THE GENTLE

GUIDE
TO ORAL
HEALTH AND
HUMAN
HAPPINESS
Walking the path
towards prevention
From São Paulo to Seoul, from Denver to Lagos, from
Barcelona to Sydney, tens of thousands of dental professionals
are changing the oral healthcare game right now. They are
walking the path of prevention – becoming gentle coaches and
passionate motivators of oral health and human happiness.

In The Gentle Guide, more than 40 dental pros from all

around the world share what it means to focus their career on
prevention – and how it affects both their daily practice and the
health and happiness of their patients.

Expert views are coupled with the latest research and WHO
policies overview, for the complete picture on the state of
prevention in the oral health industry right now.

Read this book if you want to:

→ inspire your career as a dentist, periodontist, orthodontist
→ become a better dental hygienist or nurse
→ motivate your patients to care for their oral health
→ include more prophylaxis in your daily work
→ understand how oral health affects overall health
→ learn about new prevention policies from WHO that will
affect our entire industry

Published by Curaden curaden.com

“Oral health is significantly affecting
the overall health of the public – and
the world has finally
noticed. In The Gentle
Guide, Curaden explores
what is happening,
and how the current Denis Bourgeois, Professor
at the Department of Public

generation of dental Health at the Faculty of

Dentistry, University Lyon and
former WHO dental officer
pros is responding to the
new mandate – of being a coach for
health.”
 CHAPTER ONE
PRIORITY:
PREVENTION
Backed by the policy push from
the WHO, dentistry is about
make a sharp turn, becoming a
public health priority in the next
seven years. Read the stories
of dental pros who are at the
forefront of this change.
15
CHAPTER TWO
ORAL HEALTH
AFFECTS
OVERALL
HEALTH
From The Washington Post to the
WHO, experts are acknowledging
the impact of oral health on
people’s overall health, happiness,
and quality of life of people. Why
does it matter? And how does it
influence the practice of oral care?
61
 CHAPTER THREE CHAPTER FOUR

WE’RE
COACHING
FOR ORAL
HEALTH
In Sao Paolo, in Seoul, in Hamburg,
in Johannesburg, in Copenhagen,
in Tokyo and in Sydney, an entire
generation of dentists is motivating,
educating and coaching their
patients like never before.
PROMOTING
THE WONDERS
OF ORAL
FLORA
Good coaching is not about telling
people what to do. It’s about making
them aware of what’s important, so
they can take responsibility.

97 153
 CHAPTER FIVE CHAPTER SIX

TRAINING
ORAL
PROPHYLAXIS
What we practise, we make real.
We dig deep into iTOP
(individually trained oral
prophylaxis), visit prophylaxis-
focused practicioners, and examine
the take-aways for your oral health
practice.
HOME
RITUALS
MATTER
Learn about the science behind
habit formation and motivation,
and find tips to encourage self-care
and family care of your patients.

203 235
 THE COACHING MANIFESTO

THE FOUR PILLARS

OF ORAL CARE
Prevention, Mouth as the gate, Health & happiness,
Self-care and family care – four pillars for the future
of oral health.

269
 INTRODUCTION

HELPING PEOPLE SMILE

If you care for your patient’s mouth, you care for their
whole body and happiness. This simple, beautiful
truth – known to many practising oral health pro-
fessionals for a long time – is starting to be acknowl-
edged by the broader healthcare community. From
organisations like the WHO to the healthcare jour-
nalists writing for The Washington Post, the fact that
oral health matters to the systemic health of the whole
body is becoming widely accepted.
 This gives an increased confidence and the feel-
ing of self-worth to every dental professional
anywhere in the world. It’s giving us new pur-
pose – knowing that thanks to our everyday
work, our patients will lead healthier and happi-
er lives and even postpone the physical decline
associated with ageing. It also brings a never-be-
fore-seen emphasis on prevention and coaching
of our patients. If people know why and how
to keep their oral flora balanced and healthy,
they will see less oral disease, and in turn, better
overall health.
In this publication, through the eyes of more than
40 oral health professionals and experts, Curaden
explores the current trend of dentistry as a preven-
tive, motivational and coaching practice, impacting
the overall health and happiness of people. Happy
reading!
Christine Breitschmid & Ueli Breitschmid, Curaden
 E D I TO R ’ S N OT E

HOW TO READ THIS BOOK

To get the most out of The gentle guide, you don’t

have to read it cover to cover. Start with topics that
interest you the most and move from there – the
chapters freely complement each other.
This publication is for every oral health
professional interested in prevention and
coaching of their patients, and anyone who
enjoys creating better conditions for the hap-
pier and higher quality lives of their com-
munities and neighbourhoods. As you flick
through, you will find articles, briefings and
 short interviews on what’s affecting the overall
health of your patients, a selection of recent
studies, and various approaches used by your
fellow dentists and oral health pros, from Goa
in India to Ecuador in South America.
There are six chapters in our book, and while we
had a specific order in mind – walking you from
➀ changes in dentistry to ➁ oral health affecting
overall health, to ➂ the oral health coach mindset,
➃ through oral flora ➄ to the pragmatic and belov-
ed iTOP, and finally ➅ the oral care rituals of your
patients – you can read the chapters as you like. Feel
free to explore what catches your attention and in-
spires you in any order. Have an open mind, read be-
tween the lines, take what you like, copy, remix, make
unusual combinations and invent completely new
things that make sense for your particular patients
and practice. Just don’t put this guide on your shelf
and forget about it. It belongs on your desk, where
you can return to it again and again and again.
 1.
PRIORITY:
PREVENTION

Backed by the policy push from the

World Health Organization, the next
seven years should turn dentistry into
a public health priority. Read what the
WHO says – and the voices of dental
professionals who have already been
refreshing the industry for quite some
time.
16 Priority: Prevention BRIEFING

WORLD HEALTH
ORGANIZATION:
BY 2030, 80%
OF COUNTRIES
SHOULD HAVE
AN OPERATIONAL
NATIONAL ORAL
HEALTH POLICY
OR ACTION PLAN
17 Priority: Prevention

The Global Oral Health Action Plan for 2023 to

2030, published by the WHO, has recognised
oral diseases as a major health burden – and
prevention as the key solution.

The global burden of oral diseases and

conditions is an urgent public health
challenge with social, economic and
environmental impacts. The main oral
diseases and conditions are estimat-
ed to affect close to 3.5 billion people
worldwide. Oral diseases and condi-
tions disproportionately affect poor,
vulnerable and marginalised members
of society, often including people who
are on low incomes; people living with
disability; older people living alone or
in care homes; people who are refugees,
in prison or living in remote and rural
communities; and people from minority
or other socially marginalised groups.
This prevalence of oral diseases
also has its price tag. Oral diseases are
already the third most expensive area
of healthcare in the European Union,
just behind diabetes and cardiovascular
disease. In other regions of the world,
18 Priority: Prevention
the situation is no different, and if any-
thing, the picture is even more dramatic.
It is estimated that in 2018, oral diseases
resulted in direct costs of €90 billion in
Europe in terms of treatment expend-
iture. In terms of costs, this puts oral
diseases only behind diabetes (€119 bil-
lion) and heart disease (€111 billion).
Globally, public and private expendi-
tures for oral healthcare have reached an
estimated 387 billion US dollars.
Fortunately, there is a silver lining
to these staggering numbers: most oral
diseases and conditions are preventable
and can be effectively addressed through
population-based public health meas-
ures. That’s where the WHO’s Global
Strategy on Oral Health for 2023 to
2030 comes into play.
The vision of the WHO’s Global
Strategy on Oral Health is simple – uni-
versal health coverage for oral health
for all people and communities by 2030.
Reaching this seemingly simple yet diffi-
cult to achieve goal would enable people
to enjoy the highest attainable state of
oral health and contribute to them lead-
ing healthier and more active lives.
To put it in numbers, the overar-
ching global target of the plan is that
by 2030, 80% of the global population
will be entitled to essential oral health-
care services. The secondary plan is to
reduce the burden of oral diseases by
achieving a relative reduction of com-
bined global prevalence of the main oral
diseases and conditions over the life
course by 10%.
19 Priority: Prevention

Six strategic
objectives

To reach these goals the Global Strategy

on Oral Health outlines six strategic
objectives for the member states of the
WHO, but also for private stakeholders
and civil society organisations.
The first objective, oral health gov-
ernance, aims to improve political and
resource commitment to oral health,
strengthen leadership and create win–
win partnerships within and outside the
health sector. The global target of this
strategic objective is that by 2030, 80%
of countries have an operational nation-
al oral health policy, strategy or action
plan.

Oral health promotion and oral

disease prevention, which is the second
objective, aims to enable all people to
achieve the best possible oral health and
address the social and commercial deter-
minants and risk factors of oral diseases
and conditions. The target of this ob-
jective is for 50% of countries to imple-
ment policy measures aiming to reduce
free sugars intake by 2030.
The third objective focuses on
health workers with the intention of
developing innovative workforce models
and revising and expanding competen-
cy-based education to respond to popu-
lation oral health needs. It states that by
2030, 50% of countries should have an
operational national health workforce
policy, plan or strategy that includes a
workforce trained to respond to popula-
tion oral health needs.
20 Priority: Prevention

Oral healthcare, the fourth ob-

jective, aims to integrate essential oral
healthcare and ensure related financial
protection and essential supplies in
primary healthcare. The plan is that by
2030, 80% of countries will have oral
healthcare services generally available in
primary healthcare facilities.
The fifth objective is concerned
with oral health information sys-
tems, seeking to enhance surveillance
and health information systems to
provide timely and relevant feedback
on oral health to decision-makers for
evidence-based policy-making. It states
that by 2030, 80% of countries will
have a monitoring framework for the
national oral health policy, strategy or
action plan.
The last objective, oral health re-
search agendas, proposes the creation
and continual updating of context- and
needs-specific research that is focused
on the public health aspects of oral
health. The quantifiable target of this
objective is that by 2030, 50% of coun-
tries have a national oral health research
agenda focused on public health and
population-based interventions.
Written down like this, one after
another, these objectives and their tar-
gets might seem overwhelming at first.
But they create a common goal that all
of us – dentists, companies, policymak-
ers, organisations, politicians, and oth-
er – should strive for, together.
21 Priority: Prevention
22 Priority: Prevention
23 Priority: Prevention

Oral disease
is the number
three most
expensive
disease –
yet it can be
prevented

The cost of prevention is significantly lower than

the cost of disease
24 Priority: Prevention O B S E R VAT I O N

Bruno Affentranger

The potential for

good service in the
field of oral health
is enormous
25 Priority: Prevention
The World Health Organization’s Global Oral
Health Action Plan for 2023 to 2030 is going
to change the landscape of dentistry. How?
Bruno Affentranger, strategist and Head of the
communications department at Curaden, has
the answer.
Dentists, dental hygienists and special-
ists in the field of oral health: we have
good news for you, and we have bad
news for you. We are delivering this
news at a moment when the deep change
in the oral health industry is palpable.
We are all witnessing a turning point.
And we are all affected.
Why are we at a turning point?
The WHO’s Global Oral Health Action
Plan for 2023 to 2030 marks the first
time that the organization has given oral
health the same importance as systemic
diseases. It speaks equally of treatment
and prevention, which is also a first. It
also outlines the challenges and possibil-
ities of future oral healthcare.
This brings us to the news. The
bad first: your business will likely
change dramatically in the coming dec-
ade. While some aspects of your work
will remain, others will be completely
changed or even replaced. You will have
to say goodbye to cherished securities
and an existing business with margins.
This farewell is not easy for anyone. And
it is unsettling, because at first it is not
clear for every single player in the indus-
try what will come afterwards.
But cheer up. The good news is
that, as always, there is a future. Those
who recognise the signs of the times
today and already anticipate them will
be among the winners tomorrow. At
least among those who can continue to
pursue their business with satisfaction
and do good for their customers – for us
humans.
We can already see where the road
leads. The market is going to grow spec-
tacularly. The potential for good service
in the field of oral health is enormous.
But first you have to recognise it, you
have to prepare yourself appropriately
and you should embrace it as soon as
possible.
26 Priority: Prevention TA K E -AWAYS

KEY TAKE-AWAYS FROM THE

WHO’S GLOBAL ORAL HEALTH
ACTION PLAN
Oral disease is the number three most expensive
disease – yet it can be prevented.

Oral disease affects around

45% of the world’s population,
a higher prevalence than any other
non-communicable disease. The Ⅲ
Global Oral Health Action Plan
(OHAP) aims to reduce the dis- Global oral health expenditure
ease burden by 10% by 2030. currently stands at around 387 bil-
lion US dollars, with a very unequal
distribution across regions and
countries. Oral disease dispropor-
tionately affects socio-economically
disadvantaged people, yet treat-
Ⅱ ment is complicated by high out-of-
pocket payments due to limited oral
Oral diseases and conditions share health coverage. By 2030, 80% of
risk factors with other non-com- the global population should be en-
municable diseases, such as poor titled to essential oral care services
oral hygiene, tobacco use, exces- as part of universal oral healthcare.
sive alcohol consumption and high
sugar intake. Additional risk factors
include human papillomavirus for
oropharyngeal cancers, dental trau-
ma, malnutrition and inadequate
sanitation.
27 Priority: Prevention

Ⅳ
National leadership for
oral health is crucial. By
2030, 80% of countries should
have an operational national oral
health policy, strategy or action
plan, as well as the neces-
sary staff dedicated to oral
health at their respective
ministry of health.
Ⅴ
Countries need an efficient health
workforce to respond to their pop-
ulations’ oral health needs. The
OHAP requires 50% of countries to
have an operational national health
workforce policy, plan or strategy
by 2030.

National policies should proactively promote oral health and pre-

vent disease. That is why by 2030, 50% of countries should implement
policy measures to reduce free sugars intake, and offer guidance on
optimal fluoride delivery.
28 Priority: Prevention

Oral healthcare needs to be in-

tegrated into primary care. The
OHAP’s goal is for 80% of coun-
tries to provide oral health-
care services in primary care
facilities. In addition, at least half
of the countries should offer the
essential medicines as established Ⅷ
by the WHO.
To be able to follow up the suc-
cesses of their oral health policy,
strategies or action plan, countries
need to implement a monitoring
framework. Gathering sociodemo-
graphic information from various
perspectives (e.g. gender, age, so-
cioeconomic status and location)
should contribute to more equitable
policy.

By 2030, 50% of countries should

have a national oral health re-
search agenda in place. The re-
search should be focused on pub-
lic health and population-based
interventions.
29 Priority: Prevention Q& A POLAND

Dr. Karolina
Dudalska-Lisnyj

Patients need to
understand that
prevention is
always cheaper
than restoration
30 Priority: Prevention

Thanks to her clear vision of the practice, the

dental office of Dr. Karolina Dudalska-Lisnyj in
northern Poland is one of few practices in the
region that provides a wide range of prevention
services. The focus on prophylaxis and the whole
dental team’s will to educate patients regularly
brings new patients to the practice, who come
based on the recommendations of others.

What does your daily practice

look like?
In our daily work, we focus
primarily on an individual approach to
the patient. We try to put great emphasis
on prophylaxis, including oral hygiene.
I think that especially the way of ap-
proaching patients, understanding their
needs and adjusting the prevention and
treatment according to their individual
needs are the main values that our dental
office stands on.
Is there anything about your
dental practice that you find
unique or different when you
compare it with competitors?
I think that my practice does
have some kind of unique atmosphere.
We are also glad that our office is the
only one in this area that provides such a
well-developed range of preventive ser-
vices. We also devote most of our time
to teaching our patients about proper
oral hygiene, which is unfortunately not
so common here.
31 Priority: Prevention

What does the word ‘preven-

tion’ mean to you? And can
you tell us more about the
ways you approach it at your
dental practice?
I can say that prophylaxis
is basically a treatment in my office.
Because without proper oral hygiene,
there is no long-lasting effect of any
dental treatment. Today we live in an era
when orthodontic appliances, implants
and veneers are quite common and
trendy, but some specialists forget that a
patient who has not been taught proper
oral hygiene will not be able to maintain
these implants, or other results of these
complicated treatments, for a long time.
Patients just underestimate prophylaxis,
so we are trying to show them the bene-
ficial effects of it and encourage them to
take care of their own oral health.
32 Priority: Prevention

Based on your experience, do

you think it’s possible to turn
a prevention-based dental
office into a profitable model?
It is definitely possible for
prophylaxis to be as profitable as oth-
er branches of dentistry. But at first,
dentists need to change the way their
patients think about it. It is important to
show them that even the most expensive
prophylaxis is cheaper than any restora-
tive treatment.
33 Priority: Prevention
“When prevention
is approached
properly, patients
are more satisfied
with the final effect
of their treatment,
they feel more
cared for, and last
but not least they
recommend the
office to others.”
Moreover, there is one thing
that is often forgotten often, and this is
the final outcome of a dental treatment –
which is always better and lasts longer
when combined with proper oral hy-
giene. When prevention is approached
properly, patients are more satisfied
with the final effect of their treatment,
they feel more cared for, and last but not
least they recommend the office to oth-
ers, which definitely affects the income
of the practice. I am sure that putting a
focus on prophylaxis always pays off.
You have already mentioned
that a big part of your job is
educating your patients. You
also share various educational
posts on your practice’s social
media. What ways of teaching
your patients do you use?
For me, the basis of prevention
is education. My assumption is that you
can’t expect something from a patient
if you haven’t taught it to them first.
Together with the hygienist, I try to
show, teach and explain how patients
have to take care of their oral cavity.
We also try to develop the cor-
rect patterns from an early age. Once
a year we attend prevention lessons in
kindergarten. We have also started edu-
cating pregnant women. Events promot-
ing prevention are regularly carried out
in our dental office.
34 Priority: Prevention TA K E -AWAYS

THE HIGH COST OF ORAL

DISEASE
Untreated oral disease has severe and debilitating
consequences, ranging from physical symptoms to functional
limitations and adverse effects on emotional, mental and social
well-being. The costs of treatment, when accessible in the first
place, pose a significant economic burden.

$387 $323
BILLION BILLION
$50
The cost of
direct public The cost of oral
Productivity diseases per person
and private
losses stemming per year globally
spending on oral
from oral
diseases across 194
diseases globally
countries in 2019
in 2019
35 Priority: Prevention

THE LOW COST OF

PREVENTION
Preventing oral disease through daily oral care is the most
cost-effective solution. A study by the Economist’s Intelligence
Unit comparing business as usual to a scenario that includes the
prevention of gingivitis found that the latter scenario results in
more healthy life years per patient and less costs. In addition,
preventing gingivitis eliminates oral disease as a risk factor
common for other non-communicable diseases.

● If we consider an
elimination of inci-
● Preventing gingi- dent gingivitis (for
vitis through daily example, through
● Elimination of
home care is the most improved oral
gingivitis would be
cost-effective pre- homecare), the to-
45.4% less expensive
ventive measure and tal HLYs would rise
than sticking to the
produces the highest in all countries at
status quo.
Healthy Life Years an incremental in-
(HLYs). crease of 5.7m HLY
compared to the
baseline.
36 Priority: Prevention
37 Priority: Prevention

We can
really make
a difference

Seven dental pros share their view on patient care

38 Priority: Prevention Q& A N O R WAY

Amanda Dalila
Sahnoun

I want to be in
the first line to
help beat lifestyle
diseases – one
mouth at a time
39 Priority: Prevention

Dental hygienist Amanda Dalila Sahnoun is a true

supporter of prophylactic thinking. For her, being
a good dental hygienist means that you can adapt
to the patients’ needs and guide them on their
unique road towards that goal.

What is your dental philos-

ophy and the core values of
your daily practice?
I believe that if we give pa-
tients our time and really listen to them,
we can help them with so much more
than just a check-up.
As a hygienist, I see my patients
on a regular basis – not a lot of people
working in healthcare can say that.
I have a unique opportunity to affect my
patients’ lifestyle choices, in terms of
explaining the good and bad habits that
have an impact on their oral and general
health. I believe in talking to patients as
equal human beings; I don’t see myself in
a higher position than them.
What does high-quality pa-
tient care mean to you?
Seeing patients and thinking
about their total health, not only their
oral health. What my patients put in
their mouth can potentially be bad for
their teeth and oral health, and therefore
also their general health, all of which
affects their life, family and, on a larger
scale, society.
40 Priority: Prevention
We can help prevent a lot of
the main causes of poor life quality and
bad health. As we know, oral healthcare
and systemic diseases go hand in hand.
If we are good motivators and work
with our patients as a team – towards
reaching a common goal – we can really
make a difference.
How do you motivate patients
to maintain good post-treat-
ment oral care?
I always give them a free check-
up four weeks after a treatment. One
reason is to do a check-up, but also to
keep them close so I see them earlier
than in six months’ time.
I do care about patients, and
I want them to see me often to build a
good relationship. In their first year I
tend to see them more frequently, until
I have enough data to understand what
their routines are like and to customise a
plan that is suitable for them.
What changes do you wish to
see in your field during the
next five years?
More prophylactic thinking!
And an even bigger focus on the connec-
tion between oral and general health.
I want to be in the first line to help the
world beat lifestyle diseases – one mouth
at a time.
What is a common stereotype
of dentistry you dislike?
That dental hygienists are only
teeth cleaners. I spend a lot of time ex-
plaining what I do and why I work the
way I do. Educating our patients is very
important. I have realised that knowing
the ’whys’ increases patient compliance.
What is one piece of ad-
vice you give most of your
patients?
Prophylactic treatment is the
best and most successful treatment. The
biggest threats to our mouth, teeth and
body can be kept away if we think in a
prophylactic way.
What is the most underesti-
mated oral care routine from
your point of view?
Brush thoroughly, with the
correct technique, and don’t ever skip on
interdental cleaning.
Interdental spaces are dead
spaces where there is no friction from
the lips, tongue, chewing or saliva.
We must manually interrupt the biofilm
here as it is completely hidden, so it can
grow easily and do damage. I show my
patients what to do in the mirror. This
is much more effective than telling the
patients on their way out the door that
they must floss.
Which skill and character fea-
ture is an absolute must-have
in your job as a specialised
dental hygienist?
Be knowledgeable and interest-
ed in people and guidance, but don’t ever
think you are superior to the patients.
Be personal and professional at the same
time – as I like to call it, be ’perfessional’.
Learn more about the bigger
picture; think about oral care as the key
to general health. Spend time with your
patients, as it is the most you can give
them in a society where everything is
supposed to take less and less time. Stop,
listen, and help people.
41 Priority: Prevention Q& A MEXICO

Dr. Sarah Ocaña

Chacón

A true professional
should focus on
maintaining oral
health rather than
treating diseases
42 Priority: Prevention

A dentist, periodontist, student and lecturer,

Dr. Ocaña Chacón says that being both a student
and a teacher motivates her to try to be a better
dental professional. She also has an essential
role in dentistry in Mexico as she helps to form
and design the education of the country’s future
periodontists.

What routines do you find What does the word ‘preven-

most critical for maintaining
proper oral health?
It’s essential to find time once
a day to ‘pamper’ your mouth – and by
pampering I mean brushing properly
and cleaning in between your teeth. I
live in Mexico City which is very chaot-
ic; there are many people, a lot of traffic,
everyone is always running late due to
long distances. Yet, we all manage to
find the time to take a shower. So, why
should we not also be able to find the
time to brush our teeth properly?
Depending on your sched-
ule, you may have more time to brush
at night than in the morning, but the
important thing is just to make sure to
spend enough time with your mouth.
And yes, it is important to take showers,
but I tend to say, ‘a clean mouth is more
important than a clean armpit’, so do not
forget to brush daily.
tion’ mean to you?
To me, prevention means re-
sponsibility and ethical practice. A true
professional should focus on maintain-
ing good oral health rather than treating
diseases. I really believe prevention is
the future of dentistry and that dental
professionals around the world should
start shifting the focus of dentistry as a
curative profession and turn it towards
prevention.
What is your ‘golden rule’ or
advice that you tell your pa-
tients often?
I often tell my patients to think
about how much their mouths do for
them. Through your mouth you eat,
you speak, you smile, you kiss. You use
it 24/7. So it seems fair to me that you
should ‘thank’ your mouth every day,
and the way to do so is to have a proper
oral health regime.
43 Priority: Prevention
Always remember that preven-
tive dentistry is not expensive, but den-
tistry that comes from neglecting your
oral health is.
What’s the biggest challenge
of your job?
I find it hard to convince col-
leagues that prevention and periodontal
health are key to the success of every
treatment. I often receive patients who
have been treated for years and have
beautiful restorations but have severe
active periodontitis and were never told
they had periodontal disease or even
taught how to brush properly. I always
tell my students that none of their treat-
ments will be successful if they don’t
start with an individualised oral regime
for each patient.
“A clean mouth is
more important
than a clean armpit.”
What’s the thing that you like
about your job the most?
Being able to give patients a
pleasant dental experience. Many pa-
tients come to the office with precon-
ceived notions that going to the dentist
is painful – even torturous, expensive
and not that important. Whenever I
treat a patient and they say “that didn’t
hurt at all” or they come for a second
visit and are eager to know if they’ve
improved their brushing habits, that just
makes my day. Changing the negative
perceptions towards positive dental
treatments and oral health makes me
happy.
What’s the most important
thing in terms of oral care
routine from your point of
view?
Finding the right tools for me-
chanical biofilm control at home, and
learning how to use them. A proper oral
health regime is not like a cooking reci-
pe; different people have different needs
and different needs require different
tools. Following the recommendations
of your oral health provider and going
to periodical check-ups is essential. Oral
diseases don’t always hurt in the early
stages, so just because you feel fine, it
doesn’t mean you can skip your dental
check-up.
What’s the biggest oral health
myth that you fight against?
There are so many! But I think
nowadays one of the popular myths is
‘a dental implant is just like your natural
tooth’. They’re not! Whenever it’s pos-
sible, we should always try to save our
patients’ natural teeth!
44 Priority: Prevention Q& A JA PA N

Dr. Fumihiko Kimura

Prevention means
extending the
longe­vity of one’s
health and life
45 Priority: Prevention

Periodontist and endodontist Dr. Fumihiko Kimura

is relentlessly devoted to teaching other dental
professionals how to treat endo-perio lesions, and
to never give up. Dr. Kimura is the kind of dentist
who’s always full of beans, and ready to show
kids how to look after their teeth – in the most
entertaining way.

What routines do you find

most critical for maintaining
proper oral health?
To live one’s life to its full po-
tential, one should take care of oneself
on multiple levels – and by this I don’t
only mean going for regular dental re-
calls and taking care of their mouth.
Leading a healthy lifestyle also means
exercising, cooking, reading books, even
going to beauty salons. To be able to do
all this, keeping ourselves motivated is
key – and a foundation for everything
else.
What does the word ‘preven-
tion’ mean to you?
From my point of view, pre-
vention means to extend the longevity
of one’s health and lifetime.
What is your ‘golden rule’ or
advice that you tell your pa-
tients often?
Inspiration is vital to nurture
the ever-present need to grow and have
a quality life.
46 Priority: Prevention
What’s the biggest challenge
of your job?
The biggest challenge for me
is to establish a new classification for
endo-perio disease in cooperation with
clinicians from all over the world.
What’s the thing that you like
about your job the most?
In my daily practice, I often
come up with many new things in terms
of processes or approaches that aren’t
universal yet. I love sharing my findings
and views with other dentists around
the world, and seeing that I can contrib-
ute to better preventive care.
What’s the most important
thing in terms of oral care
routine from your point of
view?
From my perspective, any den-
tal professional has to find out what’s
precisely going on with a patient’s
mouth and determine the the correct di-
agnosis. To do that, us dentists also need
someone trustworthy who can coach us.
What’s the biggest oral health
myth that you fight against?
A false prognosis that en-
do-perio disease cannot be cured. If you
understand the strategy of preserving
teeth, there is a good chance of saving
them.
47 Priority: Prevention

“What my patients
put in their mouth can
potentially be bad for
their teeth
and oral
health, and
therefore also their
general health,
all of which
affects their life, family
and, on a larger scale,
society.”

Amanda Dalila Sahnoun

48 Priority: Prevention Q& A THAILAND

Dr. Kanokwan
Urthamapimuk

Patients will
lead the change
in dentistry
49 Priority: Prevention

Dr. Kanokwan Urthamapimuk, or Dr. Catt, is an

experienced dentist who owns two dental clinics
in Bangkok. The philosophy of her practice
revolves around patient-centric dental care.

What is your dental philos-

ophy and the core values of
your daily practice?
I perceive dental services as
a personal health service because a
dental service in itself is personal. It is
very unique to every individual. In our
practice, we have coined the term ’pa-
tient-centric’ dental care to represent
our philosophy of putting our patients
at the centre. We customise our service
to suit each of our patients according to
their personality, interests and health
prognosis. Our goal is to help our pa-
tients take care of their health by im-
proving their oral health their way.
What does high-quality pa-
tient care mean to you?
In my opinion, the patient
should be the judge of the quality of
care. Therefore, to qualify as high-qual-
ity care, the service needs to have pa-
tients involved in every step of their
treatment, as well as prepare them
to take care of themselves after the
treatment.
50 Priority: Prevention

Quality treatment follows the

academic knowledge and the science
of dentistry. On the other hand, with
high-quality care, it is important to con-
sider other aspects as well, such as the
patient’s psychological preferences and
behavioural issues. This will turn ‘uni-
versal’ patient care into ‘personalised’
care. This is what premium-quality pa-
tient care means to me.
How do you motivate patients
to keep good post-treatment
oral care?
It starts from establishing the
right relationship at the very beginning.
I clearly explain the patient’s role in
achieving the expected outcome. I let
them be part of the analysis of the prog-
nosis and of the condition of their oral
health. We want to make sure that the
patient understands that it’s not only up
to us as dentists but they also have a job
to do. I start this process early and guide
the patient through it based on their
individual needs.
“A common myth
is that the patient’s
oral health is the
sole responsibility
of the dentist.”
I believe that the key factor to
establishing this relationship is to share
a common goal and understanding.
I show the patient the photos of their
oral cavity, teeth, gums, etc., and explain
what they see. Of course, different pa-
tients will need different types of guid-
ance. Then we continue with follow-up
actions. Patients need to see the progress
of work on their part as well as on our
part. As motivation works both ways,
you want to make sure that our goal as
dentists is to guide patients to ‘motivate
themselves’ in the end.
How do you educate yourself?
Reading books, research papers
and educational content from both the
Thai FDA and internationally. Watching
YouTube, listening to podcasts, attend-
ing paid and free courses on the subjects
of my interest. But the key learnings
come from my own patients and my own
team, when I try to apply what I learned
from others to live action. This is when
the real learning happens for me.
51 Priority: Prevention
What change do you wish to
see in your field during the
next five years?
I wish there would be sufficient
patient interest to convince dentists
that it is important to be their trainer
and educator, rather than just the ‘fix-
er’. Patients will drive the change in
dentistry.
What is a common stereotype
of dentistry you dislike? How
do you cope with it?
There are so many! For exam-
ple, patients perceive that dentists are
just after patients’ money, because den-
tists do just a little work and yet charge
sky-high prices. Or that dental services
are not important and are negotiable.
Another common myth is that the pa-
tient’s oral health is the sole responsi-
bility of the dentist. These are the ones
I dislike the most. Unfortunately, some-
times it’s our peers who contributed to
these stereotypes.
I manage it by being different
and letting my work speak for itself. My
way of working is to show patients that
there are dentists who are different from
those they have experienced previously.
I put the patient’s health and their inter-
ests at the centre of my work.
What is the advice that
most of your patients hear
from you?
Clean it right and keep it
clean. And then all the pain, treatment
expenses and time for fixing will be
unnecessary.
What is the most underes-
timated oral care routine
from your point of view?
How do you try to stress its
importance?
Checking your cleaning per-
formance. In most cases, people do clean
their teeth, but they seldom evaluate
whether the outcome corresponds to
what they really need.
Which skill and character fea-
ture is an absolute must-have
in your job as a specialised
dental professional?
To be empathetic.
52 Priority: Prevention Q& A DENMARK

Dr. Annemette Sabroe

All our patients

are very interested
in self-care and
prevention
53 Priority: Prevention

Meet Dr. Annemette Sabroe, a dentist with

decades of practice, who does everything for
the long-term dental health and happiness of
her patients. Her own childhood dental trauma
convinced her to study dentistry.

What was your path to den-

tistry? Why did you decide to
study this field?
When I was an 11-year-old girl,
back in 1974, I had a dental trauma that
required several treatments at the den-
tist. I think this is the time I started to
be interested in dentistry.
I graduated from the Royal
Dental College in Copenhagen in 1987.
After my studies I gained experience
working in Lausanne, Switzerland
and various different private clinics in
Denmark. In 1994 I became a self-em-
ployed clinic owner.
Could you tell us more about
your private clinic?
My practice is in the town of
Skanderborg in an old hospital build-
ing. Now it is used as a health centre
connecting many different healthcare
practitioners, laboratory testing, a di-
agnostic imaging centre, and more. At
my dental practice we are five people:
me – the dentist, two dental hygienists
and two dental assistants. We provide all
aspects of general dentistry, including
endodontics. Our main focus is on per-
forming high-end dentistry and thereby
obtaining a long-lasting relationship
with our patients: ‘the ambassadors of
the practice’.
54 Priority: Prevention

What are the special features

of your dental practice from
your point of view?
In 2020 we were the first
Danish clinic to be iTOP Advanced
certified. All our patients are very inter-
ested in self-care and prevention. Our
core values are a passion for aesthetic
restorative dentistry, balancing proper
diagnostic and treatment planning to
achieve long-term dental health and
happiness for our patients.
You’ve been treating patients
since the 1990s. What’s the
current state of oral health in
your country? Are there any
major improvements needed?
The status of oral health
in Denmark is in general very good.
However, there is an increasing number
of elderly people with chronic diseases.
There is also a connection
between chronic diseases and perio-
dontitis – this requires frequent and
thorough scaling and root planning at
the hygienist or dentist. The healthcare
system in Denmark is not properly set
up for this group of people who require
extra check-ups with the dentist or den-
tal hygienist. This group, among others,
is often bound to make out-of-pocket
payments for these extra visits – this has
a negative impact and can also entail
absence and unpleasant remarks. In the
long-run, improvements are needed, but,
this is a matter of structural changes in
the healthcare system so that we can be
well prepared for the future.
55 Priority: Prevention

“Clean it right
and keep it clean.
Then all
the

pain,
treatment
expenses and time
for fixing will be
unnecessary.”

Dr. Kanokwan Urthamapimuk

56 Priority: Prevention
VOICES FROM BRAZIL
Prof. Eduardo Sampaio
We must highlight the
importance of dentists as
health promoters
EXPERIENCE
“I’m a lecturer and specialisation-course
professor. My favourite part is seeing
our students grow and improve. I love
seeing how they change their philos-
ophy, integrating and caring for the
patient’s entire health, not only oral
health.
The main message that I always try
to impart to my students is that dentist-
ry is a profession that requires ethics,
responsibility and a lot of attention
to the patient – always seeing the pa-
tient as a whole. We must highlight the
importance of professionals as health
promoters to bring the message of oral
prevention to everyone. This will help
us prevent oral problems from being as
prevalent as they are today.
I believe that dentistry is transform-
ing, both by the evolution of technical
and scientific knowledge, and by the
quality information on prevention of
oral diseases that the population has
access to today.
The technical and scientific evolu-
tion gives us more resources to treat the
most diverse oral problems. However,
the recent change in the population’s
concern with oral prevention means that
we will need to review the educational
curricula of dental schools, which today
are predominantly focused on treat-
ments, leaving preventive techniques
forgotten. I hope to see prevention take
its right place in relation to oral prob-
lems, and with that, fewer people suf-
fering from diseases caused by a lack of
oral care.”
57 Priority: Prevention
Dr. Fernanda Castelo
Aesthetics should not be
put above oral and overall
health
“I have been a periodontist for 18 years
and I have learnt that welcoming my pa-
tients without any judgement generates
a relationship of trust and motivation,
which is important for effective treat-
ment. To make treatment efficient, it is
necessary to provide guidance and ex-
planations on a patient’s present diseases
and to monitor any changes in their oral
hygiene routine. A high-quality service
is one in which the professional and the
patient work together and cooperate
with a sole objective in mind: of improv-
ing and maintaining the patient’s oral
health.
If we want to motivate patients
to cooperate, they need to understand
why it’s important. From my experi-
ence, when I explain that the disruption
of the oral biofilm is necessary for the
prevention of oral diseases, the patient
understands and, as a result, becomes
motivated. In addition, every patient is
different, which is why it’s important to
provide them with individualised rec-
ommendations of products for effective
oral hygiene. They need to know what
tools to use and how. This is essential for
them to stay motivated.
Unfortunately, we still see many
dentistry professionals who put aesthet-
ics above oral health. That’s just wrong.
My way of dealing with this is to do
my best to contribute to the training of
professionals. Good training should be
aimed at integral health and place the
patient’s overall health as a priority, way
above aesthetics.”
58 Priority: Prevention

Key take-aways
from chapter one
59 Priority: Prevention

01 02
The oral care indus- This change will impact the
try is changing. It day-to-day nature of dentist-
is moving towards ry. Many aspects of current
prevention, in part dentistry work will disappear,
inspired by the some will remain, and oth-
WHO’s Global Oral ers will be completely new.
Health Action Plan The potential brought on by
for 2023 to 2030. the refresh of dentistry is
The plan sets a enormous.
target that by 2030
80% of the global
population will be
entitled to essential
oral healthcare
03
services. Many dentists are already
spearheading the change.
Leading prophylaxis-orient-
ed clinics; motivating their
patients towards prevention;
focusing not only on patients’
oral health but also their
overall health; and spreading
new approaches among their
colleagues.