Question from Hygienist

Dear Dr Ellie,

You talked with a patient of mind back in December, (name removed) from Tomball. She was so excited to get to talk to you directly. She has given me your book that you sent and I really appreciate it. I am enjoying reading it and learning a lot too. I have a question for you. I have been recommending your home care routine and xylitol mints and gums for a few months now but I have one patient that still concerns me. He began the rinses and xylitol 3 months ago.

Although his gums look much better and there is less bleeding than in the past, the continual bleeding still concerns me. He is on dilantin but assures me that he is following the instructions to a tee. I have no reason to doubt him. Is there something more I can do for him? I am concerned for his overall health as well as his dental health.

If you have any recommendations I would appreciate your help. I can’t tell you what a difference your program has meant to me and my patients. It’s so nice to have something so simple as 3 rinses because patients are much more compliant if they don’t have to change their brushing and flossing habits. They have heard all that before, but 3 rinses twice a day is pretty simple stuff and easy to follow.

Thank you for sharing your knowledge. Sincerely,

A Hygienist

Hi Hygienist!

So nice to hear your feedback and I am happy to offer some suggestions.

There are three things that I usually ask if I have someone who is not “progressing” in the way I would expect:

1. Are they cleaning their toothbrush and storing it properly?
This means keeping the brush away from an open toilet not stored in a bag.
Does your patient know how to “disinfect” his toothbrush each day?
Some people have a tough time with this and suggesting they clean their teeth in the kitchen may break the infection transfer.
Just an idea also you can place brushes in a dishwasher to clean.

2. Make sure your patient is using Crest Original toothpaste not other kinds.
Some patients keep “holding on” to tartar control or other pastes which interferes with progress.
Make sure they use correct “ingredients” This is like a cake recipe and wrong ingredients will spoil the outcome!!

Let me know if you would like me to send you some booklets about the system to hand out.
I really recommend they get the “kit” the first time to ensure they get it right then they can take empty bottles to “match” when they need more. Make sure everyone uses Closys first before brushing. The instructions on Closys does not say this and some people are confused.
The booklet may help sort this out.

3. Make sure everyone has ENOUGH xylitol each day.
This means at least 5 times a day frequency is important after meals is the best time.
I suggest talking with patients to discover if they chew gum, eat mints or drink water…..No point suggesting gum if they don’t like it etc. If someone will drink water then that works too. Put a packet of granular xylitol in the water and sip this during the day or night…..or if they cannot clean teeth before bed…..(!!) Mints or gum after meals and suddenly they have enough xylitol each day.

I think if you ask these three questions you will discover what is wrong:
1. Toothbrush hygiene?
2. Using correct ingredients? correct order no rinsing with water between go from Closys to brushing- to Listerine to ACT……
3. Sufficient exposure to xylitol ? at least 5 times a day and about 6 grams a day every day!

Hope this helps,

26 Corporate Woods
Rochester, NY 14623

Categories: Xylitol

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