America's Oral Health Dilemma

Recently I volunteered at the Mission of Mercy (MOM) project for the second year in a row.  MOM is a volunteer based free dental clinic administered for 2-3 days each year in various states across the U.S.  Fillings, extractions, root canals -- most basic dental procedures are performed continuously at this clinic on a GRAND scale. 

You may be wondering...who shows up for free dental care?  Is there a large demand for free dental services?  What insights can we glean from this experience regarding the state of America's oral health?

Having volunteered at the MOM Project in both Virginia and Connecticut, I saw a common troubling theme which is this:

People from all walks of life are not receiving adequate dental health care and they are suffering because of it

Cavities and periodontal disease were rampant among many of the patients we saw, illustrating years of oral health neglect and lack of care.  These patients had multiple problematic teeth in various states of decay.  Over 2,000 patients were treated in two days at the CT MOM Project, and much of this care was urgent and necessary to alleviate patients in chronic pain.  The patients I saw crossed all professions - blue collar, white collar, college students, single guys, housewives, children.  The patients crossed  all education levels and came from scattered areas of CT. 

As I filled or extracted each troublesome tooth, I recalled an old Bugs Bunny cartoon I'd seen where Bugs attempted to stop a leak in a large dike by sticking his finger in it.  But, to his dismay, as soon as he plugged the first hole a second appeared next to it.  Once he plugged the second hole another appeared, and so on and so forth.  Unfortunately, while treating these patients, I felt like Bugs with his leaks; though I've solved the immediate problematic tooth there are many other teeth about to cause pain for these patients.  Which brings us to the problem -- many of these patients will likely wait another year for a MOM dentist to plug those leaks. 

To loosely quote a wise friend of mine - the experience was akin to treating a gunshot wound with a Band-Aid!  My efforts are helping the immediate problem (pain) but ultimately the real issues causing these patients' pain (lack of care, inadequate oral health) are not being addressed. 

Don't get me wrong, the MOM project does a LOT of good, and I will continue to volunteer for it.  However, I doubt anyone volunteering with MOM, seeing patient after patient with mouths destroyed by disease, has any disillusions regarding this project --  it's no secret that our efforts simply buff some scratches out of the rusted jalopy that is America's oral health care system.  It's a problem that needs to be fixed on a fundamental level.  I am not a policy maker, though, and I admit I do not know where to begin.

A policy maker I am not...a dentist I am.  So, one message I can share is this:  The most efficient way to fight tooth decay is to prevent it from happening in the first place.  To be frank, many of the MOM patients I saw are doing EVERYTHING wrong concerning their oral health.  They enjoy their favorite vending machine candy bar with their favorite soda (or Red Bull) on a regular basis, don't brush regularly (if at all), and simply never see a dentist for a check-up. 

I'm not standing on my pulpit looking down, though.  I understand life is hectic and it's easy to let oral health maintenance fall by the wayside, especially when you don't understand the consequences of your actions.  And that's where I feel we need to begin.  By making people understand how much value there is in being diligent about their oral health -- by brushing regularly, skipping that soda, and getting regular cleanings -- we would be able to prevent these patients from slipping into a basically untreatable state of oral health. 

Prevention programs, in my humble clinical opinion, are the answer.  But I'm not a public health expert, and recognize the implementation of these programs is complex, as is positioning them to be successful.  There are programs that have made a difference.  The Give Kids a Smile program and the work done by South Park Inn in Hartford come to mind.  Obviously, more can and should be done.  In the meantime, the MOM project will be there, helping thousands of people.  I hope a day comes soon where we've found answers to this oral health dilemma that make the MOM project unnecessary.

-DRS
Northford Family Dental

What Parents Should do to Prepare their Children for the Dentist

It's a typical day in the life of a parent of a young child.  In other words, things are as hectic as ever.  Making school lunches, driving the kids to soccer practice, helping with homework, discussing the merits of wearing more than a single pair of pants all week, going to the DENTIST for a cleaning...*gulp*...this last one is often dreaded the most. 

For a child there is nothing fun about sitting still for 30 (long) minutes while strange adults poke and prod your teeth.  Parents feel like their child-rearing skills are directly reflected in their child's oral health.  They half expect the dentist to look up at them after an exam with an accusatory stare making a "tsk, tsk" noise as they shake their head in disgust.  Or, even worse, hear the dreaded word "cavity" cross the dentist's lips.  What can possibly be worse than that?

 

Well, as it turns out, many things.  But probably my greatest challenge concerning children's dental care is overcoming the psychological barriers instilled in the children (and parents, too).  I understand life is busy, it's tough to deny your children the foods they like, and even if you do they are often savvy enough to find sugary foods anyway.  

My philosophy is this: Parents who take their children to the dentist regularly are responsible, period.  So - if there are dietary, oral hygiene, or cavity issues, it's not reflective of poor parenting but of education.  A lot of people simply don't know what causes cavities and how to prevent them.  But, the most important piece of education I can share is this:

If your child has a cavity, please remember the following statement and repeat it to yourself over and over...and over again if you begin to waver:

 

"It's not a big deal."

 

This mentality is the single most important thing between a trouble free dental appointment and one that ends in crying and frustration (and by that I mean frustrated children and crying parents).  I treat most of the children at our practice and have noticed a definite pattern between an easy, efficient appointment for a child's filling or tooth extraction and one where a lot of  "resistance" emerges. 

Generally speaking, the bigger deal a parent makes out of the situation, the bigger deal a child will make out of it.  Parents want to be there for their children, understandably, and in doing so they can unknowingly project their own anxiety about dentistry onto their children.  As you know, children are remarkably perceptive.  If they hear their parents speak in length about what's going to happen, they will see this appointment as "a big deal," which, as you may remember, is what we don't want.  If the words "pain," "hurt," "sharp," or "drill" are used at any point, this appointment not only becomes "a big deal," it has the potential to become a catastrophe for everyone involved.  So, please choose how you discuss what is going to happen VERY carefully.

 

It doesn't end there, though, because like I said, children are remarkably perceptive and actions speak louder than words, so please keep the following in mind:

• Not only do parents need to speak casually about their child's upcoming appointment, they need to treat it like a visit to the barber or physician's office. 
• No rewards for good behavior should be discussed because then the child will believe what is about to happen is strange or difficult. 
• Don't discuss your personal dental experiences unless they are absolutely positive. 

Furthermore, don't even worry about not adequately preparing your child for the procedure...dentistry has come a long way since your were a kid.  Nine times out of ten the pinch of the needle is the only discomfort a child feels in my chair.  So if they don't think it's a big deal going in, they'll leave not thinking it's a big deal, won't be traumatized from the experience, will care more about their oral health, have great teeth, go to great schools, marry well, and be altogether successful.  Incredible!

 

This brings me to my final point, which may be the most important.  How YOU, as a parent act during the procedure plays a huge role in how well the procedure goes.  As recommended by pediatric dentists and child psychology experts, when a child is about four years old he/she can be separated from his/her parents without much problem.  While I realize that may sound too young, and a loving and concerned parent will often want to be there with their child during the procedure, think about the message that sends.  When you stand by their sides, holding their hands, offering soothing words through the procedure you are sending the message that, you guessed it, this is a BIG DEAL.

Parents usually can't hide their apprehension, and if a child in the dental chair sees this, his/her anxiety skyrockets which, in turn, triggers the parent to become truly fearful and ask the child if "it hurts".  Now, the child begins to panic because the concept of pain has entered the equation.  Anxiety feeds off of fear which turns to panic in a destructive tangle of emotion.  And while all this is going on, I'm trying to fill a cavity.  As you can imagine, it can be tough.  On the other end of the spectrum is the parent who either waits in the waiting room until the appointment is complete or is off to the side reading a magazine.  For them this procedure is no big deal, the children consequently are at ease, and we're usually finished in about twenty minutes.   

 

So what should you do?  If your child needs a filling, don't panic.  Remember the mantra.  Treat this procedure like a walk in the park.  Don't use words like, "pain," "hurt," or "drill."  Instead, let them know the needle may "pinch" for a second.  The dentist puts your tooth to "sleep" before he "cleans" or "fixes" the problem.  Stay positive.  Let your child know this makes him/her healthy, a big boy or girl, and above all else,

 

IS NO BIG DEAL!!!!!

 

-DRS
Northford Family Dental