Interview: “I prefer prevention for my young patients”
Dr Dominique Rosenberg is a Paris-based paediatric dentist who has been practising for over 20 years, specialising in oral care for new-born babies and children up to the age of 15. In her practice, it is greatly important to spend time with her young patients and their parents in order to prevent dental decay from happening, instead of treating it when it does. Her appointments vary between 45 minutes and an hour. In an interview with Dental Tribune Online, she talked about why prevention matters in paediatric treatment.
Dental Tribune Online: Could you please tell us more about your daily practice life?
Dr Dominique Rosenberg: In my practice, I ask my young patients to try brush their teeth twice a day, but often they are not interested. I must say that the main problem has been the parents. I see dental plaque in my young patients every day, which results in only one thing: parents having to take better care of their children’s teeth. I have met mothers who said they are not interested in helping their children achieve proper oral health. As dental professionals, we have to educate both children and parents in order to prevent decay, orthodontic problems and so on. For example, fluoride treatment twice a year definitely helps prevent oral disease. I used to seal the primary teeth and permanent teeth using fluoride. However, parents believe their child does not have dental decay, although I can clearly see an imbalance in their oral hygiene.
You specialise in preventive treatment. What has to be taken into consideration if a dentist wants to focus on preventive treatment in paediatric dentistry?
Prevention has to start with proper oral hygiene. Oral hygiene takes time and time is money. In France, oral hygiene needs to be planned, which is why, in my practice, I devote one hour to each new patient in order to understand him or her better. It is very important to me to explain tooth decay and proper prevention techniques. For example, I explain dental problems related to food, habits and other related topics. I also recommend dental flossing and interdental brushing, but this has yet to take off in France and will take some time before it becomes a habit. After I have had the chance to get to know my patient better, I make recommendations to both the parents and their children. It is important that all of them are listening and understand me. During their next appointments, I usually reinforce and repeat my first speech and recommend additional plaque checks. Often you ask children to improve their brushing technique, but they sometimes do not understand why. The plaque check reveals what can be improved.
Why do you prefer prevention to restoration?
I love prevention, because I prefer helping my patients. In daily practice routine, patients call your clinic and ask to be treated immediately. Although, sometimes, you cannot call this an emergency. This means that you have to do everything to avoid these calls from happening and is the reason I prefer hourly appointments. This first appointment can be considered as the start of a good relationship. After they understand what I want, we can both do our job in the right way and start preventative care. A population without decay is my dream. If we do our job correctly right now, decay will be gone in ten years. It is hard for a paediatric dentist to provide pain-free treatment and it is hard for a child to understand why treatment is needed. Only through prevention are we able to stop pain from ever happening.
I am convinced that if you have a preventive attitude in all aspects of your life, you can prevent many problems. I am very lucky to be working in a rich area of Paris. I can ask people to work to take care of their teeth better. If I were to work in a poorer neighbourhood, it would probably be more difficult. You need a special state of mind for what you are being asked to do. Young parents are more receptive, but older people are not. I would say that you need to have rather educated parents to take preventative care to heart, but this does not mean that not everyone can change his oral care behaviour for the better. I have patients who drive about 60 kilometres to come to my practice, because they like the way I handle and treat my patients and their parents. The children are my patients and parents are welcoming my different approach.
Why do think that soothers or pacifiers are helpful in paediatric dentistry?
In my opinion, preventive dental treatment should start on the first day of your child’s life. This is how I discovered the CURAPROX Baby pacifier. I wanted to learn more about the idea of providing early orthodontic treatment to my patients. The main aim of the CURAPROX Baby soother is to prevent the development of open bites and crossbites, which is why I support it entirely. I am convinced that if you start from birth and the first year of a child’s life, you will be able to prevent orthodontic misalignments. It does not mean that he/she will not have any further orthodontic treatment during adulthood, but you will help your child grow up. It has been proven that the CURAPROX Baby soother helps children with their tongue movement. In my opinion, this is a new approach: early prevention in paediatric dentistry. Usually, orthodontists prefer to start treatment at the age of 7 or 8 mainly because of social security reasons. But here you can achieve early prevention without having to do anything.
What was your first reaction when you saw the pacifier?
I instantly recognised that its design seems to promote the proper development of the palate and the jaw and ensures optimal breathing. This soother is very interesting, because it was developed and designed for a different purpose. Thanks to its design, breathing problems just turned out to be treated too. First of all, a soother should satisfy the suction instinct. If we can combine pleasure and correction, it is perfect. I would recommend everyone to read Dr Herbert Pick’s article and take a look at the first few case studies. I am certain that we will see more lectures in front of paediatric dentists to make sure that such products exist—maybe these could even take place in the lovely city of Paris.
Dental Tribune Online thanks Dr Rosenberg for her interview.