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J. Peter St. Clair, DMD Blog

DO YOU CLENCH?

September 17, 2018

Filed under: Uncategorized — Dr. J. Peter St. Clair, DMD @ 7:51 pm

There are many reasons people get headaches, and many medications and suggestions on how to prevent them. You may have heard that reducing stress in your life can help reduce headaches. Although methods of relaxation are important to get through the stresses of life, it may not be enough to prevent headaches, especially in the subconscious (i.e. sleeping).

Studies have shown a link between tooth grinding, clenching and headaches. For people who grind or clench, the muscles that open and close the jaw can become painful from overuse, causing a range of symptoms from tension to migraine headaches to jaw joint (TMJ) problems to tooth pain.

Bruxing (grinding) and clenching teeth is defined as abnormal tooth contact (parafunction). Ordinarily, teeth are in contact while eating and swallowing, only about 10 to 15 minutes on a daily basis. People who grind or clench their teeth during the day, or while sleeping, can have their teeth in contact for as much as six hours a day or more. Researchers say that one night of grinding is equivalent to 80 days of normal wear.

Clenching can be just as bad, and in some cases worse than grinding. The average person puts about 200 lbs. of force on back molars during function but a person who clenches can put up to 1000 lbs. on the molars. This is a lot of force for the teeth to withstand. Fractured teeth are seen on a regular basis in dental offices due to clenching.

The American Dental Association estimates that 95 % of the American population suffers from a grinding or clenching problem at some point in their lives. Some people do so much damage over time that to restore their teeth back to normal function takes a significant amount of dentistry. The key is early diagnosis and treatment.

Many patients do not realize or refuse to accept the fact that there is a problem. The reason for this is because many, if not most, do not have symptoms. The masticatory system is a very adaptive and forgiving system. This does not automatically mean, however, that there are no signs of problems. With intervention, help can prevent problems in the future.

Therefore, successful therapy starts with acceptance of the pathology present. In addition to behavior modification, nighttime bite splints can be very effective. They should be worn every night, not just when it “seems” like you have been grinding or clenching. There are many types of nightguards for different problems. Over-the-counter appliances are not recommended and can be dangerous to use. Some types of nighttime appliances can be extremely effective in treating people who suffer from headaches due to clenching.

Headaches are only one of the symptoms associated with clenching. Everything from sore muscles, sensitive teeth, worn teeth, broken teeth, and sore joints can be caused by clenching. Ask your dentist whether you have any of the signs associated with grinding or clenching. Treatment can be easy, relatively inexpensive, and save you from potential future problems.

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. 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. You can view all previously written columns at www.jpeterstclairdentistry.com/blog.

BRIGHTENING YOUR DAY

September 10, 2018

Filed under: Uncategorized — Dr. J. Peter St. Clair, DMD @ 7:31 pm

In a recent poll I read, people were asked if they would choose a cosmetic makeover, liposuction, facelift, or teeth whitening if money was no object. 52% of those surveyed said they would choose teeth whitening. While there are many ways to whiten teeth, including professionally in the dental office, consumers are spending over $1 billion per year on over-the-counter (OTC) whitening products. People want whiter teeth because it makes them look better.

Almost all whitening products will lighten teeth to a certain extent because they all contain hydrogen peroxide or a derivative. The controlled environment of the dental office and the quality of the materials used usually provides the most predictable and most effective results. If you choose to use OTC products you will just want to be aware of the potential risks, the most common being overuse.

All forms of tooth whitening can have side effects, including gum irritation and sensitive teeth. These side effects are normal and usually subside once the treatment has stopped or shortly thereafter. When your teeth are whitened under a dentist’s supervision, he or she will be able to detect any adverse side effects the bleaching may have and give suggestions to correct. If you choose to whiten on your own, it is best to make your dental team aware of the use of those products to help guide you.

The issue with overusing whitening products is the continuous assault of the pulp or nerve of the tooth through any exposed dentinal or root surface by the bleaching gel. If the whitening is causing tooth sensitivity it means the gel is affecting the pulp of the tooth in some way. In the short-term that’s usually not an issue and the pulp recovers.

In my experience it is very rare to see permanent damage done to teeth if the whitening products are used properly. It is important to note that different kinds of teeth require different strengths of bleaching to get the desired result. These different “types” of teeth also have varying levels of sensitivity to the bleaching products.

Teeth belonging to patients 30 and under and teeth that are yellow in appearance, typically take less time to achieve the desired result. These teeth are also the most susceptible to the side effects of bleaching. People with recession are also more susceptible to sensitivity. This group will usually see great results with professional at-home tray whitening in about 2 weeks.

The older and darker teeth are, the more time it takes to lighten them and the less susceptible they are to side effects. For example, I treated a patient with severe staining due to tetracycline medication as a child who was told his teeth would not lighten all that much. He did at-home professionally monitored bleaching every night (or almost) for 9 consecutive months and got amazing results.

There is nothing quite like a bright beautiful smile. The simple process of teeth bleaching can completely change a smile. There are some OTC products that are perfect for some patients as long as the included directions are followed. For those who have more bleach challenged teeth or want more predictable results, professional whitening is advised.

Teeth Whitening makes a great present too!

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. 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. You can view all previously written columns at www.jpeterstclairdentistry.com/blog.

HOW OFTEN SHOULD YOU GO?

September 5, 2018

Filed under: Uncategorized — Dr. J. Peter St. Clair, DMD @ 1:46 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 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. 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. You can view all previously written columns at www.jpeterstclairdentistry.com/blog.

Watch Out for the Different Stages of Gum Disease

September 4, 2018

Filed under: Uncategorized — Dr. J. Peter St. Clair, DMD @ 1:33 pm

Woman with healthy smile.Do your gums bleed when you brush or floss? This isn’t a toothbrush or flossing problem, it’s the first sign of periodontitis. Around 50% of American adults suffer from mild, moderate, or severe periodontal (gum) disease. The first stage of this disease is called gingivitis. Keep reading to learn the differences between gingivitis and periodontitis as well as how a mild health issue like bleeding gums can progress into something much worse.

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CHOOSE AND COMMIT – STEP 3

August 27, 2018

Filed under: Uncategorized — Dr. J. Peter St. Clair, DMD @ 3:30 pm

In the first segment of this series I discussed the role of caregivers in early dental care. Prevention starts as early as 6 months into pregnancy and continues with essential steps early in a child’s life. The second segment discussed dental care for children as they develop. In this final segment I will discuss easy prevention and maintenance steps to take to help ensure dental health for a lifetime.

As I stated a few weeks ago, in preventive-based dental practices we go far beyond saying to patients, “you need to brush and floss more.” We truly believe that dental disease, both dental caries (cavities) and gum disease, is very preventable. However, we recognize that not every individual is equal when it comes to susceptibility. Each person presents with their own unique genetic pool, good and bad habits, number and position of teeth, and willingness to truly make a change. The one constant is that most of us have room for improvement.

Here are 4 simple things that will help maintain dental health for a lifetime:

Professional Maintenance – It is easy to put professional hygiene visits on the backburner. We are pulled in many different directions in life, and the absence of pain in our mouths sometimes grants us permission to skip regular dental appointments. Some people will use the excuse of lack of insurance for not going on a regular basis. The most important thing you can do to prevent dental disease is to commit to a lifetime of professional dental visits. This is a choice. Your cell phone costs more per year than these visits will. Some people require four visits a year to maintain health and others may only require one. There are no set rules. However, it is up to you to make the commitment.

Home Care – Most people have significant room for improvement with their home care. Coaching, in anything, increases an individual’s potential for improvement. Think of us as your dental coach. We routinely ask patients to bring their toothbrushes with them to their appointments to review technique. As simple as it sounds, constant evaluation and improvement of your home care can only decrease your chances of dental disease.

Diet – What we put in our mouths, when we do it and how often are all choices as well. As with everything, some people can get away with things that others cannot. Decay rates are different for different people and can change during the course of a lifetime. This is an important topic to routinely discuss at regular visits.

Oral Appliances – This is in reference to any oral appliance typically worn while sleeping. This is another situation where absence of any symptoms sometimes allows us to ignore what is really going on. It is easy to get someone to wear an appliance in their mouth if they present with TMJ issues or headaches. On the other hand, it is often difficult to convince someone to routinely wear a nighttime appliance if they have no symptoms. For example, people who have had braces should be wearing retainers. People who have sleep apnea may have the option of wearing an oral appliance. However, those who have evidence of clenching and/or grinding are the most undertreated. It is my firm belief that if more people committed to unfailing routine use of a properly made nighttime appliance, many potential dental problems could be avoided.

I believe that most dental disease is preventable. What it takes to prevent dental disease in one person may very well not be the same for another. Choose and commit to these four things and you are guaranteed fewer dental problems over your lifetime.

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. 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. You can view all previously written columns at www.jpeterstclairdentistry.com/blog.

THE NEXT STAGE – STEP 2

August 20, 2018

Filed under: Uncategorized — Dr. J. Peter St. Clair, DMD @ 3:47 pm

Last week I talked about oral care for mothers-to-be and babies. Preventive care truly does start before birth. This week we journey past those early years of life.

In preventive-based dental practices we go far beyond saying to patients, “you need to brush and floss more.” We truly believe that dental disease, both dental caries (cavities) and gum disease, is very preventable. However, we recognize that not every individual is equal when it comes to susceptibility. Each person presents with their own unique genetic pool, good and bad habits, number and position of teeth, and willingness to truly make a change. The one constant is that most of us have room for improvement.

It goes without saying that preventive care includes regular visits to the dentist. Based on my experience, even many of those who visit the dentist on a regular basis have significant room for improvement. However, it is up to your caregivers, hygienists and dentists, to have that preventive frame of mind to go beyond just telling you to brush and floss more.

Technique is vital when it comes to home care. Although daily removal of plaque (the thin, sticky film of bacteria that creates cavities and gum disease) can be accomplished with a manual toothbrush, the proper power toothbrush is more appropriate and effective for most people. We routinely ask patients to bring their toothbrushes with them to their appointments to review technique. Think of your dentist and/or hygienist as your dental coach. Coaching, in anything, increases an individual’s potential for improvement.

The same approach goes for kids. Although we do the same thing with children, they need that additional coaching from home. The best way to guide your family to good oral health is to lead by example. Parents should supervise toothbrushing by children younger than age 8 to make sure they are doing a thorough job. This also goes for flossing. This is done until the child is consistently getting good homecare reports at dental visits.

The challenge of good home care increases with the addition of braces. Children and adults in braces need extra coaching on technique and more time spent on their daily routine. I am a firm believer that preventive visits to the dentist should increase during orthodontics. There is too much at risk during this time and the extra professional care and coaching are vital to escaping the pitfalls of poor homecare while braces are on.

As life goes on, your genetic make-up, the amount of professional care and coaching you receive, your effectiveness at home, and your willingness and ability to improve, will shape your oral health. The fact of the matter is, there are those who need more professional care and more rigorous homecare than others.

As I stated earlier, I believe that most dental disease is preventable. What it takes to prevent dental disease in one person may very well not be the same for another. Between finding the right fit with a dental office, utilizing the coaching expertise of those individuals, using the right homecare products, and always striving to improve, excellent oral health for a lifetime is possible.

In the final segment of this series next week I will discuss some simple ideas to maintain good dental health for your entire adult life. It is simpler than you think.

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. 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. You can view all previously written columns at www.jpeterstclairdentistry.com/blog.

STARTING AT BIRTH – STEP 1

August 16, 2018

Filed under: Uncategorized — Dr. J. Peter St. Clair, DMD @ 1:13 pm

Research shows that babies are born without any harmful bacteria in their mouths. However, once bacteria colonize in the mouth, children are more prone to cavities in their baby teeth and permanent teeth. How do they get the bacteria? Caregivers.

Most parents don’t know that they can pass harmful bacteria from their mouth to their baby’s mouth. The most critical time is during the child’s first 2 ½ years of life. Most children are born without a single tooth. Can bacteria passed to children without teeth affect their decay potential for their whole life? According to research the answer is yes.

Here’s a shocker…..If you have a history of poor oral health, including many fillings in your mouth, you are much more likely to transfer these harmful bacteria to children. How? Typically, this takes place through common parental or caregiver behaviors such as sharing utensils or cleaning a baby’s pacifier with your own saliva.

Prevention starts as early as 6 months into a pregnancy. Research shows that expectant mothers who chewed gum containing the sweetener xylitol are much less likely to have decay-causing bacteria in their saliva. So, take-home point number one, it is essential for expectant parents and caregivers to keep their own mouths healthy. If you reduce the bacterial levels in your own mouth, you are not only benefiting yourself but also that of your unborn child. Visiting a dentist regularly, even more often when you are pregnant, improving your homecare, and using products that specifically reduce bacteria are all essential.

Your baby is born; now what? First, eliminate potential ways of transferring saliva to your baby. Do not share utensils or let grandma or grandpa lick a cloth to clean around a baby’s mouth. Wiping your baby’s gums with a clean cloth after meals is also good practice to help reduce bacterial levels.

Once a child starts getting teeth, diet plays a significantly greater role. Minimizing snacks and drinks with fermentable sugars is key. This starts with the bottle. Bottle syndrome, also known as baby bottle tooth decay, occurs when teeth become exposed, at length and frequently, to liquids containing a form of sugar. All liquids that contain sugar can cause bottle syndrome, including breast and cow’s milk (which contain the sugar lactose), formula, fruit juice (which contains the sugar fructose), soda and other sweetened drinks. It is caused by the constant presence of milk, formula, or fruit juice in a child’s mouth during the night, during breastfeeding, during naps, or for extended periods during the day. The liquid pools around the teeth and gums, providing food for the bacteria in plaque. The bacteria produce acid as a byproduct when they consume the sugar. This acid attacks your child’s teeth and causes decay.

When your child feels comfortable with a toothbrush, brush their teeth and gums twice a day with an extra-soft toothbrush. Use a pea-sized amount of toothpaste without fluoride until your child is old enough to spit.  If your child doesn’t like toothpaste, it’s fine to brush without it.

Prevention starts before babies are born. It starts with taking care of your own mouth.

Next week, in the second part of this 3-part series, we will explore some important issues to consider during the next phase of life.

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. 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. You can view all previously written columns at www.jpeterstclairdentistry.com/blog.

INTRO TO SLEEP APNEA – PART 2

August 9, 2018

Filed under: Uncategorized — Dr. J. Peter St. Clair, DMD @ 1:18 pm

Last week I discussed what sleep apnea is. This week I will discuss diagnosis and treatment.

Specialists who diagnose and treat sleep apnea express varying opinions about the cause and best treatment of the breathing disorder. Ask a lot of questions of each specialist to determine the most appropriate procedure or combination of procedures for your particular case. Here are the specialists who may be involved in diagnosing your sleep apnea and the ways they might assist you:

An ear, nose and throat doctor (ENT) may recommend surgery to clear blockages caused by a genetic abnormality in the nose or throat. The uvulopalatopharyngoplasty (UPPP) procedure eliminates tissue from the back portion of the mouth near the top of the throat. The adenoids and tonsils may be removed as well. Should your airflow blockage be life-threatening, the ENT may find it necessary to build an opening in the windpipe through a procedure called a tracheotomy. This would be an extreme case. Also, an operation on your nose might be necessary to improve a deviated septum or to remove polyps that are blocking your airflow.

A pulmonologist (a doctor who deals with diseases of the respiratory system) may recommend a sleep evaluation based on an analysis of your breathing muscle capacity. Pulmonologists may also recommend the use of oxygen should blood-oxygen levels fall to dangerous levels during sleep.

A neurologist (a doctor who deals with nervous system disorders) will evaluate brain functionality and may recommend a medication such as acetazolamide to improve the brain’s ability to trigger the breathing muscles.

A cardiologist (a doctor who deals with diseases and disorders of the heart) may recommend a sleep test as well.

A sleep specialist may perform a sleep test that measures oxygen blood level (among other anatomical factors) during sleep. Sleep specialists may recommend the use of a continuous positive airway pressure (CPAP) machine. The machine delivers a continuous flow of oxygen through a mask that you wear over your nose during sleep.

An alternative is a bi-level positive airway pressure (bi-level PAP) machine, which increases the oxygen level upon inhalation and decreases it upon exhalation. An adaptive servo-ventilation (ASV) machine is a third choice. This equipment measures your level of breathing and records the data so that oxygen delivery can be matched to your specific needs. A CPAP machine is usually considered the best way to treat sleep apnea if the patient can tolerate it.

Certain dentists and oral surgeons are skilled in evaluating the tongue for its ability to move freely and its tendency to block airflow during sleep. The tongue can become restricted as the mouth and gum tissue shrinks with age. In this case, a laser may be used to eliminate the tissue causing the tongue restriction.

Another dental approach is to position the jaw so that airflow is not blocked. If the upper and lower jaws are responsible for sleep apnea, then an oral surgeon and an orthodontist may work together to relocate them.

Finally, many patients with sleep apnea can be successfully treated with a dental appliance made by a dentist with experience in treating this sleep disorder. The appliance is worn while sleeping to hold the lower jaw in an appropriate position to keep the airway opening. This is becoming more and more of an accepted and effective treatment.

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. 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. You can view all previously written columns at www.jpeterstclairdentistry.com/blog.

INTRO TO SLEEP APNEA – PART 1

August 6, 2018

Filed under: Uncategorized — Dr. J. Peter St. Clair, DMD @ 1:18 pm

Today and next week is a re-introduction to what this severely underdiagnosed medical condition is, and the different ways to treat it. The more you become aware of the different symptoms associated with this problem, the more likely you are to identify whether you or a loved one may be affected. Treatment can extend life.

Sleep apnea is a serious, potentially life-threatening sleep disorder that affects approximately 18 million Americans. It comes from the Greek meaning of apnea which means “want of breath”. People with sleep apnea have episodes in which they stop breathing for 10 seconds or more during sleep. (Note: They are always unaware this happens.)

Diagnosis of sleep apnea usually requires an overnight sleep study in a sleep lab, although there are methods for diagnosis at home. In fact, more and more sleep physicians are using home testing devices because they have improved in reliability.

There are two major types of sleep apnea, both of which can severely disrupt the regular sleep cycle.

Obstructive sleep apnea is when the muscles in the walls of the throat relax to the point where the airway collapses and prevents air from flowing into your nose and mouth. However, as you continue to sleep you also continue to try to breathe. This is the most common type of sleep apnea.

Central sleep apnea is the other type. This is when breathing interruptions during sleep are caused by problems with the brain mechanisms that control breathing.

What are the symptoms associated with sleep apnea? People with sleep apnea usually do not remember waking up during the night. Some of the potential problems may include morning headaches, excessive daytime sleepiness, irritability and impaired mental or emotional functioning, excessive snoring, choking/gasping during sleep, insomnia, or awakening with a dry mouth or throat.

So, what is the difference between snoring and sleep apnea? Unlike mild/moderate snoring, individuals with sleep apnea stop breathing completely for 10 seconds or more, typically between 10 and 60 times in a single night. If the person sleeping in the same room hears loud snoring punctuated by silences and then a snort or choking sound as breathing then resumes, this could be sleep apnea. (Note: In fact, these witnessed events are a strong indicator of sleep apnea.)

Studies have shown that people with diagnosed sleep apnea can be so fatigued during the day that, when driving, their performance is similar to that of a drunk driver. If left untreated, sleep apnea can lead to impaired daytime functioning, high blood pressure, heart attack, or stroke.

Sleep apnea is a medical problem and must be diagnosed by, and treatment dictated, by a physician. Since many people see their dentist on a regular basis, if there is any concern of sleep apnea, the dentist can work closely with a physician to refer for evaluation. If a positive diagnosis is made, the dentist and MD can work together to implement and manage a prescribed therapy.

More and more dentists are getting training in this area of medicine because they can be a help in the treatment of some of the problems associated with sleep-related issues. In my experience, there also seems to be a large part of the population who are un-diagnosed, or are diagnosed but have issues with treatment modalities they are using.

Next week we will discuss the diagnosis of and treatment options of this potentially life-threatening disorder.

Dr. St. Clair maintains a private dental practice in Rowley and Newburyport dedicated to health-centered family dentistry. 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. You can view all previously written columns at www.jpeterstclairdentistry.com/blog.

WE ALL HAVE CHOICES – PART 2

July 30, 2018

Filed under: Uncategorized — Dr. J. Peter St. Clair, DMD @ 1:08 pm

Last week I introduced a couple who had been seeing the same dentist for 30 years and were finally forced to make a change due to the dentist’s retirement. They visited a “new” dentist and were turned off because the dentist recommended significant treatment. Then they consulted with another dentist, who spent more time with them to discuss their specific situations and goals. However, they still missed their “old” dentist.

The couple loved their “old” dentist because she was someone they could relate to. The dentist kept things simple, and they liked simple. If they had a broken tooth, the dentist patched it up and they were on their way. They never talked about the future. They may have lost some teeth over the years, but the dentist never discussed “needing” a lot of dental work.

The first “new” dentist was a nice person. In fact, they knew the dentist outside the office before they became patients. The problem was poor communication and inability to relate to the patient’s specific needs.  This dentist looked in both their mouths and said they each “needed’ 8 crowns. It didn’t make sense to them. It seemed too complicated, expensive and unnecessary.

The second “new” dentist took a different approach and spent time with the couple discussing their current situation and future objectives. They both wanted to keep their teeth but still had trouble coming to grips with the fact that they “needed” significant dental work to accomplish their objective. Why couldn’t they continue on the same simple path they had with their original dentist?

Dentists are sometimes more interested in what they are saying than patients are. It is important to remember that the teeth are attached to a person; and that person has their own story that goes along with their teeth.

People put different values on different things. Whether we sell cars, trips, hairstyles or teeth, the objective of the “seller” is to make the prospective “buyer” aware of what they have and all the possibilities that are available to them. It is always the consumer’s decision. While there is a health component to dentistry, you can compare any other aspect of selling the other commodity examples to teeth. Things that come to mind: comfort, looks, self-esteem, and functioning in life.

To “buy” anything, people have to be ready. What makes someone ready? They are ready when they feel the need to act. In the absence of readiness, over-education by the “seller” often feels like sales pressure to the buyer. I’m sure you have experienced this if you have ever been to a car dealership.

I love analogies. I especially love car analogies as they relate to dentistry. Cars are easy because most of us rely on them every day, just like our teeth. Some of us like simple cars, while others like fancier cars. Some take better care of their cars and they last longer.  Others abuse their cars and they need more repairs. One thing is certain; maintenance is the key to long-term success of the car.

Raising awareness is a difficult task for anyone promoting their product or service. Acting on something is only accomplished when value is realized. Some end up seeing the value in their life and others do not.

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