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Dental Hygiene: Ancient Artefacts
According to the Dental Tribune, an international team of researchers has undertaken a study of plaque from teeth of our ancestors who lived 300,000 to 400,000 years ago. By analysing the content they found that their eating habits were healthier than we thought. In particular, we used to eat a lot more healthy vegetables, nuts and seeds than we imagined and less meat.
Additionally, plant fibres and micro-abrasion patterns indicate that tooth-cleaning and tooth-picking were commonplace. This is evidence of a sustainable diet using local resources along with an awareness of oral health.
So, what would archaeologists be finding in our plaque, thousands of years from now? Would they be aghast at evidence of McDonald’s meal-deals and high sugar, high acid drinks?
Diet, Diet, Diet
Well, the Dental Tribune of the year 302,015 would be full of latest research indicating that we did not seem to care about the effects that foods and drinks had on our teeth as decay rates have not changed significantly for years. Much of that bad news will be placed at the doors of us, as practitioners, for not giving more information and guidance to patients.
The GDC standards give us a responsibility to care for the holistic health of our patients. In particular:
- 4.1 A holistic approach means you must take account of patients’ overall health, their psychological and social needs, their long term oral health needs and their desired outcomes.
- 4.2 You must provide patients with treatment that is in their best interests, providing appropriate oral health advice and following clinical guidelines relevant to their situation.
As an Expert Witness, I have been involved in several cases where teeth had been lost through high caries rates. The notes indicated that no preventative or dietary advice had been given and the practitioners were found vulnerable by not giving this information.
The basic facts are that the diseases we treat are caused by bacteria which thrive on sugars and love a high acid environment. If a patient comes through our doors with any caries at all in the first instance, they should be categorised as `High Risk` and appropriate preventative advice given. If we do not do this then we are leaving ourselves open to complaint and litigation.
Of course, we can’t go to their home and police their habits or empty their fridge! However, we do need to give them information, record that we have, and check at a future date on how they are managing their personal habits in this way. Sometimes people need gentle encouragement over a period of time to make lifestyle changes – we should be a support in this process. Not to nag, but an evidence-based reminder.
The bottom line is that many general dental practitioners do give good advice, along with referral to hygienists and dental health educators..
Dr John Shapter – QCS Expert Dental Contributor