Me, every day, oh wait, I am one. Nvm.

So today I had a patient that said he had never had a clean before, he's in his mid 30s. I had the same last week for a woman who'd never had a clean before. Both of them have definitely had dental treatment done and they go regularly (or at least right now they do), but it's NHS.

Under the NHS, the dentists don't regularly refer patients for a clean unless it's private as they tend not to have hygienists working under the NHS. If they have an NHS dental therapist, they may only refer them if they have gum disease/it needs a really good clean. The only time I've seen patients sent to a hygienist under the NHS with not much to clean is in student clinics. That is just the way it happens in most practices. A lot of NHS patients don't want to pay the private fee to see a hygienist, so they never go.

Then you get dentists that have a patient refuse to go for a clean once, maybe 15 years ago, and they never suggest it again even if the patient really could do with one.

There are also dentists that prefer to do their own cleanings, and having nursed for them, they're usually not very good. It's ok when it's an NHS clean as it's included (though they can often only clean the front 6 teeth on the bottom and leave everything else) but when they charge the same as the hygienist to do 10% of the job, it makes me angry for the patients.

Then you get patients like my sister, who only occasionally saw a dentist and was never recommended to have a clean, but she is very good at keeping her teeth clean so it's never clinically been needed. I regularly saw a dentist and went to see a hygienist regularly because I wanted to, I didn't need to after my first time seeing one but I liked going. Now it's whenever it's quiet and my colleague needs something to do, so maybe once a year, my last one was probably a year ago

Then you have the people that aren't registered with a dentist, usually because they want to only see an NHS dentist and refuse to pay private fees (even if they can afford them). So they'd rather wait 6 years on a waiting list, to then not be referred to a hygienist.

Unfortunately, the amount of time people spend waiting can be long enough for gingivitis to develop into periodontal disease, which then increases their risk of tooth loss, type 2 diabetes, heart disease and (emerging research) dementia/Alzheimer's/Parkinson's. Gingivitis is reversible, periodontitis is not.

Also, the vast majority of people do not know how to clean their teeth properly. They might be doing the right things but they aren't using the correct techniques, so they're not seeing the results from their efforts. This also doesn't reduce the chances of getting tooth decay so they may feel disheartened when they do need fillings after putting in all of the hard work.

If you've never been, I highly recommend seeing a hygienist, even if it's just once a year. It can be the difference between keeping your teeth in your mouth up to the age of 95 or losing them at 35! I'm not biased due to it being what I specialise in, I'm biased because there are thousands of scientific papers that prove it is massively beneficial.