Board Certified Periodontist

57 – Forgetfulness

A tooth has four parts. This is the title to my presentation about periodontal disease I give to all my patients who come to me for a comprehensive periodontal evaluation. You can listen to this whole presentation — it takes about fifteen minutes — on my website on the home page. The website is The reason A Tooth Has Four Parts is the title is because it is how the talk begins. I have used it most of my career. It was developed and became a routine for me soon after I began working in a dental clinic in the Air Force when stationed in Germany. That would be somewhere in the last half of 1981. This first assignment out of a one-year general practice residency involved taking on the bulk of the periodontal care in a ten-dentist clinic. And it came out of the reality that every patient I would first see was completely ignorant about what their problems were and how best to treat. Eventually, patient after patient, day after day, a pattern of operation began to form. It was as if my explanation about periodontal disease turned into a procedure in the same way other treatment procedures were established. For example, when someone comes into a dental office for a filling, let’s say, the schedule will state what the purpose of the visit is for. This enables the dental assistant to set up the equipment, instruments and materials that will be needed as part of the procedure. Then the procedure, from the seating of the patient all the way through to when the patient leaves, is performed. This is not to say that all treatment is the same, but all treatment planned has an expected sequence of events. This explanation of periodontal disease is, in this sense, a planned step in the patient’s treatment. Because it can be planned, over time, it can be modified and improved upon to contain within it the exact elements necessary for the listener to be able to understand and cooperate in their own care. It enables, essentially, for people to give a broad informed consent to becoming a patient in my practice. And because it is a repetitive procedure for me, it has some strength in holding patient treatment together over time. I am able to remind and reinforce what I have told people in the past, not because I have a great memory, but because it is a standard procedure that allows me to document for the record that this important information has been accomplished. Which brings me to today’s podcast theme. Forgetfulness. Is it expected by me that patients will remember what it is that I have told them? Absolutely not. This is why reminding and reviewing are critical activities in the process of learning new routines. And when someone has had some dental treatment, there are likely some recommendations for how to manage care following the procedure. We forget all the time everyday a lot of things.

In fact, it is a normal part of living to be able to forget what is unnecessary to what is immediately in front of us. We all have over time experienced the truth about the differences between urgent and important. We can, in fact break out everything we need to do into four categories based on how urgent and important things are. We have urgent unimportant things. An example of this is losing our keys. Immediately, finding the keys is urgent because we have to go somewhere right away. Once we find them, however, the importance of this event recedes as some other immediate new problem is encountered. Longterm, however, this information about losing the keys fades from our memories because the event is no longer important. Months later, we can sort of remember losing our keys but what day of the week and the rest, at least for most of us, will no longer be found in our short-term memory banks. Another category is the important but not urgent. These are things like management of our health. These are the things we would be wise to do but right now, we are looking for those keys. The urgent has a way of eclipsing the important. And so important things are easily forgotten. And this is why it is a good strategy to find ways to remind ourselves what is important. This then speaks to the importance of establishing routines. So let’s stop here for a moment and let me make a clear and potentially memorable statement: If I have a tendency of forgetting what is important, then I need to create a routine. If I seem to forget important things, I can correct this problem by creating a routine. I can carve out of my day, make a daily task, to remind myself what is important and what is not. Have you ever had a quiet time? Perhaps you do this already. It is the idea of starting the day — or at least carving out a few moments in a day — to just sit and review — not the schedule that contains all that urgent stuff — but to review what is important. So, what is important to you? How about health? That’s a good one and consistent with my podcast objective — to provide health information and reminders centered on an area easily neglected — your mouth and teeth. How about mental health? Well that speaks to finding ways to find more happiness and diminish frustrations and sadness. I will leave it there for now, but the topic of mental and even spiritual health are not outside the realm of what I think fit into this podcast. In fact, if you have listened to previous podcasts you know what of my objectives is thinking and talking more holistically that we tend to do. My specialty may be periodontics, but this does not mean I have nothing to contribute in other areas of life.

Now back to the subject of the importance of routines. It is important that I floss my teeth. I can tell you I have not missed a day flossing for decades. This is because it is part of a routine. But flossing for me is low-hanging fruit. I get that you might think that. But remember, I don’t floss my teeth because I am a periodontist. I floss my teeth because I have teeth. Now to be honest, there are other areas in health that I still need to improve through better routines personally. These are in the areas of diet and exercise. Well, they too are important, but usually not urgent matters. How can I create good routines in these areas? It all begins, with growing in my understanding of what are good things I should consider doing in these areas. This is to say a lot of this is not settled science for me. So, my beginning of the journey toward good health is to find and review good reliable information. The routine I should then consider is to find ways to obtain good information in the areas I want to improve in. And this is why I podcast and listen to podcasts. This, at least for me, is an easy way to listen to good information while I am doing other routines. Which goes to the idea, if I can find easy ways to accomplish tasks that are more enjoyable to me, the more likely I will continue in those routines. Well that’s enough for now. I hope this has been helpful I hope it has given you a few good thoughts or ideas you might use in your own life. You have been listening to the Perio Patient Podcast, a podcast for my patients, past patients, and anyone who wants to listen. My name is Dr. Ben Young. Thanks for listening.