An Early Bite with Dr. John Paul: Prevention and Cure

By Dr. John Paul, FDA Editor

At least once a week a patient will ask me, “Why do I have to come in two (or three or four) times a year? I’ll just call you when something goes wrong.” There is a really good answer to this:

“Mrs. Gruntbuns, I have two basic tools in my kit: prevention and cure. When you decide to ‘just call me when something is wrong’ you are choosing to only use cure. You accept the risk that you will find the problem before it gets too painful or too expensive to fix.

“When we prescribe that you visit us two times, three times or even four times per year, it is an estimate of how often we need to see you to prevent disease. What you call a ‘cleaning’ is not about cleaning your teeth — it’s about evaluating your health, and as long as you are here, we throw in a cleaning.”


Have a question you have a tough time answering? Send it to Dr. Paul at jpaul@bot.floridadental.org.

An Early Bite with Dr. John Paul: “I’m Gonna Pierce My Tongue!”

By Dr. John Paul, FDA Editor

Having had more than my share of stitches and staples, I really can’t imagine electively poking holes in my person. You can imagine my dismay and confusion when someone comes in with a new piece of tongue jewelry or a glitter booger (that thing stuck through their nose, cheek, lip).

I’d love to get my two cents worth in before the assault takes place.

“Now, Ms. Gruntbuns, let me get this straight — you want to get your tongue pierced?

“Aren’t you the one who cringes while sitting in my chair and nearly faints when you get an injection? You do realize they are going to use a much bigger needle and you will not be numb? They will hold your tongue still with a big pair of pliers — remember your delicate gag reflex? — and then jam the needle right through. Then, they’ll put in the barbell, pat you on your head and send you home. Remember all those cavities we keep filling, and the bugs that cause them? They are gonna make a beeline for this new hole in your tongue and unless you are very lucky, you will have a swollen tongue from the injury and the infection that follows.

“If you are still set on adorning yourself with tongue jewelry, there is one more thing you must know. I have never seen a patient with tongue jewelry who doesn’t play with it. You flick it in and out against your teeth and bite on it, and eventually you break teeth, or fillings or crowns. There’s no warranty on restorations if you have tongue jewelry. There’s also no warranty if you have a glitter booger that wears out tooth surface or gum. Now would be a great time to let this fad pass you by.”

Have a question you have a tough time answering? Send it to Dr. Paul at jpaul@bot.floridadental.org.

An Early Bite with Dr. John Paul: “Can’t I Just Get This Done at the Mall?”

By Dr. John Paul, FDA Editor

When it comes to teeth whitening, how often do patients ask, “Why can’t I just get this done at the mall?” — which is patient speak for “I don’t want to pay what I think you are going to charge for results I want but can’t count on.”

Here’s what I tell them:

“Mrs. Gruntbuns, you certainly can go to that kiosk at the mall and get teeth whitening supplies there, but for the life of me I can’t imagine why you would want to. You don’t know where the person handing out the whitening supplies was last week. That lab coat they are wearing does not mean they are a dentist or even a certified assistant — there is no reason to believe they have any special training. There also is little or no regulation on the actual chemicals that will be sold to you. In Florida, there are regulations that say unless the person in the kiosk is a Florida-licensed dentist they cannot legally place anything into your mouth or shine a “special light” onto your mouth, but you as a consumer would have to report the procedure to see any enforcement.

When you come here, part of what you are getting is my training and expertise. I will advise you how likely whitening is to work for you. I can prescribe different products to suit your individual needs. My staff and I are overseen by the Florida Board of Dentistry and should we stray from the standard of care, my license and my livelihood would be in jeopardy. Besides the fact that I like you, I have a vested interest in running a clean office with the best products, the latest techniques and a well-trained staff.

I certainly won’t stop you from spending your money at the mall, but you should think about whether the rewards outweigh the possible risks, and whether there will be anything you can do if you are unhappy with the results.”

Have a question you have a tough time answering? Send it to Dr. Paul at jpaul@bot.floridadental.org.

An Early Bite with Dr. John Paul: “Why Are You Sending Me to a Specialist?”

By Dr. John Paul, FDA Editor

We’ve all had the patient who does most of what we suggest but never wants to leave our office. What do you say when your patient asks, “Why do I have to go to a specialist? I’m so comfortable here.”

“Mrs. Gruntbuns, I have a friend down the street who is an expert in the treatment you need. It’s all she does, and she is faster, better and cheaper than I could possibly be for you. What she can do in 45 minutes would take me three hours and two visits. For this procedure, my service isn’t the best and I want the best for you. When she’s done with your procedure, she will send you right back to me and I will take care of the other things you need.”

Maybe your patient needs more than one specialist. “Mrs. Gruntbuns, your condition is complicated and will need a team of dentists to restore your mouth the way you want it to be. We’ll work with specialists for those things because they do much better than I could, but I’ll always be the ‘general manager’ of your care. You may ask me questions anytime about the care I provide directly or the services our specialists are providing.”

Have a question you have a tough time answering? Send it to Dr. Paul at jpaul@bot.floridadental.org.