Dr. Robert Nara: Freedom from Dental Disease

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PLOWBOY: But this common attitude didn't keep you from practicing preventive therapy?

NARA: No, it didn't, and I think there are several reasons why I was able to maintain my interest in prevention. For one thing, I'm a pretty stubborn individual. For another, I dislike even trying to treat a mouth that isn't clean. I mean, why go through the time and effort necessary to really remove decay and place nice fillings when you know—because the mouth itself is not being cared for—that the new work is going to be decayed all around its margins in six months or a year? There's simply not much job satisfaction in enlarging the same filling time after time until the tooth has to come out.

So, early in my practice I tried to put together a plan that would motivate my patients, to help them establish an effective oral hygiene program. I failed miserably—as I should have known I would—because nobody wanted to listen.

My patients, at that time, shared the common attitude: "Come on, Doc, just get that tooth filled, or get this one pulled, and let me out of here." Because most folks don't want to spend any more time than is absolutely necessary in a dentist's office, they want to get away from that chair and away from those drills as quickly as possible.

PLOWBOY: This "fear" would seem to be related to the frame of reference you spoke of earlier.

NARA: Right, it's part of the same attitude. And, because of that frame of reference, a dentist can talk till he or she's blue in the face about keeping the mouth healthy and so forth. Nobody wants to hear about it... nobody even believes it!

PLOWBOY: Do people actually doubt that prevention can be effective, or do they simply feel that they lack the willpower to follow through with such a program?

NARA: I think that—in most cases—a combination of both these beliefs is at work . . . because the concept of a really effective oral health program is simply beyond the scope of most people's experience. For example, note the toothpaste ads that are run on television: "Look, Mom, only one cavity!" Now, that ad is claiming—and the manufacturers of that product are claiming—that really good prevention will result in only one cavity every six months! At that rate, a person could have more than 32 fillings by the time he or she reaches 21 years of age! It's crazy, and this kind of advertising contributes to our national indifference toward the prevention of dental disease.

And that's what the 'method' that I came to call Oramedics does: It enables me to get the patients to cooperate, to take the control of their own oral environment into their own hands. And the system works!

Another problem with the traditional approach to oral hygiene is that it's all ''teach, teach, teach". Now adults, especially—and even children to a large degree—don't really appreciate being told that someone is going to teach them something. Most folks consider the very suggestion that they need education to be an insult, a put-down. Yet, many "modern" dental offices have a room with a big sign on the door that says, "Patient Education Room". The sign might as well say. "This Way, Dummy", because that's exactly the feeling that's conveyed.

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