In dentistry we have formed prevention of dental diseases, 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. 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: decay or periodontal disease. Since there is 20 minutes of acid attack after any carbohydrate or acid exposure (soda, fruit etc), patients can brush, floss, irrigate, use xylitol gum or swish with water and STILL get rampant decay. Rather than give patients my brief “elevator speech” about bacterial attack from carbohydrates, I ask questions and 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. Consider 1) carbs frequency first and or dry mouth second (esp in the elderly and those on certain medications), Then 2) electric brush, 3) water irrigation and 4) flossing. I encourage patients 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. Certainly dry mouth is a topic for another blog!
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