Unfortunately, this has become an era of marketing schemes, and we can all agree that dental hygienists are not their demographic targets. New cosmetic and teeth-straightening products have emerged with the consumer market in mind. The products are becoming so accessible that it may even be the next drug-store impulse buy. Patients may be picking up some clear aligners along with some charcoal toothpaste and, let’s admit it, a Snickers bar from the shelf beside the checkout counter.
So, what are we supposed to do about this trend?
First, let’s discuss the concept of a clip-on veneer. This is a veneer that spans the length of the smile line, from premolar to premolar on the maxilla (if the patient prefers, on the mandible as well). Popularized by beauty bloggers and those on the other end of the camera, the curiosity has turned from a simple camera trick to people wearing these as a full-time dental solution to suit their cosmetic needs.
One company boasts about its ability to straighten, whiten, and even replace missing teeth in a person’s smile. Seen online, that same company has 4 out of 5 stars on Trustpilot from real people trying these things. The company’s products even sparked an article in Cosmopolitan magazine in 2017.
Secondly, unsupervised orthodontics has become a recent craze as well. This is slightly more unique than the clip-on veneers. The consumers involved may be more concerned with time as the primary barrier involved with it. Many patients think this form of orthodontics is the easiest and most logistical route with their work schedule. They don’t think it is feasible to make it into the office for many follow-up appointments. With online or drug store aligners, no appointments are needed.
Onslaught of Marketing Information
To discuss our role in all of this, hygienists need to accept that patients are going to do crazy things with their bodies and teeth. If we think about the sheer number of ads the typical person sees in a day, most of them starring models or celebrities, is it any surprise people are obsessed with improving appearances?
When it comes to their teeth, people will see these ads on social media and read 30 to 40 of the most recent comments. People will ask their hygienist about it, research it, and they will know in the very pit of their stomach that it is against all medical advice, and they will still click through the prompts: go to cart, check out, credit card number, CVV code, and place order.
If you think this isn’t your patients, you’re wrong.
So, the patient now has their clear aligners or clip-on veneers. What could go wrong?
With the clear aligners, there is never a radiograph to determine the health of the teeth before moving them. Even in the event that they are healthy, the lack of interproximal reduction is a scary reality as moving crowded teeth without reducing the size of them may actually push them beyond the limitations of the patient’s bony ridge.
The result? Generalized recession on the facial. Moving too quickly? Root resorption. Having an issue? Good luck talking to customer service instead of an actual team of dentists and assistants who are there to help.
With clip-on anything, just as with a partial denture or Nesbit partial, the possibility of wearing the abutment teeth away is an issue. Don’t forget that we have all met patients who refuse to take their dentures out while they sleep. So why would a clip-on denture be any different? Gingival recession from repeated irritation of taking them in and out is a probability. Imagine the petri dish it must become after a meal.
Counter with Education, The Open-Minded Kind
With that being said, let’s keep in mind that the bottom line of our job is to educate, inform, and guide patients, but we also have to be open-minded and supportive. A person’s smile can drastically impact their quality of life. Self-perception can influence work performance, a person’s willingness to pursue romantic relationships, as well as contribute to feelings of depression and hopelessness.
If they can find something to improve their self-esteem for the bargain price of a few hundred bucks, who are we to stop them?
Hygienists also need to be sensitive to the fact that some of our patients are living paycheck to paycheck. They don’t have any backup money stowed away in a fund someplace where they can just have their smile fixed. They’re not approved for financing because their credit is not good. Those patients are in our chairs every day.
Cost is a major barrier in the realm of dentistry and medicine as a whole, and insurers are often no help at all. So, patients turn to the less-costly alternative: the internet. While the patient may have crowding, stained resins, and heavily-filled anteriors, all things that we could easily correct with long-term, lasting results, just accept the fact that the patient may be satisfied with the cheaper version.
It’s Still Their Choice
So, how does this impact our care? The first step is how we respond when the topic is broached. The most important thing a hygienist needs to maintain with a patient is an open line of communication. While it is perfectly fine to discourage the use of these products in a scientific way (letting the patient know that there may be ill-effects associated with their use), you are not their mother.
It is your job to guide the patient, not to make the choice for them. The most important line you need to deliver when the patient first asks, “Have you ever heard of clip-on veneers?” is that if they plan to pursue it, we need to know about it.
Our treatment recommendations may change if the person is wearing these clip-ons for many hours during the day. They may need to be counseled about making sure they take them out to sleep and how beneficial fluoride may be to help prevent decay or wear on some of the teeth onto which the veneers clip. The last thing we want to do is to make the person feel so cognitively inept for asking about it that when they buy it anyway, they just refrain from telling us.
Conclusively, hygienists need to be aware that these things are on the market. The next time a patient asks about it, actively try to stifle the immediate and dismissive response. We need to take time with them to discuss the pros and cons.
At the end of the conversation, though, make them feel like we are on their team. If it is something they plan to pursue against our advice, that is their choice, and we will be there every step of the way to let them know if we see any damaging effects. Stress their home care and the importance of their six-month visits to monitor them through their journey.
Heck, even recommend to see them more frequently if deemed appropriate throughout their progress. Just because the marketing gimmick isn’t supervising them doesn’t mean we shouldn’t either. Be there for them. Make them feel supported, accepted, and heard. And when it all goes to crap, let them know we can probably fix it (if the damage can be treated).
