The 'outdated' part of dentistry

Oral hygiene advice given to patients must be updated to improve dental literacy, according to Steven Edwards, DDS.

Dr. Edwards is the president of Renuzoral, a dental product company. He recently spoke to Becker's to discuss the trends he is currently following.

Note: This response was lightly edited for clarity and length. 

Question: How do you think the dental industry will evolve in 2024? What changes do you hope to see?

Dr. Steven Edwards: First, I'm mostly interested in anything to do with primary dental prevention. That also means preventing recurrent disease after dental treatment. No matter how many new treatments we develop, primary dental prevention is even more critical for maintaining patients' dental investments because the costs, risks and complications become even greater as treatment failures occur and recur.

Everyone talks about access to care, affordability, better insurance coverage, payment plans, etc., but nobody talks about access to prevention. Based on the depressing results of the last U.S. Surgeon General's Oral Health Report, it's clear that standard oral hygiene instructions and basic dental education are woefully inadequate for our current Western lifestyle and diet. It's a tragedy that most of my new patients do not know that tooth decay is a disease. They think sugar causes cavities and gum problems. Worse, yet, they think brushing twice a day is adequate to fight two diseases that attack us 24/7/365. We need better dental literacy ASAP.

Second, as the inventor of Breathific dental synbiotic oral strips, I'm also interested in dental probiotics, prebiotics and postbiotics. Since dental caries and periodontal disease result from oral dysbiosis, we need to find ways to get our mouths back to a balanced, healthy microbiome.

The more we learn about the oral microbiome and how its dysbiotic state relates to various cancers and systemic problems, the more we realize the need to stop feeding the "bad bugs" and stop killing 99% of our oral "bugs" in general, and start promoting the growth and health of our "good bugs." It's ironic that some of our oral and systemic health problems are the result of outdated oral hygiene advice. For example, many antiseptic mouthwashes kill good microbes that help regulate nitric oxide, which regulates blood pressure and helps balance oral pH. Therefore, many mouthwashes actually dry our oral tissues, increase our blood pressure and alter our oral pH for the worse.

Last, as the inventor of the Renuzoral method of oral systemic fitness, I'm interested in artificial intelligence applications for preventive dentistry, especially for making sense of the vast amount of microbial research in order to design new dental preventive systems based on fitness, exercise physiology, sports, gaming, nutrition and supplementation. It's well known that fitness improves systemic health. Therefore, I say we apply fitness concepts to oral health. Since oral health is linked to systemic health, improving oral health by way of fitness should also improve systemic health. 

We know that 80% of most common dental problems are easy to prevent when you do a few things the right way and often, but oral hygiene is outdated and ineffective for today's society. From a fitness and sports perspective, nobody would argue about whether or not to floss. Flossing would simply become one type of many "exercises" for interdental fitness. Arguing about flossing would be as dumb as arguing about bench pressing or aerobics. Trying to convince everyone to floss who doesn't like flossing would be like trying to convince people to do bench presses who don't like or can't do them. Fitness is formulaic, systemized, organized and logical. Look how many types of fitness there are. Consider martial arts, dance or injury rehabilitation. There are rules and procedures to follow in a specific order. There's little debate about these things. You can easily track your fitness progress by adding more weight to your resistance training, looking in a mirror, stepping on a scale, gaining another notch on your belt, your clothes fitting better, etc., but tracking your oral hygiene progress is hard unless you do oral microbiome testing, visit the dentist or use a fancy toothbrush with Bluetooth connection to an app that tracks your efforts.

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