By Lee Ann Brady, DMD 

One of the most common ways that we temporize a patient who is having maxillary anterior implant dentistry is with an Essix retainer. Some patients will wear it 24 hours a day and others for less. Hopefully they are taking it out to rinse, brush, and floss, but the reality is they are wearing a removable device that covers all of the tooth surfaces for a lot of hours every day, and we’re increasing their risk of caries, decalcification, and gingivitis. 

In addition to discussing the normal oral hygiene to be done at home, in our practice, we typically dispense a product like Clinpro 5000 from 3M or MI Paste from GC America. These are high calcium and fluoride products that provide fluoride treatments inside the Essex retainer. 

• If a patient is sleeping in the Essix, the instructions are to brush and floss the teeth and then use a toothbrush to spread a little bit of Clinpro or MI Paste on the inside of the retainer before going to sleep. 
•  If they are not wearing the Essix during sleep, the instructions are the same but to wear the Essix for up to an hour every evening before removing it to go to sleep. 

If the patient’s caries risk is high, I prefer using 10% carbamide peroxide gel instead of Clinpro or MI Paste. This is the active ingredient we us in perio trays to help prevent gingivitis. This is also the means by which patients can whiten their teeth while wearing an Essix retainer. 

To prevent damage to the Essix, instruct patients to rinse it with cold water and, when not wearing it, to store it in the provided container.  

It was August of 1995 when I first walked through the doors of The Pankey Institute.

At that time, I had only one year of experience under my belt as a licensed hygienist, and I believed I had won the “dental lottery” by having spent the past six months working for a Pankey Institute trained dentist. Dr. Steve Ratcliff was passionate about the Institute and his philosophy of care that was inspired by what he was learning there. He proudly shared everything possible with me about how he wanted our practice to develop.

It was a hands-on perio course at the Institute where I eagerly learned about non-traditional use of Gracey currettes, utilization of ultrasonics, and the current science of periodontal disease and its management with Dr. Sam Low. I remember being so nervous and so excited. There were hygienists from all over the country with similar desires, challenges, and dreams, and together we formed a sweet community of our own, learning and growing together with an even better understanding of what was possible as a dental hygienist.

It’s difficult to believe that 25 years have flown by, and it’s so cool that here I am about to lead the 2020 version of that very same program. Appreciating the magnitude and beauty of Quid Pro Quo, I’m honored to now be teaching with Dr. Sam Low to support hygienists toward their full scope of practice.

Our program will focus on two key components of the hygiene chair:

1. What it means to be a Restorative Partner in your practice by deepening the art of co-discovery and patient engagement.

2. Understanding current science around the diagnosis and management of periodontal disease, including hands-on utilization of power instruments, air polishing, and adjunctive therapies.

There are many pieces and parts to my enthusiasm about this program, The Pankey Hygienist.

What brings me the most joy is knowing that I get to share “my version” of Dr. L.D. Pankey’s philosophy with the doctors and hygienists in attendance. The Institute was certainly a game-changer for our practice and our patients 25 years ago. It continues to be a life-changing experience for me each and every time I get to be within this community, whether it is at the Institute, at an offsite event, or visiting other dental practices inspired by their own time with the Institute. I’m not just grateful. I’m “over the moon” grateful for this life.