Preventive Care

Amabrush (and all other mouthpiece toothbrushes) do NOT clean your teeth in ten seconds

June 27, 2017 By DentalBuzz Staff 24 Comments

Update 10/22/2021: Don’t buy mouthpiece toothbrushes. Not only do they not work, most of them don’t even turn on. It’s an easy way to get people to send money for scammy things. Need more proof? Go to Electric Teeth at the link below – they have much more current information than you’ll find here.

Mouthpiece toothbrushes: think twice before you buy

IMPORTANT UPDATE 6/5/19: The Amabrush is extinct. This article is useless. Scroll to the bottom to learn why.

What do you get when you start with a silicone sports mouthguard, embed it with hundreds of tiny bristles, and magnetize a rechargable toothpaste ball that vibrates and cleans all of your teeth at the same time? DentalBuzz recently sat down with the inventor of the new Amabrush to find out where this thing came from, where it’s going, and how to get one.

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DentalBuzz: Hi Marvin. Thanks for joining us here at DentalBuzz. What’s the story? Tell us about yourself and your company, how you got into the business of toothbrushing, where the name Amabrush came from.

Marvin Musialek: Thank you for having me! Well, my name is Marvin and I’m the founder of Amabrush, a completely redefined toothbrush. I came up with this idea 6 years ago. I brush my teeth twice a day, not because I want to, but because I have to, and this is every dentist’s advice.

Six years ago I stood in front of the bathroom-mirror as usual, and asked myself, “Why are we on the edge of self-driving cars, but we all still have to stand in front of the mirror and put a stick with nylon-bristles into our mouth, in order to clean our teeth?” Since then I thought about an autonomous cleaning-robot-thingy everyday. Three years later there was still no product like this on the market, and I simply decided to “do it on my own.” I did a lot of research and put a strong team together from many disciplines: dentists, biomedical engineers, physics engineers, electronic engineers and even a psychologist. We had to clarify even the simplest questions with a scientific approach. Why are we brushing our teeth? How should we do it correctly? How much toothpaste? What angle should the bristles have? And so forth. We have been developing Amabrush for the last 3 years and have also received grants from the Austrian Government and the European Commission. With our own money and these grants we were able to finance the cost-intensive development of numerous different prototypes, test-units, pre-production-devices and expert-consultations. Our redefined toothbrush should be seen as a stable and good friend, who takes over an annoying and time-intensive task (toothbrushing) for everyone. So we decided to call it Amabrush, so people who ask “what’s that?” will get their answer: “I’m a brush.”

DB: Since it doesn’t look like a typical brush, that’s perfect! And endearing. Kind of like the name talks back to you when you say it.

Now, you’re in Austria but also have offices in San Francisco? Before everyone in the United States gets addicted to using your brush, we want to make sure that replacements will be easily available. What percentage of your sales do you see coming to the US once you’re in the retail market?

MM: Yes that’s right. We estimate that 50% of our sales will take place in Europe, especially in German-speaking Europe (Germany/Austria/Switzerland) and the other 50% will take place in North America, especially in the United States. This coincides with our research and as well with our current subscribers, who are also equally distributed between these two regions. Because of that we want to produce Amabrush in these two different regions in the long run.

DB: You have subscribers already? For a product that they can’t even get yet? Okay, so we haven’t even talked about the toothbrush. You’re estimating that its retail price is going to be around $200. While you can’t put a price on good dental health, there have been regular electric toothbrushes in this range for years that have proven not to work any better than the $60 version of the same brand (yes, we’re talking about you, Sonicare). Explain what it is about the Amabrush that puts it far ahead of its competition, and why it is a value at $200.

MM: Yes indeed. We already got 7000 subscribers within a month, which is really, really great. That proves to us that our community is as excited as we are about a toothbrush that takes over the task of toothbrushing. There are many low-priced electric toothbrushes available, but also many high-priced ones. The cost of Amabrush is more to the mid- and high-range, but the brush itself is really high-end. We had to develop everything from scratch, like the micro-pump that foams the toothpaste, the specially formulated toothpaste itself, and the mouthpiece, which was one of the most complicated parts. Not only because we use an uncommon material (anti-bacterial silicone) with a specific toughness, but also because of the integrated, carefully arranged bristles and the micro-channels that deliver the toothpaste directly to the customers’ teeth.

DB: This has the potential to change everything we think we have to do to take care of our teeth. A silicone mouthpiece instead of a handle that you hold as you move a small brush around your mouth, brushing every tooth at the same time, Bass method bristle alignment, self-contained toothpaste, sonic vibrations. If this brush is capable of consistent and thorough plaque removal, then you may have just created the holy grail of preventive dentistry. When and where will customers get the Amabrush once they’re available to the general public?

MM: We have to explain this completely new concept of toothbrushing to people a lot. Amabrush is currently “online-only.” The simplest way for people to inform themselves about Amabrush is over the internet with our online-shop and our website. But in the long run we definitely want to bring Amabrush into grocery stores and drug stores, because the majority of people still buy personal care products “offline.”

DB: Do you see an application for people whose hand dexterity is limited?

MM: Amabrush is definitely also for people with hand disabilities. We developed Amabrush on purpose as a hands-free device, not only that it is as convenient and automatically as possible, but also that there is no barrier in order to use it.

DB: What does it feel like to use?

MM: It feels like if someone else brushes your teeth with a soft bristled toothbrush paired with the feeling of a gingival massage.

DB: So it’s sort of like having your teeth cleaned by a professional? We would imagine that would be pretty effective. What kinds of plaque index scores are you getting; in other words, how well does the Amabrush actually clean compared to manual or other electric toothbrushes?

MM: That’s true, it does a pretty good job at cleaning your teeth! We’ve had plaque index scores calculated by an independent clinical institution and have been pleased with the results. What’s worth knowing is that Amabrush is not necessarily better than a regular manual or electric toothbrush, because common toothbrushes work good enough if they are used properly. The thing is, Amabrush is way more convenient. You can do so many things wrong with a regular toothbrush, as you have to be highly concentrated for at least 120 seconds each time you brush your teeth. And while brushing, you should use different methods like the Bass method paired with the red-white technique. This is not only time-consuming, but also annoying for most people. Because of this, people usually tend to do something else while brushing their teeth. Furthermore, they put too much pressure on the toothbrush which can damage their gum. What’s more, most of the people don’t brush their teeth long enough. Amabrush cleans your teeth the same every time, with the right technique, and does not depend on your concentration.

DB: What it sounds like you’re saying is that the problem with electric toothbrushes is that manual ones are just that – they have to be moved around with your hand, so even if they’re the best at what they do, they’ll still miss areas because the human being attached to the hand doesn’t apply the brush properly. The Amabrush provides hands-free brushing at a fraction of the time? Very novel.

Back to your subscribers, then. How can subscribers order the Amabrush? How can I get one as a consumer? What do I need to do?

MM: Interested customers can subscribe to our newsletter right now on our website. We created a landing-page that explains all relevant information and details about Amabrush and the upcoming Kickstarter campaign. Speaking of which, this will be the first opportunity for our customers to get Amabrush. We will start our crowdfunding-campaign on Kickstarter next week (end of June 2017). Customers have the ability to support our project, and as a return, get Amabrush at a strongly discounted price ($69 instead of $199)!

Regarding your question what the customer needs to do: simply sign up for our newsletter on our website (www.amabrush.com). We will send a reminder with the exact date of our Kickstarter-campaign to all subscribers. When the campaign is live, simply choose a package that suits best for you. All of them are strongly discounted, as this is our way to say “Thank you” to all of our supporters and the community!

DB: Dentists and dental hygienists are particularly interested in finding new ways like yours to pass on to our patients that help them keep their mouths healthy. Do you have anything more you’d like to say to us?

MM: Our pre-production units are already in the making, in order to be shipped around the globe to various dentists. We highly appreciate feedback and input from every professional expert in order to make Amabrush as perfect as it can be. We are really looking forward to the support of our community!

DB: Thanks again, Marvin for sharing your story with us, and we sincerely hope that you get all the attention that this Kickstarter campaign deserves.

MM: We hope that too. Thank you very much for the interview and the great time!

UPDATE 6/28/2017: Amabrush announced today that the launch date for their Kickstarter campaign is next week – July 5, 2017.

UPDATE 7/5/2017: The campaign is now live, with the Amabrush expected to begin shipments in December 2017. This video shows close-up vibrations of the prototype. We imagine that the production version will be even more refined.

UPDATE 8/31/2018: It’s taken quite a bit longer than expected, but today Amabrush announced that they will start to ship brushes very soon. The best part? Their testing suggests that all the hard work means that this is a true 10-second toothbrush and not a gimmick. Here’s what came in the mail:

Many patients took part in our dental studies, which took place on 3 different dates with a minimum interval of 24 hours. The tests were performed and evaluated by independent dentists. Amabrush was tested simultaneously with two different institutions and two different sets of patients.

The TQHPI (Turesky modified Quigley Hein Plaque Index) which we used as the method determines how much plaque was present on the teeth – the lower the value, the less plaque on the teeth.

Test procedure

1.) 24 hours before the test, participants were not allowed to brush their teeth. For the plaque test, the patients chewed plaque disclosing tablets so that the dentist could then determine the initial plaque values (tablet is used to make plaque visible).

2.) Patients had to brush their teeth with a regular manual toothbrush for at least two minutes. The remaining plaque values were determined afterwards.

3.) The same process was repeated for the second appointment one week later, but this time with using the Amabrush instead of the manual toothbrush. Teeth were cleaned for just 10 seconds and the dentist determined the plaque values again.

Results

The plaque index decreased statistically significant and there was no statistically significant difference between Amabrush (with 10 seconds brushing time) compared to a regular manual toothbrush (with roughly 3 minutes brushing time on average).

These results make us truly proud and show us that hard work, clever engineering and patience pays off for all of us. We hope that you also like those results, which we would have never reached without your support, help, and feedback!

Want to know when we post a detailed review of the Amabrush once it’s available and we’ve had a chance to chomp on it? Be sure to subscribe to DentalBuzz by adding your email address and you’ll automatically get notifications each time we add a new article.

FINAL UPDATE 6/5/19: Nevermind. Amabrush is officially done. No surprise there, unfortunately, because they’ve been propping up their company with delays for the last two years. Here at DentalBuzz, we never even received our super early bird Amabrush. What’s worse though, is our role in this for convincing our readers to invest in the Kickstarter campaign. At this point, we feel sort of like everyone who invested in Theranos, with their fake blood testing. Great ideas still depend on that which is physically possible, but Marvin still doesn’t seem to get this! You can read the litany of excuses here from Amabrush: https://www.amabrush.at/blogs/news/important-information-regarding-amabrush-company. Bottom line? We’re sorry, and you still have to brush your teeth for two minutes.

Get Listerine fluoride for free with Obamacare – maybe

January 30, 2017 By Trish Walraven Leave a Comment

I feel very targeted right now.

It’s because I’m one of the 16% of Americans that everyone is fighting to either “guarantee insurance” for or “force insurance” upon, depending on which side of the aisle you stand.

You see, my family has Obamacare.

It’s not because we can’t afford anything else. It’s because there simply is no other major medical care available for small employers who either aren’t required to offer insurance to their employees or cannot obtain group insurance because of the size of the company. We privately purchase the exact same plan offered on the Marketplace; it’s off the exchange, though, so there are no subsidies.

Here’s the cool (mint?) reason for mentioning this on DentalBuzz. As part of a family that’s enrolled in a plan that was created due to Obamacare, I discovered by accident that there’s a way to get Listerine fluoride rinse for free.

What happened is that I was browsing through the 2017 drug formulary from my insurance company and found something called the ACA Tier. Almost every exchange-eligible plan has a No-Cost Preventive Drug List like this one from Blue Cross Blue Shield of Texas. It states in part:

Your health plan may include certain prescription and over-the-counter (OTC) preventive medicines, as a benefit of membership, at no cost to you when you use a pharmacy or doctor in your health plan’s network. There is no co-pay, deductible or coinsurance, even if your deductible or out-of-pocket maximum has not been met. Coverage for these medicines can vary according to the type of plan you are enrolled in…. Age limits, restrictions and other requirements may apply.”

So I’m going down the list and notice several entries for Listerine:

How can I get my free bottle, that’s what I said to myself when I read this. You want your free bottle too? Not so fast. All ACA-qualified plans are only required to cover fluoride for children under age 6. Which may mean that if you have children enrolled in Obamacare and they’re preschoolers, all you may have to do is to take your child’s bottle of Listerine up to the pharmacy window, present the insurance card, and they’re supposed to zero out the expense for you. I called my insurance company and this is what they stated. You’ll need to check your own benefit booklet first, though, because some plans only cover fluoride in other forms.

As a dental hygienist and mom, though, what’s a little perplexing is trying to figure out the label directions. We’ll go after this bottle of Listerine Smart Rinse, cause it’s cute and tough all at the same time.

Toddler-friendly? Check again.

There is a huge disconnect between the FDA and the ACA, and it shows on this label! The Food and Drug Administration says you shouldn’t give it to children under six without consulting a dentist or doctor, but the Affordable Care Act pays for its use only for children that age.

Anyway, we all realize that healthcare in the United States is a work in progress. In other words, it’s a mess, right? And most of us are very much out of our element when we’re trying to figure out what’s covered and what’s not. Did you know that even most dentists and hygienists are clueless about fluoride benefits and the ACA? The only reason that I know anything myself is because I did a bit of sleuthing, found a lot of the Obamacare plans in each state, read their Preventive Drug lists, and then compiled the research. Sure, this article starts off with a little Listerine click-bait (hah! Social Marketing 101 – make ’em look!) but I do want to offer some important education, too. Here goes.

• What do all ACA-qualified plans have in common with each other? At the very least, every insurance policy must include fluoride supplementation at no cost for children under age 5. Supplements are recommended mostly in areas where the fluoride level in water supplies are inadequate, and age five and below is the time frame when teeth can be protected most by the ingestion of fluoride. The supplements can be in the form of drops, chewable tablets, or as combination vitamins. All fluoride supplements require a prescription, either from a dentist or a physician’s office.

• Many health plans also pay for the in-office topical application of fluoride varnish. This is covered by the medical side of the plan, not the dental benefit, so you should either be savvy with using the medical code (CPT 99188) or leave it in the pediatricians’ sticky hands. Haha, sticky hands. If you’ve ever worked with fluoride varnish, it sticks to evvvverrrrry thing if you’re not careful. But hey, it’s why varnish can give up to six months of cavity protection, too. Some plans cover fluoride varnish applications as an unlimited benefit, however, I found that most plans pay for no more than two applications per calendar year.

• Some of the plans reviewed include prescribed and/or over the counter (OTC) topical fluoride gels, pastes, and rinses, such as the previously mentioned Listerine Fluoride, Act Rinse, Prevident, Fluoridex, Gel-Kam, Clinpro 5000, Phos-Flur, Omni Gel and others. A few of the plans even list brand-name toothpastes, although I wouldn’t count on those getting covered.

Although I reviewed somewhere in the range of 50-100 healthcare plans available, I can’t tell you specifically which fluoride products are covered by, say, Cigna versus Aetna, because they vary so much between states. You’ll have to read your plan, or better yet, call your insurance company. Be sure to share what you discover with your dentist, hygienist, or physician, so they can help your kids get the fluoride prevention that you’ve already pre-paid for.

Because, let’s face it, pre-payment is what preventive healthcare insurance is, anyways. You only “pay an ounce” for prevention, after all, so you should get at least that much back. Especially when a pound – 16 fluid ounces – of Listerine fluoride costs your insurance company only five bucks.

It sure beats the bill for a pound of actual cure.

Trish Walraven, RDH, BS is a dental hygienist from the Dallas/Fort Worth area who cropped out her lovely daughter in this photo because it’s very, very obvious that she’s older than five. She didn’t want the Obamacare Police to have anything on her if she did show up at the pharmacy begging for her “free” bottle of bubble-gum fluoride rinse.

References and resources

United States Census Bureau, Health Insurance Coverage in the United States: 2015 https://www.census.gov/library/publications/2016/demo/p60-257.html

Aetna Health Care Reform Preventive Care Drug List: https://www.aetna.com/content/dam/aetna/pdfs/formulary/2016_HCR_Preventive.pdf

American Academy of Pediatrics – Oral Health Coding Fact Sheet for Primary Care Physicians: https://www.aap.org/en-us/Documents/coding_factsheet_oral_health.pdf

Science-Based Medicine. Preventing Tooth Decay in Kids: Fluoride and the Role of Non-Dentist Health Care Providers https://sciencebasedmedicine.org/preventing-tooth-decay-in-kids-fluoride-and-the-role-of-non-dentist-health-care-providers/

Kaiser Family Foundation. Health Insurance Coverage of the Total Population: http://kff.org/other/state-indicator/total-population/?currentTimeframe=0

United Healthcare. Topical Fluoride Treatment Dental Clinical Policy: https://www.unitedhealthcareonline.comTopical%20Fluoride.pdf

Humana Pharmacy Solutions. $0 Preventive Medication Coverage: http://apps.humana.com/marketing/documents.asp?file=2838979

Kaiser Permanente. Preventive Services Flier: http://apps.humana.com/marketing/documents.asp?file=2838979

How do you floss under a retainer?

March 14, 2016 By Trish Walraven 17 Comments

It used to be such a dread, seeing patients with fixed lingual retainers. I mean, they’re great because they keep your teeth from shifting after you’ve had braces, but GAWRSH, do they have to be so difficult to floss around?

Not any more.

Thanks to the talented hygienists over at Hygiene Edge we now can share this super-easy secret with patients as well!

Here’s how you do it:

It’s embarrassing to say this, but it took me over 20 years as a dental hygienist to find out about this trick, so now I’m thrilled to see lingual retainers on patients because it gives me a chance to share this newfound secret. That’s why I’m sharing it here, too. And as for you poor folks whose retainers are glued to each and every front tooth? I’m sorry, this trick doesn’t work. You’ll just have to stick it to ’em instead:

Remember, it’s all about friction. Whatever gets in there is good by me.

A blogger since 1997, Trish Walraven, RDH, BSDH is a mom and practicing dental hygienist in the suburbs of Dallas, Texas. Her mission with DentalBuzz is to offer a fresh podium of discourse for those involved in dentistry and to expose fun in our professional lives.

Candy that really fights cavities

February 18, 2016 By Trish Walraven 13 Comments

Why do you get cavities? It’s not because your teeth are soft. Cavities happen in mouths where the environment is all jacked up. Too much acid, too many germs, an abundance of refined foods, too little saliva. Basically the little ecosystem in your mouth is out of whack.

How do you get it back in balance? You already know some things you can do: eat better, brush and floss better, drink water. Sometimes, though that’s not enough. What do you do between meals? Between brushing?

You change the mouth itself by changing what can grow in there.

One way is with licorice:

No, that doesn’t count, sorry. It has to be real, tar-black, sugarless licorice. Real licorice contains licorice extract (unfortunately, that’s the stuff that makes it taste way worse than Red Vines). The way that licorice fights cavities is by changing the mouth environment so that the germs that cause cavities are inhibited.

These are licorice roots:

Licorice roots have been around ever since the original hunters and gatherers realized they were sweet-ish, quenched thirst, and tasted much better than most of the other twigs and sticks they used to dig around in their gums and teeth. Maybe they realized their teeth hurt less when they chewed on them, too. Licorice roots contain a compound called glycyrrhizin, which has been proven to reduce tooth decay. They’re cheap, natural, and abundant; you can even buy them here at this link on Amazon.com. But a word of caution: glycyrrhizin can be dangerous in excess amounts. Since licorice root is considered a natural herb, there’s no way for the FDA to regulate the dosage, and too much of it can cause heart arrhythmias, increase blood pressure, and reduce potassium levels.

If your response to black licorice and licorice roots are No, and Hell No, respectively, then how in the heck do you think you’re going to get kids to put licorice extract in their mouths?

Enter capitalism at its finest, folks.

When this company contacted me about a year ago, I was excited to ~~eat free candy~~ write a product review about something that may really help my patients prevent cavities. Remember what I was saying about licorice? Cavibloc™ is the proprietary formulation of licorice extract used in Loloz™ that you can read on their ingredient list here:

How this works

I’ve seen enough studies and listened to tons of lectures from smart people who know what they’re talking about to be convinced that the science is very strong behind using licorice extract in this way to prevent dental cavities. Here’s the biggest problem about it, though: it doesn’t work if you don’t use it, duh. Follow the steps below to get started on this great cavity prevention regimen:

1. Overcome your objections. Just so you know, I’ve eaten practically a whole box of the berry flavored pops, given them to my kids and friends of my kids, and they taste good. Really good. No problem on the flavor at all. Also, it will cost about $90/year for three boxes. Those are the big obstacles. Everything after this is easy.

2. Buy your boxes at Amazon.com. Lookie, it even comes with Amazon Prime! Here are your flavor choices (and by the way, these are NOT affiliate links – I’m not making any money off of this, just in case you doubt my sincerity):

Loloz Berry Lollipops

Loloz Orange Lollipops

Loloz Lemon Lollipops

For people who aren’t into the whole “stick hanging out of your mouth” thing, there are candy lozenges, too:

Loloz Berry Candy

Loloz Orange Candy

Loloz Lemon Candy

3. Open up your box when it arrives.

You’ll get 20 suckers per box… but maybe they’ll throw in a few for a bonus, with a note to let you know they didn’t count wrong. Maybe eat one of the extra ones as soon as you get them, to make sure you’re going to like them. Then…

4. Put them in the car. What? Following the recommended regimen is the most important part. It takes about 10 days of consecutive exposure time for licorice extract to disrupt the germs that cause cavities. And not just once per day. Two times per day for ten days. You’ll want to have one sucker in the morning, one in the evening. But how do you remember to have two per day? You and your kids (if you take them to school and/or work) are in your car at least twice per day. Maybe you don’t actually leave the lollipops in the car because they may get icky gooey on hot days. But you know what I mean. Discipline yourself to make sure you’re using them two times per day.

5. Repeat in 4 months. You’ll do this about three times per year for excellent cavity control, plus you get to feel good about eating candy. Whee! Over time, the bad bacteria will start creeping back in, but starting up another 10-day treatment in 3 to 4 months will help balance out the mouth environment once again. People who get cavities easily need licorice root extract. It’s just that simple. If you’ve ever been given a prescription for high fluoride toothpaste, Loloz are for you.

So you may be asking yourself, why no one else is talking about this, why there might not be a lot of Amazon reviews on Loloz, it must not be any good, right? No, that’s not it. The company made a big push a year ago to get the word out, but marketing these days is a tricky thing for new companies. I am confident that the product is spot-on, and I’m here to reinforce again to you that balancing your mouth environment is one of the most important things you can do to prevent cavities. There are other ways to reduce tooth decay, but right now Loloz are your best bet for obtaining a proven, long-term, dose-controlled antimicrobial effect against decay-causing bacteria. And if you’re a dentist or hygienist who is thinking about recommending this to your patients, remember:

COMPLIANCE IS EVERYTHING!

…She says, with a delicious, sugar-free Loloz lollipop in her mouth.

Trish Walraven RDH, BSDH is a mom and practicing dental hygienist in the suburbs of Dallas, Texas. She has a very, very bad sweet tooth and doesn’t take money from companies like Loloz because she’s afraid they would give her a lifetime supply of sugarless candy which would be no fun because, hey, if it’s good for you, the days of living dangerously from sugar highs just go phhhht. gone.

Resources and References:

International Journal of Pharma and Bio Sciences, January 2015. “Assessing the effectiveness of liquorice root extract lollopop in reducing the S. mutans count in saliva in children aged 6-12 yrs – a pilot study.” http://www.ijpbs.net/cms/php/upload/4020_pdf.pdf

European Academy of Pediatric Dentistry, December 2010. “Clinical reduction of S. mutans in pre-school children using a novel liquorice root extract lollipop: a pilot study.” http://www.ncbi.nlm.nih.gov/pubmed/21108917

Medscape, January 2012. “Licorice Root May Cut Cavities, Gum Disease.” http://www.medscape.com/viewarticle/756532

John C. Comisi, DDS, MAGD, April 2013. “Employing a whole-patient approach to the lifelong struggle of caries management.” http://www.dentalaegis.com/id/2013/04/oral-disease-the-battle-for-balance

British Dental Journal, December 2009. “Liquorice Alert.” http://www.nature.com/bdj/journal/v207/n11/full/sj.bdj.2009.1090.html

A hygienist’s answer to “what do you do?”

March 11, 2015 By DentalBuzz Staff 8 Comments

If you read Dentaltown Magazine, you may have received the edited, paper version of this article today in your snail mail box. But because I don’t have to make room for saliva ejector advertisements in the sidebar (seriously, this article helps sell SALIVA EJECTORS!) you can enjoy the original here in its more raw form.

A hygienist’s answer to “What do you do?”

by Trish Walraven RDH, BS

You’re at a gathering of acquaintances, a general hob-nobbery of casual conversing, one of those social obligations that you love/hate because you’re really more of an outgoing introvert, someone who plays well with others but enjoys their quiet, navel-gazing world too. Sooner or later you know that the question will be asked.

“So, what do you do?”

No hesitation here. You know what your profession is. You have a title, a position, a calling.

Then that inner part of your thinking begins to twitch.

You weren’t asked about your job title, actually. You were asked a direct question: What do you do?

The typical reaction of hearing that you’re a dentist or hygienist involves a full disregard of the art and compassion that you put into your profession. People want to tell you about their bad experiences as a child, or how much they hate you (but don’t take it personally!). They just nod, warily, quietly, at your response and quickly think of a way to change the subject.

Instead of giving away the conversation and letting it slide into other people’s thought bubbles, then, you can steer the dialogue back to the original question, and the feel-good answer you’ve prepared instead.

“I take care of people’s teeth.”

You’re a regular Mother Theresa now, aren’t you? The way you dedicate your life’s work to helping others, it’s so freaking noble. This response elicits a smile of comfort and familiarity from your obligatory small-talk partner. The conversation can move forward now that your profession has been deemed socially acceptable.

An hour later, driving home, you’re blissfully alone with your thoughts, rewinding your earlier social interactivity, musing over the highlights, and you really, deeply, ask yourself in hindsight, “what do I do?”

I can’t speak for dentists, but if you’re a dental hygienist, you do some pretty strange things, actually.

First of all, perfection to you is wave-shaped. It’s the curve of a thin scallop of attached pinkness that anoints each interproximal space with a coral-tipped point of the healthiest gingiva imaginable. Anything less than this in your patients’ mouths is limbo. Chaos is the reason your job exists, but you always hunger for order and balance. To achieve this imagined perfection in a mouth that is not optimal, then, means that you often resort to some diversions along the way. It’s about the journey, not the destination, right?

How do you handle the patient whose lower anterior linguals are piled with a couple of grams of Grade A calcium phosphate? Sure, you could just chunk the calculus off. But sometimes, when you’re feeling a little dastardly, you carve out the top and the bottom of the tartar evenly, so that you’ve left a neat chalky white mustache, complete with curlicues. With artistic satisfaction, you turn your attention back to your duty and politely erase the Banksy-esque dental graffiti from your patient’s teeth.

This is not something you tell people that you do.

You also tell no one that your deepest fear is running into anything artificial while you’re cleaning someone’s teeth. Your ultrasonic scaler turns into a fierce lead pencil in those situations, which means not only that you are wearing down your precious metal antennae into useless nubs, but also that you’re leaving dark lines where there was once only whiteness. Every last bit of old orthodontic cement has now been revealed like a charcoal rubbing, thanks to you. And you would never admit to leaving a grey streak on a brand new porcelain crown. How could you slip like that? You hope like heck that the prophy paste will get that scary line off before anyone notices.

When it comes to things that you enjoy, then, there’s a bit of hesitation about sharing those stories as well. Like hovering around the periapical abcess that’s begging to be relieved? Or when you’re spraying baking soda slurry under a bridge and the patient becomes aware that its odor speaks more than the thousand words that you could ever say about superfloss? To you the stink is like scoring a point. Or why your trophy at the end of a particularly difficult appointment is a 2×2 gauze loaded with something that looks like buckshot, but is really your patient’s carefully extracted calculus? Fun times.

Probably the most difficult part of your career, though, has to do with patient management. Unless you’re regularly disengaging people from their mouths via nitrous oxide, there are forceful tongues, and lip pulls, and saliva ropes, and people who forget that it’s safe to swallow their own spit. Suck. Suck. Suck. Ten times a minute. At least this way they’re remembering to breathe. When they forget to breathe they feel like they are drowning. It’s not the water; they’re just suffocating because you’re blocking any chance of mouth breathing. Never mind that noses are much more optimal for breathing but whatever. Not everyone has learned how to snorkel either. And how do you convince patients that unless they just ate a handful of almonds, brushing immediately before their dental appointment won’t make your task any easier?

Then there are the patients themselves. Not just their mouths, but the whole person. Patients whose embarrassment about their teeth are the reason they haven’t been to a dentist in a while. People who not only open their mouths but open up to you, tell you their secrets, their fears, their wishes and hopes. People who trust you to take care of them, to love them, to nurture them towards health. They see something special in your eyes, and they open wide.

So go ahead and make it known out there in the big world that you’re hygienist. Or a dentist. You scale teeth. You drill teeth. No biggie. That’s what you do.

What really matters, though, are the reasons why.

Trish Walraven RDH, BSDH is a mom and practicing dental hygienist in the suburbs of Dallas, Texas. She is a bit of an an introvert when she’s writing dental articles, but you get her together with her best friend from high school and Irish festival beer and she begins to make faces like this. She also makes faces like this under her mask if her patients aren’t paying attention to her flossing instructions.

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