We have formed the prevention in our profession around the patient’s oral hygiene (brushing, flossing, water irrigation and fluoride). We have also fostered the development of the dental hygiene profession to help us carry the message of dental health to our patients. My departed wife Linda was a consultant coaching teams to help patients have healthier mouths. “Stay in the Question” was her haul mark phrase, which to her meant: Keep Asking Questions until you are sure WHY they have diseases. We want patients to ask us; “how to I stop this disease?” After 37 years of practicing implant dentistry, my approach to helping patients decrease their dental disease has changed. These changes are dramatic from what I was taught. A small amount of information in our literature, lectures, conversations with collages etc focuses on the root cause of decay: frequency of carbohydrate intake. Routinely this is NOW the beginning of any conversation I have with patients today about why they have either of the 2 most common dental diseases. Not surprisingly, sine we haven’t focused on that 20 minutes of acid attack after any carbohydrate or acid exposure (soda), patients can brush, floss, irrigate, use xylitol gum or swish with water and STILL get rampant decay. We have all seen that. When I “stay in the question”, rather than give them my brief “elevator speech” about bacterial attack from carbs, I learn people are habitually consuming coffee with cream or sugar, sweet tea, fruit or fruit juice, crackers etc between meals, often to keep their energy levels up. If we don’t have that conversation, then typically the patient won’t understand the root cause of the problem. I encourage you to have a brief meeting with your team, discuss your order of priority to help people have less disease and role model that at the chair. Consider 1) carbs frequency first, 2) dry mouth second (esp in the elderly), Then 3) electric brush, 4) water irrigation and 5) flossing. I encourage them to get more protein at meals, or between meals to keep their blood sugar up. I note cheese, meat and nuts as well as water or plain tea or black coffee are all good things to have as snacks without promoting dental disease.
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