psychology of prophylaxis | Unacceptable status quo One thing we will always have to deal with is the mind- set of our patients: “I get decay no matter what I do or how much I brush”, “My parents too had bad teeth”, or “A tooth can be easily replaced today.” Patients are, firstly, quick to put the blame on their parents or point the finger at dental professionals. Secondly, dentistry is still associ- ated with a great deal of discomfort. Lastly, patients know about many of the treatments and solutions available. Charles-Edward Winslow, founder of the Yale School of Public Health in the US, once said that it a duty of each generation to redefine “unacceptable”. Is 38 million Americans with at least one complete denture not ab- solutely unacceptable? We live in such a fast-changing world that we have lost our connection with our mission and at times also with our patients. The time has come to change the status quo. Change must be accepted How do we bring about this change? The answer seems too simple to be true. Through the service of coaching. Nowadays, there is hardly a product sold without a value-added service. No treatment without maintenance. No dental practice without dental hygiene. In-depth instructions have become crucial for the suc- cess of a product. Is a dental office not an accumulation of service efforts? Why, then, since we as dental profes- sionals have the competence, do we not include coach- ing as a value-added service in a dental practice? Successful coaching in dentistry depends on three crucial factors: establishing personal connections, devel- oping trust, and growing relationships. Patients should become part of a long-term relationship with the office. It is not about regularly bringing in new patients, but cul tivating the ones the practice already has. The most modern practice and the friendliest team will avail nothing if the patients do not stay with the practice. Personalised connection through individual coaching is key to building a long-term relationship. No technol- ogy can replace a durable connection between a dental professional and a patient. Digitalisation cannot replace trust. A programme designed for change This is why Curaden brought individually trained oral prophylaxis (iTOP) to life. This is a programme introduced 20 years ago by Dr Jiri Sedelmayer, an established den- tist and past professor at the University of Hamburg in Germany. During his time at the university, he realised that dental students studied every detail about resto- ration, but knew nothing about keeping their own mouths healthy. Dental students were never practically taught any techniques to maintain their own oral health. This re- alisation led to the establishment of iTOP—to train future dental professionals. What began in 2006 as a single two-day course has since grown and been attended by more than 14,000 dental professionals worldwide. iTOP operates with the support of over 200 instructors in 44 countries. In our seminars, we do not differentiate between a dental hy- gienist, dental nurse, dentist or oral surgeon. All of their daily work contributes likewise to shifting the paradigm from restoration to lifelong oral health. Each of their en- deavours aspires to the best for their own health and the health of their family members, friends and patients. All of them share one common understanding: a clean tooth cannot become diseased. The iTOP programme is based on three simple criteria: acceptable, effective, non-traumatic. These pillars are the foundation for all oral healthcare products that Curaden offers to its clients. Knowing is good, action is better In order to achieve clean teeth, we employ a unique practical training concept called “touch to teach”. It is based on the idea of the dental professional experienc- ing and practising the iTOP techniques on him- or her- self first, before teaching it to others. No phantom model will ever replace the feeling of a toothbrush, interdental brush and solo brush on one’s own teeth and gingivae. Oral health needs to be taught individually and practi- cally. Sometimes it is necessary to go back to the basics to achieve change in the future. There continues to be a huge gap between knowing and doing. But let me be clear: what we know, we should apply repeatedly, every single day. It is our job to repair teeth, but it is our mission to keep our patients healthy. We should not confuse our job with our mission. Only then will we, 20 years from now, have those 38 million people smiling with their own healthy teeth denture-free. about Dr Ana Stevanovi ´c is Head of Professional Education at Curaden. She has spoken at numerous events on the importance of a paradigm shift in dentistry and bridging the knowing- doing gap in preventative oral care. Her background as a dentist, manager and development coach aids her in utilising her work with both dental professionals and patients to help shape a change in the mindset of individuals in order to change the future of oral care. m o c . k c o t s r e t t u h S / t a b e g n p © i prevention 1 2018 55