The gentleman obviously takes pride in his teeth:
I get my teeth cleaned every six months.
I also brush and floss my teeth several times a day. As a result, I’ve grown accustomed to hearing nothing but praise from the people who clean my teeth.
It’s usually something along the lines of – “Your teeth look good. You’re doing a great job. Take care and see you in six months.”
A recent visit to the dentist, however, offered little in the way of praise. In fact, it was heavy on insults and accusations.
- “Do you brush and floss your teeth?”
- “Oh, you use an electric tooth brush?”
- “There’s a lot of calculus on your teeth.”
For context, consider: Anywhere from 50 to 75% of Americans have some degree of gum disease. Only about 25% even say  they floss daily. Nearly 60% who do floss say  it makes their gums bleed. And 1 in 3 think it’s normal to spit a little blood after brushing. (Would they be so nonchalant if their hands bled a little after washing?)
This is the reality that prompts such basic questions about home care, especially when clinical observation suggests it might be a little sketchy. And the writer above is hardly the first to take offense at them. As Dr. Verigin has written,
Sometimes people react defensively when their dentist tells them that their oral hygiene could be improved. It seems like a personal insult, like they’ve been accused of being dirty, lazy, incompetent – or any other judgment we might rashly make about those with “poor hygiene.”
But the dentist is not making an accusation.
What he or she is saying is that there are things you can do now to enhance your current well being as a means of ensuring future oral – and systemic – health. It’s not about berating a person for what’s happening now. It’s about minimizing the risk of problems cropping up down the road. It’s the essence of preventive dentistry….
Obviously, it’s impossible to say whether the hygienist in question actually did speak in a “condescending” way – and certainly possible that she did. Maybe she was having a bad day. Maybe she’d worked on a difficult patient just before him. And/or maybe the writer was just trying to exaggerate for comic effect. It’s not really clear.
Regardless, he was baffled about the calculus. He brushes, he flosses. He’s had good check-ups before. His teeth should be perfect, no?
Not necessarily. Changes in diet, supplements or medications, for instance, can have a big effect on oral health. Increased stress can take its toll. Technique matters, too . The list could go on. We have seen some patients with impeccable home care who are prone to decay and periodontal disease – and others who are lax about hygiene yet seldom have problems.
The writer’s dentist seems only to have looked at his teeth after the hygienist had cleaned them. If he does this routinely, then, barring any signs of inflammation, decay or other problems, of course he’d see “nothing to worry about.”
The happy ending? The writer plans to be diligent so he can put this hygienist in her place.
Hey, whatever it takes.
Image by Old Shoe Woman , via Flickr