There are 8760 hours in one year. If you are following the advice of your dentist, you will have two cleanings with check-ups per year. This means you spend about two hours in the dental office receiving preventive care, which is point 023% of your entire year. You are on your own for 8758 hours each year. Can such a tiny fraction of your year really make your mouth healthier? The answer is a resounding YES, but perhaps not for the reason you might think.

My own personal experience over the last 30 years corroborates the above studies. I generally have three different kinds of patients. The first group generally come for cleanings twice annually. The second group come semi-regularly for cleanings. The third group only come when there is a problem. The first group has the best teeth, followed by the second, and lastly the third. My most proactive patients (I have many) are generally into healthy lifestyles and are more interested in learning the many ways to improve their health. My group of patients that only come when there is a problem are most often express bewilderment as to why they have so many problems. Most politely listen to my advice about healthier food choices and smoking cessation but do nothing.

A 2010 study that periodically followed about 1000 people from age 15, again at 18, 26 and lastly 32, showed that those who went for routine dental visits had better oral health, and that the later in life the routine visits continued, the better the oral health was. In this study, routine visits were defined as having had a check-up or scheduled an appointment within the year. (1) Sadly, routine attendance fell from 82% at 15 years of age to only 28% at 32. Conversely, another study of episodic problem-oriented visitors showed that they had three times the number of missing teeth when compared to routine visitors. (2) So clearly, having routine dental visits is associated with much healthier mouths!

The 2001 study admittted that it was unclear whether the difference was in the actual care and advice given, or it was reflecting a “healthy user” bias. (3) Let me explain the healthy user bias. Consider cigarette smokers; cigarette smokers are generally less healthy than non-smokers. The problem is that they usually have other bad habits like poor diets, poor sleep and lack of exercise, which confound any study comparing them to a control population. Conversely, there exist several studies that show when people make a healthy choice in life, they are usually making several other healthy choices.  

When scientists study a group doing something deemed healthy and compare them to control group, does it prove that the one behavior under consideration is the cause of better health? No. Due to the healthy user bias, It is most likely the sum of several healthy behaviors. A classic example is comparing vegetarians to meat eaters. Several studies have shown that the vegetarians are healthier than omnivores. The explanation given is that meat is (erroneously) considered a “bad” food. If you don’tcare that it is bad for you, then you are likely not concerned with other unhealthy behaviors and will have some. However, when patrons of health food stores were examined, the researchers found no difference in the health of the vegetarians and the meat eaters. (4)  A plausible explanation of the findings is that patrons of health food stores are practicing a wide variety of healthy behaviors and no single behavior can be assigned as the sole factor in better health. (5) This is the healthy user bias exactly.

Am I suggesting that you don’t get routine dental care if you are a super healthy lifestyle advocate? NO!!! I have many patients that believe they are doing the right thing to be healthy, but are misguided, or are not seeing the big picture. An example I see often is sipping water with lemon in it to improve the acid-base balance in their body. This often results in painful acid erosion of their teeth. This is just one example out of dozens. If I can identify a problem early, it may need no treatment, only a course correction. The longer a problem goes undiagnosed and untreated, the worse it will get.

People are not born knowing what to do, they develop a knowledge base and work from that. The willingness to use that knowledge is also important. I suggest that you find the motivation to change your life if need be. Motivation comes in many forms. Generally, you need to have a vision of a better you. That vision has to bestrong enough to make you realize that the change you are going to make will make your future better than the present despite the difficulties of having to change. Here is an example: I usually see new fathers quit smoking. They usually tell me that their motivation is to be a positive role model and live long enough to raise the child and see their grandchildren. My personal example currently is calorie tracking-something I have never HAD to do. Since I like learning, and I find calorie tracking useful for many situations, I have decided to give it a go. My other motivation is a better physique. Immediately I realized that alcohol is just empty calories and I would be better suited having something nutritious before I get to my caloric limit for the day. I like having a drink, but the idea that I will be healthier and look better outweighs the pleasure of a nice cocktail. There is no question that I will be healthier and look better in my mind. I may have to treak my methods, but I know I will get there. For me and for many, failure is not an option.

The question is, “Will I be healthier because of the strict number of calories I consumed, the macronutrient ratios, the micronutrient content, or because I gave up alcohol?” My answer is they all seem like good ideas right now, so I don’t care. I hope you keep your motivation to be healthy!