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Individualized Dental Care Should Be the Norm!

February 9, 2018

Individualized oral health care – Individualized dental care. 

The way it should be!

Our office believes in individualized dental care for optimal health. 

Dental care should be individualized to the patient.  What works for you is not necessarily what works for other patients.  Every patient deserved individualized oral health care. 

Take something as simple as the notion that every person needs to brush twice daily and floss once per day.  While this may be nice in terms of warding off bad breath, it does not really apply to all people when they want their teeth and gums to be as healthy as possible.   I see patients who really do brush and floss based on these guidelines and they still have issues with gum disease, tooth decay,  and periodontal disease!  So, there is more to this story.  Achieving oral health should be the goal of our oral hygiene procedures.  Well health and nice breath!

Treating people as individuals is not a new concept but it is one that I don’t think gets applied often enough.  This is, of course, true in medicine as well as dentistry.  Two patients with the same presenting symptoms and tests cannot necessarily be treated equally and achieve the same results.

Probably not the best way to have individualized oral health care!

 

My son in law, Jeremiah Joyce, wrote this piece recently published in the Mayo Clinic’s KER blog. It looks at the risks and benefits of adopting guideline-driven care.

This from Jeremiah, “Minimally disruptive medicine (MDM) is one of the aims of the KER unit (http://www.mayo.edu/research/labs/knowledge-evaluation-research-unit/overview) here at Mayo and they are doing some cool personalized medicine research dealing with not just disease but what individual patients themselves bring to the table.”

 

Is Evidence Based Medicine (EBM) the way to best treat patients?  Does this apply to dental patients?  I think it does!

Jeremiah is a third-year student at the Mayo Clinic School of Medicine.  Mr. Joyce responded to a writing prompt meant to develop his thoughts about the role of a primary care physician. The prompt: “The ideas behind MDM or contextualized care ask us to respect the needs and circumstances of the patient before us as we construct our care plans. But that puts us in a weird spot, yes? Because just as MDM is this decade’s push, last decade’s push was evidence-based medicine: the idea that, through science, we can find a ‘best’ way to handle a problem, a ‘best’ treatment. It becomes our job to apply the evidence with less and less spin to it, if we dedicate ourselves to EBM purity.” 

With that in mind, what is your opinion of the Minnesota Community Measures’ “D5” criteria (http://mncm.org/reports-and-websites/the-d5/)? What are the risks and benefits of adopting guideline-driven care? Do the D5 measures reflect a friendly contextualization of care?” 

Mr. Joyce’s response follows:

The Mayo motto “the needs of the patient come first” uses the singular noun; the patient is an individual. In practicing evidence based medicine, however, I think we often make the mistake of using population-based recommendations for individuals. There is an interesting precedent for the idea that a “one size fits all” model fits no one perfectly. In his book The End of Average, Todd Rose describes a U.S. Air Force study of pilot average body measurements, designed to tailor a cockpit that fit the average pilot. Out of over 4,000 pilots measured to determine the perfect dimensions, not a single one was within the average range in all of the 10 primary dimensions (Rose, 2016). This article is a fascinating physical example of a truth that undoubtedly applies to medical recommendations as well. 

In practicing medicine, we should focus on tailoring the recommendations to fit the patient, rather than forcing the patient to fit the recommendation. We are all aware of the benefits of D5 recommendations on the long-term health of populations, but we also know some patients have ASA-induced asthma and others have statin-induced myositis. Still others haven’t been able to quit smoking despite their best intentions. We as future providers risk losing a therapeutic alliance with patients if we push too far or too hard. Someone with a recent diagnosis of diabetes may quickly be overwhelmed if we add on all the D5 as soon as their A1c is at 7.1%. As Rose describes in his book, the Air Force’s solution to their cockpit dilemma was increasing flexibility in the design, allowing pilots to adjust their planes. This approach resulted in a dramatic decrease in casualties. We may see the same effect when we work with patients to achieve the greatest benefit to their health. Across a panel of patients, we would be much more satisfied with a population of half-treated and gradually improving diabetics than we would be with losing many patients to follow-up due to frustration and disappointment with a rigid healthcare system.

(Rose, 2016) “When U.S. air force discovered the flaw of averages.” https://www.thestar.com/news/insight/2016/01/16/when-us-air-force-discovered-the-flaw-of-averages.htmlhttps://www.thestar.com/news/insight/2016/01/16/when-us-air-force-discovered-the-flaw-of-averages.html 

Jess, Jeremiah and Tigris

I love the part in the title above that states, ‘the flaw of averages’!  This ties right in to the need for individualized dental care.

So what do dentists need to address if we want our patients to have optimal oral health?  In my practice, we do a complete oral health assessment for every patient and tailor our recommendations based on our findings.  If someone shows no signs of gingivitis, trauma, or periodontal disease then their current regimen of oral hygiene is adequate from an oral health standpoint.  If we see signs of disease then we determine what changes can be made to improve their oral health.  Then we continue to monitor for signs and symptoms of disease to see if modifications need to be made.

I know that I want to be treated as in individual and I believe our patients do too.

Yours for better dental health,

Julie Gillis DDS

Caring For and Enhancing Your Smile

 

 

Test Drive an Electric Toothbrush in Our Office!

September 7, 2016

Test Drive an Electric Toothbrush in Our Office!

Would you like to Test Drive an Electric Toothbrush in Our Office?  How about the Oral B Pro 5000?

Now you can do just that in our office and here is how:

Purchasing an electric toothbrush  to improve your oral hygiene is a good idea.  But which one do you buy?  How do you know the differences or whether or not you would even like using the electric toothbrush?  Our office and Oral B have made this easier for you.  You can now use an Oral B Pro 5000 in our office and test it on your own teeth.  You can see how this electric toothbrush feels in your mouth and how your teeth feel after using the brush for free in our office.

Our office is always trying to think of ways to make getting and keeping your mouth healthy as comfortable as possible.  Although you can clean your teeth very well with a regular manual toothbrush, studies have proven that you will be more effective when you use an electric toothbrush.  The Oral B Pro 5000 is a great one to try!  My hygienist, Melanie, explains how our patients can text drive the Oral B Pro 5000 in our office.  How the electric toothbrush handle is protected and how each patient wanting to test drive the toothbrush gets their own toothbrush.

Call our office in Grand Junction, Colorado at (970) 242-3635 for more information.  We would love to have you visit us on Facebook and see all the fun things going on in our office!

Yours for better dental health,

Julie Gillis DDS

Restoring Smiles/Restoring Health

Dr. Gillis Describes What Our Gums Would Like to Say to Us!

July 9, 2015

What Our Gums Would Like to Say to Us!

If only they could!

Hello!  This is your gums with a message for you.

Hello! This is your gums with a message for you.

 

Gums don’t complain much, even when we are infected!  Can you see the soft looking white stuff between the lower teeth.  That is a lot of bacteria and debris here.  Bacteria like to live between your teeth and under your gums.”

This continues to be your gums talking to YOU!  “Could you give me about five minutes of your time?  You shouldn’t neglect me even though I don’t protest.  When I bleed I don’t really hurt you, but it is not normal for me, your gums, to bleed!  I am really like skin but inside your mouth.  Do you want your skin to bleed?  Brushing and flossing help remove the debris that is accumulating all the time.  The bone below me, your gums, doesn’t talk much either.  But those darn bacteria ‘peeing’ below your gums actually cause bone destruction and open up even more places for bacteria to hide below your gums continuing the process.”

See tartar between teeth.  Periodontal disease and gum disease.

See tartar between teeth. Periodontal disease and gum disease.

“Back to the 5 minutes per day that I, your gums, am asking for:  What I would like is for you to show focused attention to brushing all areas of the teeth, mouth and gums at least twice per day and flossing or using an inter dental device (water pic, sulca brush, hydro floss or comparable) at least once per day!”

Periodontal disease and gum disease following treatment - bone loss remains but gums have healed.

Periodontal disease and gum disease following treatment – bone loss remains but gums have healed.

“This bone doesn’t complain much either, but once it is gone – it is probably gone for good. I, your gums, can actually heal given the right treatment.”

If you don’t know exactly what to do or how to take care of me, your gums, then please ask your dentist (our office!) or your dental hygienist who you should be seeing both regularly!  Our office would be happy to help you  become aware of the condition of your mouth -all the good, all the bad – and offer options to get you as healthy as possible.  Your gums and you will be happy you have taken the responsibility for this!

“Yours for better dental health,

Sincerely, your gums”

Because We Care About Your Oral Health!

June 18, 2015

Because We Care About Your Oral Health!

This letter is for you, my patients,

Do you have gum disease, gingivitis, or periodontal disease?  Do you know if there is any infection present in your mouth? Do you have oral cancer? Ninety percent (90%!) of people have some type of disease or infection in their mouths!  My guess is that far less than 90% are aware of this.  Once you take ownership of the condition of your mouth, you can make decisions that are appropriate for you to address these concerns. If you don’t know the answer to these questions, ask us! We are happy to provide you with the tools and information you need to achieve the level of health you would like.

Periodontal disease prior to treatment

Periodontal disease and gingivitis  prior to treatment

Periodontal disease after treatment

Periodontal disease and gingivitis after treatment

Only you can make the changes necessary to get your mouth healthy, so it is very important for you to OWN these diseases if present and own the responsibility for their treatment.  One of the most important things I can do for my patients is to let you know exactly what is going on in your mouth – good and bad – and offer you options to address any areas of concern.

Yours for better dental health,

Julie M Gillis DDS PC

“Caring For and Enhancing Your Smile”

(970) 242-3635 office

www.juliegillisdds.com

We would love to have you follow us on Facebook!  https://www.facebook.com/juliegillisddspc

 

Avoiding the Dreaded Strangled Finger When Flossing!

June 3, 2015

Filed under: Dental floss,Oral Hygiene — Tags: , — Dr Gillis @ 2:47 pm

Avoiding the Dreaded Strangled Finger When Flossing!

Yes!! It is possible! And, Easy.

Avoid this!

Avoid this!

It is easy to minimize this uncomfortable sensation when flossing!  Let me demonstrate!

Hold the floss across the tip of one middle finger

Hold the floss across the tip of one middle finger

Then, start to wrap the floss gently around the tip of the finger - ONE time, then -->

Then, start to wrap the floss gently around the tip of the finger – ONE time, then –>

Continue wrapping gently by spiraling the floss down the finger tip - not several wraps in one space.

Continue wrapping gently by spiraling the floss down the finger tip – not several wraps in one space.

You are almost there!

The floss should look like this when you are done - an open coil of floss that does not strangle when you pull on it!

The floss should look like this when you are done – an open coil of floss that does not strangle when you pull on it!

 

Now you can really get to flossing!

 

 

 

By wrapping the floss around a middle finger and leaving the other end free you will have freedom to floss with a first finger and a middle finger, two first fingers, or a finger and a thumb.

You will have good flossing control when you are flossing with a short piece of floss between two fingers.

You will have good flossing control when you are flossing with a short piece of floss between an index finger and a thumb OR –>.

You will have good flossing control when you are flossing with a short piece of floss between two fingers.

You will have good flossing control when you are flossing with a short piece of floss between two fingers.

You will have good flossing control when you are flossing with a short piece of floss between two fingers or two thumbs!

You will have good flossing control when you are flossing with a short piece of floss between two fingers or two thumbs!

And, by making flossing more comfortable, I hope I have made it more fun! Our office is happy to help with any of your dental hygiene concerns – we have lots of tips on flossing and more to maximize your efforts.  Our phone number in Grand Junction, Colorado is (970) 242-3635.

Yours for better dental health,

Julie Gillis, DDS. PC

Restoring Smiles/Restoring Health

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