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14th August 2014

Responsibility for Recommendations

Responsibility for RecommendationsYou know how we all fall into the trap of calling a vacuum cleaner a ‘H**ver’, or a ball-point pen a ‘B*ro’. It is so easy to do, but we have to be aware of what this means in terms of professional responsibility and retail sales. Patients do hang on our every word, and if we say, ‘Try using Senso***e for sensitive teeth’, they will assume we are recommending the best and most appropriate product for their care. If they come back and say ‘It didn`t work’, we should be prepared for a disgruntled patient who has spent more than they normally would on a toothpaste. So I’m attempting to write this without using tradenames!

When it comes to toothpastes for sensitivity, I try to adhere to a general rule of non-specific suggestions. This might manifest as “I would advise using a toothpaste aimed at sensitivity. Most manufacturers make one. Of course, the most well known is *******, but experiment with what works best for you.”

Evidence-based advice

It may seem a bit picky talking about low-cost items such as toothpaste, but we do retail much bigger and expensive items such as electric toothbrushes. It is so common to push the sales depending on the best deal we get from individual reps, or on which items we have in excess stock hanging around in the cupboard. However, patients do depend on our professional advice in making choices. Our choice of retail goods and how much emphasis we place on different brands should be based on the best evidence available.

There has been a recent Cochrane based study updating previous research results in comparing electric to manual tooth brushes. The review of studies on different kinds of toothbrushes by researchers in the UK has found that electric toothbrushes, in general, are more effective at removing dental plaque. This is sort of what we knew, or guessed, anyway. However, they found that electric toothbrushes that use oscillating-rotating technology (and we all know the trade name associated with these) are the most effective. In fact, the evidence supporting side-to-side and sonic toothbrushes (such as Ph****ps So*****e) was certainly not so clear compared to manual brushing alone.

For those who want to review this evidence, the study, titled “Powered versus manual tooth brushing for oral health”, was conducted by the Cochrane Oral Health Group, an international non-profit organisation that provides up-to-date information about the effects of health care. The current study is the latest update of a review first published in 2003. It was published online on 17 June in the Cochrane Database of Systematic Reviews 2014.

Implications for dental practices

If we are to provide evidence-based advice and care for patients we are required to know these things. Patients make the assumption that the objects we have for sale at the reception desk are the ones we would recommend professionally and that gives them a lot of credibility. We need to respect that trust and make clear the evidence behind those things for which we ask patients to part with their hard-earned cash. Be aware that the need to clear the stock cupboard or to meet retail sales targets could come back to haunt you later!

*All information is correct at the time of publishing. Use of this material is subject to your acceptance of our terms and conditions.

John Shapter

Dental Specialist

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