Have always used NHS dentists - but the Hygenist at the practice had to be paid for separately - and expensively. Four years ago, the last time I went to one, I was charged one hundred pounds for the appointment. There she tried to clean my teeth with a water flosser which caused me so much pain, that she told me to make another appointment where she gave me loads of local anaesthetic (and a charge of a further hundred pounds).
However, not sure what she did, - if she put those injections in badly, or what, - but for the next week my mouth was so sore and swollen I could barely eat. Decided then and there, NEVER EVER again to go to hygenist.
Since then, I have been very careful with my own tooth hygeine. Electric toothbrush, held on each side of each tooth for between 5-10 seconds (twice a day), interdental brushes once a day (three different sizes), water flosser once a day. Do NOT rinse toothpaste out of my mouth - let it stay there to do its work.
Since then, have had no real problems, My last check-up (different dentist), found NO PROBLEMS - even with the tooth, that four years ago I was told I would need to have taken out immediately.
I am totally unimpressed with this hygenist lark - just seems to be another way of taking our money.
Many many decades ago, hubbie was unemployed, we had six young children, - I juggled the small amount of money we had to ensure children were always fed well, and reasonably clothed. Needed filling replaced in tooth, went to Dentist to have that done and was told that if I did not make an appointment (then £15) with their new hygenist, then the gum disease dentist told me I had would cause me to painfully lose all my teeth within five years. No way could I spend that sort of money, and left there in tears. That was over forty years ago, and no gum disease has appeared.