Written By STEPH NIGHTINGALE, RDH 

Image c/o @itsstimmie 

If you’re in healthcare, you know the drill: We’re great at telling others to prioritize their health but somehow terrible at doing the same for ourselves. Case in point? The white, flat, smooth patch that had been hanging out at the back of my throat on the right side—like a strep that just won't go away. For not just months, but almost two years I avoided getting it checked. Why? Oh, just your classic cocktail of fear, a small case of anxiety and notorious for being a hypochondriac. From what I know about being a dental hygienist, is that we assess for the following:

• be cautious of any lesions that don't go away within two weeks and flag anything that continues to change in shape or colour
• monitor and assess any lesions in the mouth that are unilateral
• a red defined boarder should be on high alert
• always document, always communicate to the patient and never hold back referring to an oral pathologist

A thorough assessment is easier said that done when it's your job. But when you're doing a self-assessment out of your own sheer negligence of never being the patient in the chair and always the one working chair-side, things can either go undetected, or you can drive yourself crazy trying to self-diagnose. We all know Google doom scrolling far too well....

In dentistry, we’re trained to keep a hawk’s eye on anything unusual or asymmetrical. But in addition to what I saw clinically in my own throat, for over a year I've been having difficulty swallowing on my right side (only when I turned my head or stretched my neck over to the left). Of course, my mind is always running wild with worst-case scenarios, especially when my anxiety would kick in at night. Relatable?

Like many working in any type of health care profession, we've all sat with cancer survivors or, spoken to those who have suffered loss, and that kind of firsthand exposure really sticks with you. So naturally, I started imagining the worst. Paranoid to the max degree.

Eventually, after months of stewing in my own anxiety, I referred myself to an oral pathologist. If you’ve ever had to take that step, you know the nerves are real.

Walking into that appointment, I was shocked that I didn't hype myself up or feel anxious and overwhelmed. I was oddly calm. This is the beauty when booking appointments first thing in the morning.  I even joked to the pathologist, “You probably think I’m crazy, but once you look in there, you’ll see this isn’t in my head.”

Spoiler alert: it kind of was. Turns out, my 18 years of sitting in the same position as a right-handed clinician—leaning slightly left, neck tilted to the left—had gifted me with chronic strain in my sternocleidomastoid muscle (yep, that long band in your neck that sits near your submandibular glands). The swallowing issue finally makes sense. 

So many times we hear and read dentist talking about treating oral care issues holistically. But not everyone knows what that means. Here is the perfect example. Instead of jumping straight to invasive tests or panic-mode solutions and scans, the pathologist stepped back and asked:

• What do you do for work?
• How long have you been doing it?
• Could this be musculoskeletal-related?

This thoughtful approach led us to try physiotherapy first, focusing on the muscle strain before booking ultrasounds or scopes. And that flat, white patch with no scary red borders? Completely normal. Cue the deepest sigh of relief.

Appointment Recap: 

• appointment start to finish took around 30 minutes
• blood pressure reading + a thorough external lymph node check around head + neck
• thorough exam of back of throat, lips, cheeks + tongue
• no scopes or biopsies
• total time 30 minutes
• total cost $ 250
• peace of mind 10/10

Here’s the thing: so many jobs come with risks, especially musculoskeletal ones. For dentists and hygienists, our necks and shoulders bear the brunt of our work. For anyone working a desk job, sitting in front of a computer all day (start-up founders included), this can potentially mean issues with hips, wrists and neck. But this story isn’t just about me; it’s about stepping back and looking at the bigger picture when something feels off.

Instead of jumping to the worst conclusions, think about contributing factors—your environment, your habits, and the daily wear and tear of your job.

If I can leave you with two takeaways here, let these be it: One, make sure your dentist and or hygienist conducts regular oral cancer checks at every appointment. This is visual exam and by physically palpating the tissues. If someone is asking you to stick out your tongue and you don't know why, now you do. Two, to all my fellow over-thinkers and hypochondriacs, take a breath (through your nose, preferably—mouth breathing is a whole other topic). Getting assessed and checked out should bring on a sigh of relief and not a boast of fear. (Easier said than done). 

And if you needed a sign to stretch, fix your posture, and maybe take a break, this is it. Your neck (and your peace of mind) will thank you. 

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