Channing Harris leaned over her patient, peering into the woman’s mouth. Scritch, scritch. The sound of steel on teeth cut through the silence.
Lana Bell, University of Arkansas – Fort Smith dental hygiene instructor, stepped into the work area to watch the junior bent over her work. Bell offered suggestions such as switching the light to brighter and having Harris hold her hand at a different angle while applying more pressure. With the added pressure, the scritch deepened to scratch, as Harris’ patient lay back with her mouth open.
That patient took Harris, when she was a child, to dental appointments and so introduced her to her future career. It was natural to Amy Nelson, ’87, to volunteer to be her daughter’s first patient.
“I told her we’re making memories,” Nelson said.
Harris, of Van Buren, Arkansas, is a member of the 13-person cohort ushering in the dental hygiene program’s move to a bachelor’s degree. Students now must earn 120 hours to graduate, up from the 88 credit hours for the associate degree. They must take statistics and textual research in addition to anatomy, microbiology, physiology and chemistry before applying to the program.
“Our students need to provide evidence based care,” said Pam Davidson, executive director of dental hygiene. “We want them to be able to write and do research.”
Once in the program – which only accepts up to 16 students from the 80 that apply – juniors learn about head and neck anatomy, dental anatomy and teeth characteristics. They also learn how to clean teeth and under gums. They start out on dummy heads before moving on to other students in the program. Then at the beginning of the spring semester, the juniors see their first real patients, whom they treat during three days with three hours per treatment. While some students see friends and family for their first patients, others treat patients from the community who schedule appointments at the low-cost UAFS clinic. All of the patients receive care from students who are overseen by professional dental hygienists.
“At first we’re really hovering, then we gradually pull back,” Davidson said. “At the end, you’re watching them do what they’re supposed to do.”
Senior Jessie Woerpel of Hot Springs, Arkansas, now requires little oversight in cleaning her patients’ teeth.
“It’s cool when you finish your first patient in one appointment,” Woerpel said. “You think, ‘This is what the real world will be like.’”
But she remembers well the combination of nerves and excitement before she started cleaning her father’s teeth. A former athlete, she compared it to the feeling before a championship game.
“It’s that moment where you’re so excited but you want to throw up at the same time,” she said. “It was a moment that I dreamt of since I was a weird little kid in the dental office.”
Woerpel and Harris wanted to work with teeth since they were children, both inspired by regular trips to the dentist. Woerpel celebrated her birthday when she was in the third grade with a visit to the dentist and then to the humane society to select a puppy.
“It was the best day ever,” she said.
In kindergarten, Harris declared she wanted to be a dentist. Through years of dentist visits, braces and dental appliances, she changed her focus to become a dental hygienist.
“When you’re a dental hygienist you can’t diagnose like a dentist, but you can still help people,” Harris said.
As a second-semester junior, Harris and the others in her cohort began to give that help to patients. On Nelson’s first visit, Harris questioned her mother about her medical history, and checked her temperature and pulse before taking her blood pressure. She felt along her mother’s neck and jawline for abnormal bumps. Only then did she have her mother open her mouth to check for bumps on the mouth and tongue. Then she took a look at the hard and soft palates, throat and uvula since Nelson’s tonsils had been removed. Then she examined the gums.
“Now, I’ll probe your whole mouth to check for pocket depths,” Harris said. “It’ll be fun.”
“For who?” her mother replied.
“For me,” Harris said as she put on her safety goggles with magnifying lenses and a light.
By the time Harris, Woerpel and other dental hygiene students graduate they will have checked the gum pockets of at least 60 patients. Most of the students will have treated more than that. With each mouth opening wide, the students gain experience by helping people with a variety of medical and dental conditions as well as patients of all ages, from children to elderly, in the UAFS Dental Clinic. During the 2013-14 academic year, students saw almost 900 patients in the clinic.
Patients will sometimes come in refusing to smile and covering their mouths with their hands because they’re embarrassed by their dental conditions, Woerpel said.
“You help them feel better about themselves,” she said. “When they leave they’re smiling more.”
With each patient, the students gain confidence in their abilities and know their equipment better. Instead of searching for the right tool, their hands gain sureness.
“It’s like learning to use chopsticks,” Woerpel said. “You fumble around and then you can finally pick up sushi and it’s like, ‘I’ve got this.’”
By graduation, students will have spoken to groups about good dental hygiene and worked in the Community Dental Clinic as part of community outreach. They will have presented research to local dentists and dental hygienists.
Through clinical experience, the skills grow sharper and the knowledge wider. Both are important as the students must pass a national written exam and a clinical exam to obtain certification. UAFS has a 100 percent pass rate on the written boards and an exceptional pass rate on the clinical board.
“You need a quality student because it’s a hard program, a rigorous program,” said Davidson.
When Harris was nearly finished scratching the calculus from her mother’s teeth, Bell returned to review her work. She showed Harris how to access hard-to-reach places and to better position the small mirror to see the work.
“Use little tiny, tiny strokes,” Bell said. “Can you feel it? … Right there. …You got it.”
“Oh,” Harris said as a flake popped free, to Nelson and Bell’s laughter. “Who knew that something so microscopic and minuscule could make you excited?”
Soon Harris finished the mint-flavored polishing of her mother’s teeth. After being checked one more time by Bell and Dr. Stephen Rappeport, the clinic’s dentist, and the administering of a fluoride treatment, Harris finished her first patient’s care.
“I’m glad I got to experience it with her,” Nelson said.
“You were a great patient,” Harris said.
That afternoon Harris began treating her next patient with a little more confidence in her work.