The Telegraph: Going to the dentist every six months is unnecessary, says UK’s top dentist
Ha! So it is and I was very pleased that somebody more influential than I was able to get the topic in the broadsheet paper. In case you haven’t read my blog post about the same subject, please click here.
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Here we go again. I am annoyed about something that is waiting to burst out. I have written about integrity of the dentists in one of my previous posts and today I am going to touch the same subject.
This post is about dentist check-up frequency patients should have.
Many dental practices very commonly advise people on their websites and in the surgeries to see dentist every three to six months and they justify this by prevention of bigger dental problems.
A revelation:
Recommending the same check-up interval to all the patients is not up to the standards of modern dentistry. It is merely (once again) about maximising the profit of the practice.
Check-up intervals should be decided after carefully evaluating the current status of the oral health, general health and oral hygiene routines. I will list the guidelines that are practiced in one of the leading countries.
This concerns the patients who have
It is important to check the patient’s eating habits to make sure that they are not harmful to the teeth and encourage patient to change them if needed.
This concerns the patients who have
It is important to make a plan together with a patient to stop the decaying. This might include visits to the hygienist.
Certain groups of people might need to see dentist more often than advised above. These are:
After a comprehensive therapy for the gum disease the patient needs to see periodontist/hygienist regularly for the maintenance visits. The interval of the maintenance visits is based on many risk factors like
The more advanced gums disease the shorter the maintenance interval. The more risk factors the shorter maintenance interval.
To recommend all the patients the same 3-monthly check ups is simply madness and it stinks of foul play.
Dear patients,
please be advised that you most definitely do not need to see a dentist every three months unless you fall into one of those risk factor categories above. But even in these cases a top-notch oral hygiene habits can make wonders and extend the check-up interval from three months to six.
Also if you do want to see a dentist every three months there is no harm done. Apart from you needing to pay unnecessarily for a treatment you don’t need.
Yours sincerely,
Dental Revelations Blog
Times change. So does the dentistry. Sticking to the old ways – “it has always been done like this” – is simply not what modern dental practice should do.
More on the subject click the links below.
NICE – National Institute for Health and Care Excellence
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About 60 year-old man came to see me one morning and complained that every once in a while a layer of skin comes off inside his mouth and no-one has been able to tell why. He was concerned and felt that it was happening at that very moment as well.
I took a look at the soft tissues before the treatment and asked if he had used a mouthwash the same morning or the night before. Negative. I asked if he had drank wine last night. The patient’s face went serious and he said he had been drinking whiskey last night. I went on telling without any judgement how alcohol effects the mouth and body – the risks in mouth and the age related risks. He looked like he had eureka moment and was very happy but also shaken as he realised that his alcohol use could be damaging his health in more ways than just one.
Now, this blog post is full of information for dental professionals but there are links that are useful for the patients as well. I will give advice to the patients at the end of this post so move on over there if you want to skip the professional part.
Us professionals seem to find it hard to discuss about patient’s alcohol consumption. For some reason we think that alcohol consumption is too personal question to ask. Sometimes also the patients think the same which makes it even more difficult question to ask. But we ask about illnesses, smoking, diet and oral hygiene habits. Why not about alcohol?
Everyone knows that smoking can cause oral cancer. But not so many know that alcohol does the same. And even fewer knows that alcohol and cigarettes combined raise the risk of developing oral cancer many times higher. So dental professionals are on the frontline of preventing oral cancer. This means that asking about alcohol consumption should be a routine thing to do and I’m going to help you with that.
This is how the conversation continues:
Patient: Yes, sometimes.
You: How often would you say you drink per week?
P: When we go out after work.
Y: How often did you go out last week?
P: Last week we went out almost every night.
Y: What do you normally drink?
P: Beer.
Y: How many do you drink on your regular night out?
P: Normally 3 or 4 pints and on weekends it can be a lot more…
When you engage patient into discussing about alcohol consumption you are kind of evaluating the patient’s attitude towards the subject. Is he co-operative or defensive? If the latter, you need to advance with very small steps. A piece of information here, a piece there. Whenever the patient is ready to take in information about alcohol.
If the patient is co-operative (you would be surprised how many are!), you can move on to sum up the alcohol units the patient consumed the last week and then give information about how it affects his health. Before you can do this you need to know the facts.
2. Learn the numbers and facts behind the risks of excessive alcohol consumption
The recommended low risk (of developing an alcohol related illnesses) daily units are:
healthy women 0-1 units
healthy men 0-2 units
65+ year-olds no more than 0-2 units (no more than 7 per week)
Learn these by heart or print them out (please note, that the recommendations can vary in different countries).
The oral cancer’s death rate is nearly 50%.
Alcohol is an aldehyde and it is metabolised by oral bacteria to acetaldehyde which is carcinogenic in humans.
This is very short but effective list. With this little information you can have a significant impact on patient’s alcohol consumption.
3. Be a therapist if needed
More than once I have been in a situation with a patient when the patient opens up about his life when we discuss about alcohol. There have been patients who have thought by themselves that they are drinking too much. Some tell the reasons behind them. All they need at this point is that someone listens.
But if you feel like the patient needs more advice and guidance, remember to ask
Do you mind me giving you an advice?
People generally respect you more if you don’t offer advice without asking. Especially when it is about alcohol. Have phone numbers at hand for local AA and offer them if needed.
4. If you didn’t ask about alcohol consumption
Do ask about alcohol every time when
Do check the soft tissues and tongue every time you see the patient. It doesn’t take long and you might be saving somebody’s life. No matter if you are a nurse, hygienist or dentist. All of us can tell if something is normal or not and it doesn’t matter who points out the abnormality in the first place.
Have a dental camera or DSLR with macro lens at hand. Learn to use them so that when you see something suspicious, you are able to take a photo of it and compare it the next time.
This is an area in our profession that is too often neglected.
You are in good hands when you are interviewed thoroughly on your very first visit and and every time when you have your check-up done. If you only needed to fill in a medical history form and no-one asks further questions, it’s not a very good sign. The professionals treating you are not looking after you very well.
Please do take our questions as they are. They are questions for your best interest and health and for good quality of treatment. We need to repeat these questions over and over again every time you come in for your regular check-up.
We will ask about subjects (like alcohol consumption) you would rather not discuss with anyone but please do not hide anything or lie. Most often we can see from the patient’s mouth if we were not told the truth about certain subjects like:
smoking
alcohol consumption
how often you clean between the teeth
do you brush your teeth regularly
certain illnesses
So be honest and don’t be afraid of a judgement. It is not our job to do.
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