Open Contact Dental

I love coming into work and seeing a new patient on my schedule. I get all giddy inside and am full of anticipation. What will I find?  What can I teach them? How can I make them healthier?

This week I met a wonderful middle aged gentleman for the first time at my office. He was excited to be seen in a dental office as it had been about 2 years since his last dental visit. He had left his last office because he felt something wasn’t right. His intuition was correct.

A full set of xrays revealed overfilled root canals, open contacts between teeth, recurrent decay under old overhanging amalgam margins, moderate bone loss and subgingival calculus that you could hang a coat off of. My heart sunk. This man trusted his dentist to serve him ethically and skillfully. Unfortunately this was not the case.

This made me wonder how patients choose their dentist and how they should.

This is how patients currently pick their dentist:

(1) Cost – Most patients refer to their dental benefit package to choose their dentist. They will choose their dentist based on their coverage and their out of pocket expenses.

(2) Location – Office right around the corner? Great. Offices that are close to work or home are ideal for new patients looking for a dental home.

(3) Convenient Appointment Times – Some offices start early (6:30 am) and some stay open late (9:00 pm). This helps the working patient who has a job and the finances to pay for dentistry to come in to have work done.

All of the above are great reasons to pick a dentist, but there is more. We should be helping our friends and neighbors understand what questions to ask when interviewing their next dentist.

I recently posed a question to dental hygienists on an online social media forum asking then how they would tell someone to find a dentist if they moved to a new location.  Some said to ask a local periodontist or endodontist who they would recommend. I have offered this suggestion to my patients but I wonder if it is the best way. Specialists enlist referrals from general dentists for their business. This may be a conflict of interest when asking for a recommendation.

Could you ask friends? What are their reasons for suggesting a dental professional? Are they gentle or nice?  Is there a better way?

Let’s come up with questions to ask.

(1) How long are your checkup appointments?

·      Does your hygienist probe at every visit?

·      Do you perform oral cancers screenings at every visit? Do you have advanced equipment to examine the oral cavity?

(2) Do you have a remineralization program? This will help determine if the practice is a drill and fill practice or more focused on prevention.

(3) How do you calm patient’s fear? Can a patient stop a procedure and feel in control while it is going on? Do they offer sedation?

(4) How do you handle finances for large cases? Some patients like to get everything done at once and need to know financing options.

(5) What are the Dr and RDHs favorite CE courses?  This will get a feel for their passions.

(6) How long has staff been in practice in this office? Dedicated employees create value of services in a practice.

I’m sure there are many more questions we can come up with to find the perfect office with quality services.   Patients rely on us to provide quality care at reasonable prices in the least amount of time.

I hope next week at my new patients treatment consultation appointment he realizes that he has chosen the right office with the ability to give him his healthy smile back. My anticipation mounts!

The Power of Spit

When you think of spit most people will think of the verb “to spit”. You can spit to show emotion, to lubricate things on a whim or, for little boys, to gross out their little sisters. We know that spit is actually more important than that.

Saliva is useful for digestion and lubrication of oral tissues. It is full of information about bacteria levels and even provides DNA for research and criminal investigations. Saliva also has the ability to remineralize and demineralize teeth.

Dental decay still runs rampant in our society. Many blame heredity and the inherited “soft teeth” from their parents. I have come across patients, that for years, have been told more brushing and flossing will stop their decay yet the decay continues.

Approximately 2 years ago, I introduced pH testing in my clinical setting on all patients coming in for their preventive appointments. Surprisingly, only a small number of patients were willing to be educated on how a low pH (high acid) saliva affects their teeth. The cost of prevention deterred them from completing a xylitol regimen to increase the pH and starve out the Strep mutans bacteria, the major (but not the only) culprit of the perpetuation of decay. Since xylitol is considered a food (sugar) it cannot be prescribed to our patients like antibiotics can.  Food is not covered by a prescription health plan.

Since healthy saliva is the key to stopping the spread of dental decay education is the only way to get the key to the door. Education of patients, and their parents, about the frequency of food/drink ingestion to decrease the amount of acid attacks and the types of food which increase the pH into the neutral zone is needed as well as the introduction of xylitol, if they decide that they want to be more proactive in busting cavities.

During dental exams we examine teeth and gums. How many of us are examining saliva? Clinicians are responsible for education about the whole mouth and everything in it. Spit is important.