PDF stages second meeting during FDI

In the July/August edition of Australasian Dental Practice, Ms Terri Slough reported on her recent involvement in a meeting of the Preventive Dentistry Forum - an initiative from Pfizer Consumer Healthcare, manufacturer of Listerine Antiseptic Mouthwash.

The primary objective of the Preventive Dentistry Forum (PDF) is to contribute to discussion and, where appropriate, reach consensus on issues in oral health care, both in Australia and overseas. Topics covered by the PDF include dental health; periodontal health; general oral health; prevention; and, finding the best methods of promoting oral health. The Forum seeks to provide an innovative and forward-thinking approach to dentistry, which can be applied by all members of the dental team and other allied health professionals.

Following the success of the first meeting in May and the ensuing edition of Australian Dental Perspectives (August 2003), a second meeting of the PDF was convened in September to coincide with the FDI Symposium in Sydney.

The meeting again drew on the expertise of eight leading oral health professionals from around Australia: Dr Don Wilson, private practitioner and Chair of the ADA’s Oral Health Education Committee (SA); Dr Anders Blomberg, Prosthodontist (QLD); Dr Melanie Hinton, Periodontist (WA); Dr Yvonne Sum, Community Dentist (NSW); Dr Dennis Teoh, Community Dentist (NSW); Dr Lan Tran, Community Dentist (QLD); Mary Beare, President, Dental Hygienists’ Association of Australia and myself.

To capitalise on the international flavour provided by the FDI Symposium, two international speakers were invited to address the PDF: Dr Lori Kumar, Vice-President, Research and Development, Pfizer Consumer Healthcare; and Professor Goran Koch, Professor of Odontology, The Institute of Postgraduate Dental Education, Jonkoping Sweden.

Dr Lori Kumar provided an update on major areas of research and development currently being undertaken by Pfizer Consumer Healthcare on a global scale and gave PDF members an insight into two new studies.

The first looked at the role of Listerine in a three-part daily oral health regime (i.e. brushing, flossing and rinsing) compared with brushing and flossing or brushing alone. This research, which demonstrated the incremental benefit of using Listerine as part of a daily oral health regime, is soon to be published in the Journal of Dental Research. The second looked at the efficacy of Listerine Antiseptic Mouthwash with the addition of fluoride, on promoting enamel remineralisation, preventing caries and reversing early tooth decay. The positive results seen in this study support the upcoming introduction of a new product, Listerine Teeth Defence, which is Listerine Antiseptic Mouthwash with the addition of fluoride. It will be available in Australia in 2004.

In one of the most thought-provoking sessions of the meeting, Professor Goran Koch gave an overview of his presentation to the FDI Symposium, entitled Challenges in Clinical Preventive Dentistry, focussing primarily on caries. In the presentation, Professor Koch redefined caries as a metabolic process rather than an infectious disease. In line with this definition, he recommended a new approach to the management of caries - one of prevention rather than cure. Within this approach, he identified a number of challenges for dental professionals:

1. Identifying caries as early as possible;
2. Changing behaviour to try and halt or even reverse the process rather than dealing with the end result by taking the ‘drill and fill’ approach; and
3. Increasing patient awareness about the importance of a preventive oral health routine, including the use of fluoride to interfere with the progression of caries.

Professor Koch commented on the success of this approach in Sweden, highlighting that dentists have embraced the trend towards education, improved oral hygiene and minimally invasive treatment.

Building on the themes addressed by Professor Koch, Dr Lan Tran continued discussion relating to caries, by drawing on ideas discussed at one of the FDI’s Pre-Congress Courses - Recognise, Regenerate, Repair - Dentistry for the 21st Century Dental Team. Her discussion further emphasised the need to think of caries as a multi-faceted process with bacteria, sucrose, eating habits and salivary flow all acting as contributing factors.

Dr Tran emphasised that a mechanical solution (i.e. a “drill and fill” approach) to a metabolic or biological problem will not succeed. She also highlighted that a ‘one-size-fits-all’ approach to prevention and protection strategies is also destined to fail. She argued that patients need to be treated on a case-by-case basis and that dentists should seek to understand their patients’ needs, motivations, lifestyle and behaviours before developing a tailored oral health program specifically for them.

In the first PDF meeting, Dr Yvonne Sum introduced members to the concept of the Dilt’s Ladder of Influence as a tool to help oral health professionals deliver outcomes the patient really embraces. The ladder has six ‘rungs’ or ‘layers of influence’ that are broadly grouped into two categories - those that speak to the patient’s IQ (intelligence quotient) and those that speak to the patient’s EQ (emotional intelligence quotient).

Dr Sum brought this theory to life in the second meeting by using the example of an iceberg. The tip of the iceberg is our IQ, the obvious, rational part. No matter how significant the IQ or the tip of the iceberg may seem, the EQ, the part that lies below the surface, is even greater. Dr Sum used this example to demonstrate how important it is for oral health professionals to understand the individual’s motivations and speak to them on an emotional rather than intellectual level. She argued that only by adopting this approach does the dentist stand a chance of changing their patients’ behaviour in the long term.

The value of the PDF continues to be in the sharing of ideas and opinions to help promote education and understanding among dental health professionals as well as medical or allied health professionals in Australia and overseas.

A complete overview of the presentation and discussion topics from the second PDF meeting will be reported in the upcoming edition of Australian Dental Perspectives.

Dr Ivan Darby
Lecturer, School of Dental Science
University of Melbourne

Listerine Original: Each mL contains Ethanol 0.26mL, Benzoic Acid 1.5mg, Thymol 0.63mg, Cineole (Eucalyptol) 0.90mg. Listerine Coolmint & Freshburst: Each mL contains: Ethanol 0.22mL, Benzoic Acid 1.5mg, Thymol 0.64mg, Cineole (Eucalyptol) 0.92mg. Listerine Teeth Defence: Each mL contains: Ethanol 0.22mL, Benzoic Acid 1.5mg, Thymol 0.64mg, Cineole (Eucalyptol) 0.92mg, Sodium Fluoride 0.22mg (equivalent to 100ppm Fluoride ion).

Listerine kills the germs that cause bad breath, plaque and gingivitis. Listerine Teeth Defence also strengthens tooth enamel. The Australian Dental Association Inc. considers this product to be safe and effective when used for the purpose intended and in accordance with the manufacturer’s instructions.