Dental program plans to drill out fear factor

A pilot dental care program, which employs psychologists to persuade patients to brush more, has reversed decay in many patients.

It resulted in a 50 per cent decline in the need for first-time fillings, a 40 per cent reduction in the incidence of decay and a 50 per cent reduction in repeat visits to the dentist, Sydney University says.

That's great news for the 50 per cent of Australians who hate the drill so much that they avoid the dentist entirely or go infrequently. As a result, nearly 30 per cent of adults aged 25 to 40 have untreated dental decay.

The university's pilot program was developed by Professor Wendell Evans, who has made reversing tooth decay his life's work.

The program has had such "outstanding" results that the university will launch a new no-drill clinic at Westmead Centre for Oral Health next year.

Trainee dentists will combine prevention (such as proper brushing technique and the application of professional strength fluoride) with behavioural management.

The dean of Sydney University's Faculty of Dentistry, Professor Chris Peck, said patients in the new caries management program would undergo behavioural interviewing.

"We use psychologists to change an individual's behaviour to get them to modify diet and to use the best preventive approaches. It is not one appointment, but multiple appointments to reinforce those changes."

Most patients will initially see the dentist more often, but the results showed that it was more cost effective than traditional treatment.

"When you look at the life of a tooth using this approach, you will retain your teeth instead of getting bigger and bigger fillings. So there'll be a cost saving over time. And it is also cost effective for the dentist, in that they can still make a living using this," said Professor Peck.

The best candidates are those children and adults with small holes or early signs of decay.

Trying out the program last week at the Sydney Dental Hospital, Lliam Ferrier, 11, showed no fear of the dentist - and The Drill - that has bedevilled generations of his family.

Lliam's mother Victoria Ferrier, of Haberfield, remembered being "force fed fluoride" by her mother, who was so terrified of the drill that she went to extraordinary lengths so her children would not get cavities.

Ms Ferrier said her mother had insisted she take a toothbrush to school (and checked she'd used it) and had subjected the children to daily tooth checks.

Ms Ferrier recalls having to take the day off school to accompany her terrified mother to the dentist.

"She [her mother] really instilled into us the fear ... you've got to use toothpaste, use fluoride," said Ms Ferrier.

Today Ms Ferrier and her sister are among the small number of people with no cavities. "I thank my mother every day," she said.

Professor Peck said the no-drill treatment would not replace dental fillings and restorations completely, because some patients will still need these treatments. It will use triage to identify the best treatment for each patient according to their risk.

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