Smile Power

Three unsung heroes of dental hygiene.

Dental hygienist Wendy Mercaldo of Dr. Joseph R. Greenberg’s practice in Villanova.Similar to dentists, dental hygienists can make or break a patient visit. But, unlike their medical school counterparts, they tend to get lost in the bustle of dental offices and miss out on their due credit. That said, we sought out—and found without issue—three hygienists who personify the hygiene industry at its best.

“My job in particular is to make a patient feel at ease,” says Mary Anne Mangigian of Main Line Dental Group in Wayne. “The best thing I can do is listen to a patient. We’re lucky to have a full hour to do that.”

Mangigian has been a dental hygienist for 30 years, having worked with Dr. R. Craig Williams for the past 23. “I’m surrounded by the most intelligent staff and patients,” she says. “[But] to get a patient to do what you want them to do every day is sometimes challenging.”

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The compliant clients make such challenges that much more rewarding. “There is a perfect patient; he does exist,” says Wendy Mercaldo of Dr. Joseph R. Greenberg’s cosmetic dentistry practice in Villanova. “He brushes, flosses, shows up on time every four months. He’s about 55 years old—it takes a while to catch on. The worst patients are the college students.”

Main Line Dental Group's Mary Anne Mangigian.Narberth’s Brandi Simon knows as well as anybody about dental care for the youth. She’s worked with everyone from infants through college students for two of her eight years as a hygienist at Dr. Benjamin McKee’s pediatric practice in Devon. “I’ve had quite a few who are very close [to the perfect patient],” she says. “Here in our office, the kids who have fabulous diets still get cavities. Rather than restricting a diet, I say take everything in moderation. Sure, you can eat candy—but once a week or on special occasions.”

Beyond brushing, flossing and enjoying a moderate serving of sweet treats, the hygienists also suggest—and only use—a Sonicare electric toothbrush, which runs for two minutes. “That’s my No. 1 thing I always push,” says Mercaldo, who has 16 years of experience in dental hygiene.

What else do the preachers practice? Mercaldo’s routine includes 30 seconds of flossing, followed by brushing—both twice a day. Mangigian goes through a similar process, with an extra brushing after lunch and home bleaching every six months. For Simon, it’s three brushings per day and one flossing session after brushing at night. All rinse with Listerine.

“The mouth can tell the health of the rest of the body,” says Mangigian. “There’s lots of links to periodontal disease and the rest of your body.”

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Brandi Simon of Dr. Benjamin McKee’s practice in Devon.Mercaldo can keep a close eye on her patients’ oral health rather easily—and literally—with magnification that enlarges teeth about two-and-a-half times. It pays off during the oral cancer exams she administers with every patient visit.

The Rosemont resident got her dental hygiene training through Harcum College’s two-year program, accredited by the American Dental Association’s Commission on Dental Accreditation. At the time, the clinicals were held at the University of Pennsylvania.

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Today, 20 years after the program’s start, students have their own 16-unit, on-campus clinic in Bryn Mawr, grant funded and staffed with a full-time dentist, Dr. Philip Giarraputo. When they’re not assisting with the treatment of patients from the community at reasonable fees—only $10 for basic senior services—the hygienists-in-training are rotating among St. Christopher’s Hospital for Children, Temple University’s Maurice H. Kornberg School of Dentistry, the Philadelphia VA Medical Center, and Community Volunteers in Medicine in West Chester.

“Hygiene is a rigorous academic program,” says Jean Byrnes-Ziegler, Harcum’s program director. “There’s a lot of science. Someone needs to work well with people, have good communication skills, and work well with their hands.”

Harcum currently has 60 female students in its program, accepting 32 men and women (at most) every year. New and renewed interest is expected to surface as Pennsylvania law begins to advance the industry, with changes like legalizing local anesthesia. “People who are in the field might be returning to complete the course and apply for certification,” says Byrnes-Ziegler. “It’s new in our state, but we’re one of the last.”

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For Mercaldo, Mangigian and Simon, this news is something to celebrate. “I had anesthesia when I was at Penn, and they took it away from us,” says Mangigian, who graduated from the University of Pennsylvania in 1980. “I’m very excited to get back to anesthesia.”

Simon received her associate of science degree in dental hygiene from Harcum before moving out to Arizona, where she took a semester-long course and a board exam to become anesthesia certified. “It was an awesome, awesome thing to gain the confidence from the patients by cleaning their teeth prior to going to anesthetize them,” she says. “That’s a huge help for doctors. I like where we’re headed.”

And getting there is easier than in Arizona, since Harcum requires licensed hygienists take only a 30-hour continuing education course for certification.

This past December, Pennsylvania also passed a bill for a new classification of dental hygienist to provide educational, preventive and therapeutic services, including intra-oral procedures without the assignment or direct supervision of a dentist and radiological procedures in approved settings without the general supervision of a dentist. Known as public health dental hygiene practitioners, they get their credentials after meeting all the requirements for a dental hygienist license, passing the dental hygienist exam, and completing 3,600 hours of practice under a licensed dentist’s supervision.

“As healthcare is changing, we need more and more people who are providing care,” says Byrnes-Ziegler, whose program doesn’t currently offer this type of certification. “They’re trying to find dental healthcare that can reach out into the community.”

And that’s exactly what Simon is hoping for: greater access to dental care for the uninsured population. “I know we’re headed in that direction, but I wish we could get there a little faster,” she admits.

If Mercaldo and Mangigian could have it their way, they’d like to see dental hygienists (including themselves) become independent practitioners, like in Colorado and other states.

“I think the hygienists of the future will practice not just in remote areas,” says Mangigian, who lives in Glen Mills. “And, hopefully, mainstream dentistry will allow the hygienists to go out on their own.”

But until then, there’s plenty to be thankful for, from demand to salary to flexible hours.

“It’s a short period of education for a really great career,” says Mercaldo.

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