THE EDITOR'S CORNER
Effective oral hygiene for the prevention of caries, periodontal problems, and gingival decalcification of teeth has always been one of the cornerstones of dentistry. Since orthodontic appliances add another dimension to the difficulty of oral hygiene management, orthodontists have probably been among the more diligent in pursuing techniques of improved oral hygiene. It would seem natural that orthodontists would be among the first to accept and install the latest techniques in this area of prevention. The fact that this has not generally occurred may be attributable to a lack of communication.
In an effort to bridge the communications gap, JCO is presenting an article in this issue by Dr. Robert Barkley, one of the leading advocates of the newer methods. It may help to overcome a certain amount of complacency that some of us may have with the oral hygiene techniques that we presently employ.
It is one of the key aims of the dental profession to get people to learn and to use, throughout their lifetime, good habits of oral hygiene home care. Whatever progress has been made, we are a long way from fuIfillment. Complacency with present methods is misplaced, and so is antipathy against new methods. Some of the antipathy may derive from the attitude of older practitioners who feel that this whole new prevention "kick" is not really new, just the old knowledge dressed up in new and gaudy wrappings. Some of the antipathy may derive from the showmanship aspects of the techniques.
Opposition to these recent developments in prevention, either on a basis that they are not really new or because they are involved in too much showmanship is unwarranted. If a better way of accomplishing the goal of prevention can be obtained on a broader scale than has been achieved up to this point, we should be for it. If this is helped by showmanship, we should be for that. Indeed, it wouId appear that some showmanship may be an essential part of a broad scale program. For one thing, more conservative methods have had a limited response. For another, these programs must really begin with children to be most effective. On that basis, showmanship had probably only just begun to be realized as a motivating method. Also on that basis, orthodontists and pedodontists have a special mission in this program; especially orthodontists, since we see children at regular intervals over a relatively long period of time.
Another criticism of the new prevention is that it is creating an artificial entity in order to justify a substantial fee for the prevention service. Maybe we ought to ponder whether prevention has been an unspectacular success because of the fact that it has not been paid for separately. We need a different attitude if we are going to try to influence a different attitude in our patients. We have to believe that prevention is one of the most important dental health goals, and we must make the public believe it. We must develop workable techniques of education and procedures of care; and systems for their use in organized programs in home, school, media, and dental office. We have to keep evaluating existing programs and improving on them.
Finally, we must have so much respect for this concept of prevention, and such ability to convey that to the public, that the public will not only buy the idea intellectually and put it into practice, but buy it financially and be willing to pay for it. Otherwise, it will continue to happen only on a limited scale as a sometime program hidden in the administrative procedures and the fee structure of a practice. Thus, when we look at new programs of prevention, it is not the programs that are wrong. We are experiencing the growing pains associated with the development and implementation of a great idea.
