I was surprised to see the advice we give our patients has not changed much in over 40 years! I am reading a book called “The Tooth Trip” that was written by dentist Thomas McGuire in 1972; he describes the same prevention based dentistry we practice today. This book was written for the public to understand oral diseases and their role in preventing it.
Some of the book is way off the mark with recipes for making homemade toothpaste with Sage, Myrrh and powdered roots. Making toothbrushes from twigs and sticks does not sound like the best use of an hour of your time. What resonated so strongly with me was the descriptions of self-examination of your mouth and emphasis on prevention and working together with your dentist. A whole chapter was on dental emergencies and what constitutes a real emergency- severe or recurrent bleeding or severe pain not relived by painkillers. Just getting your patients to read this chapter alone would save thousands of wasted dental appointments. There was sensible honest advice on how and why teeth can hurt and how you can prevent it and work together with your dental team to stop it recurring.
In our modern age, if we educate our patients in the causes of dental disease and how it is entirely preventable, they too could have healthy mouths and lower dental bills. Despite the fact that most of this information is freely available on the internet or in the leaflets that some dental practices give out, not much has changed. Why is that?
I feel that until the information is specifically tailored to our patents and they can see the benefit from following that specific advice, they will switch off. If you promote the fact that you fix teeth, they will just come and expect you to fix them. This is where modern dental teams come in. We need to genuinely listen to our patients, do not interrupt them, let them get their whole story out. Examine their mouth, show them the evidence of disease in a clear and non-judgemental way. Explain their options and how as a team, you can return their mouth to health. Make them understand that without them, all your treatment will fail. Spending extra time now will save hours of treatment in the future and help educate a generation that loves going to the dentist. All good dentists want their work to be appreciated and to last a life-time.
Four Dental sins from the 1970’s that Dentists still do to this day:
1. Leaflet avoidance. Handing your patients reading matter to explain your treatment and asking them to go home to go through it. Nothing beats a face to face discussion where you allow them time to discuss their personal fears and questions. Leaflets should be only a back-up once the conversation has taken place.
2. Technical jargon. Using dental terminology or complex words to explain your diagnosis and treatment. All professions have jargon. The skilled dentists explain it in a language that that specific patient will understand.
3. Carrying out treatment whilst discussing the patient’s options. No-one can fully concentrate when lying on their back with theirs mouth open or having treatment carried out. Stop, sit the patient up and have a face to face conversation.
4. Bulldozing. Talking it through you your patient until they are worn down and just say yes. Nothing is life or death that you need to decide there and then. Place a temporary filling and then explain the options; pros, cons and cost. Then let them go away and think about it.
How are you going to make the most of your patients next tooth trip?
James Goolnik is a practising Dentist and his book “Brush” donates 100% of the profits to Dentaid. He recently led a team of 8 dental professionals to Malawi to install two dental chairs, equipment and deliver skills transfer workshops from these proceeds. He is a trustee of the charity “Heart your Smile”.