For the love of patient at-home success

Not all patients are the same. See the whole person instead of just their teeth, and tailor your recommendations accordingly.

I've encountered the statement countless times:

"You must floss! Products like water flossers or interdental brushes are merely supplementary to flossing." It's high time we put this notion to rest. Doing so will alleviate our frustration and help patients progress towards better oral health.

The effectiveness of these methods largely depends on the individual, their compliance level, the extent of the disease, socioeconomic status, and understanding of the importance of patient at-home success care and the best methods and techniques to perform it effectively.

Various products can aid the patient, but their success hinges on how well we convey instructions and whether the patient can adhere to them.

Barriers to at-home dental care compliance

There are several barriers to at-home dental care compliance that can prevent individuals from maintaining proper oral hygiene. Some of these barriers include:

• Lack of knowledge: Many people may not be fully aware of the importance of oral hygiene or the correct techniques for brushing, flossing, and using other dental care products.

• Limited access to dental care products: Some individuals might need help obtaining appropriate dental care products due to financial constraints, limited availability, or geographical location.

• Time constraints: Busy schedules and competing priorities can make it challenging for some people to dedicate sufficient time to their oral hygiene routine.

• Physical limitations: Disabilities, arthritis, or other conditions may hinder an individual's ability to perform dental care tasks effectively.

• Low motivation or perceived importance: Some people may not prioritize oral hygiene, leading to lower compliance with at-home dental care routines.

• Fear or anxiety: Dental phobia or negative past experiences can cause resistance to engaging in proper oral care practices.

• Cultural beliefs or misconceptions: Cultural differences or misconceptions about oral health can influence an individual's approach to dental care, potentially leading to non-compliance with recommended practices.

• Ineffective communication from dental professionals: If dental professionals do not effectively communicate the importance of at-home dental care or provide clear instructions, patients may struggle to comply with proper oral hygiene practices.

Addressing these barriers is crucial for improving at-home dental care compliance and promoting better oral health outcomes.

What the research suggests 

Periodontal diseases are complicated and result from various factors. Proper daily plaque control is essential for maintaining gum health. However, recent studies have found insufficient evidence to confirm that flossing alone promotes gum health. 

This isn’t to say that it doesn’t work. Still, it is more likely that patients are not flossing at home, or they are flossing in a manner that is not effective, and that more straightforward communication from the practitioner to the patient will help clarify its role in maintaining oral hygiene.

So, what can we, as practitioners, do?

We can assist our patients in overcoming their barriers to patient at-home success dental care in several ways. Providing educational materials, demonstrations, and oral hygiene instructions during appointments to help patients understand the importance of oral hygiene and the correct techniques for brushing, flossing, and using other dental care products would be the bare minimum. 

For patients who cannot afford dental care supplies at home, we should recommend affordable alternatives, providing samples or coupons if possible or connecting patients with community resources to help them access necessary dental care products.

Physical limitations that patients may have should be considered, with us, as professionals recommending adaptive tools, modified techniques, or assistive devices while recognising the ableist nature of the dental industry.

Emphasizing the long-term benefits of good oral hygiene, sharing success stories, or using visual aids to demonstrate the consequences of poor oral care may motivate those that do not understand the importance of adequate dental care to prioritize their oral health.

Above all, offering a supportive and understanding environment, practicing gentle and pain-free techniques, providing options for sedation dentistry and being culturally sensitive and aware may help patients overcome their dental phobia or anxiety.

A lack of communication is the mother of all mess ups

We should strive to improve our communication with patients by using clear and simple language and encouraging patients to ask questions. 

Remember, they are not medical professionals! 

Providing written instructions and visual aids can also help reinforce the importance of at-home dental care.

I believe in never telling patients that what they do at home is inherently wrong or bad, as it can be highly discouraging. Having a patient use a water flosser, but not another kind of tool, is better than them not flossing at all. 

I suggest you ask questions to establish whether the tools you recommend are viable for them as an individual, keeping in mind that individual human beings can never really be textbook.