Dental Disease and Overall Health: For the Dentist
The Value of Preventing Dental Disease
This page is for every dentist who believes that prevention is just as important as treatment. In talks with hundreds of dentists over the past 30 years I’ve found that putting this concept into practice is easier said than done. From the day the first dentist put out his shingle, the primary role of the dentist has always been to repair the damage done by dental disease. The terms preventive dentistry, dental prevention, and patient education are all relatively new. Only recently have we finally learned the real causes of tooth decay and gum disease. To the detriment of patient education, the focus of dentistry was and still is geared towards treatment. In fact, when I graduated from one of the best dental schools in the country, and in my 4 years there, not one class was offered on prevention and patient education.
Dental Patient Education: The Traditional approach isn’t Working
Without a doubt, todays dentists are highly trained and well skilled at repairing the damage done by dental disease. But while doing so can be very profitable, it comes at a steep price to the patient—because there is no room in a modern dental practice for effective preventive education. I know what’s coming next: “With all due respect Dr. Tom, I disagree with your premise because I’ve always had a dental hygienist working at my office and she handles preventive dentistry in my practice. I believe in preventive dentistry and I support it. In fact, we give out pamphlets and other material.” In reply, I suggest that this approach to patient education hasn’t worked in the past, isn’t working now, and will not work in the future. If it were working, we would not have over 90% of the population suffering from some form of dental disease.
The Role of the Dental Hygienist
As the scope of dentistry expanded, it became impossible for the dentist to effectively and profitably handle both restorative dentistry and patient education. The solution to this dilemma was to add another dental specialist, the dental hygienist. In a majority of dental offices, the primary role of the hygienist is to clean teeth, including root planing and curettage when necessary. Many also take X rays, place sealants, do fluoride treatments, and the like. I’m probably the biggest fan of the dental hygienist. She does a fantastic job, but after talking with hundreds of dental hygienists, I’ve found that patient education leaves a lot to be desired. The problem with thinking that preventive dentistry automatically includes patient education is that in most dental offices today, the term preventive dentistry actually refers to just another aspect of dental treatment.
Preventive Dentistry is not Preventive Education
Although what the hygienist does is called preventive dentistry, and rightfully so, most of what she does still falls under the larger category of dental treatment. Even if it is preventive in nature, it is still something that is done to the patient. As an expert in patient education, I can assure you that there is a vast difference between preventive treatment and preventive education. To fully appreciate the difference and its significance, you must understand—Treatment is what is done TO the patient; prevention is what is done BY the patient. But the patient must be effectively educated to perform that role. The simple fact is that no amount of treatment, no matter how effective, has ever prevented anything.
This takes me to my main point. I see the dental office as being responsible to the patient in three areas of dentistry:
- Restorative dental treatment
- Preventive dental treatment
- Patient education
In regard to equipment, materials, and training, restorative treatment is truly 21st century state-of-the-art, and I’d give it an A. Thanks to the skill and training of the dental hygienist, I would also give preventive dental treatment (preventive dentistry) an A. But when it comes to patient education, I believe that most dental offices deserve an F. Not an F for effort perhaps, but an F for results.