style="color: #333333; font-family: Arial, sans-serif; font-size: 15pt;">Dezarae Aldridge-Earl, RDH </span><o:p></o:p></div>
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<span style="color: #333333; font-family: Arial, sans-serif; font-size: 15pt;">Did March 2020 and COVID-19 turn your world upside down? Likely, your answer is yes, especially if you are an Independent Dental Hygienist and small business owner here in Canada. Your business is closed, you're not seeing your clients and you still have clinic rent, hydro, heat, business loans and so much more to cover every month you are closed. With so much uncertainty and fear in the air, it's very easy to fall into a negative downward spiral. <span class="apple-converted-space"> </span><o:p></o:p></span></div>
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<span style="color: #333333; font-family: Arial, sans-serif; font-size: 15pt;">As an Independent Dental Hygienist and owner of a stand alone dental hygiene clinic in Huntsville, ON, named, "Dental Hygiene with Dezarae", I have my own worries for the future of my practice and personal finances. I know whatever the personal costs, I will make my business work, but likely I will be forced to add upwards of thirty thousand dollars of debt to stay afloat. <span class="apple-converted-space"> </span><o:p></o:p></span></div>
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<span style="color: #333333; font-family: Arial, sans-serif; font-size: 15pt;"> Throughout my 18 years spent in dentistry, I can say this truly is such an extraordinary event we are all going through. Never in my career have we ever NOT had the answers like we do today. There is no person on the other end of a phone call, that can answer our questions regarding COVID-19. The answer is simply, we need time. How much time? We do not know. <span class="apple-converted-space"> </span><o:p></o:p></span></div>
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<span style="color: #333333; font-family: Arial, sans-serif; font-size: 15pt;">Personally, I believe my business experiences that occurred in the spring of 2019, have somewhat prepared me for the current season that we now find ourselves in. Last spring on April 22, 2019 my entire dental clinic flooded. My entire town was in a state of emergency and for 8 days, I waited for the flood waters to recede from my clinic, to begin the restoration and get back to seeing clients. There is no question that COVID-19 will keep our businesses CLOSED for much longer than the 5 weeks I was closed last year, due to flooding. <span class="apple-converted-space"> </span><o:p></o:p></span></div>
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<span style="color: #333333; font-family: Arial, sans-serif; font-size: 15pt;"> What last year's flood taught me was that there will most certainly be hard seasons to get through. Hard seasons both personally and professionally. We are ALL in this hard season together right now. Currently the season is "winter", and eventually "spring" will come and this too will end. If we can all find a way to get through this "winter" season with a growth mindset our "spring" will bring more joy, abundance and beauty. I believe we have been given this gift of time to reflect on our core values and priorities in life. This will be different for each of us. For some it might be simply more rest for your body, for others, more time with your loved ones, or improving your personal health and wellness. For me, it's all the above. As a small business owner, I've neglected my own personal health for the past three years. While I've spent extreme attention to all the details of my business, for three years, I've neglected myself. For the past month, I've been able to give myself the time to eat three meals a day, have the time to exercise and spend more time with my kids. I know that might sound silly to some, but all the solo DH business owners out there know exactly what I'm talking about. Understand that for every hour spent clinically, there is at least another hour spent to complete chart notes, sterilization, check clients out, book appointments, check phone messages, marketing, bookkeeping, order supplies, education and the list goes on and on. <span class="apple-converted-space"> </span><o:p></o:p></span></div>
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<span style="color: #333333; font-family: Arial, sans-serif; font-size: 15pt;"> I worry for the future of our profession and the future of fellow dental hygiene business owners throughout Canada. Most certainly the future of our profession will look different with changes to PPE and how some of our clients may question their safety of receiving care from us due to aerosol risks. <span class="apple-converted-space"> </span><o:p></o:p></span></div>
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<span style="color: #333333; font-family: Arial, sans-serif; font-size: 15pt;"> I'm sure there will be some hygienists that will decide now is the time for personal change. Some will retire, and some will not return. Some dental hygiene clinics financially will not be able to continue in the future. With no revenues for months and thousands being owed in back rent and thousands more needed to make necessary infection control changes within our clinic walls, it will be a struggle for some. I hope that there will be changes made to allow dental hygienists to "qualify" for the much needed small business loans recently made available by the government. Independent Hygienists will need the help moving forward. <span class="apple-converted-space"> </span><o:p></o:p></span></div>
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<span style="color: #333333; font-family: Arial, sans-serif; font-size: 15pt;">However, before any of these types of decisions are made, I challenge you. I challenge you to look further now. Standing before each of us are opportunities. It is up to us to see these opportunities. If we let fear override our thoughts, you will never see your full potential and you will be consumed with negativity. Instead, you will be stuck in scarcity and survival mode. We must open our hearts and stay within a positive mindset to be open to new opportunities. Allow yourself to hear what your heart might be calling. And if you're listening, you may just change the world. I was once told that "when one door closes, another door opens." This just may be the time, another door is about to open for you with new opportunities ahead. Use meditation, gratitude, exercise and journaling to stay positive every day.<span class="apple-converted-space"> </span><o:p></o:p></span></div>
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<span style="color: #333333; font-family: Arial, sans-serif; font-size: 15pt;"> Perhaps now, may be the perfect time to plan your future to practice DH independently. Work on writing a business plan to start your own business in the future, so YOU can be in control of your time and schedule. Create more time for your loved ones and family. <span class="apple-converted-space"> </span><o:p></o:p></span></div>
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<span style="color: #333333; font-family: Arial, sans-serif; font-size: 15pt;"> Or maybe your body is getting tired and it's time to pivot and learn new skills. Dental Hygienists make great health coaches and myofunctional therapists. How about learning orofacial myofunctional therapy and taking a course, so you can offer therapy via ZOOM or Skype through videohealth. We can also increase our community presence by offering more value to our communities and clients by creating online learning through Facebook Lives or Groups, ZOOM meetings, and challenges. Focusing on topics such as "how to" maintain proper oral health, through nutrition, pH levels of foods and drinks we consume, pregnancy, post cancer treatment care, the importance of airway health, and all other oral systemic health topics. <span class="apple-converted-space"> </span><o:p></o:p></span></div>
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<span style="color: #333333; font-family: Arial, sans-serif; font-size: 15pt;"> We may not be able to clean teeth right now, but we CAN still help create the strong foundations for successful and improved overall health and wellness. We can accomplish this by encouraging and teaching kids how to stop sucking their thumb or what a daily healthy diet may look like. <span class="apple-converted-space"> </span><o:p></o:p></span></div>
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<span style="color: #333333; font-family: Arial, sans-serif; font-size: 15pt;"> I believe the profession of Dental Hygiene can be brighter than ever, as we navigate our way through these dark waters. Together we can RISE UP and be a voice for the future of a healthier nation. The opportunity is now to create tremendous value in our communities and build strong, loyal, relationships with clients. The type of relationships that will grow your business through this storm. Then later on, when we finally get to "summer" and "fall" we will reap the rewards from our harvest. Grow through the seasons and be stronger for it.<span class="apple-converted-space"> </span><o:p></o:p></span></div>
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<span style="color: #333333; font-family: Arial, sans-serif; font-size: 15pt;"> I'm grateful for this stillness of time and the opportunity to create a new revised vision for my business and the successes I plan for the future ahead. I've had the opportunity to connect with other Independent Dental Hygiene practice owners throughout the past month. I've felt more connected as a community, as we navigate our way through all of this together. <span class="apple-converted-space"> </span><o:p></o:p></span></div>
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<span style="color: #333333; font-family: Arial, sans-serif; font-size: 15pt;"> I hope you will join me in your own opportunity for growth and development in these challenging and uncertain times and look towards the brighter days ahead. <span class="apple-converted-space"> </span><o:p></o:p></span></div>
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<span style="color: #333333; font-family: Arial, sans-serif; font-size: 15pt;">Together we are #RDHSTRONG. <span class="apple-converted-space"> </span><o:p></o:p></span></div>
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<span style="color: #333333; font-family: Arial, sans-serif; font-size: 15pt;"> Love & Gratitude<br />Dezarae Aldridge-Earl, RDH<o:p></o:p></span></div>
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<span style="color: #333333; font-family: Arial, sans-serif; font-size: 15pt;">CEO of Dental Hygiene with Dezarae<o:p></o:p></span></div>
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<span style="color: #333333; font-family: Arial, sans-serif; font-size: 15pt;">Follow on Instagram @dezaraerdh<o:p></o:p></span></div>
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L Lynda McKeownhttp://www.blogger.com/profile/11983607867026839508noreply@blogger.com0tag:blogger.com,1999:blog-3287883320651248770.post-12048437735411224632019-11-04T05:01:00.003-08:002019-11-04T05:01:54.184-08:00<h2 style="background-color: white; border-collapse: collapse; border-spacing: 0px; border: 0px; caret-color: rgb(102, 102, 102); color: #666666; font-family: system-ui, sans-serif; font-size: 20px; font-stretch: normal; font-weight: normal; line-height: 24px; list-style: none; margin: 0px; padding: 0px;">
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<span lang="EN-US" style="font-size: 16pt;">Controlling Oral Diseases for Residents in Long Term Care Homes <o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 16pt;">L Lynda McKeown RDH, HBA, MA <o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 16pt;">“Simple and cheap public health methods are available to prevent and control oral/dental disease because the causes are known: they are diet and dirt”<a href="applewebdata://F5DB89AD-68B1-45EB-A22D-8052E8CF39CE#_edn1" name="_ednref1" title=""><span class="MsoEndnoteReference" style="vertical-align: super;"><span class="MsoEndnoteReference" style="vertical-align: super;"><span lang="EN-US" style="font-size: 16pt;">[1]</span></span></span></a>.<o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 16pt;">My experiences as a dental hygienist in various roles over many years confirms Sheiham’s comments “diet and dirt” cause oral diseases. This paper addresses the issues of ‘diet and dirt’ for residents in Long Term Care Homes. Individuals move to Long Term Care homes, because they can no longer live on their own. The reasons are usually due to physical and or cognitive deterioration. Thus they need nursing care and personal. At this point in time mouth care is included as part of personal care, as such is provided usually by nursing staff assigning to personal support workers / health care aids.<o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 16pt;"> The issues surrounding the provision of adequate mouth care are complex. I don't admit to having all the answers. Perhaps others with similar experiences will share their successes. The challenges can be overcome. <o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 16pt;">Diets which contain refined carbohydrates and sugars combined with ‘dirt’ harmful bacteria in the mouth cause oral disease. Restoring diseased teeth is expensive. When these treatments are done in a mouth that is not kept clean the restorations fail. Often destruction to the teeth has advanced so far that oral surgery is required. Surgical solutions for residents usually requires hospitalization. General anesthetic can be expensive and put frail residents with complex medical histories at risk.<o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 16pt;"> I see residents on the call of the family, and/or by request of nursing staff. I started in1997. Tom had been a client of mine in private practice. He developed Alzheimer’s disease and could no longer be cared for at home. His wife and his family dentist requested I see him at his long term care residence. Much to their credit they recognized that routine oral care was not a priority for staff. Tom’s cognitive and physical abilities were insufficient for oral self care. And his mouth left to its own defenses would not remain in a healthy state. Much time and money had been invested in a functional dentition and healthy tissue. This was my first experience in a LTC facility as a ‘worker’.<o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 16pt;"> My mother lived in Long Term Care for 4 years but that was more than two decades ago. She had Alzheimer’s and remained at home with help, until she fell and broke her hip. After the surgical repair of her hip . she required ‘nursing’ care and was moved as a resident to the long term care section of the local hospital. I took her for dental and dental hygiene visits, while she could still walk up stairs to the offices. When that was no longer possible and her mobility was by way of wheelchair I took her to a dentist we could access via elevator and wheelchair. I admit I did no personal onsite mouth care for her, the reason was fear, fear of losing my license. At the time-The Royal College Dental Surgeons of Ontario licensed dental hygienists and did not permit dental hygienists to work in the mouth unless supervised and or directed by a dentist physically on site. Fear of being called before RCDSO was a major deterrent It seems so silly now as I reflect. <o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 16pt;">Once I became a ‘worker’ I discovered that residents were not getting proper mouth care. Abundant debris and disease causing plaque adhered to teeth and tissue. In addition evening snacks often consisted of peanut butter sandwiches. Other sticky high carbohydrate, or highly refined sugars were consumed during the day. These are ‘tasty morsels’ for acid forming, decay causing bacteria. <o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 16pt;">People assume that mouth care involves tooth brushing and anybody is capable of the task.. And why wouldn’t they? Most toothbrush and tooth paste commercials show the brush whizzing across the tooth nowhere near where the bacteria are located. But the bacteria don’t adhere to the smooth flat surface of teeth due to the action of the teeth, tongue and saliva. The bacteria hide in fissures and around the gingival margin..<span style="color: blue;"> </span>To clean the mouth effectively a person needs to have cognitive and technical abilities. The oral physiotherapy tools, the various sizes of brushes and floss must be properly adapted into fissures and gingival margins harbouring disease causing bacteria. Sheiham states “it is no surprise that the bacteria is waving at the brush as it goes past.”<a href="applewebdata://F5DB89AD-68B1-45EB-A22D-8052E8CF39CE#_edn2" name="_ednref2" title=""><span class="MsoEndnoteReference" style="vertical-align: super;"><span class="MsoEndnoteReference" style="vertical-align: super;"><span lang="EN-US" style="font-size: 16pt;">[2]</span></span></span></a><o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 16pt;">My goal to put it in ‘nursing jargon’ of ‘wounds’ was to heal the gingival wounds(bleeding gums) and avoid the reoccurrence by removing the irritating ‘debris’. This I achieved by ‘non invasive’ debridement—no sharp ‘picky’ instruments. <o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 16pt;">Harmful plaque/biofilm needs to be removed on a daily basis to disrupt the disease cycle. Scaling/ debridement every 3 months is not the answer to maintain health, from my observation. The disease causing bacteria must be reduced on a regular basis to prevent ‘wounds’ of the gingival tissue and decay of the teeth.<span style="color: #339966;"><o:p></o:p></span></span></div>
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<span style="font-size: 16pt;">Soft foods can be nutritious, although they might not be very enjoyable, but most of the soft highly processed foods are often sticky, high in refined sugar. Supplements such as Ensure are high in sugar content. Highly processed sticky foods can contribute to dental caries and gingival inflammation. Highly processed foods do not require much chewing.<a href="applewebdata://F5DB89AD-68B1-45EB-A22D-8052E8CF39CE#_edn3" name="_ednref3" title=""><span class="MsoEndnoteReference" style="vertical-align: super;"><span class="MsoEndnoteReference" style="vertical-align: super;"><span style="font-size: 16pt;">[3]</span></span></span></a> So the nerve and blood vessels in the teeth get less ‘exercise’.</span><span style="font-size: 16pt;"> <span lang="EN-US">Parkinson’s disease patients are given oral exercises to do daily</span></span><span lang="EN-US" style="color: #00b0f0; font-size: 16pt;">. </span><span lang="EN-US" style="font-size: 16pt;">Individual health in organs in the organism is dependent on biological mechanisms in a dynamic balance. </span><span style="font-size: 16pt;"><o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 16pt;">In the oral cavity, interventions between saliva, diet, oral microflora, tooth surfaces and the oral mucosa support a healthy condition Therefore proper interventions related to oral diseases must include activities at several levels in order to reestablish ecological balance and therefore health.<a href="applewebdata://F5DB89AD-68B1-45EB-A22D-8052E8CF39CE#_edn4" name="_ednref4" title=""><span class="MsoEndnoteReference" style="vertical-align: super;"><span class="MsoEndnoteReference" style="vertical-align: super;"><span lang="EN-US" style="font-size: 16pt;">[4]</span></span></span></a> The human body is remarkably resilient. Our organic systems have an amazing ability to reestablish ecological balance. But the resilience is dependent on the quality of the internal defense mechanisms such as the oral immune system or the ability of odontoblasts to form reparative dentine. The body’s resilience can be stressed by external <b>factors such as foods with refined sugars and carbohydrates</b><span style="color: green;">.</span><a href="applewebdata://F5DB89AD-68B1-45EB-A22D-8052E8CF39CE#_edn5" name="_ednref5" title=""><span class="MsoEndnoteReference" style="vertical-align: super;"><span class="MsoEndnoteReference" style="vertical-align: super;"><span lang="EN-US" style="font-size: 16pt;">[5]</span></span></span></a><o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 16pt;">In LTC residents are given something to eat and drink throughout the day. The pH of the saliva does not get a chance to rebalance, reduce bacteria that cause tooth decay.<o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 16pt;">Of course it is a fact of life that the human organism is not intended to live forever. When a person arrives in a long term care facility they and /or their family is no longer able to look after them at home. As a society I think we are morally responsible to maintain the residents’ health and quality of life, as long as possible. This includes oral health- palliative dental hygiene –clean comfortable. <o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 16pt;"> Factors such as overload of bacteria on teeth and oral tissues may cause stress to a person’s system, resulting in imbalance and the emergence of disease. In some individuals the reaction to bacteria may lead to an excessive host response resulting in a general inflammation response. Plaque/ biofilm -Debris-removal with oral physiotherapy tools continues to be the most effective and reliable way to avoid ‘gingival wounds’ and severe inflammation. Of course the mouth cleaning, to be effective, has to be sufficiently thorough and performed at appropriate intervals.<a href="applewebdata://F5DB89AD-68B1-45EB-A22D-8052E8CF39CE#_edn6" name="_ednref6" title=""><span class="MsoEndnoteReference" style="vertical-align: super;"><span class="MsoEndnoteReference" style="vertical-align: super;"><span lang="EN-US" style="font-size: 16pt;">[6]</span></span></span></a><o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 16pt;">Mouths health can be maintained. Diets can be controlled and the ‘dirt’ harmful bacteria removed. I have learned quite a bit from the residents in the last decade. For instance teeth may fracture at the gingival margin Frequently endodontically treated teeth, non vital teeth with crowns fracture. Bridges may break off but abutment teeth remain functional and pain free with palliative dental hygiene care. <o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 16pt;">Following are some observations from looking in mouths on a weekly basis for more than two decades. From my experience if a mouth is properly cleaned, sanitized and cleaned thoroughly at least once week using antimicrobials and proper oral physiotherapy tools the tissue will be healthy and the dentition functional enough. Not necessarily what we would accept in a private practice clinical setting. <o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 16pt;">Helen’s daughter hired me to do mouth care It was evident the staff was not cleaning the mouth routinely. Although the same amount of plaque /biofilm had accumulated each week the tissue did not bleed, it was not ‘wounded’. I did ‘non invasive ‘treatment each week. This included oral physiotherapy tools; stimulator, Soft small head brush, proxa brushes, and unwaxed floss. Each tool used with an antimicrobial rinse and ‘dip and brush’ method. Periodically every couple of weeks or at least once a month Fluoride was applied on teeth.<o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 16pt;"> Helen’s bridge broke off but she had no pain. Her dentition remained functional until her death.<o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 16pt;">Bill’s brother John took Bill to the dentist’s office for monthly dental hygiene treatment. It became evident that this was insufficient. I was called in to see Bill once a week. John is adamantly opposed to fluoride. I used .2% CHX rinse Perio Plus ‘dip and brush’ with a variety of oral physiotherapy aids for non invasive plaque removal. Bill was ambulatory and able to go with his brother to dentist. Bill had extensive/expensive dental treatment. Almost every tooth was crowned. Bill developed a pocket on buccal 4.6? 5-6 mm kept clean with Curaprox embrasure system used vertically into pocket with .2% CHX rinse to sanitize pocket. John took his brother for consults with dental specialists. Bill had pain with tooth and we thought might have to be extracted. But another example of the body’s resilience and dental hygienist sanitizing mouth. The problem resolved. <o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 16pt;"> </span><b><i><span lang="EN-US" style="font-size: 16pt;"> </span></i></b><a href="https://www.blogger.com/null" name="OLE_LINK4"></a><a href="https://www.blogger.com/null" name="OLE_LINK3"></a><a href="https://www.blogger.com/null" name="OLE_LINK2"></a><a href="https://www.blogger.com/null" name="OLE_LINK1"><span lang="EN-US" style="font-size: 16pt;">IMPORTANCE OF GOOD ORAL CARE:<br />Digestion starts in the mouth. Research indicates that a clean mouth prevents aspiration pneumonia, gum disease, and helps prevent heart disease and Diabetes.<o:p></o:p></span></a></div>
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<span lang="EN-US" style="font-size: 16pt;"> Salivary flow is reduced by some medications and medical treatments. Reduced saliva flow results in less natural washing away of oral bacteria. Thus it is important that oral bacterial plaque and biofilm be removed daily with various oral physiotherapy aids. Oral health maintenance requires both physical and cognitive ability. Many people who develop physical and or mental disabilities need help with this ‘cleaning’ activity</span><b><i><span lang="EN-US" style="font-size: 16pt;">.</span></i></b><span lang="EN-US" style="font-size: 16pt;"><o:p></o:p></span></div>
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<a href="applewebdata://F5DB89AD-68B1-45EB-A22D-8052E8CF39CE#_ednref1" name="_edn1" title=""></a><span lang="EN-US">References<o:p></o:p></span></div>
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<span class="MsoEndnoteReference" style="vertical-align: super;"><span lang="EN-US"><span class="MsoEndnoteReference" style="vertical-align: super;"><span lang="EN-US" style="font-size: 12pt;">[1]</span></span></span></span><span lang="EN-US"> Sheiham A. Assessment of Role of Western Dentistry in the Oral Health Alliance Promoting Oral Health in Deprived Communities International Seminars 1991 and 1992<span style="color: blue;"> </span>Mautsch W and Sheiham A., editors Berlin, German foundation for international development, 1995; pp120, 132<o:p></o:p></span></div>
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<a href="applewebdata://F5DB89AD-68B1-45EB-A22D-8052E8CF39CE#_ednref2" name="_edn2" title=""><span class="MsoEndnoteReference" style="vertical-align: super;"><span lang="EN-US" style="font-size: 12pt;"><span class="MsoEndnoteReference" style="vertical-align: super;"><span lang="EN-US" style="font-size: 12pt;">[2]</span></span></span></span></a><span lang="EN-US" style="font-size: 12pt;"> Ibid p129<o:p></o:p></span></div>
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<span class="MsoEndnoteReference" style="vertical-align: super;"><span lang="EN-US">3</span></span><span lang="EN-US"> </span>Lingstrom P, van Houte J,Kashket S. Food starches and dental caries. <i>Crit Rev Oral Biol Med.2000;11(3):366-80 <o:p></o:p></i></div>
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<span lang="EN-US" style="font-size: 12pt;">4 Ericksen, H. M., Dimitro V., Rohlin et al The oral ecosystem: implications for education European Journal of dental education 200;10:.192-196<o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 12pt;">5 Ibid.<o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 12pt;">6 B.Soder IJDH 4 (suppl.1), 2006;22-25<o:p></o:p></span></div>
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L Lynda McKeownhttp://www.blogger.com/profile/11983607867026839508noreply@blogger.com0tag:blogger.com,1999:blog-3287883320651248770.post-83741880735027422022016-08-18T09:39:00.000-07:002016-08-18T09:39:18.142-07:00<div align="center" class="MsoNormal" style="line-height: normal; text-align: center;">
<i style="mso-bidi-font-style: normal;"><span lang="EN-US" style="font-size: 12.0pt;">PHILOSOPHIC PONDERING</span></i></div>
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<i style="mso-bidi-font-style: normal;"><span lang="EN-US" style="font-size: 12.0pt;">We
shall not cease from exploration<o:p></o:p></span></i></div>
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<i style="mso-bidi-font-style: normal;"><span lang="EN-US" style="font-size: 12.0pt;">And
the end of all our exploring<o:p></o:p></span></i></div>
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<i style="mso-bidi-font-style: normal;"><span lang="EN-US" style="font-size: 12.0pt;">Will
be to arrive where we started<o:p></o:p></span></i></div>
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<i style="mso-bidi-font-style: normal;"><span lang="EN-US" style="font-size: 12.0pt;">And
know the place for the first time<a href="https://www.blogger.com/blogger.g?blogID=3287883320651248770#_edn1" name="_ednref1" style="mso-endnote-id: edn1;" title=""><span class="MsoEndnoteReference"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoEndnoteReference"><b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="font-family: Calibri; font-size: 12.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: "Times New Roman"; mso-bidi-language: AR-SA; mso-bidi-theme-font: minor-bidi; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">[i]</span></b></span><!--[endif]--></span></span></a><o:p></o:p></span></i></div>
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<span lang="EN-US" style="font-size: 12.0pt; line-height: 150%;">Philosophy and a curious mind was a legacy from my
grandfather. Recently I read a book by Rebecca Goldstein “<i style="mso-bidi-font-style: normal;">36 Arguments for the Existence of God, a work of fiction” </i>In her
appendix<span style="mso-spacerun: yes;"> </span>Argument 36 The argument from
the Intelligibility of the Universe ( Spinoza’s God) <o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 12.0pt; line-height: 150%;">My grandfather was old, in his late 80s when I was a
teen. He spewed out words of Spinoza, and Greek philosophers. In Grade XIII I
wrote an essay for Peggy Fulton’s English class on Spinoza “ A Great
Philosopher”. I still have the hand written paper. I see it is pretty much
plagiarized. At any rate the essence of Spinoza’s thought is that the universe
is perfectly lawful and necessary, worthy of our awe,<span style="mso-spacerun: yes;"> </span>provides all the answers about itself- is
God, neither transcendent nor transcendental. Seeds <span style="mso-spacerun: yes;"> </span>were planted in my mind, and later germinated
as I studied philosophy with Frank Doan at Lakehead University. It seems <span style="mso-spacerun: yes;"> </span>odd that 50 years after my <span style="mso-spacerun: yes;"> </span>grandpa’s death<span style="mso-spacerun: yes;"> </span>I should come upon a novel with Spinoza’s
philosophy, as its theme.<o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 12.0pt; line-height: 150%;">Goldstein’s novel led me to another of her books
Betraying Spinoza. She tells the reader that Spinoza<span style="mso-spacerun: yes;"> </span>received <span style="mso-spacerun: yes;"> </span>a vehemence letter from a student, who turned
aside from his teacher’s thought, and told him why, in <span style="mso-spacerun: yes;"> </span>terms. <span style="mso-spacerun: yes;"> </span>Spinoza was<span style="mso-spacerun: yes;">
</span>dying of tuberculosis but he gathered enough strength to respond
(December 1675):<o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 12.0pt;">”the first and foremost rule to remember is that we
have no control over anything other than the progress of our own understanding.
And the second rule is to care only about that which we have control. We don’t
have control over others’ understanding no matter how hard we try to help them
advance.”<a href="https://www.blogger.com/blogger.g?blogID=3287883320651248770#_edn2" name="_ednref2" style="mso-endnote-id: edn2;" title=""><span class="MsoEndnoteReference"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoEndnoteReference"><span lang="EN-US" style="font-family: Calibri; font-size: 12.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: "Times New Roman"; mso-bidi-language: AR-SA; mso-bidi-theme-font: minor-bidi; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">[ii]</span></span><!--[endif]--></span></span></a><o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 12.0pt; line-height: 150%;">Spinoza was unable to keep the student ‘Albert Burgh
from descending into narrow minded confusion. <o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 12.0pt; line-height: 150%;">As teachers we have to keep<span style="mso-spacerun: yes;"> </span>in mind that the power to pursue knowledge,
understanding. and truth remains with the student. We can do what we can. We
can encourage and set examples. But we cannot learn for the student. This
desire to make the effort to seek knowledge, and understanding <span style="mso-spacerun: yes;"> </span>lies with the students themselves. Students <span style="mso-spacerun: yes;"> </span>must learn to set aside <span style="mso-spacerun: yes;"> </span>superstitions and false beliefs. </span><span lang="EN-US" style="mso-ascii-font-family: Calibri; mso-bidi-font-family: Arial; mso-hansi-font-family: Calibri;">According to Spinoza<a href="https://www.blogger.com/blogger.g?blogID=3287883320651248770#_edn3" name="_ednref3" style="mso-endnote-id: edn3;" title=""><span class="MsoEndnoteReference"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoEndnoteReference"><span lang="EN-US" style="font-family: Calibri; font-size: 11.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-bidi-font-family: Arial; mso-bidi-language: AR-SA; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-latin;">[iii]</span></span><!--[endif]--></span></span></a>
“Superstitions as opposed<span style="mso-spacerun: yes;"> </span>to religion
offer us false cures for our finitude. They make us believe that we are more
cosmically important than we are…,”<o:p></o:p></span></div>
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<span lang="EN-US" style="font-size: 12.0pt; line-height: 150%;">To become fully functioning autonomous human beings
learn to make judgments based on reason,<span style="mso-spacerun: yes;">
</span>be objective, balance the facts.<span style="mso-spacerun: yes;"> </span><o:p></o:p></span></div>
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<!--StartFragment-->
<!--EndFragment--><br />
<div style="mso-element: endnote-list;">
<!--[if !supportEndnotes]--><br clear="all" />
<hr align="left" size="1" width="33%" />
<!--[endif]-->
<div id="edn1" style="mso-element: endnote;">
<div class="MsoNormal" style="line-height: normal;">
<a href="https://www.blogger.com/blogger.g?blogID=3287883320651248770#_ednref1" name="_edn1" style="mso-endnote-id: edn1;" title=""><span class="MsoEndnoteReference"><span lang="EN-US"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoEndnoteReference"><span lang="EN-US" style="font-family: Calibri; font-size: 11.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: "Times New Roman"; mso-bidi-language: AR-SA; mso-bidi-theme-font: minor-bidi; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">[i]</span></span><!--[endif]--></span></span></span></a><span lang="EN-US"> </span><span class="MsoEndnoteReference"><i style="mso-bidi-font-style: normal;"><span lang="EN-US" style="font-size: 12.0pt;"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoEndnoteReference"><b style="mso-bidi-font-weight: normal;"><span lang="EN-US" style="font-family: Calibri; font-size: 12.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: "Times New Roman"; mso-bidi-language: AR-SA; mso-bidi-theme-font: minor-bidi; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">[i]</span></b></span><!--[endif]--></span></span></i></span><i style="mso-bidi-font-style: normal;"><span lang="EN-US" style="font-size: 12.0pt;"><span style="mso-spacerun: yes;"> </span></span></i><span lang="EN-US" style="font-size: 10.0pt;">T.S. Eliot Four Quartets Little Gidding<span style="mso-spacerun: yes;">
</span>( p222 Collected Poems 1907-1962<span style="mso-spacerun: yes;">
</span>Faber and Faber 1963)<o:p></o:p></span></div>
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<br /></div>
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<a href="https://www.blogger.com/blogger.g?blogID=3287883320651248770#_ednref2" name="_edn2" style="mso-endnote-id: edn2;" title=""><span class="MsoEndnoteReference"><span lang="EN-US"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoEndnoteReference"><span lang="EN-US" style="font-family: Calibri; font-size: 10.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: "Times New Roman"; mso-bidi-language: AR-SA; mso-bidi-theme-font: minor-bidi; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">[ii]</span></span><!--[endif]--></span></span></span></a><span lang="EN-US"> Rebecca<span style="mso-spacerun: yes;"> </span>Goldstein Betraying
Spinoza Random House (2006) Page169<o:p></o:p></span></div>
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<a href="https://www.blogger.com/blogger.g?blogID=3287883320651248770#_ednref3" name="_edn3" style="mso-endnote-id: edn3;" title=""><span class="MsoEndnoteReference"><span lang="EN-US"><span style="mso-special-character: footnote;"><!--[if !supportFootnotes]--><span class="MsoEndnoteReference"><span lang="EN-US" style="font-family: Calibri; font-size: 10.0pt; line-height: 115%; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: "Times New Roman"; mso-bidi-language: AR-SA; mso-bidi-theme-font: minor-bidi; mso-fareast-font-family: Calibri; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">[iii]</span></span><!--[endif]--></span></span></span></a><span lang="EN-US"> ibid p122<o:p></o:p></span></div>
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L Lynda McKeownhttp://www.blogger.com/profile/11983607867026839508noreply@blogger.com0tag:blogger.com,1999:blog-3287883320651248770.post-20042032351801862352011-07-10T05:24:00.000-07:002011-07-10T05:24:34.952-07:00Bad breath in the workplace<div align="center" class="MsoNormal" style="margin: 0in 0in 0pt; text-align: center;"><b style="mso-bidi-font-weight: normal;"><span style="font-size: 14pt; mso-bidi-font-size: 10.0pt;">Fresh Breath for the Workplace</span></b></div><div align="center" class="MsoNormal" style="margin: 0in 0in 0pt; text-align: center;"><br />
</div><div class="MsoNormal" style="line-height: 200%; margin: 0in 0in 0pt;"><span style="font-size: 12pt; line-height: 200%; mso-bidi-font-size: 10.0pt;">Being physically near to someone in the workplace can have certain consequences.</span></div><div class="MsoNormal" style="line-height: 200%; margin: 0in 0in 0pt;"><span style="font-size: 12pt; line-height: 200%; mso-bidi-font-size: 10.0pt;">For instance, offensive mouth odour (halitosis) cannot be contained and may be extremely offensive to spouses, friends, acquaintances and, or co-workers.</span></div><div class="MsoNormal" style="line-height: 200%; margin: 0in 0in 0pt;"><span style="font-size: 12pt; line-height: 200%; mso-bidi-font-size: 10.0pt;">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.</span></div><div class="MsoNormal" style="line-height: 200%; margin: 0in 0in 0pt;"><span style="font-size: 12pt; line-height: 200%; mso-bidi-font-size: 10.0pt;">Unfortunately, individuals are unaware of their own odour as it cannot<span style="mso-spacerun: yes;"> </span>be smelled by oneself. The<span style="mso-spacerun: yes;"> </span>sinister thing about bad breath is that<span style="mso-spacerun: yes;"> </span>the odour can be most repulsive and </span></div><div class="MsoNormal" style="line-height: 200%; margin: 0in 0in 0pt;"><span style="font-size: 12pt; line-height: 200%; mso-bidi-font-size: 10.0pt;">cause distress to people nearby.</span></div><div class="MsoNormal" style="line-height: 200%; margin: 0in 0in 0pt;"><span style="font-size: 12pt; line-height: 200%; mso-bidi-font-size: 10.0pt;">Since smells and odours have such a high ability to produce emotional responses, defense tactics such as negative body language may be used<span style="mso-spacerun: yes;"> </span>around people with bad breath. These<span style="mso-spacerun: yes;"> </span>defensive behaviours can erode an individual’s self image. Thus breath odour can have devastating social and employment consequences.<span style="mso-spacerun: yes;"> </span>It is a difficult but important issue to approach with co-workers. Sometimes breath odour indicates an untreated systemic medical condition. </span></div><div class="MsoNormal" style="line-height: 200%; margin: 0in 0in 0pt;"><span style="font-size: 12pt; line-height: 200%; mso-bidi-font-size: 10.0pt;">L. McKeown <a href="http://www.oralcare.ca/">http://www.oralcare.ca/</a></span></div><div class="MsoNormal" style="line-height: 200%; margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="line-height: 200%; margin: 0in 0in 0pt;"><br />
</div>L Lynda McKeownhttp://www.blogger.com/profile/11983607867026839508noreply@blogger.com1tag:blogger.com,1999:blog-3287883320651248770.post-9702628639385858472011-07-10T05:20:00.001-07:002011-07-10T05:20:52.251-07:00Sociology Oral health behaviors & dental hygienists<div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="mso-bidi-font-size: 11.0pt;"><span style="font-family: Calibri;">Gallagher and Moody wrote an article in 1981 <i style="mso-bidi-font-style: normal;">Dentists and the Oral Health Behavior of Patients: A Sociological Perspective. </i>They state:</span></span></div><div class="MsoNormal" style="margin: 0in 27pt 10pt 40.5pt;"><span style="mso-bidi-font-size: 11.0pt;"><span style="font-family: Calibri;">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. </span><a href="http://www.blogger.com/post-create.g?blogID=3287883320651248770#_edn1" name="_ednref1" style="mso-endnote-id: edn1;" title=""><span class="MsoEndnoteReference"><span style="mso-special-character: footnote;"><span class="MsoEndnoteReference"><span style="font-family: 'Calibri','sans-serif'; font-size: 11pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-language: AR-SA; mso-bidi-theme-font: minor-bidi; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-fareast; mso-hansi-theme-font: minor-latin;">[i]</span></span></span></span></a></span></div><div class="MsoFooter" style="margin: 0in 0in 0pt;"><span style="font-family: 'Calibri','sans-serif'; font-size: 11pt; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Dentistry<span style="mso-spacerun: yes;"> </span>developed in the mid to late 1800s. Dentistry arose out of the public health movement. Adams (2000)<a href="http://www.blogger.com/post-create.g?blogID=3287883320651248770#_edn2" name="_ednref2" style="mso-endnote-id: edn2;" title=""><span class="MsoEndnoteReference"><span style="mso-special-character: footnote;"><span class="MsoEndnoteReference"><span style="font-family: 'Calibri','sans-serif'; font-size: 11pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-language: AR-SA; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-US; mso-hansi-theme-font: minor-latin;">[ii]</span></span></span></span></a> 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.<a href="http://www.blogger.com/post-create.g?blogID=3287883320651248770#_edn3" name="_ednref3" style="mso-endnote-id: edn3;" title=""><span class="MsoEndnoteReference"><span style="mso-special-character: footnote;"><span class="MsoEndnoteReference"><span style="font-family: 'Calibri','sans-serif'; font-size: 11pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-language: AR-SA; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-US; mso-hansi-theme-font: minor-latin;">[iii]</span></span></span></span></a><span style="mso-spacerun: yes;"> </span>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.</span></div><div class="MsoFooter" style="margin: 0in 0in 0pt;"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Calibri','sans-serif'; font-size: 11pt; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Dental hygiene</span></b><span style="font-family: 'Calibri','sans-serif'; font-size: 11pt; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;"> 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<span style="mso-spacerun: yes;"> </span>but important public health and preventive dental work, for a fraction of the cost and with little training” (Adams 2000)<a href="http://www.blogger.com/post-create.g?blogID=3287883320651248770#_edn4" name="_ednref4" style="mso-endnote-id: edn4;" title=""><span class="MsoEndnoteReference"><span style="mso-special-character: footnote;"><span class="MsoEndnoteReference"><span style="font-family: 'Calibri','sans-serif'; font-size: 11pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-language: AR-SA; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-US; mso-hansi-theme-font: minor-latin;">[iv]</span></span></span></span></a> Dentistry was more interested in extracting and<span style="mso-spacerun: yes;"> </span>filling teeth than teaching children or treating gums. So dentistry assigned the ‘mouthkeeping’ tasks to the female dental hygienists.</span></div><div class="MsoFooter" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoFooter" style="margin: 0in 0in 0pt;"><span style="font-family: 'Calibri','sans-serif'; font-size: 11pt; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">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?'<a href="http://www.blogger.com/post-create.g?blogID=3287883320651248770#_edn5" name="_ednref5" style="mso-endnote-id: edn5;" title=""><span class="MsoEndnoteReference"><span style="mso-special-character: footnote;"><span class="MsoEndnoteReference"><span style="font-family: 'Calibri','sans-serif'; font-size: 11pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-language: AR-SA; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-US; mso-hansi-theme-font: minor-latin;">[v]</span></span></span></span></a></span></div><div class="MsoFooter" style="margin: 0in 0in 0pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="mso-bidi-font-size: 11.0pt;"><span style="font-family: Calibri;">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<span style="mso-spacerun: yes;"> </span>maintenance of the teeth and tissues in the mouth.<span style="mso-spacerun: yes;"> </span>Dentistry possesses power as expressed in the social organization of oral health care delivery, power they worked hard to establish.</span></span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="mso-bidi-font-size: 11.0pt;"><span style="font-family: Calibri;"><span style="mso-spacerun: yes;"> </span>The mouth, and the practices that surround the mouth, are <span style="mso-spacerun: yes;"> </span>ordinarily mundane and academically unexplored areas. However, the oral cavity provides<b style="mso-bidi-font-weight: normal;"> </b>an opportunity for sociologists to examine multiple processes.<span style="mso-spacerun: yes;"> </span>These various processes create the conditions for the possibility of reorganization of oral health care delivery.<span style="mso-spacerun: yes;"> </span>As networks of professions, consumers, bureaucrats, and politicians oscillate between the curative, medical treatment model and the preventive wellness model of health<b style="mso-bidi-font-weight: normal;">, </b>new knowledge<b style="mso-bidi-font-weight: normal;"> </b>of oral health should<b style="mso-bidi-font-weight: normal;"> </b>emerge.<b style="mso-bidi-font-weight: normal;"> </b><span style="mso-spacerun: yes;"> </span></span></span></div><div class="MsoFooter" style="margin: 0in 0in 0pt;"><span style="font-family: 'Calibri','sans-serif'; font-size: 11pt; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">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.<span style="mso-spacerun: yes;"> </span>Dental hygiene was created to meet these needs, to encourage primarily young children to adopt and maintain healthy behaviors. </span></div><div class="MsoFooter" style="margin: 0in 0in 0pt;"><span style="font-family: 'Calibri','sans-serif'; font-size: 11pt; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Dental hygiene appears to be occupationally stabilized in 2011. <span style="mso-spacerun: yes;"> </span>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. </span></div><div class="MsoFooter" style="margin: 0in 0in 0pt;"><span style="font-family: 'Calibri','sans-serif'; font-size: 11pt; mso-ascii-theme-font: minor-latin; mso-hansi-theme-font: minor-latin;">Now that the profession is ‘stabilized’ do dental hygienists improve the oral health behaviors of patients/clients?<span style="mso-spacerun: yes;"> </span></span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="mso-bidi-font-size: 11.0pt;"><span style="font-family: Calibri;">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 <span style="mso-spacerun: yes;"> </span>mundane topics provide opportunities for sociology researchers.</span></span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="mso-bidi-font-size: 11.0pt;"><span style="font-family: Calibri;">L McKeown July 2011<span style="mso-spacerun: yes;"> </span>www.oralcare.ca</span></span></div><div style="mso-element: endnote-list;"><br clear="all" /><span style="font-family: Calibri;"><hr align="left" size="1" width="33%" /></span><div id="edn1" style="mso-element: endnote;"><div class="MsoEndnoteText" style="margin: 0in 0in 0pt;"><a href="http://www.blogger.com/post-create.g?blogID=3287883320651248770#_ednref1" name="_edn1" style="mso-endnote-id: edn1;" title=""><span class="MsoEndnoteReference"><span style="mso-special-character: footnote;"><span class="MsoEndnoteReference"><span style="font-family: 'Calibri','sans-serif'; font-size: 10pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-language: AR-SA; mso-bidi-theme-font: minor-bidi; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-fareast; mso-hansi-theme-font: minor-latin;">[i]</span></span></span></span></a><span style="font-family: Calibri; font-size: x-small;"> Gallagher, E. B.<span style="mso-spacerun: yes;"> </span>Moody, P.M. (1981) Dentists and the Oral Health Behavior of Patients: A Sociological Perspective</span></div><div class="MsoEndnoteText" style="margin: 0in 0in 0pt;"><span style="font-family: Calibri; font-size: x-small;">Journal of Behavioral Medicine<span style="mso-spacerun: yes;"> </span>4(3) 283-295.</span></div></div><div id="edn2" style="mso-element: endnote;"><div class="MsoEndnoteText" style="margin: 0in 0in 0pt;"><a href="http://www.blogger.com/post-create.g?blogID=3287883320651248770#_ednref2" name="_edn2" style="mso-endnote-id: edn2;" title=""><span class="MsoEndnoteReference"><span style="mso-special-character: footnote;"><span class="MsoEndnoteReference"><span style="font-family: 'Calibri','sans-serif'; font-size: 10pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-language: AR-SA; mso-bidi-theme-font: minor-bidi; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-fareast; mso-hansi-theme-font: minor-latin;">[ii]</span></span></span></span></a><span style="font-family: Calibri; font-size: x-small;"> Adams, T. L (2000) <i style="mso-bidi-font-style: normal;">A Dentist and a Gentleman </i>Toronto University Toronto Press<i style="mso-bidi-font-style: normal;"> </i>p90</span></div></div><div id="edn3" style="mso-element: endnote;"><div class="MsoNormal" style="margin: 0in 0in 10pt; tab-stops: dotted -.8in blank -.5in center dotted 0in left blank .5in 1.0in 1.25in 2.0in 2.5in 3.0in 3.5in 4.0in 4.5in 5.0in 5.5in 5.9in 6.5in 7.0in 7.5in 8.0in;"><a href="http://www.blogger.com/post-create.g?blogID=3287883320651248770#_ednref3" name="_edn3" style="mso-endnote-id: edn3;" title=""><span class="MsoEndnoteReference"><span style="mso-special-character: footnote;"><span class="MsoEndnoteReference"><span style="font-family: 'Calibri','sans-serif'; font-size: 11pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-font-size: 10.0pt; mso-bidi-language: AR-SA; mso-bidi-theme-font: minor-bidi; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-fareast; mso-hansi-theme-font: minor-latin;">[iii]</span></span></span></span></a><span style="font-family: Calibri;"> <span style="font-size: 10pt;">Nettleton, Sarah (1992) <i style="mso-bidi-font-style: normal;">Power, Pain and Dentistry.</i><span style="mso-spacerun: yes;"> </span>Great Britain: St. Edmunsbury Press.</span> <span style="mso-spacerun: yes;"> </span><span style="font-size: 10pt;">p123-4 </span><span style="mso-spacerun: yes;"> </span><span style="font-size: 10pt;"></span></span></div></div><div id="edn4" style="mso-element: endnote;"><div class="MsoEndnoteText" style="margin: 0in 0in 0pt;"><a href="http://www.blogger.com/post-create.g?blogID=3287883320651248770#_ednref4" name="_edn4" style="mso-endnote-id: edn4;" title=""><span class="MsoEndnoteReference"><span style="mso-special-character: footnote;"><span class="MsoEndnoteReference"><span style="font-family: 'Calibri','sans-serif'; font-size: 10pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-language: AR-SA; mso-bidi-theme-font: minor-bidi; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-fareast; mso-hansi-theme-font: minor-latin;">[iv]</span></span></span></span></a><span style="font-family: Calibri; font-size: x-small;"> Adams, T. L (2000) <i style="mso-bidi-font-style: normal;">A Dentist and a Gentleman </i>Toronto: University Toronto Press<i style="mso-bidi-font-style: normal;"> </i>p.122</span></div></div><div id="edn5" style="mso-element: endnote;"><div class="MsoEndnoteText" style="margin: 0in 0in 0pt;"><a href="http://www.blogger.com/post-create.g?blogID=3287883320651248770#_ednref5" name="_edn5" style="mso-endnote-id: edn5;" title=""><span class="MsoEndnoteReference"><span style="mso-special-character: footnote;"><span class="MsoEndnoteReference"><span style="font-family: 'Calibri','sans-serif'; font-size: 10pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-language: AR-SA; mso-bidi-theme-font: minor-bidi; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-fareast; mso-hansi-theme-font: minor-latin;">[v]</span></span></span></span></a><span style="font-family: Calibri; font-size: x-small;"> Gallagher & Moody (1981)p295</span></div></div></div>L Lynda McKeownhttp://www.blogger.com/profile/11983607867026839508noreply@blogger.com3tag:blogger.com,1999:blog-3287883320651248770.post-9027345108355624592011-07-01T07:02:00.001-07:002011-07-01T07:02:54.718-07:00Dental Hygiene education<div class="PadderBetweenControlandBody" style="margin: 0in 0in 6pt;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: Calibri;">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<span style="mso-spacerun: yes;"> </span>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<span style="mso-spacerun: yes;"> </span>gained from a degree program will benefit dental hygienists.</span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: Calibri;">The problem as I see it now is, if <span style="mso-spacerun: yes;"> </span>dental hygiene college graduates<span style="mso-spacerun: yes;"> </span><span style="mso-spacerun: yes;"> </span>become dissatisfied in private dental practices (dentists the primary employer) dental hygienists do not have the <b><u>credentials </u></b>to easily change jobs.</span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: Calibri;">I believe it is important to have the ability to complete a degree though/after the present dental hygiene diploma programs.</span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: Calibri;">Recently, I have seen and heard the term, ‘creeping credentialism’. ( Physiotherapy <span style="mso-spacerun: yes;"> </span>and respiratory<span style="mso-spacerun: yes;"> </span>therapy now require an <b><u>MA</u></b> for entrance to practice.) DH has been caught in this entry to practice issue as several Universities were about<span style="mso-spacerun: yes;"> </span>to implement<span style="mso-spacerun: yes;"> </span>degree programs.</span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: Calibri;">I<span style="mso-spacerun: yes;"> </span>wondered what ‘creeping credentialism’ meant although I did not give it much thought<span style="mso-spacerun: yes;"> </span>until I began to read<span style="mso-spacerun: yes;"> </span>Jane Jacobs<span style="mso-spacerun: yes;"> </span>book <span style="mso-spacerun: yes;"> </span>In <i style="mso-bidi-font-style: normal;">Dark Age Ahead</i><u> </u><span style="mso-spacerun: yes;"> </span>chapter 3, titled ‘credentialing versus educating’<span style="mso-spacerun: yes;"> </span>Jacobs speaks to<span style="mso-spacerun: yes;"> </span>credentialing and education.</span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><i><span style="font-family: Calibri;">“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.”</span></i></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><i><span style="font-family: Calibri;">Today, young people recognize that post secondary education is a key to a good job.</span></i></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: Calibri;">Her words provoked my thought.</span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: Calibri;">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<span style="mso-spacerun: yes;"> </span>dental hygienists are dissatisfied with private practice they have a means to move to another career without having to start all over again. </span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: Calibri;">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’</span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: Calibri;">On the dismal side of things perhaps the students won’t get an ‘education’ in a degree program. Another note of Jacobs:</span></div><div class="MsoBodyText" style="margin: 0in 0in 0pt;"><em>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<span style="mso-spacerun: yes;"> </span>consist of True or False? and<span style="mso-spacerun: yes;"> </span>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…</em></div><div class="MsoBodyText" style="margin: 0in 0in 0pt;"><span style="font-style: normal;">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.</span></div><div class="MsoBodyText" style="margin: 0in 0in 0pt;"><span style="font-style: normal;">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.<span style="mso-spacerun: yes;"> </span>Dental hygienists with<span style="mso-spacerun: yes;"> </span>a degree, the ‘credential’ will have more ‘knowledge’ about various social issues, and<span style="mso-spacerun: yes;"> </span>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.</span></div>L Lynda McKeownhttp://www.blogger.com/profile/11983607867026839508noreply@blogger.com0tag:blogger.com,1999:blog-3287883320651248770.post-29309648207514312062011-06-27T04:42:00.000-07:002011-06-27T04:42:38.317-07:00Power Foucault Dental Hygiene<h2 style="margin: auto 0in;"><span style="font-size: 11pt;">Power<span style="mso-spacerun: yes;"> </span></span><span style="font-size: 11pt; font-weight: normal; mso-bidi-font-weight: bold;">All work,including dental hygiene, like social life itself, is a collective. Power as analyzed by Foucault(1980)<span class="MsoEndnoteReference"><span style="mso-special-character: footnote;"><span class="MsoEndnoteReference"><span style="font-family: 'Times New Roman','serif'; font-size: 11pt; line-height: 115%; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-US;">[i]</span></span></span></span> is something that circulates. </span><span style="font-size: 11pt;">Power relations</span><span style="font-size: 11pt; font-weight: normal; mso-bidi-font-weight: bold;"> are rooted in the system of social networks, rather like the capillaries forming a total network in the body or the fine meshes of a living spider web states philosopher Foucault.<span style="mso-spacerun: yes;"> </span>It never resides in any one person or group’s hands.<span style="mso-spacerun: yes;"> </span>His approach<span style="mso-spacerun: yes;"> </span>to power opens up the possibility for applying the sociological imagination and studying the micro-practices surrounding the oral cavity, and dental hygiene a provider of care.<span style="mso-spacerun: yes;"> </span></span></h2><div class="MsoNormal" style="line-height: normal; margin: 0in 0in 10pt;"><span style="font-family: 'Times New Roman','serif';">Power is only power when addressing individuals who are free (autonomous) to choose to act in one way or another.<span style="mso-spacerun: yes;"> </span>Power is exercised with intention.<span style="mso-spacerun: yes;"> </span>Power is actions upon others' actions in order to interfere with them.<span style="mso-spacerun: yes;"> </span>Power presupposes freedom in the sense that power is not enforcement, but ways of making people by themselves behave in other ways than would have done. One way of doing this is by threatening with violence. However, suggesting how happy people will become if they buy an off-roader is an exercise of power as well. Marketing provides<span style="mso-spacerun: yes;"> </span>a large body of knowledge of techniques for how to (try to) produce such behavior.</span></div><h2 style="margin: auto 0in;"><span style="font-size: 11pt; font-weight: normal; mso-bidi-font-weight: bold;">The </span><span style="font-size: 11pt;">ordinarily mundane and academically unexplored area of the oral cavity provides</span><span style="font-size: 11pt; font-weight: normal; mso-bidi-font-weight: bold;"> an opportunity to examine multiple processes.<span style="mso-spacerun: yes;"> </span>These various processes create the conditions for the possibility of reorganization of oral health care delivery.<span style="mso-spacerun: yes;"> </span></span></h2><h2 style="margin: auto 0in;"><span style="font-size: 11pt; font-weight: normal; mso-bidi-font-weight: bold;">Dental hygiene students must meet criteria<span style="mso-spacerun: yes;"> </span>to enter<span style="mso-spacerun: yes;"> </span>dental hygiene programs. She/he must<span style="mso-spacerun: yes;"> </span>pass exams successfully to exit dental hygiene programs. Then, write more exams to qualify for registration/licensure<span style="mso-spacerun: yes;"> </span>to legally practice as a dental hygienist. In Canada the National Dental Hygiene Examing Board examinations and a Jurisprudence exam in Ontario must be completed successfully to be able to gain admittance to a dental hygiene operatory. After payment of fees the<span style="mso-spacerun: yes;"> </span>dental hygienist gains authorization to practice.</span></h2><h2 style="margin: auto 0in;"><span style="font-size: 11pt; font-weight: normal; mso-bidi-font-weight: bold;">Specified objectives are expected to be<span style="mso-spacerun: yes;"> </span>accomplished in effective and efficient ways. Dental hygienists are trained/educated to: gather information about a client’s health and medical history, to examine the mouth and teeth to identify, itemize and quantify plaque/biofilm deposits, <span style="mso-spacerun: yes;"> </span>note areas of bleeding and calculus <span style="mso-spacerun: yes;"> </span>and periodontal pocket depths. Much of this is done with sharp instruments</span></h2><h2 style="margin: auto 0in;"><span style="font-size: 11pt; font-weight: normal; mso-bidi-font-weight: bold;">Through technology of the chair (Nettleton, 1992) the DH controls the client’s posture, back and forth<span style="mso-spacerun: yes;"> </span>and up and down. The strong sometimes blinding light shines in the client’s mouth. The client provides intimate exposure of her/his mouth. The client must be taught lessons, trained<span style="mso-spacerun: yes;"> </span>in proper mouthkeeping. This lesson is not learned at the 1<sup>st</sup> teaching so must be repeated at regular three, four six month intervals. Although the DH has control of the client in the chair, the dentist controls the practice and the employment situation.</span></h2><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: Calibri;">References</span></div><div class="MsoNormal" style="margin: 0in 0in 10pt 1.25in; tab-stops: dotted -.8in blank -.5in center dotted 0in left blank .5in 1.0in 1.25in 2.0in 2.5in 3.0in 3.5in 4.0in 4.5in 5.0in 5.5in 5.9in 6.5in 7.0in 7.5in 8.0in; text-align: justify; text-indent: -1.25in;"><span style="font-family: 'Times New Roman','serif'; font-size: 10pt; line-height: 115%;">Foucault M. (1980) <i style="mso-bidi-font-style: normal;">Power/Knowledge: Selected Interviews and Other Writings.</i><span style="mso-spacerun: yes;"> </span>Ed. <span style="mso-spacerun: yes;"> </span>C. Cordon.<span style="mso-spacerun: yes;"> </span>New York: Pantheon</span></div><div class="MsoNormal" style="margin: 0in 0in 10pt 1.25in; tab-stops: dotted -.8in blank -.5in center dotted 0in left blank .5in 1.0in 1.25in 2.0in 2.5in 3.0in 3.5in 4.0in 4.5in 5.0in 5.5in 5.9in 6.5in 7.0in 7.5in 8.0in; text-align: justify; text-indent: -1.25in;"><span style="font-family: 'Times New Roman','serif'; font-size: 10pt; line-height: 115%;">Nettleton S. (1992) <em>Power Pain and Dentistry</em> Great Britain: St Edmunsbury Press.</span></div><div style="mso-element: endnote-list;"><br clear="all" /><hr align="left" size="1" width="33%" /><div id="edn1" style="mso-element: endnote;"><div class="MsoEndnoteText" style="margin: 0in 0in 0pt;"><br />
</div></div></div>L Lynda McKeownhttp://www.blogger.com/profile/11983607867026839508noreply@blogger.com1tag:blogger.com,1999:blog-3287883320651248770.post-67700387183061410342011-06-24T05:06:00.000-07:002011-06-24T05:24:20.070-07:00What‘s the Mouth got to do with other diseases?<span style="font-family: 'Arial','sans-serif';">The reporter from the local newspaper was interviewing me. He wanted to know more about the<span style="mso-spacerun: yes;"> </span>Breath Odour Clinic. The conversation somehow moved from the topic of treating clients with oral malodor at the<span style="mso-spacerun: yes;"> </span>clinic to bacterial plaque removal for residents in long term care facilities. As I rambled on about lowering the bacterial 'loads' in the mouth to prevent other illnesses Jim, the reporter, interrupted. "What's the mouth got to do with other diseases?" "Various bacteria in the mouth have been found to contribute to other disease in the body," I replied.</span><br />
<span style="font-family: 'Arial','sans-serif';">During our conversation, I had 'introduced' Jim to Prophyromonas Gingivalis, Treponema Denticola and Bacteriodes Forsythus in relation to periodontal disease and chronic bad breath. He was 'mildly' interested. After all, he had a job to do. He had to prepare an article for the health section of the paper. He was being appropriately attentive as I supplied information about testing for breath odor.</span><br />
<span style="font-family: 'Arial','sans-serif';">Then I remembered something on my desk. My sister had e-mailed an article prepared by Christian Millman,<span style="mso-spacerun: yes;"> </span>for a Men's Health section for ABC News. I was able to quote: "Farmers, cowboys and other sensible men always examine a horse's mouth before buying the animal. One good look can sum up the horse's health history and predict how long the old boy will live. A human mouth isn't much different. Keep your pie hole clean so disease causing bacteria don't gain entry to your blood stream."</span><br />
<span style="font-family: 'Arial','sans-serif';">I could tell that I 'caught' his attention. It was my good fortune that another part of the article referred to bacteria we had previously mentioned when we talked about breath odor problems.</span><br />
<span style="font-family: 'Arial','sans-serif';">Dr. Robert J. Genco of the <placetype w:st="on">University</placetype> of <placename w:st="on">Buffalo</placename> studies 1372 people at the Gila River Indian community in <state w:st="on"><place w:st="on">Arizona</place></state>. He found that those with gum disease had triple the risk of heart attacks in a 10-year period. He believes that oral bacteria enter the blood stream through small tears in the gums. The bacteria Genco suggests, may infect the liver and cause it to produce artery clogging proteins, or the bacteria may directly infect the heart arteries and somehow cause blockages. The exact mode of attack is still a mystery, but porphyromonas gingivalis bacteria have been found in fatty arterial blockages that cause heart failure.</span><br />
<span style="font-family: 'Arial','sans-serif';">A further portion of the article related to our discussion about residents in long term care: "With every breath, your lungs suck down a stew of bacteria including chlamydia, pneumonia and pseudommas aeruginosa, two bugs that cause respiratory disease. Our immune systems usually destroy these invaders, but when a person's resistance is low, such as during an illness or after surgery, these bugs can infect our lungs and cause bacterial pneumonia."</span><br />
<span style="font-family: 'Arial','sans-serif';">I explained to Jim that if a person in a long term care facility has a great deal of bacterial accumulation in their mouth, the 'barrier systems' of the mouth may 'break down' resulting in respiratory pneumonia. If a resident has to be moved to an acute care facility for treatment, this is costly to the publicly funded health care system. Therefore, it is cost effective to keep the mouth clean.</span>L Lynda McKeownhttp://www.blogger.com/profile/11983607867026839508noreply@blogger.com0tag:blogger.com,1999:blog-3287883320651248770.post-81677433693882719802011-06-20T07:09:00.000-07:002011-06-20T07:09:57.712-07:00Sociological imagination oral health care<div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: 'Times New Roman','serif';">Adopting a <b>sociological imagination</b> involves questioning our own views and assumptions about the world. A critical sociological imagination is based on an acceptance that some things may contradict and challenge what we believe. Therefore it is important to avoid being biased. Bias can arise when we believe something even when there is no evidence to support our belief. Using the sociological imagination<span style="mso-spacerun: yes;"> </span>provides an opportunity<span style="mso-spacerun: yes;"> </span>to get a fresh view of the world of oral care, the mundane topic of the mouth, teeth and gums, dental hygiene and dentistry, all seldom considered in Sociology</span><span style="font-family: Calibri;">.</span></div><div class="MsoFooter" style="margin: 0in 0in 0pt;">Dentistry<span style="mso-spacerun: yes;"> </span>developed in the mid to late 1800s. It <span style="mso-spacerun: yes;"> </span>arose out of the public health movement. Adams(2000 p90) <a href="http://www.blogger.com/post-create.g?blogID=3287883320651248770#_edn1" name="_ednref1" style="mso-endnote-id: edn1;" title=""><span class="MsoEndnoteReference"><span style="mso-special-character: footnote;"><span class="MsoEndnoteReference"><span style="font-family: 'Times New Roman','serif'; font-size: 12pt; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-US;">[i]</span></span></span></span></a>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 of the public. A<span style="mso-spacerun: yes;"> </span>discourse of the mouth, <span style="mso-spacerun: yes;"> </span>delivery of care and treatment of the mouth, was structured. In the Professions Ideology Change course, in addition to looking at historical development <span style="mso-spacerun: yes;"> </span>of dental hygiene <span style="mso-spacerun: yes;"> </span>we can consider the genealogical study,<span style="mso-spacerun: yes;"> </span>the relations between dental power and the establishment of dental knowledge. Nettleton (1992 p124) <span style="mso-spacerun: yes;"> </span><a href="http://www.blogger.com/post-create.g?blogID=3287883320651248770#_edn2" name="_ednref2" style="mso-endnote-id: edn2;" title=""><span class="MsoEndnoteReference"><span style="mso-special-character: footnote;"><span class="MsoEndnoteReference"><span style="font-family: 'Times New Roman','serif'; font-size: 12pt; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-US;">[ii]</span></span></span></span></a> <span style="mso-spacerun: yes;"> </span>In her text Nettleton examines the circumstances, the small things, events and techniques such as regular 2x daily toothbrushing, professional cleaning, that led to the mouth and the teeth becoming the focus of a distinct discipline called dentistry. She<span style="mso-spacerun: yes;"> </span>demonstrates<span style="mso-spacerun: yes;"> </span>how<span style="mso-spacerun: yes;"> </span>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.</div><div class="MsoFooter" style="margin: 0in 0in 0pt;">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<span style="mso-spacerun: yes;"> </span>but important public health and preventive dental work, for a fraction of the cost and with little training” (Adams 2000p122)<a href="http://www.blogger.com/post-create.g?blogID=3287883320651248770#_edn3" name="_ednref3" style="mso-endnote-id: edn3;" title=""><span class="MsoEndnoteReference"><span style="mso-special-character: footnote;"><span class="MsoEndnoteReference"><span style="font-family: 'Times New Roman','serif'; font-size: 12pt; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-US;">[iii]</span></span></span></span></a>Dentistry was more interested in extracting and<span style="mso-spacerun: yes;"> </span>filling teeth than teaching children or treating gums. </div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: 'Times New Roman','serif';">Dentistry views itself, as does society, as the profession that has control over professional oral care, the restoration and<span style="mso-spacerun: yes;"> </span>maintenance of the teeth and tissues in the<span style="mso-spacerun: yes;"> </span>mouth.<span style="mso-spacerun: yes;"> </span>Dentistry possesses<span style="mso-spacerun: yes;"> </span>power as expressed in the social organization of oral health care delivery. Power they worked hard to establish. Dentistry became an official profession Canada in 1867. Society gave to<span style="mso-spacerun: yes;"> </span>dentistry the authority and professional autonomy to be the dominant profession in<span style="mso-spacerun: yes;"> </span>oral health care delivery.</span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: 'Times New Roman','serif'; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"> </span>In a course DH331<span style="mso-spacerun: yes;"> </span>Professions Ideology and Change,<span style="mso-spacerun: yes;"> </span>students examine and analyze the institution and practice of dentistry, and the emergence of dental hygiene practice within the oral health care field.<span style="mso-spacerun: yes;"> </span>This ordinarily mundane and academically unexplored area of the oral cavity provides<b style="mso-bidi-font-weight: normal;"> </b>an opportunity to examine multiple processes.<span style="mso-spacerun: yes;"> </span>These various processes create the conditions for the possibility of reorganization of oral health care delivery.<span style="mso-spacerun: yes;"> </span>As networks of professions, consumers, bureaucrats, and politicians oscillate between the curative, medical treatment model and the preventive wellness model of health<b style="mso-bidi-font-weight: normal;">, </b>new knowledge<b style="mso-bidi-font-weight: normal;"> </b>of oral health<span style="mso-spacerun: yes;"> </span>will<b style="mso-bidi-font-weight: normal;"> </b>emerge.<b style="mso-bidi-font-weight: normal;"> </b><span style="mso-spacerun: yes;"> </span>Adopting a <b>sociological imagination</b> involves questioning our own views and assumptions about the world. A critical sociological imagination is based on an acceptance that some things may contradict and challenge what we believe. Therefore it is important to avoid being biased. Bias can arise when we believe something even when there is no evidence to support our belief. It is understandable that we prefer not to be criticized or to admit errors in judgment. It is more comforting to believe that our opinions are right rather than wrong. Hopefully students<span style="mso-spacerun: yes;"> </span>gain a broader perspective, as they examine the social landscape of oral health care, beyond the confines of the<span style="mso-spacerun: yes;"> </span>dental hygiene cubicle in the dental office.<span style="mso-spacerun: yes;"> </span></span></div><span style="font-family: 'Times New Roman','serif'; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"><div id="edn1" style="mso-element: endnote;"><div class="MsoEndnoteText" style="margin: 0in 0in 0pt;"><a href="http://www.blogger.com/post-create.g?blogID=3287883320651248770#_ednref1" name="_edn1" style="mso-endnote-id: edn1;" title=""><span class="MsoEndnoteReference"><span style="mso-special-character: footnote;"><span class="MsoEndnoteReference"><span style="font-family: 'Times New Roman','serif'; font-size: 10pt; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-US;">[i]</span></span></span></span></a><span style="font-size: x-small;"> Adams, T. L(2000) <i style="mso-bidi-font-style: normal;">A Dentist and a Gentleman </i>Toronto: University Toronto Press<i style="mso-bidi-font-style: normal;"> </i></span></div></div><div id="edn2" style="mso-element: endnote;"><div class="MsoNormal" style="margin: 0in 0in 10pt; tab-stops: dotted -.8in blank -.5in center dotted 0in left blank .5in 1.0in 1.25in 2.0in 2.5in 3.0in 3.5in 4.0in 4.5in 5.0in 5.5in 5.9in 6.5in 7.0in 7.5in 8.0in;"><a href="http://www.blogger.com/post-create.g?blogID=3287883320651248770#_ednref2" name="_edn2" style="mso-endnote-id: edn2;" title=""><span class="MsoEndnoteReference"><span style="mso-special-character: footnote;"><span class="MsoEndnoteReference"><span style="font-family: 'Calibri','sans-serif'; font-size: 11pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-font-size: 10.0pt; mso-bidi-language: AR-SA; mso-bidi-theme-font: minor-bidi; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-fareast; mso-hansi-theme-font: minor-latin;">[ii]</span></span></span></span></a><span style="font-family: Calibri;"> <span style="font-size: 10pt;">Nettleton, Sarah (1992) <i style="mso-bidi-font-style: normal;">Power, Pain and Dentistry.</i><span style="mso-spacerun: yes;"> </span>Great Britain: St. Edmunsbury Press.</span></span></div></div><div id="edn3" style="mso-element: endnote;"><div class="MsoEndnoteText" style="margin: 0in 0in 0pt;"><a href="http://www.blogger.com/post-create.g?blogID=3287883320651248770#_ednref3" name="_edn3" style="mso-endnote-id: edn3;" title=""><span class="MsoEndnoteReference"><span style="mso-special-character: footnote;"><span class="MsoEndnoteReference"><span style="font-family: 'Times New Roman','serif'; font-size: 10pt; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-US;">[iii]</span></span></span></span></a><span style="font-size: x-small;"> Adams, T. L(2000) <i style="mso-bidi-font-style: normal;"><span style="mso-spacerun: yes;"> </span>ibid </i>p90</span></div></div></span></span><div class="MsoNormal" style="margin: 0in 0in 10pt;"><br />
</div><span style="font-family: 'Times New Roman','serif'; mso-bidi-font-size: 11.0pt;"><span style="mso-spacerun: yes;"></span><div class="MsoNormal" style="line-height: 150%; margin: 0in 0in 10pt;"><span style="font-family: Calibri;"><span style="line-height: 150%; mso-bidi-font-size: 11.0pt;">Lynda McKeown Mickelson’s MA thesis 1995 <b style="mso-bidi-font-weight: normal;"><i style="mso-bidi-font-style: normal;">The Regulated Health Professions Act and Dental Hygiene: A Study of the Changing<span style="mso-spacerun: yes;"> </span>Social Organization of Health Care Delivery in Ontario</i></b></span><i style="mso-bidi-font-style: normal;"><span style="font-size: 10pt; line-height: 150%;">.<a href="http://www.blogger.com/post-create.g?blogID=3287883320651248770#_edn1" name="_ednref1" style="mso-endnote-id: edn1;" title=""><span class="MsoEndnoteReference"><span style="mso-special-character: footnote;"><span class="MsoEndnoteReference"><b style="mso-bidi-font-weight: normal;"><span style="font-family: 'Calibri','sans-serif'; font-size: 10pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-language: AR-SA; mso-bidi-theme-font: minor-bidi; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-fareast; mso-hansi-theme-font: minor-latin;">[i]</span></b></span></span></span></a></span></i><span style="font-size: 10pt; line-height: 150%;"><span style="mso-spacerun: yes;"> </span>casts light on the RHPA 1994. McKeown Mickelson<span style="mso-spacerun: yes;"> </span>“describes the problematic relationship between public legislation and<span style="mso-spacerun: yes;"> </span>its actual enactment or implementation. The<span style="mso-spacerun: yes;"> </span>fractious relationships<span style="mso-spacerun: yes;"> </span>between dentistry and dental hygiene are described and analyzed.” (Coburn 1995)<a href="http://www.blogger.com/post-create.g?blogID=3287883320651248770#_edn2" name="_ednref2" style="mso-endnote-id: edn2;" title=""><span class="MsoEndnoteReference"><span style="mso-special-character: footnote;"><span class="MsoEndnoteReference"><span style="font-family: 'Calibri','sans-serif'; font-size: 10pt; mso-ansi-language: EN-US; mso-ascii-theme-font: minor-latin; mso-bidi-font-family: 'Times New Roman'; mso-bidi-language: AR-SA; mso-bidi-theme-font: minor-bidi; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-US; mso-fareast-theme-font: minor-fareast; mso-hansi-theme-font: minor-latin;">[ii]</span></span></span></span></a> Her research showed that the<span style="mso-spacerun: yes;"> </span>legislation, which governs twenty-four health professions, is a site of power relations.<span style="mso-spacerun: yes;"> </span>Part of the intent of the <u>R.H.P.A.</u> 1994 was to increase the accountability of professionals and to increase the consumer's ability to access affordable options for health care.</span></span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin: 0in 0in 10pt;"><span style="font-size: 10pt; line-height: 150%;"><span style="font-family: Calibri;">Michel Foucault provided McKeown Mickelson with a way to examine the initial impact of the <u>R.H.P.A.</u><span style="mso-spacerun: yes;"> </span>.<span style="mso-spacerun: yes;"> </span>He thinks and conceptualizes power as diffused through multiple social sites, as something that is exercised, not as something such as a position that is held in a hierarchical structure.<span style="mso-spacerun: yes;"> </span>Rather like a spider web or the capillary vascular system of the<span style="mso-spacerun: yes;"> </span>human body. Foucault insists on a close connection between power and resistance. Resistance is not external to power but inherent in power relations. Power provokes resistance</span></span></div><div class="MsoNormal" style="line-height: 150%; margin: 0in 0in 10pt;"><br />
</div><div class="MsoNormal" style="line-height: 150%; margin: 0in 0in 10pt;"><span style="font-size: 10pt; line-height: 150%;"><span style="font-family: Calibri;">Using personal experience of the professional self-governing process and Foucault's approach to power relations, the seemingly mundane and ordinary practice of oral health care delivery was examined to find evidence of change in the social organization of health care.<span style="mso-spacerun: yes;"> </span>The relationship between two providers of services surrounding the mouth and oral health care, dental hygiene and dentistry exemplify the power relations and the inherent resistance emerging as the legislation is enacted.<span style="mso-spacerun: yes;"> </span>Dental hygiene<span style="mso-spacerun: yes;"> </span>struggles to attain autonomy and is still advocating for more interdependent provision of health services and the public's freedom to choose their access point to preventive oral health services.<span style="mso-spacerun: yes;"> </span>Dentistry is struggling to preserve the 'status quo.'<span style="mso-spacerun: yes;"> </span>A 'tug of war' continues<span style="mso-spacerun: yes;"> </span>in 2011 to take place between the implementation of more community based, preventive services of interrelated health care providers, and the preservation of the traditional, independent, fee-for-serve treatment practices.<span style="mso-spacerun: yes;"> </span>However, legislation has legitimized and enabled many emerging professions such as dental hygiene to voice their concerns through open consultations and public forums.</span></span></div><div class="MsoNormal" style="line-height: 150%; margin: 0in 0in 10pt;"><span style="font-size: 10pt; line-height: 150%;"><span style="font-family: Calibri;">For McKeown Mickelson the<span style="mso-spacerun: yes;"> </span>evidence in 1995<span style="mso-spacerun: yes;"> </span>indicated that the existing professional monopolies would not be disrupted easily. This appears to be the case in 2011. </span></span></div><div class="MsoNormal" style="line-height: 150%; margin: 0in 0in 10pt;"><span style="font-family: Calibri;"><span style="font-size: 10pt; line-height: 150%;">Thus, distribution of nontraditional health care providers to alternate practice settings in urban communities or Northern, remote and rural areas, was not an immediate result of the passing of this new legislation RHPA.<span style="mso-spacerun: yes;"> </span>McKeown Mickelson identified<span style="mso-spacerun: yes;"> </span>themes that emerged from the struggle to reframe the relations between dentistry and dental hygiene under the new R.H.P.A. These<span style="mso-spacerun: yes;"> </span>are: discourse/language, professional dominance, technologies of bureaucracy, gender, and power/knowledge</span>.</span></div><div class="MsoNormal" style="line-height: 150%; margin: 0in 0in 10pt;"><span style="font-size: 10pt; line-height: 150%;"><span style="font-family: Calibri;"><span style="mso-spacerun: yes;"> </span>This research was initiated to determine what effect new health legislation has on the social organization of health care delivery in Ontario.<span style="mso-spacerun: yes;"> </span>Does the <u>Regulated Health Professions Act, 1994</u> in fact change the social organization of health care delivery in Ontario?<span style="mso-spacerun: yes;"> </span>As the research progressed, it became evident that there is a division between the changes for the newly regulated providers and the changes for consumers.<span style="mso-spacerun: yes;"> </span>There is a definite change in social organization for the providers with the introduction of the <u>R.H.P.A.</u><span style="mso-spacerun: yes;"> </span>Legislation has legitimized and enabled many emerging professions, such as midwifery, nursing and dental hygiene, to voice their concerns through open consultations and public forums.<span style="mso-spacerun: yes;"> </span>Also, it has become apparent that the existing professional monopolies may not be ruptured easily and that the distribution of non-traditional health care providers to alternate delivery settings in urban communities or in Northern, remote and rural areas will not be immediate and will require consumer advocacy for freedom to choose previously unavailable or inaccessible health care services.</span></span></div><div class="MsoNormal" style="line-height: 150%; margin: 0in 0in 10pt; text-align: justify; text-justify: inter-ideograph;"><span style="font-size: 10pt; line-height: 150%;"><span style="font-family: Calibri;"><span style="mso-tab-count: 1;"> </span>As a participant observer, knowledgeable and experienced in the regulatory process, qualitative research was the method chosen for this study.<span style="mso-spacerun: yes;"> </span>Using personal experience and Foucault's approach to power relations and the inherent resistances, a seemingly mundane and ordinary practice, oral health care delivery, is explored.<span style="mso-spacerun: yes;"> </span>The study provides an opportunity to look at contrasting perceptions regarding practices surrounding the mouth.</span></span></div><div class="MsoNormal" style="line-height: 150%; margin: 0in 0in 10pt;"><span style="font-size: 10pt; line-height: 150%;"><span style="font-family: Calibri;">The <u>Regulated Health Professions Act, 1994</u>, new health legislation in the province of Ontario, proclaimed December 31, 1993, is a site of power relations and health politics.<span style="mso-spacerun: yes;"> </span>Included with this legislation are twenty-one profession specific Acts regulating twenty-four health occupations (Appendix A).<span style="mso-spacerun: yes;"> </span>Many of these health occupations are independently regulated for the first time.<span style="mso-spacerun: yes;"> </span>This study takes the new legislation as a starting point and also looks at pre-proclamation events such as previous health legislation and the findings of the Health Professions Legislative Review.<span style="mso-spacerun: yes;"> </span>The <u>R.H.P.A.</u> and the twenty-one profession specific Acts establish a whole series of power networks that invest in the body.</span></span></div><div class="MsoBodyText2" style="line-height: 150%; margin: 0in 0in 6pt;"><span style="font-size: 10pt; line-height: 150%;"><span style="mso-tab-count: 1;"> </span>For the purpose of this study, dentistry and dental hygiene are used as examples of resistance and, thus, new power relations that are occurring with this new professional regulatory legislation.<span style="mso-spacerun: yes;"> </span>Gross has stated that:</span></div><div class="MsoNormal" style="margin: 0in 0.5in 10pt;"><br />
</div><div class="MsoBlockText" style="margin: 0in 0.5in 0pt;"><span style="mso-bidi-font-size: 10.0pt;"><span style="font-size: x-small;">... changes in licensing regulations that enhance competition and accountability will create other changes which will shape professional services to raise quality, reduce cost, and increase public self-protection (Gross, 1984 xii<span style="mso-spacerun: yes;"> </span></span></span><i style="mso-bidi-font-style: normal;"><span style="font-size: 8pt;">Of Foxes and Henhouses</span></i><span style="font-size: 8pt;">.<span style="mso-spacerun: yes;"> </span>Connecticut: Quorum Books</span><span style="mso-bidi-font-size: 10.0pt;"><span style="font-size: x-small;">).<span style="mso-spacerun: yes;"> </span></span></span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><br />
</div><div class="MsoBodyText2" style="line-height: 150%; margin: 0in 0in 6pt;"><span style="font-size: 10pt; line-height: 150%;"><span style="mso-tab-count: 1;"> </span>Looking at dental hygiene's attempt to regulate itself independently of dentistry provides, for this researcher, a starting point and a point from which to stand.<span style="mso-spacerun: yes;"> </span>As the regulatory body of dental hygiene (the College of Dental Hygienists of Ontario) attempts to have the word ‘order’ removed for prophylaxis, the non contraindicated procedures of scaling and root planing, the possibility for change in the social organization of health care delivery and the opposition and resistance to the 'status quo' emerge.<span style="mso-spacerun: yes;"> </span>These two health occupations provide a contrast between dental hygiene, an emerging preventive/health promotion, wellness oriented health care provider, and dentistry, an established, curative medical treatment-focused health care provider.<span style="mso-spacerun: yes;"> </span>These two valued perspectives openly clashed as both regulatory bodies prepared for proclamation of new health legislation.<span style="mso-spacerun: yes;"> </span>The study focuses on dentistry's attempt to maintain control of dental hygiene through dentistry's interpretation of the word 'order' in its regulations, and dental hygiene's resistance to continued subordination by its attempt to amend the Dental Hygiene Act.<span style="mso-spacerun: yes;"> </span>It will be shown that this struggle indicates a change in the social organization of health care delivery for providers.</span></div><div class="MsoBodyText2" style="line-height: 150%; margin: 0in 0in 6pt;"><span style="font-size: 10pt; line-height: 150%;"><span style="mso-tab-count: 1;"> </span>Hopefully, this new regulatory system for health care professionals will result in positive changes in health care delivery.<span style="mso-spacerun: yes;"> </span>It is possible that the way society thinks and perceives of health care in general and oral health care in particular could be so different in the future that it would be unrecognizable from this present stand point.<span style="mso-spacerun: yes;"> </span>I present my perspective to avoid any misinterpretation by the reader.</span></div><div class="MsoBodyText2" style="line-height: 150%; margin: 0in 0in 6pt;"><span style="font-size: 10pt; line-height: 150%;"><span style="mso-tab-count: 1;"> </span>Independent regulation for dental hygiene' means increased accountability and autonomy.<span style="mso-spacerun: yes;"> </span>My perspective is that this autonomy does not mean freedom to be entrepreneurs nor freedom to reproduce the established traditional patterns of hierarchy and patriarchy, rather it is freedom to form new alliances and to work in nontraditional practice settings.<span style="mso-spacerun: yes;"> </span>The freedom to form new alliances with health care professionals such as nutritionists, chiropodists, massage therapists, nurses, etc., could provide the opportunity to re-establish the link between the mouth, the gateway to the body and the rest of the person.<span style="mso-spacerun: yes;"> </span>Good oral health is inextricably linked to good general health.<span style="mso-spacerun: yes;"> </span>Oral health is not just a matter of appearance.<span style="mso-spacerun: yes;"> </span>The mouth is essential to speech and the digestive system.<span style="mso-spacerun: yes;"> </span>Poor oral conditions affect social interaction and appearance and contribute unnecessarily to pain and erode the individuals morale and overall attitude.<span style="mso-spacerun: yes;"> </span>Oral health problems can have significant consequences on an individuals general health and quality of life.<span style="mso-spacerun: yes;"> </span>However, the present funding system appears to separate the mouth from the rest of the body.<span style="mso-spacerun: yes;"> </span>Countries such as Norway, Sweden and Scotland recognize that oral health is important to total health and include oral health in publicly funded health care programs.</span></div><div class="MsoBodyText2" style="line-height: 150%; margin: 0in 0in 6pt;"><span style="font-size: 10pt; line-height: 150%;"><span style="mso-tab-count: 1;"> </span>I see a collaborative approach to health care, one which includes a "circle" of providers of care, not a "ladder" or hierarchy of curative treatment providers.<span style="mso-spacerun: yes;"> </span>This freedom will enable and empower providers to work interdependently in their preferred location with other health care providers of their choice.<span style="mso-spacerun: yes;"> </span>I conceive these alliances perhaps in community health centres, to be a new version of the "old time" family physician who knew and understood the family with all of its interactions and its social, spiritual, physical and emotional components.<span style="mso-spacerun: yes;"> </span>The body and person will be recognized as a unified whole, connected to the external environment.<span style="mso-spacerun: yes;"> </span>The various health care providers will collaborate with each other and the client in attempts to achieve good health and total well-being.<span style="mso-spacerun: yes;"> </span>So, it is my hope that clients will have the freedom to choose health care providers in appropriate practice settings in all communities in all parts of the province.</span></div><div class="MsoBodyText2" style="line-height: 150%; margin: 0in 0in 6pt;"><span style="font-size: 10pt; line-height: 150%;"><span style="mso-tab-count: 1;"> </span>Discourse/language can be effective in changing the public's perception and awareness of certain practices within society.<span style="mso-spacerun: yes;"> </span>However, discourse/language can also perpetuate established traditions of power/knowledge.<span style="mso-spacerun: yes;"> </span>The word 'order' is an example.<span style="mso-spacerun: yes;"> </span>The word 'order' is included in a few, mainly female dominated, profession specific Acts.<span style="mso-spacerun: yes;"> </span>The word 'order' in the Dental Hygiene Act acts as a catalyst which reveals two different and valued perspectives, dentistry (treatment) and dental hygiene (prevention).<span style="mso-spacerun: yes;"> </span>The word 'order' carries with it historical, military language (Appendix B).<span style="mso-spacerun: yes;"> </span>It is a coded sign of obedience.<span style="mso-spacerun: yes;"> </span>It is a word that traditionally differentiates values and levels of knowledge.<span style="mso-spacerun: yes;"> </span>Thus, the inclusion of the word 'order' is questionable in new health legislation as it is impregnated with professional dominance, power, and the privileges of specialized knowledge, technologies of bureaucracy, and gender inequities.</span></div><div class="MsoBodyText2" style="line-height: 150%; margin: 0in 0in 6pt;"><span style="font-size: 10pt; line-height: 150%;"><span style="mso-tab-count: 1;"> </span>The social organization of oral health care is generally considered a rather ordinary and mundane practice.<span style="mso-spacerun: yes;"> </span>However, looking at this rather mundane practice provides the opportunity to observe speech and language practices that surround the mouth.<span style="mso-spacerun: yes;"> </span>It becomes evident to this researcher that the mouth and its care are examples of the way power is exercised. The research reported here shows that this new, multi-health occupational legislation is a site of power relations with their inherent resistances.<span style="mso-spacerun: yes;"> </span>The relationship between two providers of services surrounding the mouth and oral health care, dentistry, and dental hygiene exemplify power relations and sites of resistance.<span style="mso-spacerun: yes;"> </span>Related themes and patterns emerge.<span style="mso-spacerun: yes;"> </span>“<a href="http://www.blogger.com/post-create.g?blogID=3287883320651248770#_edn3" name="_ednref3" style="mso-endnote-id: edn3;" title=""><span class="MsoEndnoteReference"><span style="mso-special-character: footnote;"><span class="MsoEndnoteReference"><span style="font-family: 'Times New Roman','serif'; font-size: 10pt; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-US;">[iii]</span></span></span></span></a></span></div><span style="font-size: 10pt; line-height: 150%;"><hr align="left" size="1" width="33%" /><div class="MsoBodyText2" style="line-height: 150%; margin: 0in 0in 6pt;"><span style="font-size: small;"></span></div><div id="edn1" style="mso-element: endnote;"></div><div class="MsoNormal" style="margin: 0in 0in 10pt 0.25in; text-align: justify; text-justify: inter-ideograph;"><br />
</div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: Calibri;">There was really no necessity for the development of dentistry as a distinct discipline. Adopting a genealogical perspective and applying sociological imagination we can look at the circumstances that enabled<span style="mso-spacerun: yes;"> </span>this particular study of the mouth, discipline of dentistry. These conditions of possibility arose out of the public health movement, monitoring mouths to prevent disease. The mouth was a vulnerable part of the body which had to be protected. The mouth is the boundary between the internal body and the external<span style="mso-spacerun: yes;"> </span>sources of pollution. This original concept fits with the theories of ecology today. The dental services in schools<span style="mso-spacerun: yes;"> </span>created a market for treatment, as disease was discovered when children’s mouths were observed and examined.<span style="mso-spacerun: yes;"> </span>Nettleton (1992) p26-7 quotes several writers of the early 1900s. ‘By far the greatest number germ infections gain entrance by the mouth. The mouth and nose are the portals of the greatest importance, from the infective agents which are introduced through them.’ <span style="mso-spacerun: yes;"> </span>Dentistry originally<span style="mso-spacerun: yes;"> </span>implemented dental public health<span style="mso-spacerun: yes;"> </span>programs to monitor<span style="mso-spacerun: yes;"> </span>and treat teeth.<span style="mso-spacerun: yes;"> </span>The aims of<span style="mso-spacerun: yes;"> </span>dentists were not always implemented, nor always successful. When the dental programs were carried out they often met with problems, conflict and resistance. Resistance is found between professions, patients /clients and among professionals themselves and within vocational disciplines.(Nettleton p140) </span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: Calibri;">Dental education<span style="mso-spacerun: yes;"> </span>focuses on restorative<span style="mso-spacerun: yes;"> </span>treatment, surgical procedures, not observation, collection of statistical data or educating patients in prevention. Community dental health may be marginalized in dental schools. The orthodontist and oral maxillary surgeon get greater respect than the expert in nutritional counseling.</span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: Calibri;">Dental hygiene was assigned the preventive<span style="mso-spacerun: yes;"> </span>and housekeeping/mouthkeeping tasks by dentistry. Much the same can be said about dental hygiene curriculum as stated about the dental curriculum. Students studying dental hygiene <span style="mso-spacerun: yes;"> </span>focus on <span style="mso-spacerun: yes;"> </span>fine motor skill development for<span style="mso-spacerun: yes;"> </span>debridement, removal of calculus deposits. Although nutritional counseling and tobacco cessation are part of the curriculum, public and community health<span style="mso-spacerun: yes;"> </span>education of society is<span style="mso-spacerun: yes;"> </span>a small part of the curriculum.</span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: Calibri;">Resistances, squabbles and struggles serve as a catalyst and bring to light power relations. The amendment to Dental Hygiene Act in 2007 in Ontario (authorizing self initiation) reignited power struggles that were evident when dental hygiene was granted self regulation by ON government in 1991.<span style="mso-spacerun: yes;"> </span>When the legislation was Promulgated<span style="mso-spacerun: yes;"> </span>in 1994 many dental hygienists could not get an ‘order’ as required by the Dental Hygiene Act to proceed with controlled acts. <span style="mso-spacerun: yes;"> </span>As this requirement was not in the Dentistry Act most dentists ignored the dental hygiene legislation and continued with the <i style="mso-bidi-font-style: normal;">status quo</i> in their private practices.</span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: Calibri;"><span style="mso-spacerun: yes;"> </span>Power struggles continue. Dentistry maintains control as an employer.<span style="mso-spacerun: yes;"> </span>With the proliferation of dental hygiene programs there are increased numbers of graduates. So in many parts of Canada dental hygienists can’t find employment with dentists.<span style="mso-spacerun: yes;"> </span>As a result dental hygienists<span style="mso-spacerun: yes;"> </span>are establishing independent practice without, not surprisingly, dentistry’s blessing.<span style="mso-spacerun: yes;"> </span></span></div><div class="MsoNormal" style="margin: 0in 0in 10pt;"><span style="font-family: Calibri;">The oral care field is changing. It is possible that how we currently think about, and see oral care delivery could be so very different that it will be unrecognizable to us from our present standpoint. New power struggles will create new knowledge. In this<span style="mso-spacerun: yes;"> </span>21<sup>st</sup> C there is an increased link between fashion, and treatment and an increasing consumerism. </span></div><div style="mso-element: endnote-list;"><br clear="all" /><span style="font-family: Calibri;"><hr align="left" size="1" width="33%" /></span><div id="edn1" style="mso-element: endnote;"><div class="MsoEndnoteText" style="margin: 0in 0in 0pt;"><a href="http://www.blogger.com/post-create.g?blogID=3287883320651248770#_ednref1" name="_edn1" style="mso-endnote-id: edn1;" title=""><span class="MsoEndnoteReference"><span style="mso-special-character: footnote;"><span class="MsoEndnoteReference"><span style="font-family: 'Times New Roman','serif'; font-size: 10pt; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-US;">[i]</span></span></span></span></a><span style="font-size: x-small;"> McKeown Mickelson ( 1995)<i style="mso-bidi-font-style: normal;">The Regulated Health professions Act and Dental Hygiene: A Study of the Changing Social Organization of Health Care delivery in Ontario</i>. unpublished Sociology Master thesis Lakehead<span style="mso-spacerun: yes;"> </span>University: Thunder Bay ON</span></div></div><div id="edn2" style="mso-element: endnote;"><div class="MsoEndnoteText" style="margin: 0in 0in 0pt;"><a href="http://www.blogger.com/post-create.g?blogID=3287883320651248770#_ednref2" name="_edn2" style="mso-endnote-id: edn2;" title=""><span class="MsoEndnoteReference"><span style="mso-special-character: footnote;"><span class="MsoEndnoteReference"><span style="font-family: 'Times New Roman','serif'; font-size: 10pt; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-US;">[ii]</span></span></span></span></a><span style="font-size: x-small;"> Coburn, D. external<span style="mso-spacerun: yes;"> </span>reader<i style="mso-bidi-font-style: normal;"> </i>for<i style="mso-bidi-font-style: normal;"> </i>McKeown Mickelson’s thesis<i style="mso-bidi-font-style: normal;"> The Regulated Health professions Act and Dental Hygiene</i></span></div></div><div id="edn3" style="mso-element: endnote;"><div class="MsoEndnoteText" style="margin: 0in 0in 0pt;"><a href="http://www.blogger.com/post-create.g?blogID=3287883320651248770#_ednref3" name="_edn3" style="mso-endnote-id: edn3;" title=""><span class="MsoEndnoteReference"><span style="mso-special-character: footnote;"><span class="MsoEndnoteReference"><span style="font-family: 'Times New Roman','serif'; font-size: 10pt; mso-ansi-language: EN-US; mso-bidi-language: AR-SA; mso-fareast-font-family: 'Times New Roman'; mso-fareast-language: EN-US;">[iii]</span></span></span></span></a><span style="font-size: x-small;"><span style="mso-spacerun: yes;"> </span>McKeown Mickelson (1995) <i style="mso-bidi-font-style: normal;">ibid </i><span style="mso-spacerun: yes;"> </span>introduction pp 1-5</span></div></div></div></span><span style="font-family: Calibri;">*******************************************************************************</span></span><div style="mso-element: endnote-list;"><br clear="all" /> </div>L Lynda McKeownhttp://www.blogger.com/profile/11983607867026839508noreply@blogger.com2