This is the time of the great flossing controversy! Should we or shouldn’t we? A New York Time article says it is not proven to be beneficial and could even do harm! Patients flock to dental offices to ask if it’s true!
Aren’t you tired of talking about flossing? “To floss or not to floss” is a distraction. The more we focus on that question, the more we become defined as task masters trying to convince people to do something they don’t want to do. It gets in the way of our ability to develop partnerships with people to support them in achieving their goals.
We know that inflammation ¾ in the mouth and elsewhere in the body ¾ is a significant health problem. We know that flossing is a relatively easy and inexpensive way to remove the interproximal biofilm that initiates inflammation.
It is not hard to help patients see the value of flossing. My periodontist friend, Dr. Mike McDevitt has patients flossing twice a day with un-waxed dental floss. It’s not that difficult when patients own their disease and feel supported, not judged, in moving toward health. Click here to learn about our “Continuing to Care” workshop with Dr. Mike McDevitt.
When patients ask about the recent New York Times article I wonder what they are asking; what they want to know more about. Do they really want details about dental/medical research? Or do they want your opinion about what is best for them, given their unique history, conditions, and goals?
Wouldn’t you like to change the focus of the conversation? Wouldn’t you like to talk about health? About your commitment to helping someone achieve a lifetime of health?
I like to tell patients that I don’t recommend that everyone, do anything, every anything; brush, floss, have x-rays, have cleanings, etc. Studies can help us understand what works best for a certain segment of the population. But only careful attention to conditions and changes in their mouth will tell us what works best for them. I want my patient to know that they can count on me to make recommendations based on science, my experience, and my understanding of what is important to him or her.
I think that patients have a right to expect three things from us when we do either an initial or periodic exam.
I tell patients they have a right to expect that we will:
Look for Health: I want patients to know that I will look for what they are already doing to support health that is working well for them. I start with the belief that they have been trying to take care of themselves the best they can, and I will look for evidence that is true. I will point out teeth that have no fillings, tissue that looks healthy, restorations that have saved their teeth to date, dietary changes they have made to change old patterns of disease, etc.
Look for Disease: I want to assure patients that I will carefully check their teeth and surrounding structures for any active disease. I will look for dental decay, gum and bone disease, oral cancer and other soft tissue lesions, and joint disease. I will want their perspective on any changes they are observing and will pay attention to their concerns.
Look for Risk Factors: Because I believe it is easier and more economical to prevent a problem than to fix it, I tell patients that I will let them know when I see signs that they are at risk for disease, dental or otherwise. They need to know that changes in their overall health frequently show up first in their mouth. Their medical and dental history; attempts to control disease; and current clinical conditions combine to form a pattern of health and disease unique to them. No other human body responds to health challenges in exactly the way theirs does. Only in monitoring their body’s response to interventions ¾ ours and theirs ¾can we help them make good choices about their health over time.
Patients have a right to expect our thoroughness, our perspective, and our honest counsel in the context of their unique set of circumstances. We have a responsibility to be as comprehensive in our understanding of who they are, as we are in their clinical conditions.
Some of the things I am curious about in my conversations with patients are: What is important to you? What do you know about your health in general and dental health in particular? What are your long and short term goals in regard to your health? What have you tried to do to achieve your goals? What challenges do you face in achieving health? What do you want from me?
To floss or not to floss?
That is not the question.