Dr. Robert Nara: Freedom from Dental Disease

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PLOWBOY: How did you manage to communicate the necessary information without insulting your patients, then?

NARA: Well, I knew that most people avoid the dentist's office until they need work done . . . usually either a filling or an extraction. And people in pain aren't likely to be receptive to a cute story about preventing the disease. So, I had to design a system that would penetrate, first, the preoccupation with money worries and physical discomfort that most folks bring to the office with them. And I also had to figure out a way to change the preconception that nothing can be done about tooth decay and gum disease anyway.

With all of these cards stacked against me. I knew that I needed a very effective psychological delivery system. So, I spent a lot of time thinking about it, saying to myself, "How can I do this?"

My goal was to stop disease, and I was sure that I could stop it—I had all of the scientific evidence in the world to back me up— if could get the patients' help and cooperation.

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!

PLOWBOY: But as soon as you started practicing this form of prevention, you began to encounter resistance from the dental establishment. When did the first signs of your coming "war" with organized dentistry show up?

NARA: I began working, in 1968, to bring about some changes in the outmoded dental laws that still exist in much of the U.S. At that point I was mainly concerned with setting up a system that would help the dentist to be more effective in his or her job. Part of the problem, as I saw it. was that most dentists simply didn't have the time to handle health education effectively. I felt that this situation could be remedied if the doctors were able to delegate some of the more routine dental tasks to paradental personnel. After all, there are many new types of paramedical jobs and paralegal jobs today, but we really don't have any new paradental positions . . . there haven't been any "new kids on the team" for years.

So, I started lecturing that dental assistants should be trained to polish teeth, to give fluoride treatments, and so forth ... in order to allow these people to become really worthwhile members of the dental health team. I pushed pretty hard to get new laws passed that would help bring about these changes. For instance, I got myself elected to the American Dental Association's House of Delegates in 1971 and spent four years pushing for modern laws.

Unfortunately, dental laws fall under the category of state's rights, so—even though the House of Delegates did vote to recommend liberalized legislation—direct action could only be taken at the state level. And it just so happens that my home state of Michigan is one of the most backward places—in terms of dental progress—in the Union. This is because we have a network of long-entrenched "dental politicians" in Michigan. In many states, on the other hand, there is a regular turnover among professional politicians, because many people compete for these positions. Michigan, however, lacks that healthy competition, and old dental ideas are seldom challenged here. In fact, just as an example, we had two men—father and son— who ran the Michigan State Board of Dentistry for 40 years!

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