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On being a healer rather than a cleaner: questions to guide a healthy discussion with dental patients
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On being a healer rather than a cleaner: questions to guide a healthy discussion with dental patients


It's time for a new conversation when discussing oral care with patients.


Despite the fact that the dental profession encourages brushing, flossing and regular dental visits, more than 75% of people have gum disease. Many patients think that having their teeth cleaned by a professional will prevent or cure such problems. Frank discussions with patients about the limitations of professional cleaning and the value of effective gum care could dramatically improve this statistic.

This requires that dental professionals perceive themselves as healers and proactively discuss with patients how to become healthier with effective oral hygiene practices. During exams and cleanings the following questions can help to guide these conversations.


What do you want to get out of your visit today?

This question helps to identify the patient's goals and expectations so you can determine how best to meet them. As you proceed through the exam or cleaning, explain what you are looking for and what you are doing and finding along the way. This helps to reassure and to educate the patient so he or she understands the importance of what you do.


Do you have any concerns about this exam/cleaning?

If you know whether a patient has fears or concerns, you can address these appropriately. Encouraging the patient to ask questions during the exam or cleaning is also helpful in alleviating any worries.


Do you know how the health of your gums affects the health of your body?

This is an opportunity to explain what an oral biofilm is and what happens if the balance of this biofilm is disrupted. Patients need to understand the potential impact of gum disease on their whole body health. This means that if a biofilm becomes unhealthy, toxic bacteria can break the seal formed by the gums around the teeth, enter the bloodstream and spread through the body.  Left untreated, gum disease becomes a constant source of inflammation that can damage the body's immune system and contribute to diseases like diabetes, cancer, heart attack, stroke, Alzheimer's and more.


Do you want to see where harmful plaque is accumulating in your mouth?

A plaque reveal is often enlightening to patients since many think their teeth and gums are "clean."

By disclosing plaque you can demonstrate where these biofilms are located. You can also suggest ways patients can adjust techniques for brushing and cleaning between teeth in order to eliminate more biofilm accumulation.


Did you know that you can pass on gum disease to other people?

Here's an opportunity to motivate patients to get healthy, if not for themselves, then for the ones they love. Explain that gum disease is infectious and contagious – if they have gum disease they can transfer it through saliva to their kissing partner or their kids.  


Do you know why your gums are bleeding?

Many patients think their gums bleed or hurt when they visit the dentist or dental hygienist because of the instruments used to examine or clean teeth. This is why it's crucial to explain that bleeding is caused by inflammation, not probing. Inflammation indicates the presence of gingivitis or periodontitis. Reinforce the need to eliminate bleeding with appropriate oral care or dental treatment. If there is significant bleeding, consider recommending a  microbial analysis to test for disease-causing bacteria.


Do you know that the way you clean your gums can prevent and heal disease?

It's important to explain to patients the significance of their own role in keeping their gums healthy to keep their body healthy. Explain how to do proper personal oral care including brushing gums, teeth and tongue and rinsing with antiseptic mouthwash twice a day and cleaning between the teeth once a day.


Is there anything you don't like to do when it comes to following proper care of your teeth and gums?

Let's face it, while many people know how to do proper oral care, they don't. Therefore find out what is preventing the patient from following proper oral care and offer options that are more appealing. Flossing, for example, is one of the least used cleaning techniques. You might therefore suggest using a soft pick brush, water flosser, interdental brush or a plaque pick. Demonstrate how different tools work so the patient can determine what he or she might like to try.


Can we confirm next steps for you?

To be sure patients understand what is needed to prevent or treat gum disease, confirm follow-up with them. This could be a specific treatment plan or scheduling another dental examination to reassess the health of their gums.


In order to reduce the prevalence of gum disease it's essential to reinforce your role as a gatekeeper for your patient's health.

Having discussions that include these questions will enable your patients to see you, not as a tedious teeth cleaner, but as a valued healer.