I retired from clinical dentistry last year and spend a lot of my time thinking of how we can improve our health delivery. While there have been many advances in dentistry, when it comes to checking if our teeth are clean, disclosing still works best. Unfortunately, it's a bit too cheap to get much recognition. However, when it comes to research, there have been 3270 papers written on the subject, and a Cochrane review recent paper concluded that only one was of value.
So with my simple maths, if extrapolated, it means of the two million research papers published each year, less than 700 are of value. To progress in academia, you need to get published, and there may be a conflict of interest here?
I like conspiracy theories, and I've wondered why we can only get one make of toothpaste on prescription in the UK? There are far better products and have been available for many years in different countries. I came across Clinpro 5000 in Las Vegas six years ago at a digital dentistry conference. Now we have an innovative toothpaste Biomin available in the UK, with FDA approval but only on prescription in the States.
We are still investigating rather than implementing silver diamine fluoride in the UK when we are fully aware of its benefits It is used in the USA, Canada, and has been used in Japan for over 70 years. Do we have different teeth? There is some movement on fluoridation, but it has been regularly reviewed ever four years for the last fifty years. The evidence is there, but no political will. Let's continue to traumatise the children with increasing GA sessions at a cost to the NHS, us the taxpayer, of billions of pounds, which is nothing compared to the mental trauma of the child and their parents to a potentially life-threatening procedure.
Unlike covid, we will never be vaccinated for gingivitis or caries. However, when it comes to prevention of the worlds most common diseases, why do we have these barriers?
There is a lot of discussion about the link between oral health and general health. This was more an observation.
The pharmaceutical industry has improved since I listened to my audiobook on BadPharma. Unfortunately, even google is struggling to find the relevant paper regarding a future study on the relationship between general health and oral health I read recently. And that to avoid the three-quarters of poor outcomes which were never published, the research criteria is such that the method is issued prior to it being implemented. A recent paper I read, but even google can't help me with this morning, was on the oral and general health link. The parts that struck me were the study required irrigation of the pockets with GSK chlorhexidine, while all the other cleaning products were from Colgate. I had a "Cavimed" years ago which applied the chlorhexidine directly in the pocket. I stopped using it when new research demonstrated the results showed only a transient effect. One can only conclude that the research will show a result that using these products improve general health. We can imagine the marketing campaign that is already written.
Yeara ago, I discussed with a Professor of periodontology my idea of oxygenating the periodontal pocket with ozone using suck down splints. Even I knew it would never be possible. It must have been after the Legionnaires scare, and I asked about the safe concentration of hypochlorous acid in a pocket through a standard ultrasonic, and sodium hypochlorite. His answer was no one knew, as hypochlorite was too cheap for the research to be funded. Well, we know now. This is one of many recent obscure papers.
Now again with my simple maths, how much hypochlorite is required to irrigate the root canal?
The most viewed TedTalk is by Sir Ken Robinson. It explains how through our training, we may stop being curious and now have a different view.
Many GDPs my age are relieved to retire due to the external threats that create unnecessary stress, which, as we are aware results in poor performance. My vision is to create an eHealth product Promoting Public Prevention in oral health for the public and reducing GDPs' stress. The free teeth4App could help reach the 48% of adults who don't visit a dentist regularly and give preventive advice through videos. The videos in the teeth4life App has about 60 videos based on my forty years of experience and my CPD. It would be far better if it were a collaborative effort endorsed by a professional body rather than a business whose main priority is profit for the shareholders rather than the health of public.
The App has a scoring system devised by the evidence from some of the dental health research papers already published. It is not perfect, it could be improved, it will never be 100% accurate. It does give a reasonable indication of oral health in a traffic light system, and more accurately, the risk of oral cancer and how to monitor yourself for this sixth most common cancer. Like all cancers, early diagnosis is the key.
I have had a lot of contact with AHSNs and Orcha. My App will never get a rating to be "approved" by Orcha unless I remove the traffic light system which indicates the risks above. If I remove the scoring, it will pass. It will be good enough from the criteria set indirectly by NHSx, but serve little value for the general public. I have been advised to carry out some research to justify my figures, they can reevaluate it. And they recommend I will have to make it self funding, therefore charge for it.
If we make a viable version and engages the public and is financed by some of the profession, then the profession should take the credit. I think we can make prevention work, but we have to engage with those outside academia and those with a skillset outside dentistry and ask simple questions for simple answers to help improve all our wellbeing. The biggest dental corporate had hindered rather than helped oral health over the last twenty years. There is a better alternative, we just haven't thought of it yet. Please help.
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Dental Entrepreneur promoting prevention for both the public and the profession through FREE eHealth product
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