A short time after I qualified a San Francisco dentist, Thomas Maguire, published a book called The Tooth Trip. Bear in mind that this was just after the ‘summer of love’ – if you can remember it you weren’t there, or at least you didn’t inhale – and you’ll see that ‘trip’ in this sense meant more than just a short journey.
Don’t get me wrong, Dr Tom was not advocating the use of mind-altering substances, but he had the idea of addressing a very serious book about dental health self-care using the vernacular of the day, and to appeal to
the widest readership, especially the young and the trendy.
The book has lots of advice that is fundamentally sound today, although more than 40 years ago, the fact that fluoride toothpastes had not yet become the norm, even in the US, coloured his views about its potentially beneficial effects. He does however make the point obliquely that just because fluoride is available, we shouldn’t use it as an excuse not to educate people about the importance of good home mouth care.
Incidentally, I came across a review of the book by chance, and as there was no internet, let alone Amazon (other web-based book-sellers are available), I had to ask some friends holidaying in New York to buy me a copy....
My point is this: we need to tell people, yes even in this day and age, about their responsibilities in the area of oral care. We can all say: “oh yes, boring, same old messages”, but Dr Tom’s idea was to use these messages (brushing, flossing, diet, self-awareness) even though they were age-old by
then, and to couch them in fresh and appealing terms.
I recall that when the first report on the new NHS Pilot contracts was released in December 2012, there was a call for both the profession and the public to become aware that dentistry had changed and was changing further. Particularly in a capitation-based system, there must be coherence between the clinician and the patient.
Put another way, it’s been said that the role of the dental team is ‘to help the patient to achieve and maintain optimal oral health’. And, that the most important word in that sentence is ‘help’. Or, as I was taught: “There is nothing that the dental team can do, that will overcome what the patient won’t do”.
It’s good to know that a third edition of Delivering Better Oral Health is on the way and may even be published by the time you read this. It’s also encouraging that this will be accompanied, later in the year by a
patient guide. What concerns me a little is that the latter document may
be written in a way which is scientific, logical and clear, but which is also as
dull as spittoon water.
We do need a way to try and launch oral health, its benefits, and of course its potential impact on general health, particularly for an ageing demographic, into mass public consciousness. Moreover, we have to find a way to get behaviour change, as well as knowledge and intention.
The Heart Your Smile charity recently launched a little video (check out What Can You Do In Two Minutes on Youtube) as a pilot attempt to get the public - and particularly the digital, always-connected, age-group, to pick up on oral health in a fun and innovative way. It needs more hits! And we need to get patients to see it too.
And finally, we need to get better at communicating the personal message about oral health to patients, to find new and relevant ways for each individual to turn their aspirations (“I want to have healthy teeth and gums”)
into actions (“I will avoid sugary snacks, brush for two minutes and floss each day”). Put like that, it is, as we all no doubt agree, a well-worn mantra, but if we can learn how to actually achieve change by nudging each patient or sparking an interest, then that is time well spent.
It may be difficult if there are UDAs to achieve, but some are doing it. It’s much easier in a well remunerated capitation or fee-per-item based practice, provided we can persuade our patients (and I do mean persuade) that we are no longer there merely to sell them a restoration, a crown or a scaling, but to work with them (not merely on them) to maintain their health.
It’s a big change. And, like other changes on the way, it has the power and potential to keep us all busy, doing what we were trained to do, and what the GDC now, in fact requires: to treat each patient preventively and holistically. The trip to the dentist could then be a worthwhile journey.