Please activate JavaScript!
Please install Adobe Flash Player, click here for download

prevention International magazine for oral health No. 1, 2017

practical prevention | biorepulsivity I need partners from microbiology and medicine in order to treat periodontitis holistically. nary and complementary collaboration between dentists, doctors, natural prac- titioners and therapists. Why did you opt for preventive dentistry? And did you know from the start that your practice would focus on preven- tion? Kulka: For me, it was a gradual process, since prevention reflects a lot of experi- ence. It all began with periodontitis and treatment methods that did not really convince me. After all those years, the results of treating periodontitis were dis- satisfying for me—and I can hardly even call them results. So, I asked, what is the alternative if I am not able to com- pletely cure periodontitis? I prevent it. This approach works well when it comes to tooth decay, but we still need to work on periodontitis prophylaxis. What does prevention mean to you per- sonally? Kulka: For me personally, there are three approaches to prevention. Firstly, I want to primarily avoid illnesses and their causes. Treatment is better when the patient is healthy. The second ap- proach is stabilisation. For example, after we have achieved a satisfying thera- peutic result, whether the problem is completely cured or not, we have to maintain the health status of the pa- tient. The third approach is about pre- venting recurrence when we see the patient again. Prevention is applicable to patients of all age groups from the age of three. However, prevention in younger children involves also training the parent, establishing or developing an awareness of health and creating the foundations for well-informed children. Prophylaxis training can work well in a group setting, but long-lasting success and motivation are only derived from individual training and education. Teichmann: I believe prevention would greatly unburden the healthcare sys- tem. It allows us to treat the people who really need help and require intensive therapy. Why are some dentists shying away from comprehensive perio-prophylaxis? Kulka: If you want to understand perio- prophylaxis, you have to understand the immune system. A perfect immune sys- tem masters attacks and tolerance. Den- tistry has to compare periodontitis, as an invisible chronic illness, with coronary heart disease, diabetes and Chron’s disease. Then the question arises: Can we even treat periodontitis locally, or is it more of a systemic problem? Well, I would say it is a systemic problem. I need partners from microbiology and medicine in order to treat periodontitis holistically. I believe therapy and preven- tion can only be successful together. Teichmann: Understanding oral micro- biology is more important than ever. We have to pay much more attention to our internal flora. Bacteria live in us and we are alive thanks to these bacteria. There- fore, we have to check that our oral flora and intestinal flora are balanced. When our oral flora is out of balance, it has an effect on the rest of the body. So, we have to stabilise the oral flora. The prevention trend benefits the pa- tient most of all. Many patients want to keep their teeth and have become more aware of their own health. However, a lack of motivation is often the problem. Kulka: That’s exactly why I take the pa- tient seriously. In my team, the patient is the boss—they decide when they need a break. They also decide if they are ready to give up smoking, for exam- ple. Together, we come up with specific tasks for the patient to do at home. If you give your patient the ability to make decisions, you are also motivating and involving them. That is what preven- tion is all about: motivation, training and constant support. For example, I offer smokers a tailored prevention pro- gramme with a check-up session every two months. Prevention takes time, but not every dentist gives him- or herself, and the patient, enough time for diagnosis. And, september 2017 57

Pages Overview