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prevention International magazine for oral health No. 1, 2018

special: dental hygiene in Belgium | brush does not meet the criteria desired in an effective toothbrush. Comparing the oral hygiene products from dif- ferent companies, we see a variety of designs and features. This is interesting because there is no such thing as the perfect interdental brush. There are always compromises to make and what some patients like, may be rejected or dis- approved of by others. We as dentists have only an advisory, consultative role. Nevertheless, CURAPROX makes Swiss-qual- ity products designed by dental professionals, and the company is willing to listen to advice on how to improve its products. What is the status of dental hygiene in Bel- gium? In other words, how does the Belgian mouth look? When I go abroad to congresses and meet with peers, I feel their displeasure when they hear that I come from Belgium. The first thing I am asked is, how can you treat periodontal disease without a dental hygienist? For them, it is like having bars and pubs, but no beer. I have read some articles in which the decayed, missing and filled teeth and decayed, missing and filled surfaces scores of children were compared between different European countries. Though Belgium was not top of the class, it wasn’t at the bottom either. In articles from the US, it is re- ported that, at 30 years of age, 25 per cent of the American population have mild periodontitis, 60 per cent have chronic periodontitis and 15 per cent have aggres- sive periodontitis. This is exactly the same breakdown as in Europe. The question is not about whether dental hygien- ists are necessary; the question is, what percentage of the population do dentists reach and can afford to go to a den- tal hygienist on a regular basis? Despite all this, we seem to be able to manage the periodontal situation in Belgium and this was one of the reasons for the second study. Does the addition of dental hygienists make financial sense or does prophylaxis make financial sense for the dental practice if the practice already makes good money with implants? I understand your point of view that, in the perfect world of prophylaxis, dental implants have no place because everything should be done to prevent implant treatment. I remember Prof. Jan Lindhe saying that, nowadays, too many treatable teeth are extracted to be replaced by den- tal implants. As a periodontist I agree with Prof. Lindhe; a dental implant is an effective instrument to rehabilitate edentulous areas, but only after all other options have been considered. But often life decides differently, and at Ghent University, I see a lot of young people seeking dental care because of, for example, fracture of one or more of the front teeth owing to biking and other kinds of accidents, sometimes under the influence of alcohol or drugs. These students don’t want to wear removable dentures for life. With respect to the first part of the question, of course the addition of dental hygienists makes financial sense. The purpose is to relieve dentists of those tasks that can be del- egated to auxiliary staff. Secondly, dental hygienists will be trained to communicate with patients about their problems and questions. Delegating prophylactic care to the den- tal hygienist implies that more patients can be treated and followed up on. We also must not forget patients who live in nursing homes. Since nurses are not allowed to provide dental treatment, we are glad that, in the near future, dental hygienists will be available to give these people the neces- sary preventative care. What kind of prophylaxis does the Belgian dentist per- form in the office? How much time do you devote to prophylaxis? m o c . k c o t s r e t t u h S / o k n e h c a z o K a h O © l prevention 1 2018 45

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