Dubai-based hygienist Kate Paszkowska discusses why regional hygienists aren't yet ready to go solo.
Where did you practice, before moving to the UAE?
A dental clinic is stressful...it is almost as important to be a good psychologist as a good hygienist.
I trained in Warsaw, Poland's capital city. The training was only two years but was very intensive. I graduated in 1995 and then continued working in Poland until my move to Dubai three years ago.
How does the style of work in Dubai compare?
It is very difficult to find a role as a qualified hygienist in Poland, so many of my colleagues worked alongside dentists as dental assistants. My work here is simpler, because it is easier to motivate the patients.
It is much easier to encourage patients to maintain better hygiene and to improve - but that is also because we predominately see expatriate adults.
Are expatriates more conscious of oral health?
It depends greatly on what country a patient is from as to how much education they have about oral health. American people, for example, typically have very good teeth and take their oral health very seriously.
In Dubai, we need to educate younger children on the importance of good oral care. At Drs Nicholas and Asp, we provide an education programme for local schools. We visit children and discuss what types of food are healthy choices for their teeth, and which are not.
Do community outreach programmes help with this?
It is difficult to motivate local children to improve their oral hygiene but I try and speak with their parents and get them to enforce it at home.
With about 60% of those patients, we'll see a real improvement, but the rest will continue to have very poor oral hygiene.
Even if I explain the impact of decay, and poor oral health, because they're young they find it difficult to imagine that it could become a problem in the future.
How do you encourage parental involvement?
By explaining that children need to be told more than once. They need to be encouraged to maintain good oral care by their parents - without this it is very difficult.
Often when I show the parents how the children should be brushing they are surprised and they say that no one has shown them before. Parents need to supervise young children while they're brushing.
I also like to schedule follow-up appointments one month on, to see whether the children have returned to their bad habits.
There needs to be control from my side and from the parent's side, but if the parents have had bad problems with decay they can be quite proactive.
We'll often see the whole family coming back with very good results and much improved oral hygiene.
How do you improve patient-compliance with adults?
I've learnt it is not enough to tell them that a certain brush or technique is better than another - you have to really educate the patient.
For example, explaining that removing plaque depends on the frequency of the movements and that an electric toothbrush will always be moving faster than a manual brush.
But the most important thing is that there is some chemistry between the patient and the hygienist so that the patient is motivated to follow your advice.
If they don't like you, they won't be interested - they have to enjoy the experience, or they won't return. Visiting a dental clinic is still a stressful prospect for many patients.
Even in the 21st century, when lasers and injections have made dentistry almost pain-free, many adults are still very nervous. We need to be more welcoming to patients - it is almost as important to be a good psychologist as a good hygienist.
Do the same rules apply for children?
With children, one of the best ways is to try and relate it to their friends. If you ask them if any of their friends have poor teeth, then they will realise that they don't want bad teeth themselves.
Equally, if there are other children at their school with braces, they know it isn't the end of the world. Showing them pictures of other children with the same problem is also helpful.
Do you see a future role for hygienist-only centres in the Middle East?
I think most hygienists are considering what it would be like to be independent, but there are a lot of procedures, like gum therapy, that are difficult to do without dentists.
I also don't think the patients in the Middle East are as educated as in the United States, for example. In the US they know to visit the hygienist every six months, but local residents are more likely to visit the dentist because they are in pain.
In which case they look for a dentist, not a hygienist. At the moment, it's better for us if we work as a team.