On the edge of preventive dentistry

The process of change involves an overlap of old to new, the proverbial passing of the baton to amass what is needed and then surge toward new goals and challenges. Pfizer Consumer Healthcare, manufacturer of Listerine® Antiseptic Mouthwash, has just passed the baton from the Listerine Advisory Board (LAB) to the new Preventive Dentistry Forum (PDF).

The LAB and PDF initiatives are about creating discussion of clinical research and of the issues and new developments in oral care amongst a select team of leading oral health professionals in Australia. The baton is passed in moving from a forum soliciting opinions and advice in terms of clinical positioning and marketing activity for Listerine to one that reflects a more innovative, forward thinking panel on the preventative approach in dental practice.

I am one of the nine Australian oral health professionals who are members of the PDF and find it to be both admirable and challenging. It is prestigious to be recognised as a member of the panel beside the eight prominent dentists from around Australia: Dr Don Wilson (SA); Dr Anders Blomberg, Prosthodontist (QLD); Dr Susan Buchanan (NSW), absent; Dr Ivan Darby, Periodontist and Lecturer, University of Melbourne (VIC); Dr Melanie Hinton, Periodontist (WA); Dr Yvonne Sum, Community Dentist (NSW); Dr Dennis Teoh Community Dentist (NSW); and Dr Lan Tran Community Dentist (QLD).

Our agenda, designed to generate an interactive consultation within our respective fields and provide Pfizer Consumer Healthcare with a better understanding of the practice needs and concerns of the dental profession, proved very successful. One of the most vibrant exchanges occurred in the discussion of the formulation of Listerine Antiseptic Mouthwash, in particular, the alcohol content. Russ Ellis, Senior Manager of Product Development & Innovation at Pfizer explained the role of alcohol in the carefully balanced formula of Listerine.

Mr Ellis explained that the alcohol is utilised to control the essential oil particle size, in turn controlling the translucency of the mouthwash. Decreasing the alcohol decreases the solubility, rendering the essential oils less effective and causing a cloudy appearance. A scavenger level of alcohol exists at 5% or below, which correlates to the use of 5% hydro-alcohol solutions used as "controls" in clinical studies. Bringing this vital information to the dental professionals in literature and textbooks was considered to be important and highly beneficial.

Panel members participated in presenting overviews within their respective fields on the changing nature of the Australian dental profession. Dr Ivan Darby highlighted that the face of dental education is changing in the advent of Melbourne University's curriculums meeting a minimum of 4-years study. Dentistry has moved toward prevention with education now delivered as problem-based, eliciting critical reasoning in patient assessments.

A definitive message was that we can no longer afford to just target dentists to deliver oral health education to the public because to do so we would be missing a large contingency of people in charge of patients' wellbeing.

Dr Melanie Hinton supported the need to broaden the delivery of oral health education. She emphasised that Australia should expect a severe shortage of periodontists given the lack of graduates of Periodontics Masters programmes coupled with an alarming statistic showing that 50% of Periodontist in Australia will be retired in the next 15 years.¹

Building on the role, strengths and barriers of Preventive Dentistry in general practice, Dr Lan Tran, with special interests in children's preventive dentistry, resounded the need for broadening oral health communication to ensure all caregivers are educated, including teachers and politicians. Dentists have a huge role in sending out the message about prevention but need to broaden their approach.

Utilisation of the dental hygienist in their role as preventive experts conveys the essence that prevention involves a team approach. Oral health management in a team approach promotes judicious recommendations of the right OTC products, enables people to gain control of their oral health and directs patients to good resources.

Motivating the general population towards prevention is not accomplished in a one-size fits all approach. Motivation works with accepting responsibility. This responsibility rests with the parent(s) of children while young adults are receptive to role models and adults are "self" motivated. Dr Yvonne Sum introduced the model of influence as a road map in understanding how effective communication can change values and beliefs to spawn new techniques thereby altering behaviour. Two distinct communication styles are dominant: IQ logical intelligence and EQ emotional intelligence. Dentists are trained to perform on a high IQ level, which becomes a hindrance to tapping into the emotional component of patients. Emotional intelligence will have far reaching benefits in eliciting patient acceptance, responsibility and ultimately motivation for preventive oral health. The equally intelligent dental auxiliary and allied health professionals are more skilled in this approach through the nature of their education and work.

The value of this forum was one of education and understanding. There are great benefits in sharing professional directives. Solitary initiatives, no matter how great a cause, will be disadvantaged in their ability to encompass the whole picture. Building a preventive oral health future for the community at large is truly a team effort, and one that exists beyond the dentists and beyond the dental profession.

Reference

1. Brown L et al. Workforce and Planning Issues for the Profession of Periodontics in Australia and New Zealand. Aust Coll Dent Surg 2002; 16, 97-104. The Preventive Dentistry Forum charter maintains that the group will meet formally once a year. In some instances however, a meeting outside of this annual agreed meeting may also be called.