To Floss or Not to Floss?

Ann Clark, RDH
To Floss or Not to Floss?
Since the Feds removed flossing from their dietary guidelines I still get a lot of patients asking if they really need to floss.  The answer is simple:  only the floss the teeth you wish to keep.  How did something so basic and assuredly easy to understand become the subject of debate?  Does anyone really believe that after years of hearing your hygienists request you to floss that we had it wrong?  No.  It is one of the most universal recommendations in all of public health.
So, how has this happened?  Why would the Federal Government remove a guideline so firmly endorsed by the American Dental Association?  The Associated Press reported that the Federal Government removed the recommendation to floss from its dietary guidelines which was first recommended by them in 1979.  Long story short: when asked, they reported that the research supporting its effectiveness didn’t meet their standards.  Any recommendations recommended in its guidelines must, by law, be based on scientific evidence.  They focused on 25 studies over the past decade.  They found the evidence to be “weak/very unreliable”.  The studies sadly used outdated methods or tested too few subjects.  Some lasted only two weeks, too short for a cavity or dental disease to manifest.  One, actually tested people after a single use of floss.  The research focused on warnings signs like bleeding and inflammation, not dealing with gum disease or cavities. Unfortunately there just hasn’t been any great research done on flossing and it’s effects.  There is not only a lack of research done in this area but also it’s actually a difficult subject to produce clear research on for a number of reasons.  So, weak scientific evidence and brief duration of studies has gotten us into this mess.  When the Associated Press failed to get the research to back their recommendations and kept pursuing it…the Feds gave in and removed it from their latest guideline postings.  It’s respectful that they require evidence-based research, and until someone does the work, it just is what it is.
As a dental hygienist of long-standing who sees the difference of a flossed mouth and  a non-flossed mouth on a regular basis, I highly recommend flossing.  Regular flossers can attest to changes in their oral health for the better.  24 hours a day we build a fuzzy film of plaque bacteria in the mouth.   Above the gumline we can clear them with a toothbrush on 3 of the 5 sides of your tooth.  These bacteria also grow below the gumline where the toothbrush can not reach.  Then, let’s say you have deeper pocket depths, places for bacteria to hide?  And what about the 2 sides of the tooth where teeth touch?  How will you get those cleaned?  What small, flexible aide would make sense to use under the tissues to remove that thicker, smelly film?  Unremoved plaque is known to cause redness and inflammation.  Unremoved debris after a period of time lets those conditions fester away eventually eating its way to the bone and subsequently:  causing boneloss…the root of periodontal disease.
The American Dental Association still recommends that you floss.  Regular flossers can attest to changes in their gum health and tooth health.  There are just common sense benefits to flossing.
Questions that I have heard:
     -Can I just use my water pick? ( Or water flosser?) This is another great aide but does not replace floss.  Plain and simple the bacteria on your tooth above the gumline are mechanically disrupted by the motion of the toothbrush.  You need the same between the teeth and below the gumline.  Floss is small enough to go under the gum and extend down the side of the tooth, bend into a “C” shape, stay tight against the tooth structure and physically disrupt the plaque in it’s formation.   Also the very small spot where the 2 sides of your tooth touch together is usually the exact spot where cavities form.  The only way to clean it?? Yes! With floss.   Always floss in conjunction with this great aide.
     -Do I still have to floss?  Lack of strong evidence does not equal lack of effectiveness.
The dept. of Health and Human Services reaffirms the importance of floss in an August 4th statement to the ADA.  “Flossing is an important oral hygiene procedure.  Tooth decay and gum disease can develop when plaque is allowed to build-up on the tooth and along the gumline.  Professional cleaning, tooth brushing and cleaning between the teeth (with aides) have been shown to disrupt and remove plaque.”

Why Do I Need “X-rays” Today?


Why do I need “x-rays” today?

Many patients are concerned about radiograph frequencies, fearing they are receiving too much radiation.  While too much radiation is not good, I want to clarify what is too much and share some important facts about the purpose and benefits of radiographs.

Why do we need to take radiographs?

Radiographs can help dental professionals evaluate and diagnose many oral diseases and conditions.  Radiographs can be used to evaluate cavities, bone levels, calculus deposits, abscesses, root apices, wisdom teeth, cysts, sinuses, growths, foreign objects, jaw joints, and/or jaw fractures.  Much of what goes on in the mouth is not viewable without a radiograph.  In most cases, treating patients without radiographs would be performing below the standard of care.  Exceptions can be made in certain circumstances regarding pregnancy or patients who have undergone extensive radiation treatment for other reasons.

How often should radiographs be taken?

Radiograph frequencies are recommended by the American Dental Association.  A “full set” of radiographs is generally 18-20 images, depending on the office.  A full set is usually taken at a patient’s initial visit to the office and then every 3-5 years after.  Panoramic radiographs are helpful in assessing when/if wisdom teeth need to be removed and in viewing eruption of permanent teeth in children.  In these cases the dentist uses his/her clinical judgment to determine if a panoramic radiograph is necessary.  “Check-up” radiographs usually consist of bitewings and anterior peri-apical radiographs.  Frequency of these radiographs will vary from patient to patient but can be prescribed anywhere between 6 months and 36 months.  Radiograph frequency is prescribed by the dentist based on a patient’s risk of caries or history of caries.

Am I getting too much radiation?

On average, Americans receive a radiation dose of about 0.62 rem (620 millirem) each year.  We live in a radioactive world.  Radiation is part of the environment and some types can’t be avoided.  These include the air around us, cosmic rays, and the Earth itself.  About half of our radiation dose comes from these sources.  The other half of our yearly dose comes from man-made radiation sources that can include medical, commercial, and industrial sources.  Medical radiographic imaging causes more radiation than dental radiographs.  One dental intraoral radiograph has a radiation dose of about 0.005 rem.   Similarly, a full set of radiographs at a dental office has the same amount of radiation as flying roundtrip from L.A. to New York.  In this day and age many dental offices are using digital equipment to process radiographs.  Digital imaging emits even less radiation (as much as 80% less) while still producing diagnostic images.

Radiation Safety

As dental professionals we are aware that patient’s are exposed to radiation.  We take proper precautions and cover the neck, thyroid, and chest with a lead apron.  We also make sure our radiology equipment has regular checks to ensure it is functioning properly.  Radiographs are prescribed with the patient’s best interest at heart.   

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Oral Cancer Awareness


Oral Cancer Awareness

  • Oral cancer is on the rise.
  • One person an hour dies from oral cancer.
  • The most common risk factors for oral cancer are HPV-16 (Human Papilloma Virus- Version 16), Tobacco, and alcohol.
  • In its early stages oral cancer can be painless and often go unnoticed to the patient. The good news is that your dentist can often see and feel changes in your tissue, or notice irregular patterns in the early stages of oral cancer.
  • If caught in its early stages, oral cancer has a survival rate of 80-90%.
  • The most common sites for oral cancer are the sides or base of the tongue, and the floor of the mouth.
  • There are several different types of oral cancer. The most common type of oral cancer is squamous cell carcinoma.
  • Common symptoms of oral cancer can include:
    • A sore that does not heal
    • Pain in the mouth that does not go away
    • Difficulty chewing or swallowing
    • Numbness of the tongue or other areas of the mouth
    • Swelling, lump, or mass in the neck or jaw

If you notice any of these symptoms that do not improve or go away within 10-14 days, please contact our office.

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Why are My Teeth Sensitive?

Cortney Davis, RDH

Why Are My Teeth Sensitive?

Tooth sensitivity is one of the most common complaints among dental patients. It’s estimated that around 40 million people suffer from sensitive teeth in the United States. There are many reasons why your teeth can become sensitive and we are going to be discussing some of those reasons.

A common reason teeth are sensitive is because of exposed areas of a tooth. This happens when movement of fluid goes through tiny tubes located in the dentin (the layer which contains the inner pulp, found beneath the hard enamel), which results in nerve irritation. When enamel is worn down or gums have receded, pain can be caused by eating, drinking hot or cold beverages, or exposing them to cold air. There are different products that can help with tooth sensitivity due to worn down enamel or gum recession. There is toothpaste, such as Sensodyne toothpaste that contains desensitizing agents that protects the exposed dentin by blocking the tubes in the teeth that are connected to nerves. Most people that use sensitive toothpaste notice a difference around 2-4 weeks. Dentists also have a variety of regimens to help patients manage tooth sensitivity as well, so if you’re experiencing frequent tooth sensitivity be sure to talk to your dentist.

Another common cause of tooth sensitivity is brushing with too much force or using a hard-bristled toothbrush. Overtime, people can wear down the protective layers of their teeth. The simplest solutions are to switch to a toothbrush with soft bristles and to be gentler when brushing.

The third thing that causes tooth sensitivity is grinding your teeth. Even though your tooth enamel is the strongest substance in your body, excessive grinding can wear down the enamel which can also expose the dentin. It’s important to talk to your dentist about getting a night guard that helps people stop grinding on their teeth. The best guards are custom-made to fit a patient’s bite.

Another common cause of tooth sensitivity is excessive plaque left on the tooth. The purpose of brushing and flossing is to remove plaque that forms on your teeth. An excessive build-up of plaque can cause tooth enamel to wear away, which as stated previously can cause your teeth to become more sensitive. If gingivitis or gum disease is the problem, your hygienist alongside with the dentist will come up with a plan to treat the underlying disease.

A cracked tooth or decay can also cause tooth sensitivity. A chipped or cracked tooth can cause pain that goes beyond tooth sensitivity. Your dentist will need to evaluate the sensitive tooth and decide what treatment is best for you. Also, if you have a cavity and it is left untreated it can become larger causing tooth sensitivity.

If your sensitivity persists or is extreme, be sure to visit your dentist for an evaluation. The dentist and hygienists can determine the most likely cause and give you the best solution for your particular situation.

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If You’re Not Whitening, You’re Yellowing!


Ann Clark, RDH


If You’re Not Whitening, You’re Yellowing!
Every year our offices participate in a whitening opportunity that benefits not only our patients but also children and people in less fortunate areas of Africa.  Smiles of Hope is a non-profit organization where volunteers pay their way over to Africa to selflessly provide their services to benefit the less fortunate with eye and teeth assistance, while experiencing a life-changing adventure.  The whitening opportunity consists of products donated to our offices and we  happily donate our time.   100% of the money goes to the charity for product and supplies.  We offer 3 ways to whiten through trays and take home product,  In-office, Dentist supervised  applications to your teeth and the third option is through In-office Dentist supervised  applications with the trays and take home product as a package.  The prices are always at our lowest financial opportunity for you, the patient, during the months of March-June.
What is whitening and how does it work?
Tooth color is the result of genetics, drugs and meds during pregnancy,  the child during the tooth development stage, or an environmental factor such as increased fluoride uptake or maternal infections such as tetracycline stains, postnatal infection, measles, chicken pox, strep infections and scarlet fever.  Your tooth is made up of an outer hard enamel layer over the softer dentin. The enamel is porous and  will absorb stain from anything with color you put in your mouth…coffee, cigarette, foods.  Another layer basically forms on top of the enamel which we call a pellicle film.  We can clean this film with scaling and polishing, you can try to clean it with abrasive whitening toothpastes but this is like a scouring pad cleaning a dish.  As the film sits on your teeth, after years, is absorbs through the tooth’s pores.  Although these deeper stains are harmless they are unattractive.  This is when you need the “good stuff”.  Whiteners use bleaching chemicals to get down into the enamel and set off an oxidation chemical reaction that breaks apart the staining compounds.  Whiteners use either a carbide peroxide or hydrogen peroxide agent.  When used in the mouth, carbide peroxide breaks down into hydrogen peroxide and urea, with hydrogen peroxide being the effective agent.
Is whitening safe?
Most studies confirm that whitening is with effective and safe.  Whitening products with less than 10% carbide peroxide (3.6 hydrogen peroxide), have not been shown to cause any concerns to tooth enamel.  Higher concentrations can cause some weakening to the enamel but these also contain fluoride which counter-acts this potential side-effect.  If tooth sensitivity or gum irritation occurs it is best to reduce product frequency and time spent whitening.  Prescription  fluoride is used to treat sensitivity sometimes associated with whitening.  Gum irritation can result from any of the whitening options but is reversible and usually mild.  Over the counter oracle can also treat these symptoms.
Before any whitening service it is always recommended to have had a dental examination and any cavities filled or other dental work accomplished.

Periodontal Probing


Katie Moynihan-Sias, BS RDH

Periodontal Probing

During your routine dental hygiene visits, your hygienist will perform an assessment called periodontal probing. Periodontal means to surround or encase a tooth. This assessment is used to determine the health of your gums and supporting structures. A periodontal probe is used to determine how deep the pockets are around your teeth. This probe consists of millimeter increment markings that allows the hygienist to measure the space between the tooth and the gums. As the hygienist performs this assessment, each millimeter measurement is documented with its correlating tooth. These measurements, along with x-rays and other assessments taken throughout the appointment, allow the dentist and hygienist to accurately recommend a proper cleaning for you.

Here is a breakdown of what each number means:

Pocket depths 1-3mm: tissues are in health with no bone loss present. Usually gums are firm and light pink in color with no bleeding upon probing.

Pocket depths 4mm: gingivitis is present but no bone loss. Usually the gums are red and inflamed with light-moderate bleeding present.

Pocket depths 5+mm: periodontitis is present with bone loss visible on x-rays. Periodontal disease can be classified as mild to advanced. Usually the gums are severely inflamed and painful, bleed easily, and tooth mobility can occur. Mild periodontitis is present with 4-5mm probe depths. Moderate periodontitis is present with 5-6mm probe depths. Advanced periodontitis is present with >6mm probe depths.

Once your hygienist performs a complete periodontal assessment of your mouth, he or she will inform you of your periodontal health. The dentist and hygienist will review all clinical assessments before recommending a proper cleaning. A “regular” cleaning may not be suitable for everyone. Once a patient presents with signs of periodontal disease, non-surgical periodontal therapy, such as scaling and root planning (a deep cleaning), will be recommended to properly treat the active disease. For more information on that please visit Non-Surgical Periodontal Therapy. In signs of advanced periodontitis, a referral to a Periodontist may be recommended for further evaluation and treatment.

The next time you are in for a cleaning, ask your hygienist for a report of your latest periodontal probings! As always, routine dental cleanings and proper homecare is recommended to keep your mouth happy and healthy!

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Staining and Whitening Toothpaste


Becky Larson, RDH

Staining and Whitening Toothpaste

What’s the deal with whitening toothpaste?  Does it really work?

First off, let’s talk about what causes teeth to become discolored or less white.  The main cause is food.  Any foods that contain dark pigment can leave dark stains on the teeth.  These include coffee, tea, soda, wine, chocolate, dark fruits, etc.  Smoking or using tobacco products can also leave dark stains.  If plaque is not removed thoroughly from the tooth surface, it can harden and has a yellow appearance.  Most of these stains can be prevented or removed.  The only real way to prevent dark stains from adhering to the teeth is not eat or drink the foods that cause the staining.  Plaque that has hardened over time will need to be removed by your dental hygienist.  If cutting these foods or drinks out is not ideal, brushing with toothpaste before and rinsing with plain water after can help reduce the amount of stain present. Efforts to reduce the amount of plaque left include brushing with an electric toothbrush twice daily for 2 minutes and use the “C” shape method of flossing where the floss is wrapped around the lateral side of the tooth while flossing.

Using a whitening toothpaste can also help reduce surface stains as well.  Many toothpaste brands offer whitening toothpastes.  In our offices we offer the Colgate Optic White toothpaste.  While all toothpastes can remove surface stains because of mild abrasive ingredients, the whitening toothpastes tend to be slightly more abrasive to further remove those tough coffee, tea, or tobacco stains left on the teeth.  The Colgate Optic White does contain hydrogen peroxide, which has a history as a bleaching agent.  However, in toothpaste, the hydrogen peroxide usually combines with other ingredients (such as baking soda) and helps to polish and wear away surface stains left on the teeth.  Usually whitening toothpastes can help whiten teeth up to about 1 shade lighter, where as in office bleaching can whiten 3-8 times lighter.

If you are worried about staining on your teeth please talk to your dentist or dental hygienist to see which products would be best for you.  Happy brushing!

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Allow me to introduce myself……..


Nora Torres, RDH

Allow me to introduce myself……..

My name is Nora Torres, Dental Hygienist.  I am somewhat new to this awesome practice.  Hard to believe it has been six months! Time sure flies by when you’re having fun!

I have been lucky to have met some of you and looking forward to meeting ALL of you! Now a little info about me:

I have been in the Dental field for 18 years! Wow! I was a Dental Assistant for eight years and I have been a Hygienist for ten years now.

My family and I moved to Arizona July 16, 2015 from Idaho (I know, huge difference)!  My husband proudly served in the Air Force for 23 years and we were ready to find our forever home. Arizona was our top choice since it’s close to our home state (New Mexico). The Air Force took us to a few places, North Carolina, Japan for three years and we were lucky to be in Idaho for 18 years. We have three children and having a place to call home for them was important to us.

I am looking forward in meeting every one of you! I know we tend to have conversations while our fingers, mouth mirror, and a sharp instrument are in your mouth! You would be amazed how good our communication skills are at that point!

We are a team of dental professionals, but also tend to get close to our patients. I like to think of it as one big, happy “dental” family! So, do not hesitate to call one of our locations to schedule your appointment today! We would love to help you and your dental needs.

We offer evening appointments and some of our offices are open on Saturdays too.  We also like to offer specials, this month we have Invisalign special for $3995!

What are you waiting for? Call our office and schedule your appointment today. I promise you not be disappointed!



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What are your Tooth Fairy Traditions?

Sharma RDH
Sharma Mulqueen RDH
What are your Tooth Fairy Traditions?
The tooth fairy is one of many childhood fantasy figures we remember fondly. We lost our baby teeth, stuck them under our pillow, and the mysterious tooth fairy would swap our teeth out for money or maybe
a special toy! What could be better than that?
The tooth fairy isn’t quite the same for everyone though!
The legend of the tooth fairy has changed over the years and even varies widely around the world. Let’s learn a little bit more about other tooth fairy traditions!
The Tooth Fairy Legend Began with Ancient Superstitions
Before the tooth fairy went looking under our pillow for baby teeth; she used to look in the ground! In early Europe, burying or burning baby teeth was a precaution taken against witches. It was believed that if a witch got a hold of one of your teeth, they could have complete power over you!
Along with a fear of witches, children were instructed to burn their teeth so that they could have a peaceful afterlife. It was believed that if a tooth wasn’t incinerated, the person would be doomed to spend eternity searching for them. As you can imagine burning their teeth was very important!
The Vikings didn’t want to destroy baby teeth, however. They even paid for them! In Norse culture, children’s teeth were believed to bring good luck in battle, so many warriors had necklaces made of children’s fallen out teeth!
The Tooth Mouse Might Be More Popular that the Fairy
In many Spanish speaking and French speaking countries like France, little children place their tooth under their pillow. Instead of the tooth fairy, they wait for the “Tooth Mouse” to come and take their tooth away and replace it with money.
What is the Tooth Mouse Called?
In French speaking countries, the tooth mouse is called La petite Souri
In Spanish speaking countries it is called
el Ratoncito Perez=Perez the mouse (Argentina, Spain)
el Raton=Little mouse= (Venezuela, Mexico and Guatemala)
Tooth Bunny
Instead of a tooth fairy or tooth mouse, El Salvador has a small bunny that comes for their baby teeth.
Tooth Tossing
In Middle Eastern Countries like Iraq, Jordan and Egypt. It is customary for the children to throw their lost teeth towards the sun, asking they send them a new, stronger tooth.
The Dominican Republic, Ethiopia, and Botswana throw their teeth onto a roof in hopes that a mouse will take the teeth from the roof and replace them with teeth that are strong like a rodent’s.
In some Asian countries, when a child loses a tooth, they give it a toss. In India, they toss it onto the roof. In Japan, they throw it straight up into the air if it came from their upper jaw, and straight down if it came from their lower jaw. Why? To ensure their new adult teeth grow in as straight as possible.
How Our Modern Tooth Fairy Came to Be
As with many American traditions, the tooth fairy has roots in European folklore. Instead of burying our teeth in the ground, we “bury” our teeth under our pillow! It is said that our modern conception of the tooth fairy came about in the early 1900s. With the help of Walt Disney’s beloved fairy characters, the idea of a tooth fairy gained popularity and became what it is today! Today’s going rate for a tooth is $3.19.
The Tooth Fairy Plays an Important Role for Children
The legend of the tooth fairy is likely still so prevalent because it helps comfort children when they lose their teeth, an experience that can be traumatic for some. When a child losses his/her teeth it can be a scary moment. Parents can comfort their children by congratulating them on losing a tooth. Bed time will be lots of fun preparing the tooth for pickup! The tooth fairy helps them see this big step as a positive experience and a sign that they are growing up!
From time to time you may be in one of our Signature offices and may spot a Tooth Fairy. Keep your eyes open.
 Tooth Fairy
If you have any questions regarding your children’s teeth, please call one of our offices and we will be glad to help you.

I am a Dental Hygienist


Peggy Crooper, RDH

I am a dental hygienist… and I love what I do.

I am a dental hygienist. I am not a dental assistant and I am not a dentist.

“Yes, I am qualified to do this. Yes, I am licensed to do this. Yes, I went to school for this. Yes, what I told you is true”.


I am a dental hygienist.

No, I do not “just clean teeth.”

Yes I do scale above and below your gum tissues to remove calculus, bacteria, and plaque from your teeth.

Yes I do polish your teeth.

Is that all I do? I will let you decide.


I am a dental hygienist.

I give multiple injections to make sure you are comfortable.

I administer nitrous oxide to make sure you are not nervous.

I take x-rays of your teeth to detect bone loss, decay and restorations.

I take complete comprehensive health histories; I take your vital signs, perform oral cancer screenings and periodontal exams to ensure not only your oral health, but your overall health.

I counsel and motivate you with tobacco cessation, nutritional counseling and oral health care. I recommend you seek medical attention if it is in your best interest.

I treat your children and I apply fluoride and sealants to save you the time, pain and expense that comes with tooth decay.

I help you achieve that whiter smile and fresh breath to give you more confidence. We know that gum disease has a contribution to other diseases, such as heart disease, diabetes, and stroke.  We are learning more everyday about this systemic link and I educate you about this link.

But I “just clean teeth.”


I am a dental hygienist.

They tell me it is not a real job. They don’t know that I went to school and have a degree.

Some have devalued my profession. Many do not even know that we are a profession.

They do not even know what to call me.


I am a dental hygienist.

I have been trained to respond to medical emergencies and give CPR.

I have learned and understand how to treat a variety of patients.

I research their medical conditions, accommodate their special needs and put their concerns as a priority.

I have extensive knowledge of the general sciences, Anatomy, Microbiology, Human Development, Pharmacology, and Psychology.

I have to be well versed in oral pathology and I look for signs of oral disease, pathology, and cancer.


I have learned to take multiple forms of x-rays and I am able to understand and explain pathology if present.

I have developed the extremely difficult skill and techniques of scaling that strains my hands, my neck, and my back while making sure you are not in pain.

I am a dental hygienist.

They say anyone can do what I do.

They say its “just a cleaning.”


I am a dental hygienist.

To be considered for Dental Hygiene school, I made A’s in Biology, Microbiology, Chemistry, Anatomy, and Physiology. I took 2 years of higher-level courses in Psychology, Mathematics, English, and other required course work.

Once accepted, I had 2 years of intensive clinical training, alongside detailed courses in Head and Neck Anatomy and Physiology, Oral Pathology, Pharmacology, Dental Anatomy, Human Development, and Public Health.

I had countless clinical examinations.

I had someone watching over my shoulder while I tried not to shake.

I had 50 patient cancellations and no-shows.

I often had to pay my patients to allow me to treat them.


I had anxiety and cried weekly.

I still have nightmares about school a year after graduation.

I took 5 licensing exams, while my nursing friends took one.

I paid thousands of extra dollars for my dental instruments, licenses, and loupes on top of my tuition. I will be paying student loans for years. And now that I am working and out of school, I must continue to take multiple courses every year to remain current and to maintain my licenses.


I am a dental hygienist.

They thanked me.

They brought me homemade gifts.

They cried out of gratitude.

They recommended their friends and family.

They requested me.

They told me all about their life, their joys and their sorrows.

They grew to love me and I them. They know that I care about them.


I am a dental hygienist.

I work in a private practice.

I work in schools.

I work in hospitals.

I work in retirement homes.

I work in jails.

I travel to other countries delivering care.

I travel to group homes for those with special needs.

I travel to multiple events to volunteer my time to helping my community.

I am a dental hygienist, and I may be underappreciated.

But I love what I do.


When I do get those patients who are thankful for my help,

I am reminded of why I chose this profession.

When I find oral cancer,

or help someone control their periodontal disease,

or help someone quit smoking,

I know I make a difference.

So whether or not you know and appreciate what I do,

I know my role in prevention of disease.

I know my role in promotion of health. I know that I am a clinician, an educator, and a health care professional. And I know that I love what I do.

Amanda Andra AZ MOM

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