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Patti DiGangi, RDH, BS, believes dentistry is no longer just about fixing teeth. Dentistry is oral medÂicine. Her work helps dental professionals embrace the opportunities and understand the metrics that accurate insurance coding provides. The ADA recognized her expertise by inviting her to write a chapter in its CDT 2017 Companion book and again for its CDT 2018 Companion. She is the author of the DentalCodeology series of easy-to-read, bite-size books. Her latest book, "Teledentistry: Pathway to Pathology" was co-written with Cindy Purdy, RDH, BS. She can be reached at firstname.lastname@example.org.
Mass media face tight restrictions on time and space. There are limited minutes to deliver the message in a fast-changing, ever-more complex world, and the tendency can be to oversimplify.
Oversimplifying complex issues and giving simplistic answers can feel like the best choice; the saying “If all you have is a hammer, everything looks like a nail” can apply here. This concept applies to other industries as well. In dental hygiene with our limited minutes, care often falls into two almighty, seemingly unchallengeable f-words: Floss and fluoride.
Hammers and Nails
When you say you are as dental hygienist, how many times has the response been, “I didn’t floss?” Advertising seems to indicate the permeation of fluoride into most dental products is the golden ingredient to oral health. The public now believes, based on our constant hammering, that everything can be solved with floss and fluoride.
Hammers are useful tools but only if they are used for the right purpose. There is nothing better than a hammer for driving nails, but nothing worse for cleaning glass or scratching your back. When it comes to patient care, it’s time to rethink and discover more than just the dental hygiene F-words.
Shortage of Fluoride
Dental caries is a transmissible bacterial infection of the teeth resulting in white spot lesions, cavitation and potential tooth loss. It sounds simplistic but it is very different from traditional cariology. Dental caries is a pH imbalance of normal biofilm on the teeth. This means that caries balance is an ever-changing and requires monitoring. Yet over and over in the presence of the infectious outcome-cavities, an immediate oversimplification starts. The hygiene f-word – fluoride – is automatic solution. Caries infection is NOT a shortage of fluoride! It’s time to quit seeing fluoride as our only or best option. It is an arrow in the quiver, yet deciding which arrows match the individual patient is best based on risk-assessment and diagnosis – the “why” of the infection.
Flossing Prevents Heart Disease
In 2012, many dental professionals were upset with a new scientific statement from the American Heart Association (AHA) that poured cold water on the idea that periodontal disease contributes to heart disease. The statement was the supported by the American Dental Association. How absurd? Could this be? As hygienists, we know that if someone flosses they can prevent heart disease. Though few us will go that far, our communication seems to indicate that if they entire world flossed, we would have world peace.
The AHA statement clarifies the difference between causality and association. Causality means there is irrefutable proof that one entity is consequence of other. Association means they share characteristics and possibly risk factors, yet one does not necessarily cause the other. The question of whether a clinically significant association exists between periodontal disease and heart disease has tremendous importance.
Research continues to evolve almost daily, yet the real message here is again oversimplifying the complex. What risk factor assessment and diagnostic tools are we using to make the diagnosis? Was a diagnosis made?
More often, a huge leap is made to the f-word as part of our treatment plan. The patient must floss to reach and maintain periodontal health. Floss is an arrow in the quiver yet deciding which arrows match the individual patient is best based on risk-assessment and diagnosis – the “why” of the infection (didn’t we say that already?).
Concise vs. Simple
Millennials are a generation of individuals who are consuming content in tiny, multimedia-saturated bites. If you have ever used Twitter, you know 140 characters means you have to be concise. That means you have to know exactly what you want to say and say it in as few words as possible. Millennials have discovered more concise ways to communicate. It does not mean oversimplifying. Concise language forces us to exercise our vocabulary; it can make us better writers. It also has the opportunity to make us more concise thinkers.
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Next time, we will explore the 5 new words for dental practice.