Do you ever discuss dietary or nutritional matters with your patients?
Much has been made lately in the public press about reported oral health benefits of certain foods—tomatoes, cranberries, the wasabi paste consumed with sushi and even chocolate.
These reports claim that wasabi contains compounds that kill caries-inducing Streptococcus mutans; the chemical lycopene found in tomatoes kills oral cancer cells; flavonoids in cranberries can make bacteria "less sticky," which may inhibit them from adhering to teeth; and dark chocolate may curb plaque formation.
Forty-eight percent of respondents to February JADA’s Question of the Month said they frequently discuss dietary or nutritional matters with their patients, but on a more traditional note.
Respondents said their discussions primarily are about sugar and caries control, soda pop, and vitamin and nutritional supplements.
"Yes, the conversation usually is relative to traditional nutritional concerns such as healthy diet, cariogenic foods and getting enough calcium and iron, as well as balanced diets and the food pyramid," said a reader.
Several said that they mainly discuss sugar with their younger patients. "Conversations in our pediatric practice more often are concerned with soda, sweets and snacks," said one.
"In 2000, the average U.S. teenage girl drank 365 cans of soda, and the [average] boy 150.7 percent of that," said another. "No wonder we still have decay in beautiful teeth."
On the other end of the spectrum, some said they discuss nutrition primarily with patients older than 50 years. "This is where I see the chance for the greatest nutrition-related problems," said one.
Forty percent of readers said they sometimes talk about nutrition with their patients "mostly with parents concerning their children’s diets and eating habits," said one.
Respondents said their discussions primarily are about sugar and caries control, soda pop, and vitamin and nutritional supplements.
"I discuss nutrition with my patients as far as scientific research determines hazards and benefits," said one. "Anecdotes don’t work."
Two percent of readers said they never or rarely bring up the subject of nutrition with their patients.
"We don’t feel it is really part of dentistry," said one reader. "We do, however, emphasize foods low [in] or without sugar, especially to children."
"There isn’t a procedure code for this I’ve seen," said another.
The Code on Dental Procedures and Nomenclature (published as CDT-2 version 2000), in fact, does include a procedure code for this topic. Procedure code D0130 is "nutritional counseling for control of dental disease," and the descriptor reads, "Counseling on food selection and dietary habits as a part of treatment and control of periodontal disease and caries."
The ADA Council on Dental Benefit Programs’ Mary Essling said this procedure code was developed to report the time and cognitive skills necessary to educate patients on the prevention of dental disease. "Dentists inherently want to prevent disease, and counseling patients on proper nutrition and new scientific discoveries is a beneficial service to patients," said Ms. Essling, who is the CDBP’s assistant manager on the Code and Third Party Issues.
For more information about procedure code D0130, contact Ms. Essling by dialing the toll-free number on the back of your membership card and asking for Ext. 2760, or by calling 1-312-440-2760.
