Confession. I eat chocolate every day and I don’t feel guilty. I also don’t make my clients feel guilty about having a sweet tooth. That’s because I know how to decrease the harm from sweets on my teeth and I tell my clients how to do the same. We all have bad habits that we can’t or don’t want to stop. But we also don’t want the negative consequences of those habits. So, what can we do? It’s called harm reduction. It’s a way to reduce the harmful effects of our addictions without stopping the habit. It is used for substance use disorders, but it can easily be used for habits that harm our oral health. Here are ways we can use harm reduction to level up our clients’ oral health.
I think dental team members eat more sweets than the average person. Just look at all the desserts in our office kitchens, not to mention the chocolate stashed in our lockers. We can relate to our clients who love sugar. I make my clients feel understood by saying, “I like sweets, too. It’s best to stop or cut them down. If you really need something sweet, avoid the sticky kind and don’t keep it in your mouth long. When having flavoured drinks, drink them fast. Decrease how often and for how long sugar is in your mouth. Have sweets with your meals. Afterwards, drink water and eat hard cheese.” These are all ways to continue eating your cake and decrease tooth decay.
Smoking and Vaping
I feel uncomfortable doing smoking cessation with clients. I notice some clients fold their arms or look away. I can see that they feel like I am judging them and don’t understand how hard it is to quit. Instead of preaching to them, I ask if they are interested in stopping. If they don’t want to quit, I advise them of ways to decrease the effects of smoking on their oral health. I tell them it is best to stop smoking or cut down and welcome them to talk to me when they are ready to quit. I encourage them to drink lots of water, practice good oral hygiene, and have frequent dental cleanings. This way, smoking won’t be as harmful to their oral health.
You can always tell when clients don’t brush twice a day or don’t floss. When you ask them, they give a pause or an embarrassed smile. Instead of giving them another oral hygiene lecture, ask them why they don’t brush and floss. Give them tips on adding healthy habits into their routine, like brushing in the shower or flossing while watching a video. Level them up to an electric toothbrush and toothpaste with stannous fluoride, which will decrease decay, sensitivity and gingivitis. Encourage them to use a water flosser, interproximal brushes or floss sticks if they don’t floss. Recommend they use mouthwash twice daily to decrease gingivitis and decay. For clients who don’t brush, advise them to eat hard food like cucumbers, carrots and nuts to clean their teeth. While it is best to brush and floss, clients can cleanse their mouths in other ways.
When you can’t get a client to stop a bad habit, prevent the harm from that habit. Start using harm reduction in your practice and level up your clients.
About the Author
Sanj is a general dentist who graduated from the University of Toronto in 1999. She practices in Brampton, Ontario. She can be reached by email: firstname.lastname@example.org