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.

A New Dentist’s Approach to a Couple’s Treatment Goals

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.

People often ask me how I have time to write columns, and how I’ve come up with topics for as long as The Town Common has been around. If you have read my columns over the years, you’ll remember I have discussed that time was one of the barriers keeping people from getting the dental care they need. Time is an excuse and I use it as an excuse all the time. However, we always make time for things that are important to us. The topics I come up with have been an evolution. I try to keep it interesting. Of course, many of the things that I find interesting in dentistry would bore others. While some of my columns may bore you to tears, hopefully there are others that you can relate to, or stimulate thoughts or questions.

A Couple’s Search for Care After Their Dentist Retires

Let’s talk today about a common scenario seen in all dental offices. New patients, husband and wife in their 60’s, are “forced” to make a dental provider change. I say “forced” because regardless of our situation, we always have a choice in our providers. This couple had been seeing the same dentist for 30 years. Despite the fact that they moved 20 miles from the dentist 10 years ago, they continued to make the drive to the office. They were dedicated and they loved their dentist. Then one day the dentist retired and they decided it was time to choose someone closer to where they lived. Both went to their new office for hygiene appointments and then discussed their experience. They both felt the office staff was less friendly than their previous office. Of course, they knew that “old” office and loved everyone there. They were still willing to give it a chance, until they met the dentist. The dentist seemed like a nice person but took a quick look and said the same thing to both husband and wife – You NEED 8 crowns. How could this be, they thought? They had been going to the same office for 30 years, neither ever had a crown, and when something broke, their favorite dentist would “patch” them up. They were completely turned off. They were “forced” again to make a change. This time they wanted to meet the dentist first and see what the dentist had to say before they committed. They set up a 30-minute appointment. At that appointment, the “new” dentist examined their x-rays and took photographs of their teeth. They had an in-depth conversation about the condition of their dental health. They were asked what their short-term and long-term objectives were. The word “crown” was never mentioned…..until one of them asked the dentist. The dentist discussed advantages and disadvantages of different kinds of treatment. Since the patient’s long-term objective was to have teeth forever, they discussed options for treatment, prioritization and sequencing, as well as financial options. Although they were not ready to dive into treatment, they left the office with a much better understanding of where they stood and appreciated the time that was taken to explain their specific situations. Every person, every patient, every dentist, is different. This couple experienced three different practice styles. They could relate to Dentist #1 – their “old” dentist. Dentist #2 lacked communication skills, therefore the relationship failed. Dentist #3 took the time to learn about their specific needs and goals. They didn’t feel sales pressure but are still overwhelmed by their apparent “needs.” To be continued……

If there’s one thing about modern life that’s both a blessing and a curse, it’s all the choices we have. On one hand, it seems great that we can choose from so many options for every product at the grocery store. On the other hand, it can be confusing and overwhelming to make a decision. When it comes to all the toothpaste out there, most people would be hard-pressed to name each type, let alone decide which one is best for them. That’s where the expertise of a dentist comes in. Keep reading to find out what each toothpaste formula does and whether it would be right for you!

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Free Sugars and the Research on Cavity Risk

According to a recent study by British researchers, in order to reduce the significant financial and social burdens of dental decay, free sugars in the diet should make up no more than 3% of total energy intake. Dental decay (caries) is the most common chronic disease worldwide, affecting 60% to 90% of schoolchildren and the majority of adults. In the U.S., 92% of adults ages 20 to 64 have had caries in at least one of their permanent teeth. The treatment of dental diseases costs 5% to 10% of total health expenditure in industrialized countries. The study findings indicate that current approaches to controlling dental caries are failing to prevent high levels of caries in adults in all countries, according to the researchers. This is related to the current high amount of sugar intake worldwide, and a new and radical policy of progressive sugar reduction is needed. “It is now even more important to develop a radical prevention policy with a marked reduction in sugar intake since the use of fluoride on its own is insufficient to reduce substantially the burden of caries over the lifetime of individuals,” they wrote. According to World Health Organization (WHO) nutrition guidelines, “free sugars” include “monosaccharides and disaccharides added to foods by the manufacturer, cook, or consumer, and sugars naturally present in honey, syrups, fruit juices, and fruit concentrates.” Sugar consumption should make up only 10% of total energy intake, ideally only 5%, based on WHO guidelines, even with the use of fluoridated water and fluoride toothpaste. That equals about 3 tablespoons (50 grams) of free sugars as the daily maximum, with 2 tablespoons (25 grams) as the target. Research published earlier this year suggests that 5% should be the maximum, with a target of less than 3%. The researchers recommended radical policy changes to reduce sugar consumption and address the issue of caries. “Our top priority is not to allow the idea of a magic single bullet to solve the problem to be developed,” stated study co-author Philip James, MD, an honorary professor of nutrition at the London School of Hygiene & Tropical Medicine, in the release. “A fundamental aspect of public health planning is to develop society-wide measures which impact the health of the whole community.” He believes vending machines that sell sugary drinks in areas that are controlled or supported financially by local or central governments should be removed. Publicly supported facilities should not contribute to the expensive problems of dental caries, obesity, and diabetes, Dr. James noted. The food industry should progressively reformulate their products to reduce or remove all sugar from their products, and food labels should label anything containing more than 2.5% sugars as “high,” he recommended. Dentists, including myself, see far more decay than we should. As I have stated in past columns, dental decay has numerous etiologies but is a very preventable disease. 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.