Are You Telling the Truth about Your Health When You See Your Dentist?

dental-revelations-blog

Interview Is the Most Important Part of the Check Up

When you see your dentist for a regular check up it should always start by interviewing you. No matter how long you have known your dentist and you think they know you inside out, the same questions should be repeated every time. These questions make the treatment you might need safe to perform when it comes to your health.

If the dentist or dental hygienist does not ask about your medical history when you see them for a check up or an emergency visit, I would advice you to change the practice. In worst case your life might be at risk.

If your dentist or dental hygienist does ask about medical history, you are in good hands but only if you are honest. Do not hide anything even if you think something is not relevant or you are embarrassed about it.

The most important ones to mention are

  • anticoagulants (all of them – even aspirin and omega 3-products) and why you have been prescribed these
  • allergies – all of them! The ones the patients often fail to disclose are food allergies and allergy to latex. One might think that why would food allergy make any difference to dentist but it does. There is milk protein in a product called GC Tooth Mousse that is used e.g. after teeth cleaning
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  • antidepressants – you don’t need to be embarrassed about them, we are professionals and will take matters as they are
  • eating disorders – the past and current ones. There is no reason to hide them from the professionals. It might be actually a relief for you to share it with somebody (believe me, I have witnessed this several times during my professional life)
  • excessive alcohol consumption – even if you won’t tell us we can often see it from your mouth or how you response to the treatment. Heavy alcohol consumption may affect the effectiveness of the local anaesthesia – it might be difficult to get your tooth numb. Also certain drugs like antibiotics won’t be effective enough. These are just two examples. If you are interested to read my post about alcohol, please click here.
  • if you have artificial joint/s
  • all the systemic diseases
  • if your immune system is impaired – HIV, hepatitis A or C. This won’t change the way we treat you as we should treat all the patients in such way that no cross-contamination can happen. But we need know in case we see something in your mouth (e.g. soft tissues) we do not understand unless we know about your illness. Also the information will help us in the case of unfortunate accident if one of us professionals cut ourselves by contaminated instrument.

It Is All about Trust

Everything you tell us at the dental office is confidential. Even if you are a public figure.

I must tell from an experience that I felt utterly disappointed and mistrusted once when a well-known person who had seen me for years, told in the press that she has had hepatitis C for a long time. You tell this publicly but not in a place you should! Why o why? Trust us for God’s sake!

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Today I Saw My One in a Thousand Patient

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A-mazing. Simply amazing. That is what I thought when I took a look at one of my patient’s mouth today. It wasn’t something I expected to happen after interviewing the patient.

You see amongst many other things I always ask the patient if he uses fluoride toothpaste. This patient didn’t. And the reason for not using fluoride was a fear of the side effects and the fact that he has never had decay. He was 36 years old. I was sceptical of course. I was certain what I was going to find. If you have read my post Anti-Patients you know what it is. If you haven’t and you are about to click the link, do scroll down to the paragraph Anti-Fuoride when you get there.

So today I was certain that I was going to find decay. At least the early stages of it. Or dental erosion. And I was prepared to go through the routine of informing the patient about the consequences of not using the fluoride toothpaste.

But. A big but. The teeth were in immaculate condition. No plaque, only tiny amount of tartar and definitely no decay. No matter how hard I tried to find even the smallest evidence of it – of the patient being fool not to use fluoride. But he was no fool. Far from it. He had good eating and oral hygiene habits and he attended the dentist regularly. That made him very wise.

Both me and the patient had the same question in our minds. Why isn’t there a toothpaste which contains only calcium for the patients like this one. They don’t need fluoride. Would calcium be enough? But then again, do they need toothpaste at all?

And for those not using the fluoride toothpaste by choice, remember that it really is one in a thousand that will get away with it. Most people will get problems with decay or dental erosion.

 

 

Ever Seen a Patient with an Implant? Read This!

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Today I saw a patient who had had an implant done to replace upper right first molar. The implant treatment was finished a year ago in another practice.

Since then the patient had seen hygienist twice in my practice. The implant crown itself looked immaculate but the gum was very red and puffy and it bled heavily after probing.

I knew what to ask next and I even knew the patient’s reply to this.

“Were you told how to clean the implant at home?”

“No I wasn’t” replied the patient with is-it-supposed-to-be-cleaned-expression on his face.

This happens too often. Almost every time I see a patient who has recently had an implant done.

Note for all the dental professionals who make the implant treatment’s final stages and do not give oral hygiene instructions (OHI) for the patient:

You should always tell and show how the patient can clean these costly pieces of metal and porcelain. It is your responsibility as a dental professional and the paying patient’s right!

Can you give me any other excuse for not giving OHI than the fact that you are too busy making money and forgetting the basics? I believe you cannot.

And you hygienists who see patients with implants:

  1. Always check how the patient is cleaning them. More so if the gum around the implant is either bleeding or there is plaque around it
  2. Advice if necessary and show in their mouth how it is done
  3. Check if the patient understood your instructions by asking them to show they can do it. Teach them if they struggle
  4. Check on a follow-up visit that the gum has healed. If not, refer to a dentist

Why Is It So Important?

With the implants it is vital that there is no bleeding in the surrounding gum. They will get an implant’s equivalent to gingivitis – peri-implant mucositis which can lead to the peri-implantitis (same as periodontitis with teeth) very rapidly. The worst case scenario is that the implant will lose its integration to the bone which could have been easily prevented.

The patient I saw today left home with instructions on how to look after his implant. And I will see him for a follow-up visit to make sure the gum has healed (can you see the shining halo around my head?).

Honestly, it’s not that hard to do your job properly so shape up please!


Here‘s further reading on the subject.