October 13, 2020
by Madina Knight and Daniel Cordaro
Floss. Brush. Rinse.
These simple instructions for healthy teeth seem easy enough. So why is it that only 4% of Canadians follow this dentist-recommended regimen? In a survey1 run by Crest and Oral B, most people cited fatigue and lack of time as their reasons for skipping out on oral care.
But of course, dentists across the country don’t need a survey to tell them that. They hear it every day from the people in their chairs. Patients are given every reason to devote 3-5 minutes a day on their teeth – but when added to their long to-do list, oral care is most-often regulated to the “I’ll-get-to-it-later” column.
Maybe it’s time dentists take a new approach when communicating with their patients. According to the same survey, the majority of Canadians say that oral health is important to them. They just don’t have the headspace to invest in it.
What if dentists developed a new focus on their patients’ mental wellbeing? Mindfulness training could be a surprising solution to dentists’ most enduring qualm and introduce many more benefits to your own personal practice.
What is Mindfulness?
Take a moment to draw your attention to your breath. Don’t change it – just take note. Is it shallow or deep? Fast or slow? Now follow it inward to take stock of your body. Does anything hurt? How are you sitting? How are you in this current moment?
Mindfulness is a state of being where one is fully present and aware. You have probably experienced it many times in your life – if only in small doses.
We use mindfulness to complete tasks that require our full attention – like surgery –and to have really engaged conversations with patients and co-workers. Pilots call it situation awareness.
When we are in a state of mindfulness, we don’t over-react or get overwhelmed by the world around us rather we are better equipped to handle challenges and come up with innovative solutions.
But for most of us, mindfulness is not a constant state. We fall in and out of it and our work and home-lives suffer because of it. According to the Canadian Mental Health Association, around 1 in 5 Canadians experience mental health problems including depression and anxiety. Meanwhile, nearly 83% of dentists perceive their profession to be stressful or very stressful.
The effects of mental wellbeing in dentists’ offices are clear. Mindful dentists are more present with their patients, provide better service, and become more attuned to their individual needs. Not to mention the personal benefits of increased energy levels, decreased blood pressure, and a heightened sense of enjoyment at work and at home.2
Despite this, there are few resources in place to help workplaces achieve higher states of mindfulness and mental wellbeing. That’s something Positive Psychologist, Dr. Daniel Coradaro at the
Contentment Foundation is hoping to change.
The Key to Happiness is not Happiness
High in the eastern Himalayas lives a remote Bhutanese community that has had relatively no contact with the rest of the world. In 2014, Daniel and his team from Yale University were fortunate enough to be granted permission to interview these people as part of their research into human emotions.
The study had already led them through 11 distinct cultures around the globe, where they cross-referenced emotions told through body language, vocal expressions, and facial expressions.
Daniel and his team found that people in all of these cultures – including the remote Bhutanese community – were able to identify 18 emotional expressions, which confirmed that many emotions are universally human.
The results of this study were groundbreaking and fundamentally changed the field of psychology, but Daniel walked away from it with entirely new questions. He had not been surprised to find happiness among the most common and recognizable of human expressions, but he was intrigued to discover that another emotion may better embody the peaceful bliss that we often confuse for happiness.
The remote people group in Bhutan call it “chok shay.” In English, it is called “contentment.” In both languages, it expresses a state of “enoughness” – the idea that one can be satisfied in every moment, regardless of what they are experiencing.
“My team of researchers and I poured through the last 5,000 years of ancient wisdom traditions and were shocked to find that the ancients almost never used the word happiness when they were talking about what it means to be well. More than 90% of the time, they used the word contentment and described it as a state of ‘unconditional wholeness’, regardless of what was happening externally.”
That distinction is what sets contentment apart from all of our other emotions. Unlike happiness which builds and fades, contentment is not dependent on any external source.
By seeking out contentment, Daniel discovered pathways toward the eternal happiness humanity has always sought.
The Four Pillars for Dentists
In 2011, Daniel and his team at The Contentment Foundation compiled their research to create The Four Pillars of Wellbeing, which is a valuable tool that clinicians can use to improve their own mental health, as well as that of their patients.
In the mindfulness pillar, we are asked to use mindful breathing as a regular practice for focusing our awareness and modulating the flow of attention. As our mindfulness grows, it becomes an important skill – helping us to direct all of our attention on a task at hand and experience a sense of self-control when making decisions.
The second pillar, self-curiosity, is a form of metacognition where we are encouraged to treat all inner experiences (physical, mental, and emotional) as interesting and worthy of investigation – just as a scientist would treat an area of study. Through a series of lessons, we are empowered to understand what triggers us emotionally, why those triggers exist, and what we can do to change the perspectives and assumptions that created the triggers.
The community pillar utilizes the concept of “selfless service” to cultivate strong value systems that contribute to individual and collective growth. The well-being curriculum asks us to look for ways to help the world around us. Adopting a more altruistic mindset is obviously beneficial to our practices and society as a whole, but it has also been proven to make us more satisfied individuals.
All of these skills culminate in the fourth pillar, contentment – the art of appreciating the present moment, no matter what it brings. Instead of obsessing about having more, being more, striving for more, and always wanting more – people who are content can rest in the completeness that is internally sourced. This is an important step towards reducing stress in the office, where external factors are often unpredictable.
Some clinicians have started offering the Contentment Foundation’s wellbeing curriculum to their staff with great results. Many reported a dramatic shift in their overall well-being, as well as an increase in productivity.
This has an immediate effect on the quality of care patients receive. There is even an opportunity to start spreading mindfulness techniques through oral care instructions.
The recommended twice-daily floss, brush, and rinse routine is a perfect opportunity for patients to practice mindfulness as they start and end their day.
Here is an example of how to instruct your patients to practice mindful oral-care.
A Mindful Oral Health Routine:
Step one: Close your eyes and relax your neck and jaw. Take three slow, deep breaths through your nose.
Step two: Open your eyes, and begin to floss – continuing to breathe deeply.
For every space between your teeth, acknowledge something you’re grateful for. These can be simple: a cup of coffee, running water, a sunny day.
Beginning and ending your day with mindful gratitude is hugely beneficial to your mental wellbeing.
Step three: Rinse and begin to brush your teeth. (If it is helpful, set a timer for two minutes.) As you brush, try not to let your thoughts wander. Stay present. Picture each tooth as you clean it – becoming aware of the feeling of the bristles on your gums and the taste of the toothpaste. Check in with the rest of your body. Relax your shoulders. Loosen your grip on the toothbrush. Embrace the current moment.
Step four: As you rinse, notice your clean teeth. Smile at yourself in the mirror and take one final deep breath.
Hopefully, by adding mindfulness to their oral care, patients will skip it less. Instead of viewing the 3-5-minute routine as just another thing on their to-do list, they will begin to see it as an opportunity to re-center and practice self-care.
Anyone can benefit from adopting mindfulness and contentment into their lives, and if we all dedicated a small amount of time to our mental wellbeing – we might also take care of our teeth!
Oral Health welcomes this original article.
About the Authors
Madina Knight is director of Kindtype, a New Zealand-based communications agency that works with purpose-led organizations. She is a guest writer and storytelling consultant for the Contentment Foundation. With a heart for social justice, Madina has spent the last decade working in media and communications, helping non-profits, government agencies and social enterprises amplify their message.
Daniel Cordaro, Ph.D. is the Founder and CEO of the Contentment Foundation (contentment.org). Formerly a faculty member at Yale University, he has studied human emotion and wellbeing for over 10 years. As an Edmund Hillary Fellow and a Global Visionary Fellow, his goal is to bring sustainable wellness practices to one billion people in one generation.