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J. Peter St. Clair, DMD Blog

THE ORAL-SYSTEMIC LINK 2/3

October 18, 2021

Filed under: Uncategorized — Dr. J. Peter St. Clair, DMD @ 1:06 pm

If you missed Part 1 of this series, you can find it at www.thetowncommon.com.

I ended last week with a statement that I have used numerous times before – just because it doesn’t hurt doesn’t mean there isn’t a problem. We keep learning more and more about the link between the mouth and the rest of the body. It is essential that dentists and physicians do a better job at co-managing patients, and learn more about the relationship between oral and systemic disease.

It is clear that if you want to take better care of yourself, you need to take better care of your mouth. Familial history is very important. If you know of any family history of dental problems, you are at higher risk. Higher risk individuals need to be treated differently, and may need a more aggressive preventive protocol to help ward off progression of disease. In addition, an otherwise healthy person who presents with a sudden increase in gum inflammation should possibly be evaluated by their physician to rule out any systemic causes if there is not a simple explanation for the change.

Salivary biomarkers are among the tools being researched to help determine the particular disease path that a person is on. Although in their infancy, this precision approach to the prevention and treatment of periodontal disease accounts for variability in a person’s genes, environment, and lifestyle. Because it is more personalized to the individual, it results in more accurate treatment planning, as well as improved outcomes for the patient.

Considering the aging population, periodontal (gum) disease has the potential to become the most prevalent dental disease in the near future. It is more important than ever for dentists to take the time to develop and incorporate a comprehensive periodontal examination and treatment protocol for adults.

As with most diseases, delaying the treatment of periodontal disease until the advanced stages results in treatment that is more expensive, more complex, and less predictable. Most early to moderate stage disease can be treated in a general dental office if the inflammation is easy to control, the patient doesn’t have numerous systemic issues, and is determined to do their part at home. If all these things have been done without resolution, or if the periodontal disease is more severe, it may be in the patient’s best interest to be referred to a like-minded periodontist. A periodontist is a specialist who treats disease of the gums and bone that support the teeth.

When half of the US population is still affected with periodontal disease, despite decades of research and treatments, something is still missing. That missing key is a more collaborative approach involving, dentists, periodontists and physicians.

….and remember, just because it doesn’t hurt doesn’t mean there isn’t a problem. To be continued.

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. He has a special interest in treating sleep apnea and TMJ problems. If there are certain topics you would like to see written about or questions you have please email them to him at

THE ORAL-SYSTEMIC LINK 1/3

October 12, 2021

Filed under: Uncategorized — Dr. J. Peter St. Clair, DMD @ 11:23 am

The connection between oral health and systemic health is well-established and ever-evolving. One thing we know for certain; we are living longer, but with more chronic diseases and medication than ever before.

The latest statistics are alarming. Forty-seven percent of US adults who are age 30 or older – an estimated 64.7 million Americans – have either mild gum disease (8.7%), moderate gum disease (30%) or severe gum disease (8.5%). As the population ages, the prevalence rises with 70% of individuals over the age of 65 exhibiting some level of gum disease. And, since we are on statistics, by 2030, it is estimated that the number of people over 70 years of age will have doubled from 35 million to 71 million.

So, as we age, our risk of developing disease increases. Interestingly, there is also a direct correlation between the regions of the US with the greatest concentration of gum disease, and those that have a high incidence of cardiovascular disease and diabetes. Although a direct cause-and-effect link is still in the process of being established between gum disease (periodontitis) and other systemic diseases, inflammation is often a common denominator. And it is always important to remember that the mouth is the gateway to the rest of the body.

We used to think that if people didn’t brush their teeth well, or didn’t visit a dentist often, they would automatically get gum disease. However, there are patients who have poor home care who never develop gum disease, and there are also patients who have great home care, visit a dentist regularly, and continue to experience breakdown from gum disease – albeit at a slower rate than they would if they had poor habits.

We now know that managing gum disease and other chronic inflammatory diseases like cardiovascular disease, diabetes, respiratory disease and arthritis are more patient specific based on an individual’s “inflammatory mediators”. These are molecules released by immune cells and are largely responsible for individual responses to disease susceptibility and progression. This is why probiotics are likely to play a significant role in treatment of chronic inflammation in the future.

As we wait for research development for different ways to combat chronic inflammation, it is without dispute that people should do all they can to minimize inflammation in the mouth. The mouth is very accessible and with proper training, coaching and monitoring, a healthy mouth is better for your whole body.

Although some may say that the associations between gum and systemic diseases are statistical by nature, not causal, the data is fairly strong that there is a link between gum disease and cardiovascular disease – such as heart infarction and stroke.  This supports diagnosing and treating oral infections, including lifelong professional maintenance and good home care.

Remember – just because it doesn’t hurt doesn’t mean there isn’t a problem. More next week.

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. He has a special interest in treating sleep apnea and TMJ problems. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com

DON’T WASTE BENEFITS

October 4, 2021

Filed under: Uncategorized — Dr. J. Peter St. Clair, DMD @ 11:35 am

October is here!!  This means only 3 months left in 2021. It’s crunch time to get everything done that we haven’t gotten done during the rest of the year. For those with remaining dental benefits, it’s also the time of year to consider utilizing those so you don’t lose them.

Unused dental benefits go directly back to the insurance company, which generates hundreds and hundreds of thousands of dollars for the insurance companies each year. Dental insurance companies count on the fact that many people will not claim their $1000 or so in benefits by the end of the calendar year. Those with dental benefits should look for legitimate means to use these benefits before they are lost, especially if you haven’t been to a dentist in a while.

For example, maybe a crown has been recommended by your dentist, but you have procrastinated about it. It would make sense to consider using those dental benefits before the end of the calendar year. This allows a whole new round of dental benefits to be used for unexpected dental needs, and maximizes the value of the premiums paid.

Remember, insurance companies are in the business to make money. They don’t want you to use your dental benefits. If the balance (co-payment) you will owe for the dental work is too much for you, consider financing options through your dental office. Most dental offices offer interest-free financing to patients for up to 12 months. Financing your balance in this way may make more financial sense than throwing money away to fund the insurance company’s pocketbooks.

Another thing to consider as the end of the year approaches is the use of flex spending accounts. Many employers now offer pre-tax flex spending accounts for healthcare expenses. Often underutilized, these are excellent mechanisms for saving about 20 percent on needed dental care. If you are paying for your dental insurance premiums, it may even make sense to fund an available flex spending account with that premium money instead of, or in conjunction with it.

For example, if you are anticipating the need for $3000 in dental care, opting to place the $3000 in a flex spending account can save the income tax on those monies and can usually be used as soon as January 1st. If you have money left in a flex spending account, remember to check with your employer to determine if that money needs to be used by the end of the year. You don’t want to lose that money either.

As you begin to make financial decisions for the end of this year and for the upcoming year, consider a discussion with your dental office’s financial person. They are often an untapped wealth of information, and can usually thoroughly and knowledgeably discuss your dental financial options with you.

And, don’t wait too long. Dental office schedules get full quickly this time of year with patients trying to use dental insurance benefits and unused flex account money. Maximize your hard-earned dollars.

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. He has a special interest in treating sleep apnea and TMJ problems. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com

WHAT DO YOU WANT?

September 27, 2021

Filed under: Uncategorized — Dr. J. Peter St. Clair, DMD @ 3:24 pm

Gravity is precise in nature, governed by laws and formulas; it does not respond to individual circumstances or objectives. It’s easy because it always works. Clinical dentistry, on the other hand, is science for sure, but an inexact science at best. Inexact science requires the skill of an artist to create a consistent and predictable result, since it is not a matter of an equation; hence the “Art and Science of Dentistry.” This inexactness is something that dentists struggle with daily.

I am currently treating a patient who presented with a bunch of broken teeth. The patient is frustrated because these teeth have been “fixed” numerous times over the past few years. His previous dentist had tried to bond things here and there to keep the cost down for the patient, but they just kept breaking. The patient, an engineer, said that he even tried giving the dentist suggestions to make things “stronger”. Those suggestions only led to more failure. Predictable dentistry often requires doing things that you would rather not do.

I recently heard an ad on the radio with a famous actor talking about colon cancer screening. He describes that having a colonoscopy after age 50 is huge in finding and treating early changes that lead to colon cancer. Most people don’t want to have a colonoscopy, but also don’t want to get colon cancer, so there is a dilemma. These actions have now become inconsistent with the desired outcome, much like the patient I just described. He doesn’t want to have a complete exam and map out a precise treatment plan that will ensure a more predictable result, but he wants to save his teeth.

We have come to a fork in the road. If you don’t want to get colon cancer, you get screened and treat any early signs of problems to help avoid the cancer. If you want to risk getting colon cancer, you don’t get screened. If this dental patient doesn’t want to lose his teeth, he should get a complete exam and address the issues in a more logical and predictable manner. If he wants to risk losing teeth, he can keep putting band-aids on the teeth, but they may not hold up as he has already experienced.

Dentists often struggle with patients whose actions are inconsistent with what they want from dental treatment. It is important for dentists to listen to people to know what they want. A patient who says she doesn’t want to do a crown on a tooth has not said she would not do thecrown. She is saying she doesn’t want to do it, would rather not spend the money to do it, won’t enjoy doing it, and will want it to be over as quickly as possible. What does she want the outcome to be?

Too many disappointments have occurred because a dentist compromised treatment and the result was not what the patient expected. The dentist and the patient need to be very clear on compromise. The patient must understand that, if there is failure, it is most likely the result of the decision not to do the more ideal treatment. The dentist needs to thoroughly explain to the patient the risks and benefits of any treatment they are doing so that everyone is on the same page.

Co-discovery, co-diagnosis, co-treatment planning. A mutually respectful and open (authentic) dentist/patient relationship will have less disappointments and be more gratifying for all.

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. He has a special interest in treating sleep apnea and TMJ problems. If there are certain topics you would like to see written about or questions you have please email them to him at

APPOINTMENT ETIQUETTE

September 20, 2021

Filed under: Uncategorized — Dr. J. Peter St. Clair, DMD @ 11:43 am

Your dentist may have the best technology, may have gone to a top dental school, and do great clinical work, but none of those are the primary reasons people choose to stay with a dental practice or any service provider. Generally speaking, people stay with their provider because of the relationships they have built with individuals within the office.

When we have a problem, we all like the convenience of calling someone we know and are comfortable with. Whether that problem is a broken filling or needing to change an appointment, it is nice to deal with people who know us and are eager to help with solving our dilemma.

I recently had an appointment with an office that I needed to change. The appointment was a week and a half away. When I called the office to change the appointment, I was less than thrilled with the way I was treated. While I didn’t necessarily expect to know the person on the other end of the phone, I wasn’t expecting to feel like a criminal. The first question I was asked by the grumpy person answering the phone was, “Why do you need to change your appointment?” This was quickly followed by how inconvenient it was for their office that I needed to change my appointment.

I can completely understand how difficult it is for front desk personnel to have to deal with these kinds of issues all day long. In my office, we had over 40 appointment changes last month. That is a lot of conversations about the same thing, and stressful for any staff member who deals with a busy schedule.

We all have busy lives. Things change and sometimes we have to re-manipulate our schedules to accommodate all we have to do. However, there needs to be accountability on both ends. If we have a scheduled appointment with our dentist, our hairdresser, or anyone, it is our obligation to realize that they are relying on us to be there. Giving adequate notice (preferably as far in advance as possible – like 48 hours) of the need to change an appointment is common courtesy.

On the other end, it is important for the provider’s office to realize that people have lives outside of their appointments. While it may be inconvenient for the office to have to reschedule an appointment, the request must be handled with respect and as much accommodation as possible.

An appointment is a commitment and it is important to take our commitments seriously. If you routinely have to change appointments to accommodate your busy schedule, it may make sense to make your appointments differently, such as being “on call” when you are due for an appointment vs. pre-scheduling.

Dental offices typically schedule your next dental hygienist appointment in advance. It may be 3, 4, or 6 months away. One of the reasons this is done is for patients to choose and reserve a time that usually best fits their schedule. Patients are often disappointed if they call to reschedule and the appointment time options are limited.

The need to change appointments happens. As long as it is not a frequently occurring issue, most providers’ offices understand. Mutual respect builds relationships.

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. He has a special interest in treating sleep apnea and TMJ problems. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com

ORAL HEALTH IS ESSENTIAL

September 13, 2021

Filed under: Uncategorized — Dr. J. Peter St. Clair, DMD @ 12:11 pm

What is your definition of oral health? Is there even a standard definition of oral health? One thing is clear; the definition of oral health is not solely the absence of pain. Pain is also not necessarily an indication of poor oral health.

It wasn’t until the year 2000 that oral health was brought to the forefront of the surgeon general’s report as a critical component to overall health. This was an important event, but unfortunately never amounted to much in terms of being incorporated into most healthcare policies. This has led to continued poor to non-existent cross-over coverage between medical and dental insurance.

In 2005 at the World Congress of Preventive Dentistry, participants from 43 countries made it clear that oral health is an integral part of general health and overall well-being. They even concluded that oral health is a basic human right.

More recently, the United Nations recognized oral disease as an integral part of other non-communicable diseases such as diabetes, cardiovascular disease, stroke, chronic respiratory diseases and cancer. This association with these other diseases was based on common social determinants such as socioeconomic status, diet, tobacco and alcohol use, and not on the basis of transmission. However, there is still no solid definition of what oral health really is.

According to a column in the Journal of the American Dental Association, the American Dental Association is working on a proposed definition of oral health. The authors of the column state, “A proposed definition is necessary to achieve a common understanding of the scope of oral health, to help understand the array of complex oral and systemic health issues facing dental and medical professions now and in the future, and to provide a rationale to position oral health professionals as partners within primary health care.”

The authors go on to say that the definition of oral health needs to align with the current definition of dentistry. That definition currently states, “dentists are responsible not only for the evaluation, diagnosis, prevention and treatment of diseases and conditions of the oral cavity, the maxillofacial area and adjacent areas but also for assessing their impact on the human body.”

As new tests and knowledge in the area of oral health increases, the days of simply recording missing and decayed teeth and poking patients with instruments to chart periodontal (gum) issues may not be enough to best serve patients. What we can learn from things such as genetic testing and salivary diagnostics will change the way we interact with our medical colleagues and greatly benefit our patients.

In conclusion, the authors state, “As the definition of oral health evolves and likely will continue to evolve well into the future, no matter how oral health is defined, the message remains: Oral health is essential to an individual’s general health and quality of life.”

So, while the powers that be work on the definition of oral health, it is our individual responsibility to take care of ourselves. If we know that oral health is connected to the rest of the body and if we care enough to take care of our body, then regular professional maintenance and constantly improving our home care should be at the forefront of our self-care.

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. He has a special interest in treating sleep apnea and TMJ problems. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com

BACK-TO-SCHOOL QUIZ

September 7, 2021

Filed under: Uncategorized — Dr. J. Peter St. Clair, DMD @ 7:14 pm

We are all hoping for a productive and enjoyable school year for students of all ages. Here’s a quiz to help get those learning juices flowing. Good luck!

Question #1: The risk factors for gum disease are the same as for heart disease (genetics, smoking, weight, lack of exercise, and high cholesterol).

Answer: False. Genetics and smoking tobacco are major risk factors, but stress, medications, lack of proper hygiene, and systemic problems, such as diabetes, are additional risk factors. Just like heart disease, management of gum disease requires strict maintenance visits to monitor and control the disease. Taking care of your body includes taking care of your oral health.

Question #2: Less than one in ten people will experience a fractured tooth.

Answer: False. About one in four sustain a fracture to a front tooth by the age of 18. Front teeth tend to get in the way when falling or with flying/swinging objects. If you have older amalgam (silver) fillings and/or clench or grind, you are at much higher risk for fracture of back teeth.

Question #3: Precancerous lesions are common in the mouths of smokers.

Answer: True. The red and white patches precede malignancy and require biopsy. Precancerous lesions are also common in the mouths of heavy drinkers. Again, regular maintenance visits are essential for monitoring and appropriate referrals to be given for such lesions.

Question #4: Your toothbrush should be changed every six months.

Answer: False. Your toothbrush should be changed every 8-12 weeks. Bacteria accumulation and effectiveness of the bristles make it necessary to change it this often. It should also be replaced after you have been sick. This goes for manual as well as power toothbrush users. Even is the brush head looks ok, change regularly.

Question #5: The average person will lose less than six teeth by age 72.

Answer: True. According to the Academy of General Dentistry, 5.4 teeth are lost by age 72. This number has declined over the years but there is still room for improvement. Remember, studies show that the quality of life decreases with each tooth lost.

Question #6: Regular use of dental floss may help you live as many as six years longer.

Answer: True. While just 10% of households floss regularly, researchers at SUNY-Buffalo estimate longer lives for flossers. A healthier mouth means less chronic inflammation and a decreased chance of heart disease.

Extra Credit: (True or False) Ancient teeth, with small perfectly round holes in the biting surface may be the earliest archaeological evidence of prehistoric dentistry. Researchers believe a stone bit was used to drill through teeth, as holes of the exact same diameter were found in beads made for jewelry 8-9000 years ago. Scientists speculate that the holes had been filled with plant matter to treat tooth decay.

Answer: True. Feel lucky you live in the 21st Century.

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. He has a special interest in treating sleep apnea and TMJ problems. If there are certain topics you would like to see written about or questions you have please email them to him at

THE MOUTH IS THE GATEWAY

August 30, 2021

Filed under: Uncategorized — Dr. J. Peter St. Clair, DMD @ 2:35 pm

You may have heard the phrase “the mouth is the gateway to the rest of the body.” The mouth is connected to the rest of the body, and the only healthcare providers who spend time examining this area are your dental team. The days of the dentist being just the “tooth fixer” are gone. The key here is the practitioner thinking “outside the box” and treating each patient’s total-body health.

The average physician spends seven minutes every two years with a patient. There may be a 5 second glance inside the mouth during those visits. If you see a dentist on a regular basis, we (dentists and hygienists) spend an hour twice a year concentrating on a very specific region of the body. There is a lot of information available within that tiny little space.

For example, everyone has heard of gum disease. While many patients and dentists see periodontal (gum) disease as a tooth or oral health problem, the fact is, it is a bacterial disease and bacteria can travel throughout the body. About a dozen of the nearly 7,000 types of oral bacteria can wreak havoc on the body, not just the oral cavity.

In a study that looked at blood clots from acute heart attack and stroke patients, researchers found that oral bacteria in the clots were 16 times more concentrated than in the surrounding blood. I think it is safe to say that sometimes there is more going on than what we can see in the dental chair.

Some dentists are recommending salivary testing as they believe that it is a crucial part of diagnosing and reversing oral bacteria and inflammation. The salivary tests can show whether patients have abnormally high levels of the specific bacteria associated with heart disease, diabetes, and other total-body conditions. Diagnosis can then lead to treating the bacteria with a combination of antibiotics, antimicrobials and specific homecare techniques. In a perfect world, this information would be shared with the rest of the patient’s medical team to be able to provide comprehensive total-body care.

This is the same reason many dentists screen patients for sleep-disordered breathing. Sleep affects the function of the entire body. For a dentist, there is more to screening for sleep apnea than simply asking patients about snoring. Bruxing (grinding), clenching, and gastric reflux are just a few other signs to look deeper and ask more questions. It is believed that some patients who grind or clench their teeth at night do so as the bodies response to poor air flow. In addition, experts feel that many children diagnosed with attention deficit disorders may have airway problems that are contributing to, or causing the problem.

Nutrition is another area that should have more emphasis from the dental community. While dentists and hygienists often talk to patients about how sugar affects teeth, they should also be educating patients on how other foods, such as processed carbohydrates, cause body-wide inflammation.

This just touches on some of the systemic issues which can be screened for, and make a huge difference in patient lives. There is a link between your mouth and the rest of your body.

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. He has a special interest in treating sleep apnea and TMJ problems. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com

HOW OFTEN SHOULD YOU GO?

August 23, 2021

Filed under: Uncategorized — Dr. J. Peter St. Clair, DMD @ 12:50 pm

Despite the generalized notion that people should visit a dentist bi-annually, I am more a proponent of individualized frequency recommendations based on a few factors. We are not all the same; therefore, each of us has our own specific needs.

Results from a recent Gallup-Healthways poll of 355,334 Americans indicate that more than one-third of the population, 34% to be exact, did not visit a dentist last year at all. Over 50% of the population said they visited the dentist one time or less last year.

In a study reported in The New York Times and other major media, a report by the Journal of Dental Research indicates “little evidence supports biannual preventive care for all adults.”  Similarly, the headline from HealthDay News read, “Annual Dental Cleaning May be Enough for Some.”

The researchers explored the association between long-term tooth loss and the frequency of preventive dental visits in adults with and without three risk factors for periodontal disease: smoking, diabetes and interleukin-1 genetic variations (regulates immune and inflammatory responses). Subjects were deemed low risk if they had none of these factors.

The data showed that as a group the high-risk patients who had two preventive dental visits lost significantly fewer teeth compared to the high-risk group that had only one preventive dental visit per year. By contrast, there was no difference in tooth loss for the groups at low-risk based on one versus two preventive visits per year. The researchers concluded that individual risk factors should dictate the frequency of cleanings.

The American Dental Association recommends regular dental visits at an interval determined by the patient’s dentist. The patient’s dentist makes an individualized recommendation based on the patient’s health history and current oral health status.

Here are some points that may help you understand the study and the importance of personalized care:

  • The key takeaway from this study is that personalized oral care—taking into account your oral and overall health history—is necessary for good dental health.
  • The study only looked at tooth extraction and its association with risk factors for gum disease; however, other health conditions can contribute to poor oral health. That’s why personalized dental care is critical to good patient care.
  • Personalized treatment plans should be the priority. Recommendations for future dental appointments should be based on what is seen during your examination, your health history, and any concerns you may have about your oral health.
  • The American Dental Association’s website at www.mouthhealthy.org has a lot of information on how to take care of your oral health between dental visits.

While there is clearly a segment of the population who can “get away” with visiting a dentist once a year to maintain a healthy mouth, this group is relatively small. 75% of the population has some form of gingivitis or periodontal (gum) disease. Within that group, there are those who should see a dentist/hygienist twice per year, some three times and others four times or more to maintain proper health.

It is up to you and your dentist to have an open conversation about how often you should go. If it has been a while, getting there the first time is step number one.

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. He has a special interest in treating sleep apnea and TMJ problems. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com

NOT SO FAST

August 16, 2021

Filed under: Uncategorized — Dr. J. Peter St. Clair, DMD @ 11:17 am

This is the story about a woman I met recently named “Carol”. Carol’s story is the reason I do what I do every day and brings me back the next day. The interesting thing is that it has absolutely nothing to do with performing the actual physical work of dentistry.

Carol is in her 70’s and has gone to the dentist infrequently for most of her life. She presented to my office a couple of months ago for a second opinion. At our first appointment Carol brought her most recent x-rays, a treatment plan from another dentist, and a page-long list of questions. She was well-prepared for the consultation and seemed to know exactly what she wanted.

About 8 years ago, Carol visited a “holistic” dental office. Carol had about $10,000 of dentistry done at that time. Her reason for visiting that particular office was because she was/is very concerned about her health and believed that a “holistic” office could provide her with what she was looking for. Now, only 8 years later, her teeth are falling apart.

Carol had eight crowns done on her back teeth at that time. The crowns, still in her mouth, were failing due to recurrent decay. More importantly to Carol, her front teeth were in severe breakdown. Carol had her mind made up; she wanted full dentures.

Carol sought out a local dentist, presented her desires, got a written treatment plan with fees, and then came to me for a second opinion. She brought that treatment plan with her and it appeared very reasonable – take out all remaining teeth and place full dentures.

The first thing I noticed was that Carol had 6 lower front teeth that have been decay-free and have had excellent bone supporting them for 70 years. However, her mind was made-up, she wanted everything taken out. She did not want to have to deal with maintenance of teeth any more.

Over the next two consultation appointments I had with Carol, we discussed many different treatment options. We thoroughly reviewed the advantages of keeping these lower front teeth each time we met. Carol brought a list of questions to each of these meetings, which we discussed in depth. It was decided – Carol was moving forward with full dentures.

At each appointment during the process, I discussed a different aspect of why it would be such an advantage to her to keep those lower front teeth. Her mind was not changed, until yesterday. Yesterday, Carol walked into my office to tell me that she has decided that she wants to keep her lower teeth.

Okay, so what’s the point? The point has nothing to do with what Carol’s final treatment is. Carol has every right to decide on what she feels is right for her.

The local dentist she got the treatment plan from provided a very reasonable treatment proposal. They had one visit, decided on treatment and her next step was to go to the oral surgeon and have all her teeth out.

Far too many times I see patients and dentists rush into treating teeth. Taking the time to engage in conversation and treat the person as a person and not just a head with teeth, is the truly holistic approach.

My point of this story is not that I got Carol to do what I felt was best for her, but that I gave her my time, answered all her questions, and allowed her to decide what was best for her. She needed the time.

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. He has a special interest in treating sleep apnea and TMJ problems. If there are certain topics you would like to see written about or questions you have please email them to him at jpstclair@stclairdmd.com

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