Izabela Wilewska spends her days a few centimetres from other people’s faces.
She is a dental hygienist, named among the Top 10 Hygienists of the Year in Poland, and she trains other hygienists in the profession. She sees people from very close up, at the moment most of us would rather not be looked at at all.
We wrote to her because her chair is a place people manage not to visit for ten years.
Not out of fear of pain, as everyone assumes. We wanted to hear from someone who watches it every day what a person is really afraid of when they finally sit down, and what someone who knows what they are looking at can read from a set of teeth.
What follows are her answers, short and without padding, in her own words.
This is a conversation about shame, about what teeth give away, and about a patient who was supposed to be difficult and became one of the most important.
People can put off a visit to a hygienist for years, more often than with other specialists. What are they actually afraid of when they finally sit in the chair?
People put off the visit to a hygienist for a very simple reason: they do not want to be judged. Perhaps they were ill for a long time, perhaps they lost a child and are not ready to explain to a stranger why they did not brush their teeth. Perhaps they were a victim of violence and do not want to talk to anyone about it. Perhaps they are raising a child alone and never make an appointment for lack of time for themselves. Or perhaps it is money. All of it comes down to one conclusion: no judgement.
Someone comes in who for years covered their mouth with a hand when they laughed. What happens to that person during the visit, and what happens afterwards?
The foundation of this profession is respect for the other person, without judgement. A willingness to listen if they want to talk. And a sense of safety and ease during the procedure.
Teeth are the only part of the skeleton we show on the outside. Can you see things about somebody’s life in their teeth that they would never say out loud?
I definitely see many things patients do not talk about. The basic and most common one is that they do not floss. I can see that someone may be bulimic, may be using drugs, may love fizzy drinks. I can also recognise someone who plays a wind instrument. People are often surprised, but a holistic view of the patient is key in this profession, because it lets you help with every problem you find, not only the one they came in with.
Good hygiene work is invisible, you only see it when it is missing. What is it like to work in a profession whose result is the absence of an impression?
I would not say it is invisible. Patients’ hygiene problems very often amount to an enormous aesthetic problem, and it is precisely after treatment in the surgery that the results can be spectacular, and the feeling and the impression are big.
People ask for whiter teeth, but it is rarely really about the colour. What is it about?
Behind the wish for whiter teeth there are often psychological reasons. People want to feel more confident and to be liked by others.
You train other hygienists. What is the hardest thing to teach somebody who is just starting to work a few centimetres from another person’s face?
I teach respect for the patient’s space. Looking after them so that during procedures they feel as cared for as possible: petroleum jelly on the lips, glasses on the face, an agreed way of communicating with me while the procedure is going on. Those small things build a sense of safety in the patient. When you see them relax, you know you are doing it right.
You spend whole days very close to people’s faces. Has it changed the way you look at faces outside the surgery, and at your own?
I see more, I notice a lot of details, but I do not judge. Sometimes I just feel like inviting someone in. I do not look at my own face any differently. I only remember to always have flossed teeth, because I am the example.
Was there a patient who changed your mind about something to do with appearance? What did they do or say?
There was a patient with years of drug addiction behind him. I thought we would not get on, because at the first visit he was very brusque. But he accepted me and came to like me enough that now I enjoy it when he comes back and tells me about his progress, social and personal. The fact that people feel comfortable with me and open up is the most wonderful professional feeling in the world.
Three things worth taking from this conversation.
First, people do not avoid the chair out of fear of pain but out of fear of judgement, which is a completely different problem and needs a completely different cure. Second, teeth are the only part of the skeleton we wear on the outside, and they say things about us we would tell nobody, a reminder that appearance is not a surface but a record. Third, petroleum jelly on the lips and glasses on the face do more for trust than many a campaign, because trust is built in the details nobody was supposed to notice.
Izabela Wilewska is a dental hygienist and educator working in Poland: instagram.com/izka.higienistka