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STILL UNDER CONSTRUCTION.....
Before Covert Bailey became rich & famous writing the Fit of Fat series & recommending the Healthrider, he was teaching dental teams to teach preventive dentistry. Lou & I hosted a three-weekend seminar in Carnelian Bay in '73 for 35 dental teams on the 21-Objective Preventive Dentistry Information teaching concept Covert had developed. We were so impressed with the results that we wrote a manual that we used to build the most successful preventive dental practice within driving distance. Covert was so impressed with Tahoe & with Lou's cooking, that he credits us with his move to Tahoe. Here are a few segments of our manual, which we wrote for our team to teach our clients. the results in the 70's were amazing! This is the basis of my un-published best-selling book "How to Achieve Dental Health while Continuing to Live Unhealthfully", sort of an owner's manual for one's mouth. Since it's remained unpublished since '73, we'll probably publish it on the InterNet. Anyhow, here's some PDI: Why the 21 objectives?-- If you are to help people learn this stuff, YOU've gotta be comfortable with it. The "objectives" originated in the early seventies from Covert Bailey and a group of dentists and educators in the Bay Area. They concluded that people needed to know all these concepts in order to initiate a LASTING behavioral change. The usual alternative-- Before this system was devised, dental offices TOLD patients to brush & floss & how to do it. We see the results of this method every day in the mouths of new clients to our office: a very small percentage actually take care of their mouths. Most just brush and floss for a week or so after their hygiene visit, motivated out of fear or "duty to mother hygienist" & the day or two before their next dental visit and are praised for their efforts while their teeth are dissolved by caries, their gums fall off and their excellent restorative dentistry must be redone due to recurrent dental disease. 1--WHY PDI ??? Indeed!! Why should we go to all this trouble to learn all the stuff in this booklet (& lots more) and try to help people learn it? It ain't easy and since it is not what people are used to, EVERYONE seems to resist -- at least a little -- at first. Everyone fears change and tends to avoid it and most of the stuff in this booklet urges BIG changes (a little at a time, 'tho). Here's why I decided on doing it this way. In 1970 Lou & I attended a 2-day seminar by Jack Anderson, a Minnesota pedodontist and a strong advocate of preventive dentistry. Lots of dentists at that time CLAIMED to be strong advocates of preventive dentistry. Jack was strong enough that he offered to provide all dental treatment for his clients free of charge on two conditions: 1) They KEPT up & practiced his preventive methods (he had objective tests to check on this periodically). 2) They had their mouths restored to best possible health first. So he charged his clients for restoring their teeth to optimal health & for his prevention & recall programs & once they were controlling their dental problems themselves, he did their restorative treatment at no charge. The result was that within a few years he had to open a branch office 200 miles away 'cause he'd prevented all the dental disease within a 100 mile circle. The population there was static, families lived there for generations, never moving. Tahoe's population is not static--a third of our clients move away each year & new ones join our practice. In '72 Lou & I built the present practice at North Shore Tuesday thru Friday & practiced in another dentist's office at South Shore Saturday thru Monday for 9 months. That office was NOT preventive oriented. About half of what that dentist did was redoing his own restorations that had failed due to continued dental disease, removing teeth he'd previously restored due to perio problems, replacing "filings" that have leaked &/or cracked their host teeth with crowns, replacing those crowns with bridges, those bridges with partial dentures, those partials with full dentures. In short, he was practicing supervised neglect & allowing his clients to gradually become dental cripples at great expense. That was very frustrating to watch. THAT makes dental burnout & all sorts of physical & mental health problems for the dental team operating that way. So we don't do it that way. Since '72 we've seen many outstanding successes in our patient/clients. When our team's prevention program is working efficiently, our people can attain unexcelled levels of oral health & seeing THAT over the years makes it all worth while! So........the MAIN purpose of the PDI effort is to help our client/patient toward better dental health thru his/her own efforts. But that's not the ONLY important purpose. Equally important is the establishment of the CARING, TRUSTING RELATIONSHIP between our team (mostly you) and the client AND increasing the person's "oral awareness" or dental "IQ" so he/she'll WANT what's best for him/her (& want us to provide it). It's generally true that people require a change in what they BELIEVE before they produce a HABIT change & they must change their underlying PHILOSOPHY (the "why's") before they change those beliefs. HOWEVER, sometimes we can give SOME people a few "how-to's" and SOMETIMES see a little change. Since we CAN'T "teach", but only help people learn; & since this only happens when the person likes us 'cause we care, then our main aim with the PDI opportunity is to establish the caring relationship with the client. -- They don't CARE HOW MUCH WE KNOW 'til they KNOW HOW MUCH WE CARE. Showing 'em how to outgrow their need for US demonstrates that we really care. some people, like ME, believe that our clients sense the relationship TEAM has with each other & won't build a meaningful relationship with us if they sense that we don't like each other. Therefore, our efforts to maintain team relationship full time. |
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4.4--SEIJA'S SECRET-- Back in '73-4 Seija Janzen was our Preventive Dentistry Therapist. She got amazing results helping people change their behavior & achieve lasting improvements in their overall health & particularly their dental health! AMAZING RESULTS! She was able to help old people who originally claimed they didn't care about themselves anymore, young people who didn't seem to understand what the rest of us were talking about, teenyboppers who couldn't relate to anyone, religionists who figured god would handle all their problems for 'em.....drug-crazed hippies who couldn't even focus on reality ten seconds in a row. No, she couldn't help everyone, and I never saw her walk on very deep water. One person in particular stands out in my memory. Paul Fox was a former drug-crazed hippie who had wall-to wall caries, teeth rotted off at the gum line, red, bleeding, puffy gingiva and no money to buy the $6,000 treatment need at that time to rebuild his mouth. Seija did not give up on him. Thru her magic he motivated himself to try brushing & flossing, he eventually altered his high sucrose diet. We did very minor caries removal, some application of cements over deep lesions, most of which fell off in the years before we eventually rebuilt his mouth. He never could afford even the hygiene care that he should have received. but when we finally did start rebuilding his mouth with cast restorations, tooth by tooth, his gingiva was healthy, his caries had not only not progressed, but the teeth had actually REMINERALIZED--the carious tooth surfaces we'd never even cleaned up were HARD, FIRM & HEALTHY! For many years I assumed that Seija just had a natural gift for teaching. She did. But she also had a secret she never shared with us. She would have shared it if she'd known it herself. More likely, she DID share it & I was not ready to hear it. Years later, after listening to Dr. Doug Young's Communication tape for about the seventh time, he told me her secret: "Information alone has never and never will change anyone's behavior (If info alone changed behavior, none of us would smoke, none of us would eat sucrose, ethanol or caffeine, we'd all be aerobically fit from exercising regularly, we'd all always get enough sleep & we'd all wear our seatbelts anytime we were in a moving car. Probably none of us does all this stuff right, even tho we HAVE the information.). Information in the context of a relationship MAY help someone change their behavior." Example: You have a problem & ask advice of a casual acquaintance you don't know very well. (S)he gives you an answer, you clarify the answer & think about it & decide, 'no, I don't think that's for me". Then you go to a person who you KNOW cares about you, someone you trust or have known a long time or perhaps someone you know loves you & ask for the advice & receive exactly the same advice you'd gotten from the first person. It sounds different & you say 'Yeah, that's great, I'm gonna act on that!" The relationship makes the difference. That's it. She spent time getting to know that person BEFORE ever talking about teeth or gums or sugar or floss. Those people knew she cared about them before any "teaching" started. Then, what happened was "learning", not teaching. 1. "Relate the person's problem or potential problem to the prevention concept" Real Objective in #1: You & your patient/client get to know each other as friends! Then be sure (s)he knows & understands our preventive philosophy. Minimum Requirement - The client should be able to relate his, or family's or friend's dental problem (real or felt) -to the prevention concept. 2. "Diseases caused by plaque--relate to prevention" Minimum Requirement - The client should be able to state approximately what percent of dental problems is caused by plaque, name the two major categories of dental disease caused by plaque, and give two to three ramifications of each: 90-98% of dental problems, dental disease and dental bills are caused by plaque and are 100% preventable. 90-98% of dental disease is caries (cavities) and periodontal (gum) disease. Types and results of periodontal disease: gingivitis, recession, bleeding gums, bone loss, pyorrhea, trench mouth, NUG, Vincent's infection, tooth loss. Two to three examples in client's wording OK. Since about '90, my constant study has helped me appreciate that what we've been taught to call "disease" is a misH-mash of causes, effects, signs & symptoms and that real "disease" is really a HEALING PROCESS conducted by our body-mind to & regain maintain health. Since normal people will not understand that, the rest of this PDI booklet will probably consider the symptoms to be the "disease" so that normal folks will unnerstan. So, just ignore this footnote! |
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Additional Information-- "The direct cause of periodontal disease is the adherent colonized microbial mass found on the tooth surface at the gingival crest, in the sulcus, and in the periodontal pocket with its associated bordering communities of motile and non-motile bacteria, protozoa, leukocytes, drifting desquamated cells, as well as other varieties of microscopic life living or dead. This is called the microcosm."--Arnim, S. S., "Microcosms of the human mouth", J Tenn Dent. Assn, 39:3-28, Jan '59. --No matter what the age of onset, a little gingivitis is neither normal nor harmless. A little gingival bleeding is abnormal and may be the first sign of impending problems. Bleeding on probing Y our client's report of "pink toothbrush" are signs of more serious problems. (Charles F. Rau, "Recognizing early clinical signs of periodontal disease", Quintessence International 3/77 pg 51). --Another "disease" of the mouth caused by bacterial plaque is halitosis. "Bad Breath", while surely better than no breath at all, is a powerful motivator for people to change whatever's causing it. TV & the rest of the media emphasize sweetness of breath as a major sexual attraction & we ought to make use of this in helping people get healthier. "Breath disease" can be caused by sinus problems, gastro-intestinal problems, various foods & drugs, and infections of the pulmonary system. 90% of the time, the foul odor is due to volatile sulfur compounds (methylmercaptan (CH3SH) and hydrogen sulfide (H2S) produced by the bacterial plaque. The tongue is the major source of CH3SH & H2S. Brushing & eating are effective tongue cleaning methods & reduce bad breath symptoms (Tonzetich, J. and Ng, S. K/ "Reduction of malodor by oral cleansing procedures"' Oral Surg 42:172-181 Aug 1976.). |
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The other 2-10% of dental problems: 1. Trauma (through accident or faulty occlusion) - can cause both endodontic and periodontal problems (Including occlusal trauma in the 2-10% of non-plaque caused of dental problems may be excessive over-simplification, since unfavorable forces resulting from less-than-ideal jaw relationships contribute massively to periodontal breakdown and dental destruction (abfraction & attrition). We're doing it here to help our clients focus in bacterial plaque.) 2. Many systemic diseases - can cause dental problems (diabetes, leukemia, cancer); 3. Local non-plaque infections (yeast, mold, virus, other parasites. 4. Systemic drugs (antibiotics, metabolism-altering preparations, drugs that depress salivary flow, alter composition of saliva, chemotherapy); 5. Topically applied agents (aspirin, eugenol); 6. Chemical or mechanical irritants (poorly fitting prostheses); 7. Congenital abnormalities, etc. 8. Surgery or radiation treatments of salivary glands. We have very thick Oral Pathology books dealing with these 2-10%, if someone's very interested. |
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Tongue Cleaning--Yes, I brush my tongue daily as part of cleaning my oral orifice, including the back part, which also stimulates a gag reflex that supposedly squeezes debris from the tonsillar pillars & lets it be digested by my stomach acids. If I were going to invest in a special instrument for cleaning my tongue, I'd buy a cheap tablespoon, one that's so cheap it doesn't have polished edges). Since '71, I've delegated most of my decisions re techniques & products to Drs Rella & Gordon Christensen & their staff of researchers & panel of 2-300 practicing dentists. For over a quarter century, these people, whom I know personally have been rigidly honest & incorruptible & have created Clinical Research Associates (CRA), the most respected & trusted dental evaluation organization on the planet. I dunno why they'd devote an entire 2-page spread to tongue cleaners, but I'm submitting it to Bob for publication. CRA conclusions: they all probably work, & cost between $3-5 ($1-3 to dentists), benefits unknown--similar to my own conclusions. 3. "Draw or visualize etiology diagram" Minimum Requirement - The client should be able to illustrate the relationship of plaque to his body (host), what he eats and his oral hygiene through the diagram: Food Habits Oral Hygiene [FUTURE IMAGE HERE] PLAQUE [FUTURE IMAGE HERE] Acids Toxins Sulfur Compounds [FUTURE IMAGE HERE] Body (host): teeth gums saliva [FUTURE IMAGE HERE] cavities Periodontal "Breath Disease disease" [FUTURE IMAGE HERE] 4. "What is plaque? (3 constituents)" Minimum Requirement - The client should be able to list descriptive phrases for each of the three primary components of plaque: a. organized or colonized bacteria b. congealed or gelled saliva--protein precipitate (mucopolysaccharide) c. food in solution--chemical (microscopic) nutrients of food debris Additional Information - Plaque can be defined as a tenaciously adherent, gelatinous mass composed mainly of bacterial colonies (bacteria form about 70% of plaque -- Gram positive facultative cocci form 28% of the cultivable bacterial population of plaque. There are in addition 24% gram positive facultative rods, 18% gram positive anaerobic rods, 13% anaerobic gram positive cocci, 10% gram negative anaerobic rods and 6% gram negative anaerobic cocci. There are also numerous filaments, fungi, and other bacterial forms, water, desquamated epithelial cells, white blood cells, and food residues. Because the deleterious effects of plaque are due to its bacterial content, it's definition can be simplified: a collection of bacterial colonies tenaciously adherent to the surface of the teeth. While we're completing construction of the Preventive Dentistry part of this site, here's some great dental nutrition information lifted with great appreciation and respect from the International Natural Hygiene Society website , followed by parts of the nutrition section #'s 16 & 17 from the Preventive Dentistry Information Manual used in our dental office for a quarter century: Tooth decay - your diet is deficient. Weston Price, DDS: Nutrition and Physical Degeneration The prehistoric Indians of California were vegetarians, unlike most folks of that period, and they had tooth decay. In contrast, the Sioux Indians lived on buffalo meat and were devoid of cavities. The Pueblos worshipped the Corn God, but he was not grateful. They have the most wretched teeth of all the American Indian tribes. They live on corn, squash and beans. The Laplanders, who ate mostly reindeer meat during the 18th century, rarely had cavities. Modern laps have a decay rate of 85% of their teeth.
Weston Price DDS: Nutrition and Physical Degeneration Thus, sugar consumption causes tooth decay not because it promotes bacterial growth in the mouth, as most dentists believe, but because it alters the internal body chemistry. Orthodox nutritionists admit that sugar causes tooth decay, although they may be mistaken about just why this is so, but their warnings to avoid tooth decay by limiting sweets are disingenuous. Most people would be willing to pay the price for bad teeth as long as they did not have to stop eating sugar. After all, teeth can be repaired or replaced. But poor teeth are always the outward sign of other types of degeneration in the body, degeneration that cannot be repaired by mechanical means. In 1984 I visited Fiji and stayed six months. There is a remarkably fertile and small region on the main island there, the Sigatoka River Valley, where the soils are alluvial and refreshed every few years with freshly-ground rock flour, happens when the Sigatoka River floods in a cyclone. .... When I ate the food from the Sigatoka Valley over half a year my teeth got tighter in my jaw; Isabelle's fingernails hardened, our whole sense of well-being improved. Steve Solomon, 3-04 A. Sucrose penetrates plaque in 1/2 sec and saturates it with enough sugar to cause 20 minutes of acid and toxin production -- probably due to stearic hindrance, etc. This is faster than any other "plaque food" can penetrate. |
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