Like pulling teeth

A couple of months ago, I had the wonderful pleasure of attending the American Academy of Optometry's annual conference in Boston. I had the chance to reconnect with a lot of classmates and friends, as well as visit my school and attend lectures at the meeting. One evening, as we were enjoying a night out on the town, a current 4th year student approached me and said "Harbir, you need write a blog about the importance of regular eye exams!". I told him that I'm sure I've mentioned it a few times already. "Yeah, but why is it that people are willing to go the dentist to get their teeth cleaned every 6 months but they refuse to have their eye health checked every 2 years?!" (Yes, he was both inquisitive and exclamatory all at the same time).

This particular discussion has been a long time coming. I talk about it daily with patients, friends, family, and random unsuspecting people walking down the street who I unwittingly coerce into conversation. But, to this day, I have avoided writing about it because I was afraid that I would end up writing a novel, or it would open up a can of worms, or that all the dentists in the world would hate me and I would never be able to receive adequate oral care (I guess its a good thing I've never had a cavity!). But, with this recent encouragement from the enthusiastic intern, I decided to give it a shot. And I will try to keep it short!

Less 24 hours after being newly inspired, I had the most convenient and fortuitous encounter with friend of a friend who just happened to be a dental student. True story. After restraining myself to allow an appropriate amount of time to become acquainted (maybe 30 or 40 seconds), I jumped at the chance to talk about having my teeth examined bi-annually.

Allow me to summarize.

Harbir: Why do dentists have patients come back every 6 months to have their teeth checked?

Dental student: Because we can.

OK fine, that's not exactly what she said. But, the gist of the story was, dentists have convinced the world that having your teeth scraped with sharp tools and gargling fluoride every six months are absolutely necessary. When, in fact, according to my new acquaintance who now probably hates me, there is no direct correlation between oral hygiene and dental health. Having your teeth cleaned is not the important part. The few minutes at the end of the visit where the dentist pokes and prods around with another sharp instrument, that's the important part. But even that doesn't need to happen every 6 months. Nonetheless, oral care professionals have done an amazing job of convincing people that these regular visits are obligatory.

I'm not mad at them. In fact, I applaud them. I reach out to them and ask them how I can convince my patients to have their eye health examined more frequently.

I know this is a bit crude but honestly, what happens when your teeth fall out? You get new ones. Crowns, or veneers, or dentures. In any case, you can smile and bite and eat again. But what happens when you lose your vision? Nothing. Once its gone, its gone.

But we don't clean or polish. We refract and dilate. Maybe that's not as exciting for patients. Maybe we should start a new division of eye care where we have people come in to have their eye lids cleansed and eye drops instilled every six months. We'll call it ocular hygiene. Maybe then I'll have patients in my chair more regularly so I can check for silent eye diseases like glaucoma that can cause irreversible vision loss in asymptomatic patients. Because convincing people of the latter alone does not seem to be enough.