Q. From your experience as dental professionals, what are your thoughts on the prevention of tooth decay & gum disease in your practice/with your patients?
After graduating from Sydney Uni in 2004, I bought my first practice in country Australia. I’ve been a country dentist for over 15 years. The practices I’ve been involved with have all been generational practices from grandparents to great-great-grandchildren. Seeing generations of the same family have allowed me to paint a picture of how tooth decay & gum disease have affected each and how prevention strategies have improved since the early to mid-nineteen hundreds.
I have also first-hand witnessed the positive anticavity effects of fluoride especially in children. In my first practice, the township had been fluoridated for over 40 years. 30 km away and in surrounding farming properties where fluoridation was not mandatory, I could see a stark difference in the decay rate between the two groups. Not discounting other specific risk factors, I could almost tell where a patient was from simply by the amount of decay present in their teeth.
The sad part was towards the end of my journey there, my country township stopped fluoridating the local water supply. About 3 years after that point, it was as if decay rates fell off a cliff. I could no longer predictably tell the difference.
During my early 30’s I decided to take time away from dentistry and travel the world, focused on understanding the effects of tooth decay in developing communities and what I found was quite eye-opening.
In some of these remote communities, industrialisation had started to show its impact. Connectivity such as the internet, mobile phones are great, but the change in diet to ‘fast’ foods, less balanced whole foods shifting from a traditional staple diet lead to catastrophe.
The problem I found was lack of awareness, understanding, and the fundamental fact that there simply were not enough dentists to treat the problem, let alone prevent it.
In one of the communities, I found 25-30-year-old with almost perfect teeth. Whilst their 15-20-year-old siblings with large decay. Trying to understand further, the only difference I could see was the change in diet. The younger ones had access to industrialised foods, Whilst the older sibling would stay at home eating traditional meal sources.
The problem with tooth decay & gum disease for me is in the understanding that it, not a treatment cure situation but rather consistent management for life. And with this, the mouth is constantly changing and therefore requires adaptive approaches and strategies to maintain a healthy balance.
In an ideal world, I wish I could educate more on the importance of health balance in the mouth and I wish the message of the mouth being the gateway to the body could be more appreciated and understood. I feel if this could happen, it would be the first step to lifelong prevention, not just in the mouth, but the whole body as well.
BDS Sydney 2004