John Wilcox is a highly organised man. He holds down a responsible position in corporate planning at local government level. He washes his car once a week, fills out a tax statement soon after June 30, makes sure his two boys are never disappointed on their birthdays and visits his elderly parents every other Sunday for a roast lunch.

But there is one appointment that rarely gets punched into his palm organiser: a visit to the dentist.

He says cost and forgetfulness are the reasons for the neglect, but upon closer ‘examination' John, 45, has a deep-rooted fear of what might happen once he allows himself to be strapped into ‘the chair', tipped backwards and blinded by a large spotlight.

“It's the sound of the drill,” admits John. “It just seems completely out of proportion to what's probably going on. And the smell of ground (drilled) teeth. The fear of what happens if they drill too far is part of it.”

High Anxiety

This anxiety is very common. Studies in America have shown that 50% of the population do not seek regular dental care. An estimated 9-15% (or between 30-40 million) stay away due to some anxiety stemming from a bad experience, the media or friends who have told them horror stories.
“People can feel very vulnerable,” says Dr John Bartak, who runs a busy practice near La Trobe University in Melbourne's north-east.

“They will put up with a sore finger, but when the pain is in the head, this is a more intimate place and there is more fear.”

The perceived financial cost of a visit is also a deterrent, and it's easy to forget that the fee is spread over six to 12 months.

“I completely forget to go until I reckon something's wrong,” admits Linda Oon, 35. “When I have gone for a check-up, it seems to cost more than servicing the car.”

Children commonly have regular treatments. Once they hit 20, leave home and take more responsibility for their lives, the young adult sets dental care at a low priority until he or she can resist no longer due do:

Guilt – “I'm an idiot for not going, I ‘should' be more responsible.”
A sore or chipped tooth – “Why does it hurt so much when I eat this pear?”
Common sense – “Better clean up my act, prevention IS better than cure.”
Vanity – “Is it too late to straighten my teeth? Does my breath really smell that bad?”

Consequences

Baby boomers will know that many of their grandparents had white, straight, perfect teeth. At 80! This was because they weren't real. They could be removed, scrubbed and plopped in a glass of water by the bed.
While teeth will still fall out with chronic neglect, dentures are far less common these days according to Dr Bartak.
“People are more educated about dentistry and have higher expectations,” he says. “Few people expect to end up with false teeth. Dental techniques have become more pleasant and people are going in for more cosmetic procedures.”

While losing all your teeth is an extreme outcome of long-term neglect, studies demonstrate that, as we age, our quality of life, general health and self-esteem are directly related to our oral health. If that's not enough, research also indicates a strong link between gum disease and cardiovascular disease.
Perhaps this is because the worse thing you can do for your teeth and for your waistline is to snack on food containing sugars or starches.

That coffee with half a sugar you relish at 11am…

The chocolate biscuits you snaffle from the office kitchen….

The can of soft drink you sip on all afternoon to keep awake….
Those dried apricots you pack for a special treat…

All bad news, unless you drink some water straight away or take a toilet break and brush your teeth at regular intervals throughout the day. And if you suspect you have bad breath, brush your tongue as well and rinse out with a safe mouthwash.

Signs of rot

The main cause of teeth problems is gunk (more commonly known as plaque) building up in, around and on the teeth.
Micro-organisms in food debris cause havoc in the mouth if not brushed and flossed away.

Over time, you may experience the following problems:

• A centralised pain for no apparent reason
• A piece of tooth chips off, again without explanation
• Gum conditions deteriorate leading to bleeding or soreness due to loose teeth
• Nerve damage, swelling on the gum, tenderness when eating
• Sensitivity to heat, indicating that a nerve is dying
• Bone loss in the mouth
• Brittle teeth
• Enamel wears off the teeth
• Difficulty chewing
• Oral cancer due to smoking or poor dietary habits. A primary tumour in the mouth can produce secondary lesions in the bone.

Reality Check

Like most things, the longer you leave it the more the financial outlay. Bridge, dentures, implants and other complicated procedures will dent the pay packet, but the best action is to take action.
If your prognosis is sunny and/or you've been blessed with strong teeth, count yourself lucky and make sure you keep having regular six to 12 month check-ups.

If there's some work to be done, be thankful and press on with treatment.

If there's a lot to be done, don't beat yourself up over it: work out a sensible plan of action with your dentist and invest in your mouth. Of course, it doesn't have to become a dire situation if you make a habit of the following:

• Limit snacking between meals. Acids attack your teeth for up to 20 minutes after you have eaten foods containing sugars or starches.
• Brush/floss regularly, especially after eating sweet foods.
• Snack on raw vegetables to stimulate saliva. This helps protect teeth against plaque.
• Visit the dentist between 6-12 months.
• If you have bad breath, use a non-sweet freshener, not peppermints or sugary lozenges.
• Drink lots of water.

A word on costs

In Australia, there is no such thing as a ‘recommended fee' for any dental treatment. A dentist charges what he or she thinks is appropriate for the service they provide, taking into account all their costs and the particular circumstances of each treatment.

The suggestion that some dentists depart from an ‘approved' or ‘recommended' level of fees, thereby increasing the gaps between the fee and the Health Fun rebates is both false and misleading.

In fact, it is against Trade Practices law for dentists to collude in the maintenance of any set fee scale.

Health Funds set their rebates at a level that suits their commercial needs. Those rebates are not related to any recognised fee scale. The responsibility of adequately adjusting rebates lies with the Health Funds. (Australian Dental Association)

Useful Sites

www.australiandentaldocshop – find a dentist

www.aboutsmiles.org/prevh.htm – basic dental information

www.floss.com – explore your dental fear

www.ada.org.au/ - Australian Dental Association