what do dentists teach?

4
265 __..._____ THE JOCTRNAL 01’ SCHOOL HE.\LTII .~ WHAT DO DENTISTS TEACH‘! SHIRLEY E. WEBSTER, B.S., R.D.H. Dctztal Hygiewe Teacher, Bedjord Central Scliool District, AIoiittt I<isco, S e w I’ork Keeping abreast of dental research is one of the routine ch0re.z of the dental hygiene teacher. Otherwise she might find herself in the embsrass- ing position of advising a student-or his parent-that “a clean tooth nerver decays”, a favorite maxim of bygone years, or giving out some other misleading, incomplete, or even actually wroneous information, as of 19G2. Up-to-date information, of itself, however, can lead to an unrealistic position for the dental hygiene teacher whose students are also the patients of many different private dentists in the area where she is teaching. There is bound to be some time lag between new research and its appli- cation by the general practitioner of dentistry. One dentist may be quick to try new drugs and techniques while another may be estreniely conservative, with many gradations between. It behooves the dental hygienist who is a teacher, not only to know what is going on in research laboratories but how extensively this research is being applied by the family dentists in her community in order that her teaching will be coordinatrd and realistic. With this thinking in mind a questionnaire was sent out late last spring to 27 local practicing dentists in the area covered by the Bedford Central School District in northern Westchester County, about 40 miles north of New York City. The district encompasses four villages and their surrounding residential development. Total enrollment of the schools of the district, kindergarten through 12th grade is upwards of 3000 pupils, plus more than 700 parochial school children in grades kindergarten through 8th. A covering letter was sent with the qucstion- naire briefly outlining the reasons for seeking information. A stamped, addressed envelope was enclosed for the questionnaire’s return. No timc limit was given, and each dentist was asked to fill in answers and to sign his nanw if he wished. Over a period of several weeks 21 of the 27 were returned. A summation of an>werswas made during the summer and a copy sent to the participating dentists in September. Questions asked were those which would naturally fall into the ov~r- lapping area of the dental hygiene teacher and the dentist in tlicir work with school-age children. Thcw were eight questions grouped around three topics-fiuoridcs, Imishing and dental floss, and limiting of swects in the divt of childrcn. Fluoride questions covered topical application, using both sodium or stannous fluoridc, dirt supplement in the form of pills or drops, fluorides in public water supplies, and toothpastes contain- ing fluoride. Methods of tooth brushing preferred by the drntists and hands of brushes recommended were askcd for. Did they advise dental flohs for children, and if so at what age? Concerning the thorny question of limiting swecbts three specific questions werc askcd and thew were tid in with brushing. A chance was given for each dentist to express himself. 1411 questions (except the first one on topical application of fluoride) were Answers were tabulated on the 21 replies.

Upload: shirley-e-webster

Post on 28-Sep-2016

217 views

Category:

Documents


2 download

TRANSCRIPT

Page 1: WHAT DO DENTISTS TEACH?

265 __..._____

THE JOCTRNAL 01’ SCHOOL HE.\LTII .~

WHAT DO DENTISTS TEACH‘!

SHIRLEY E. WEBSTER, B.S., R.D.H. Dctztal Hygiewe Teacher, Bedjord Central Scliool District,

AIoiittt I<isco, S e w I’ork

Keeping abreast of dental research is one of the routine ch0re.z of the dental hygiene teacher. Otherwise she might find herself in the embsrass- ing position of advising a student-or his parent-that “a clean tooth nerver decays”, a favorite maxim of bygone years, or giving out some other misleading, incomplete, or even actually wroneous information, as of 19G2.

Up-to-date information, of itself, however, can lead to an unrealistic position for the dental hygiene teacher whose students are also the patients of many different private dentists in the area where she is teaching. There is bound to be some time lag between new research and its appli- cation by the general practitioner of dentistry. One dentist may be quick to t ry new drugs and techniques while another may be estreniely conservative, with many gradations between. It behooves the dental hygienist who is a teacher, not only to know what is going on in research laboratories but how extensively this research is being applied by the family dentists in her community in order that her teaching will be coordinatrd and realistic.

With this thinking in mind a questionnaire was sent out late last spring to 27 local practicing dentists in the area covered by the Bedford Central School District in northern Westchester County, about 40 miles north of New York City. The district encompasses four villages and their surrounding residential development. Total enrollment of the schools of the district, kindergarten through 12th grade is upwards of 3000 pupils, plus more than 700 parochial school children in grades kindergarten through 8th. A covering letter was sent with the qucstion- naire briefly outlining the reasons for seeking information. A stamped, addressed envelope was enclosed for the questionnaire’s return. No timc limit was given, and each dentist was asked to fill in answers and to sign his nanw if he wished. Over a period of several weeks 21 of the 27 were returned. A summation of an>wers was made during the summer and a copy sent to the participating dentists in September.

Questions asked were those which would naturally fall into the o v ~ r - lapping area of the dental hygiene teacher and the dentist in tlicir work with school-age children. Thcw were eight questions grouped around three topics-fiuoridcs, Imishing and dental floss, and limiting of swects i n the divt of childrcn. Fluoride questions covered topical application, using both sodium or stannous fluoridc, dirt supplement in the form of pills or drops, fluorides in public water supplies, and toothpastes contain- ing fluoride. Methods of tooth brushing preferred by the drntists and hands of brushes recommended were askcd for. Did they advise dental flohs for children, and if so a t what age? Concerning the thorny question of limiting swecbts three specific questions werc askcd and thew were t i d in with brushing. A chance was given for each dentist to express himself. 1411 questions (except the first one on topical application of fluoride) were

Answers were tabulated on the 21 replies.

Page 2: WHAT DO DENTISTS TEACH?

260 THE JOlJRNAL OF SCHOOL HEALTH

followed by the word “comment” and a colon, to encourage individual opinions. A note on the bottom of the sheet asked the recipient to use the blank back of the paper for further comment.

Topical Appl icat ion of Fluoride Solution to the Teeth Though stannous fluoride is much more used than its older counter-

part, sodium fluoride, it is used routinely by only four of our 21 reporting dentists. Twelve used stannous fluoride “occasionally”, one seldom, and three, never. Sodium fluoride was used routinely by only one dentist (incorporated in a prophylactic paste) occasionally by two, seldom by four, and never by 13.

Addit ion of Fluoride to Diet as a Supplement Seventeen of the 21 reporting are prescribing some form of internal

addition of fluoride to the diet of children up to 10, and for pregnant womcin. One prescribed fluoride occasionally, two, never, and one did not reply. I t is apparent that interest in the diet supplement is much stronger than in topical application.

“I discuss it, if interested I give prescription.” “I leave up to obstetrician”. “. , . always when child is prone to have a number of cavities.”

Almost complete unanimity was expressed by the answers to this question. Twenty of the 21 reporting replied that they were actively in favor of fluoridation of public drinking water. Almost all discussed it “if questioned” or “when asked”.

One dentist abstained from reply.

Comments included these :

(referring to pregnant women)

Addit ion of Fluorides to Drinking Water

Crest Toothpaste While Crest found favor with 1 G of the 21 reporting dentists five

declined to recommend it. Negative comments included such state- ments as:

“I never rccommend any special brand of toothpaste.” ‘ I . . . not satisfied with studies, too much emphasis on toothpaste and not enough on diet, brushing habits, etc.” “. . . worth a try.”

In this catcgory thew was great divergcncc of opinion, which might be expccted. Urlilikr drug therapy or nutritional research the mechanical stimulation of brushing can be accomplishrd i n a number of ways. The dental hygiene tmchrr must lie rather consistent with teaching her chosen method but should a t thc hame tinir know that the family dentist may favor a slightly diffcrmt techniqiic for accomplishing thc same task. She can make clear t o a class (or an individual child) that,, as in arithmetic, there may be scvml methods of arriving a t the right answer, so in the case of the problem of frwing thr tcicth of food particlcs while stimulating the surrounding tissws.

The greatest number, five, favorccl thc Modified-Stillman technique (pointing hrihtles to roots of twth and pressing towards occlusal or incisal cidges). Two answercd “~tillmsn-RlcCall” which is essentially the same

.If etliod of loothbrushitig Preferred

Page 3: WHAT DO DENTISTS TEACH?

THE JOURNAL OF SCHOOL HEALTH 267

motion, One each said “Charters” (the opposite motion from Stillman, working the bristles between the teeth while pressing towards the gum tissue) and “Rotary”, a series of circles. hlost of the men described rather than named the technique they preferred. Comments were plenti- ful reflecting the fact that dentists have observed toothbrushing to lw something of a neglected art, and that brushing of the gums was even more so.

Deutal Floss for Children Eight

said they did advocate it but qualified their answers with remarks such as the following:

Thirteen of the 21 did not advocate dental floss for children.

“any age if necessary to prevent food accumulation.” “improperly used does more harm than good.” “depends on maturity of child”. “middle teen-age is probably best to start.”

Limiting Sweeis The largest number, 12 of the 21 reporting, advocated no sweets

between meals. Eight checked brushing right after snacks. Twelve said that brushing right after breakfast and dinner was most important. The tie-in between brushing right after eating was marked. This re- presents a change of thinking from that of a few years ago when brushing a t any time was considered a deterrent to cavities. Comments recognized the prominent place sweets occupy in the diet of the average child:

“save sweets for after dinner and then brush.” “brush after breakfast.

Brush before bed.” “cut down on sweet beveragcs.” “no hard candies ever, limit soft drinks”. ‘kweets at meals only”. “if unable to brush (after eating) rinse mouth thoroughly.”

Brand of Toothbrush Fifteen of the 21 replying described the type of brush they prefcrred

and the names most often mentioned were “Pycope” and “Lactona” with “Oral-B” mentioned once. Four answered flatly “no” to brand names. Two abstained from answering this question a t all. Four answered “yes” to a special brush for orthodontic appliances while 11 atiswered “no” to this question. Six did not reply. It was rvidrnt from comment that most dentists had a favorite style of hush-natural bristle, straight line, small head, two rows, hard. I t is interesting to notc that the tremendous advertising push in behalf of soft, multifilanient bristles is not reflected in professional thinking a t least in the Bedford area.

Conclusion Less than one-fourth of the dentists polled used stannous fluoride

routinely on the teeth of children but only three never used it. Sodium fluoride is obsolescent. Eighty percent advocate some kind of internal fluoride additive to the diet of children and pregnant women. Opinion on addition of fluorides to the public drinking water was almost unanimouh.

Eat strictly three meals a day, eliminat- ing between-meal eating.

Page 4: WHAT DO DENTISTS TEACH?

2DR T H E JO11RN.41A OF SCHOOL HEALTH

Crest toothpaste found favor with more than half the dentists questioned. There was no agreement on methods of brushing but various methods were favored to accomplish removal of food clebris and gum massage. Also, brushing was almost universally taught as a means of removing sweet foods from the teeth. More than half recognized no sweets be- tween meals as a practical means of advising parents to control intake of sweets. The two-row, straight-line hard natural brush was favored for bcst results in brushing.

It is evident that along with the vast amount of technical and sci- entific knowledge which our local dentists possess they are well aware of‘ the practical means of caries control which are availablc to children and their parents. A streak of conservatism is obvious in that they do not immediately accept all that is presented to them by the research labora- tories but prefer a wait-and-see attitude in some cases. Though far from rubbcr-stamped in thcir opinions a common meeting ground of profes- sional training and awareness was clearly visible.

No serious conflict appeared between the teachings of the family dentist and that of the dental hygiene teacher in the overlapping area of instructing children in prevention and good dental health practice.

* * * * *

PROPOSED A3CIENDMENTS TO THE BY-LAWS OF THE AMERICAN SCHOOL HEALTH ASSOCIATION

The following proposals t o amend the By-Laws of the American School Health Association will be considered at the annual meeting in Miami, October 12-19, 1962:

Two new sections to be added to Article V to read as follows: Section 6-No one person shall serve concurrently as chair- man of more than one committee unless, as an officer, his or her position automatically requires said person to assume the chairmanship of a standing committee, or, unless a ma- jority of the Governing Council votes otherwise. Section 7--A member or fellow of the Association niay serve on only oiic study and/or standing committee unless a ma- jority of the Governing Council votes otherwise. Proposed amendment to the Manual for Program Develop- ment for the Annual Meeting of the American School Health Association. (Operating Code for the Program Committee).

"rider phase IV-Finn1 Program Coordiiiation, add a sixth state- ment to read s follows:

As a general rule a member or fellow will participate in only one major prograiii event during the annual meet- ing unless as an officer his position requires additional responsibilities.

1.

2.