Tag: Fluoride

Profit, Profit And More Profit

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Dental Revelations Blog-3559
Do you sometimes feel like screaming after something you read? I do.

I just read a very good article about a new ingredient in toothpaste that will save the teeth of many people. I must say I am normally sceptical about these kinds of releases in the field of dental hygiene products as it is not rocket science when it comes to keeping your teeth healthy. Really!

If you are a healthy individual and you

  1. brush your teeth twice a day with a fluoride toothpaste
  2. clean between the teeth most nights (no-one is perfect – apart from me as I do it meticulously every night)
  3. maintain healthy eating habits (eating 5-6 times per day including the snacks)
  4. don’t drink anything else than water/plain coffee/tea between the meals/snacks

Then you do not get decay. But having said that remember that your teeth won’t suffer from the odd relapse of the routine and good habits. Celebrations, night out, traveling normally mess up the routines and that’s fine. No worries. Your teeth won’t decay because of them as long as you get back to the routines again.

And because it is as simple as this I have found that the news of groundbreaking techniques/bristles in toothbrushes or breakthrough ingredients in toothpastes/mouthwashes are simply ways of marketing for the dental hygiene product manufacturers.

Today it was this toothpaste. With an ingredient that will slowly release calcium, phosphate and fluoride ions. All those that are lost from the enamel of the tooth when we eat or drink something with carbohydrates.

By the way, I never speak about sugar as it is misleading – people tend to think that e.g. bread does not cause decay as it doesn’t have sugar in it (well some do, but you get my point I hope). But it has carbohydrates and if the bread is eaten as a snack many times a day, the bacteria will metabolise the carbohydrates to acid many times a day. And the acids will remove minerals from the enamel of the tooth.

When I began reading the news I said to myself

Just give it a chance… for once just read it through!

And I did. And I found my excitement getting bigger. And bigger. Finally something that might improve the oral hygiene of the ones that are not responsible for decaying of their teeth like children or people suffering from extreme dryness of the mouth.

While I was reading I heard a voice in my head criticising me for being always so sceptical about the dental hygiene products. I started to think that maybe I have missed something important over the years when I have not given a chance for this sort of news.

But then. I began to read the last sentence:

A fluoride free version of xxxxxx is also being developed for individuals who do not want or need fluoride toothpaste.

Beeeeeeeeeeeeeb.

Somebody-pulled-the-plug-feeling. Then anger.

Once again a new innovation is motivated by profit. Or perhaps there was a genuine desire to find something that would be “The Product” for the sufferers of the decay. But when it became groundbreaking innovation it immediately made it a product with high profit potential. And if you have read my previous post about integrity in dentistry you understand that it is the greed that is orchestrating this release of the toothpaste. No matter how good the initial intentions were.

A Fluoride Free Version? Are You Serious?

I read through many articles about this new ingredient and all of them had one thing in common.

The slow release of fluoride has been identified to be particularly beneficial in prevention of tooth decay.

This sentence in the same article with my previous quote. Do I need to say more? I don’t think so but I will.

I will break down the first quote.

…for individuals who do not want…

Of course there are people who do not want to use fluoride toothpaste. I have written about them in my another previous post Anti-Patients.  But these are the ones who need our guidance in this matter. What they don’t need is another sign from the dental professionals that it is ok to use a fluoride free toothpaste. When it is not.

…for individuals who do not… … need to use fluoride toothpaste.

Excuse me? Do they mean the people who have dentures or mouth full of implants and no teeth at all? They must have as I haven’t met any individual with natural teeth who do not need fluoride toothpaste. But then again if they have meant these people with dentures and implants why would they use this toothpaste anyway?

Conclusion

I am just simply and utterly annoyed and ashamed of the motives of some of the dental professionals. With just one sentence that is spreading in the internet fast and far they made lives of good and honest dentists, hygienists and nurses more difficult when they try to convince patients to use fluoride toothpaste.

The toothpaste manufacturers must be now competing bitterly to get their new toothpaste with this groundbreaking ingredient in the market first. The one that wins this competition is the one that probably paid the most to the company that developed this ingredient.

You would think that they would make enough money just by making fluoride toothpaste as majority of people do use it. But that is so very typical for dentistry – to squeeze out every dollar/pound/euro (or whatever) you can from an opportunity.

Money, profit, creed. A triangle of shame.

When will there be a dental hygiene product line that looks out the consumer’s best interest and is based on the advices of dental professionals? Effective enough electric toothbrush, soap-free fluoride toothpaste (soap is there just for because people think the foam makes it more effective), effective floss and interdental brushes (well there is already one of both, click here to find out which).

In the past and currently there are dental hygiene products that are made for what patient’s are looking for

  • a cheap electric toothbrush (battery operated)
  • toothpaste that will deal with all the problems in mouth in one go and it makes mouth full of foam too
  • good tasting and easy to use floss/tape in a fancy looking package

This confuses the consumers as all these products are advertised as if they were very effective. They are not effective in cleaning the teeth and they are just big companies’ way of maximising the profit when they reach all the needs of all different types of people.

I am tempted to write little bit about new models of the manual toothbrushes that the manufacturers bring out every year with massive advertisement campaigns. I am amused every time I see toothbrush ad on tv. It’s just a manual toothbrush for god’s sake. How much can you do developing for it? It has a handle and bristles. That’s all.

Here’s a link to one of the articles about this new ingredient (for those who do not know what on earth I am on about).

 

Anti-Patients

Dental Revelations11 Comments

Dental Revelations Blog-24982

I have a confession to make. I am not perfect as a dental professional even though my posts may give the expression that I do everything as we are taught at the dental school. I do my best but I have weaknesses as well.

Another confession. I sometimes feel quite overwhelmed by some patients’ way of arguing about the well researched facts on dental health. Banging your head against the wall is not fun in the long run and in our business it tends to make us cynical and worn out mentally.

Of course there are good days and bad days. On bad days I have thought about changing my profession to the one where I could sit between piles of paper and no-one to talk to (anyone care to hire me?). On bad days I have given up trying to convince the patient about cleaning between the teeth when I have faced a non-cooperative patient the fifth time that day.

Fine, carry on practicing your beliefs…

Sooner or later you will learn I was right…

It’s your teeth not mine…

This does not happen often, but I wanted to bring out the great mental load we have on our profession. We need to have sort of a mental radar on ALL the time so that we can find the right approach to each patient. As each patient is different. But there will be a patient that slips beneath our radar. I have come to conclusion that with these patients there is no right approach. I call these patients Anti-Patients.

There are at least 5 types of Anti-Patients that I have listed below. If a new one comes to your mind, please share it in the comment box.

Anti-Fluoride

When I interview patients on their first visit, one of my questions is:

Which toothpaste do you use?

The most common reply is:

Dunno… Anything they sell in the supermarket.

But if the patient is a health-conscious one, they know exactly which toothpaste they use. And it won’t be just anything from the supermarket’s shelf. They also know that often their beliefs in health can be found controversial amongst the health professionals.

So after they have told that they use the aloe vera toothpaste/herbal toothpaste or any other non-fluoride toothpaste, they will carry on explaining the reasons behind it with fists raised into boxer’s pose (not really, but you get the gist?).

The fluoride is toxic..

There is fluoride in the drinking water anyway…

The fluoride is linked to health problems like cancer…

I only listen, let the patient finish and then carry on to the next question on the interview. I leave the toothpaste issue until I have build up a little bit more trust and until I have examined the patient’s mouth.

I know what I am going to find especially when the patient has used non-fluoride toothpaste for a long time. In my experience about 1 in 1000 patients has oral hygiene habits that good that my interference is not needed. One in thousand! And the likelihood that this one patient is the one who uses the non-fluoride toothpaste is close to zero. This means that poor oral hygiene together with non-fluoride toothpaste results in decay. And that is what I am going to find from the anti-fluoride patient’s teeth.

A faint white line on the enamel of the tooth close to the gum line that is the first stage of the decay. They are still reversible lesions of decay but they will often get discolouration that ruin the aesthetics of the smile. Sometimes the decay is already beyond stopping and requires a filling.

As some anti-fluoride patients take the advice on board, many don’t. And the most disheartening are the ones who practice their anti-fluoride beliefs on their children as well.

Want to know more impartial information on fluoride? Click here.

Anti-Amalgam

Amalgam has been used for about 150 years on people’s teeth. Although we have passed the peak of the amalgam phobia long time ago, there are patients who still believe the amalgam is a health risk. They either do not want to have a new filling made of the amalgam or they want to have the existing ones to be removed and replaced with white ones.

Now, there are dentists who have dollar/pound/euro (or whatever your currency) signs in their eyes whenever this kind of a patient walks in. They do not discuss about the reasons behind the patient’s wish or what the operation of changing the amalgam into white fillings mean. Of course they don’t. They do not want the patient to change their mind.

When a patient expresses this kind of a wish to me, they get this info every time:

  • Composite filling is not an option for an amalgam. Instead the ceramic or gold fillings are and those are many times more expensive than amalgam
  • Amalgam can last a lifetime, whereas average lifespan of a composite filling is somewhere way under 10 years and ceramic’s just slightly higher
  • If there is no problems with the amalgam filling, there is no reason to replace it
  • Replacing many amalgam fillings with white fillings will affect the bite
  • There are no health risks with amalgam as a filling
  • If choosing to have all the amalgam replaced with white fillings anyways, find a dentist who does laboratory-made ceramic/gold fillings and uses proper protection when removing the amalgam fillings as it is the most hazardous part of the life of an amalgam filling

I am always happy when I learn on the next visit that the patient has changed his mind about having amalgam replaced. And for some reason the patient is relieved as well.

It makes me sad when beautiful amalgam fillings have been replaced with composite fillings. It just isn’t right.

Note for professionals: Do polish the amalgam fillings regularly as the darkened amalgam fillings work as retention for bacteria. This is important especially with patients who have advanced periodontal disease.

Anti-X-Ray

X-rays are the vital part of making a diagnosis for the dentists and certain conditions will go undetected without them.

Refusing to have an x-ray taken is just pure madness. It is almost the same as if you would take your car to the car mechanic and tell him that

There is something wrong with the car but do not look under the hood.

In the worst case scenario, your life might be at risk. In the matter of the car and refusing the x-rays.

Anyone concerned about radiation with dental x-rays should read this and simply trust the dental professional’s judgement on whether or not you need to have x-rays taken.

Anti-Safety Glasses

Why on earth would you decline using the safety glasses that are meant for the protection of your eyes? Beats me.

We drill at high speed just a short distance of your eyes and anything can fly out of the patients mouth – a piece of an enamel, calculus (tartar), a broken bur and all sorts of nasty bacteria and viruses. We use chemicals that are acidic when making a filling. None of these you want in your eyes, believe me.

“We should not treat a patient who refuses to use the safety glasses”, I was told on one of the health and safety courses. In ideal world yes. But when you work at a private practice it is totally different story. What do you think that would happen if I send a patient home for not using the safety glasses. No income for the practice and who is the blame? Me.

So we let the patient to refuse the use of the safety glasses and tell them to keep their eyes closed. But they never do, do they?

Anti-Everything-You-Say-or-Do

I know the fear of the dental visit can bring out the worst in people. But it is always frightening when a patient comes across as aggressive from the moment you call the patient in. They walk to the surgery, throw their belongings to the side table and almost jump to the dental chair with arms crossed. They

  • dismiss everything you say
  • do not take the safety glasses
  • are suspicious of everything you do and want to see every instrument you have
  • tell you that they do not want to have a lecture
  • ask when you graduated
  • tell you how another dentist/hygienist did things differently compared to you

Thank goodness these kinds of patients are rare. But when I am faced with this kind of a hostile situation, I speak only when it is absolutely necessary and just do my job. I am glad when the patient is gone and hope we never meet again. But there is an exception. You see sometimes a miracle happens somewhere between the polishing and goodbyes.

The patient that just moments ago was a manifestation of the devil is suddenly the opposite and full of questions about oral hygiene. “Now he wants advice!” is my thought when I have couple of minutes time left before the next patient. But I do not have a heart to ask the patient to leave when I realise that all the hostility was due to the fear of the dental visit. The amazing fear!

Want to know one more Anti-patient type? Click here for my post Yet Another Anti-Patient.