PSILENT PRODUCTIONS
Dr.
Gregory Psaltis
Olympia,
WA
Phone
and FAX: (360) 413-5760
e-mail: drpsaltis@orcalink.com
Website: www.psaltis.info
I Was on
the Internet Last Night
Behavior
Management in a Pediatric Dental Setting
I. Opening
remarks
A. Topics
will be controversial
B. My goal
is NOT to convince anyone of a given topic
C. The
first goal is to provide a broader picture of the internet’s
impact
D. The
second goal is give suggestions on how to deal with patients’
input
II. Why the
Internet “problem” has become so common
A. It is where everyone goes for
information now
B. The number of searches
has increased exponentially
C. There are blogs/opinion
pieces/factual sites to satisfy every situation
D. These sites will also
cater to your own beliefs
E. A couple of controversies
1. Autism
2. Flossing
III Why
Science is challenged today
A. Charles Taber, PhD
1. People seek out
information that is motivated by their own reasoning
2. We are all fundamentally
biased and tend to perpetuate our own beliefs
B. Brendan Nyhan, PhD
1. Trying to correct a
misperception can backfire
2. Your belief grows
stronger when you encounter facts that don’t support it
C. Factors
that effect your own beliefs
1. Social
media
2. The
press has become partisan
a. The
station do you watch/listen to will influence you
b. Your
beliefs will usually be supported by your choice
3. Gabriel
Sherman: The
Loudest Voice in the Room
a. News is
no longer a means of information about the world
b. We now
tend to gather information that advances our own beliefs
e. Every
single action in a practice is creating managed behavior
4.
National Geographic, March, 2015
a. We live
in an age when all manner of scientific knowledge faces
opposition
b.
Doubters have declared war on the consensus of experts
5. Andrew
Shtulman, Occidental College
a. As we
become scientifically literate, we repress our naïve beliefs
b. In
spite of that, we never eliminate these beliefs entirely
c. Even
scientists are vulnerable to confirmation bias
d.
Science appeals to the rational brain
e. Our
beliefs are largely motivated by emotion
6. Neil
deGrasse Tyson, PhD
“I
fear we have lost the ability to judge what is true and what is
not.”
7.
However, surveys show that more people trust scientists than:
a.
Congress
b.
Executive branch of the government
c. The
press
d. People
who run major companies
e. Banks
and financial institutions
f. The
Supreme Court
g.
Organized religion
8. Daniel
Kahan, Yale University Law Professor
a. Issues
like climate change isn’t about what you know
b. The
issue is about who you are
c. It is
not about knowledge, but curiosity that makes us accepting of
science
9.
Christopher Graves, President, Ogilvey Center for Behaviorial
Sciences
a. People
cannot grasp something as fact if it undermines their identity
b. More
access to information doesn’t tug us toward the center, but
makes us more
polarized
10. Marcia
McNutt, PhD, Director of National Academy of Sciences
a. Science
is about the unbiased search for the truth
b.
Scientists test intuitions to see if they are right
IV. Some
of the current controversies
A. Humans
are causing global warming
1. NASA’s
Goddard institute’s data about temperature increase over time
2. Union
of Concerned Scientists, August, 2017 website (ucusa.com)
a. Human
influence on the climate is clear
b.
Greenhouse gas emissions are ghe highest in history
c.
Observed changes since the 1950’s are unprecedented over decades
3.
Environmental Research Letters, Vol 8, No. 2, May 15, 2013
a.
Multiple studies in peer-reviewed scientific journals show 97%
or more agree
b. Climate
warming trends are likely due to human activity
c. Most
leading scientific organizations worldwide have issued
statements that
endorse
this position
4.
National Review article, May 22, 2015 (author: Rupert Darwall)
a.
Isolated phenomena is a substitute for the real thing
b. The 18
year failure of average global temperature to rise is a problem
c. Global
warming warming is preeminently a political project
d. The
role of experts is to provide scientific consensus to support
the alarm
B. Breast
feeding causes Early Childhood Caries (ECC)
1. The
empirical viewpoint
a. Very
young children have caries (perhaps even ECC)
b. The
child’s mother reports the child “only breast feeds”
c. We
decide breast feeding caused the caries
2. The
scientific view
a. No
evidence establishes this link
b. Too
many variables blur the results
c.
Mother’s milk has multiple benefits
3. The
AAPD (American Academy of Pediatric Dentistry) position
a.
Frequent night-time bottle-feeding with milk and ad libitum
breast feeding are
associated
with, but not consistently implicated in ECC
b. Breast
feeding in combination with carbohydrates in vitro in highly
cariogenic
4. The ADA
(American Dental Association) position
“Unrestricted,
at-will nocturnal breast feeding after eruption of the child’s
first
tooth can
lead to increased risk of caries” (from the ADA website)
C. Mercury
in dental fillings is harmful
1.
The FDA (Food and Drug Administration) position (from its
website)
a. Dental
amalgam is strong and long-lasting
b. It is
less likely to break than other fillings
c. It is
the least expensive type of filling
d. Based
on evidence, FDA considers it safe for adults and children over
6
e.
Evidence has found no link between dental amalgam and health
issues
2. The ADA
position (from its website)
a. Dental
amalgam is durable and affordable
b. There
is no justification for discontinuing it
c. The DFE
World Dental Federation and the World Health Organization
concluded
in 1997 that “no controlled studies have demonstrated adverse
effects
3. From
toxicteeth.org (website)
a. Amalgam
is called “silver fillings” to deceive consumers
b. Amalgam
is unstable after it is implanted into human teeth
c. Amalgam
releases mercury vapor into your body, which bioaccumulates
d. Dental
mercury endangers our health
4. Doctor
Oz (from doctoroz.com)
a.
Scandinavian countries banned amalgam fillings in 2008
b. Swedish
studies showed 78% of patients with chronic fatigue syndrome
reported
improved
health after removal of amalgam fillings
c. Studies
correlate number of dental fillings to incidence of cancer
mental
conditions,
thyroid conditions, neurological conditions and others
5.
International Academy of Oral Medicine and Toxicology (IAMT)
D.
Fluoride is dangerous to your health
1. The
AAPD position (from the AAPD Reference Manual, Page 45)
a. It
affirms the safe and effectiveness in reducing the risk of
caries
b. It
encourages public health officials and health care providers to
optimize
fluoride
exposure
2. The ADA
position (from ada.org)
a. More
than 70 years of research has shown fluoride to be safe
b. The CDC
named community water fluoridation one of the 10 great public
health
achievements
of the 20th century
3. The
IAMT position (from the iamt.org website)
Policies
should reduce and work toward eliminating avoidable sources of
fluoride
V. Some
discrepancies in the data
A. Excess
salt can lead to increased blood pressure
1.
Lawrence Appel, MD, Professor of medicine at Johns Hopkins
University
a. The
food supply is loaded with salt, which we know raises blood
pressure
b. Almost
everyone should cut back
2. Suzanee
Oparil, MD, Professor of medicine at Univ. of Alabama
a.
Spokesperson for the American Heart Association
b.
There is zero evidence that reducing salt is beneficial
3. L.
Gabriel Navar, PhD, Chairman, Dept. of Physiology, Tulane
University
a. The
factor here is not how much salt one consumes
b.
The factor is whether your body can process the sodium it
contains
B. Which
sealant technique/material is the best?
1. JADA,
Feb 2012, pp. 115-122
a.
Compared resin-based and glass ionomer sealants
b. 24
month followup indicated glass ionomers may be a better choice
2.
Pediatric Dentisty, Jan-Feb 2012, pp. 46-50
a.
Compared resin-based and glass ionomer sealants
b.
24 month study indicated resin-based sealants were better
retained
C.
Formocresol is genotoxic
VI. Four possible
scenarios
A. Parent
wants no x-rays
B. Parent
wants only “tooth-colored” crowns—not silver (stainless steel)
C. Parent
wants no crowns at all—only fillings for large lesions
D. Parent
wants no fluoride for the child
VII. How I view
these four scenarios
A. Parent
wanting no x-rays is a ________________________ issue
B. Parent
wanting tooth colored crowns is a _______________________ issue
C. Parent
wanting no crowns is a ________________________ issue
D Parent
wanting no fluoride is a ________________________ issue
VIII. Other
techniques for dealing with issues
A. Listen
first, talk later
B. Do not
get into a scientific/emotional “fly-by”
C. Ask,
“is there more?” until parent/patient has said everything
1.Each
time the “heat” will be reduced
2.
Parent/patient will definitely feel “heard”
D. Do not
try to convince them of an opposing opinion
E.
Determine if the issue is ethical, preference, outcome or
non-essential
F. State
your truth and be ready to send the patient elsewhere
©PSILENT PRODUCTIONS, 2020