Habits & Decision Fatigue


The reason I wanted to talk about habits is the very obvious thing that all dentists should want to talk about: brushing & flossing. HOWEVER... It just doesn't fit into my personality to scold or cajole my patients for their inconsistent oral hygiene behaviors. I'm not here to judge why your teeth are in the condition they are in (good or bad), I am here to serve as someone to help YOU. I have received the highest training in dentistry by going to one of the finest dental schools in the world (Arthur A. Dugoni School of Dentistry - UOP!). I was very fortunate and blessed to do so.

When I was 18, I saw the dentist and did my usual routine of brushing like crazy (as though one day of brushing could make up for 6 months of laziness!) But I was always pretty good about brushing before bed (thanks to my parents), but I was terrible about flossing. I took pride in my dental visits, because I never had a single cavity (thanks to my parents!). But this time, I heard something disconcerting: gingivitis! I was told I had gingivitis by the hygienist. Scared me straight! And I brushed, flossed and used Listerine mouth rinse every night before bed for 15 years straight.

Why is it so hard for people to brush twice a day and floss once a day? I hear of many people who have no problem brushing in the morning, but it is difficult at bedtime. I have a working hypothesis: Decision Fatigue.

What is decision fatigue? It is something that happens to all of us whether we realize it or not. It refers to the deteriorating quality of decisions made by an individual after a long session of decision making. You should read more about it here: https://en.wikipedia.org/wiki/Decision_fatigue Unfortunately, most of us are not well aware of this phenomenon and it has real impacts on our ability to make good decisions at places like the cash register (impulse purchases), car dealership (too many choices), or fast-food drive through (large menu, optional meal upgrades and dessert add-ons)... and many more.

Highly successful people know about decision fatigue, and structure their lives to optimize their decision making. Billionaire businessmen like Steve Jobs or Mark Zuckerberg have been known to limit their clothing options in order to combat the effects of decision fatigue.

But how does that come into play with daily habits? By the end of the day, many people are faced with a decision: Should I brush my teeth? Hopefully for you this is an automatic YES. Now comes the next decision: Should I floss? Here is where many people get hung up. Flossing is difficult to do for many of us. It isn't very much fun. Sometimes, it gets much less fun after having a lot of dental work.

So my hypothesis goes as such: I hypothesize that people are considering brushing and flossing as a decision, when it should be a HABIT (Automatic).

When deciding whether to floss the answer should be an automatic YES. Every. Single. Day. If you want to avoid dental work: BRUSH & FLOSS. Every. Single. Day.

Now I'm guess most of us know that. But why do we still struggle?

Might I make some suggestions. Use them if only if you think you would find them useful.

#1 - Have a morning and nighttime routine.
Decide in advance what this will always include. Never deviate from this in the moment. Always do those things. (Include when you will brush and floss).

#2 - Find the easiest flossing method you will actually do.
In dental school, the department head of Periodontics (gum health), Dr. Lundergan, said (and I'll never forget it) . . . . "the most effective form of flossing is the one you'll actually do." Personally, I like Glide. I find it easy to use, and I have tight flossing contacts.

If you have difficulty holding or manipulating the floss, we will get you a floss holder. Or use the disposable floss holders. I also highly recommend water flossers such as a WaterPik. Some evidence suggests that a proper use of a WaterPik does as good or better of a job than flossing. For me the jury is still out somewhat, but I am highly optimistic about what I have seen from my patients, including a couple who are not able to floss.

#3 - Don't get caught up in perfection.
This can be a positive habit killer. This is usually due to catastrophic thinking like, "oh, now I've totally screwed up my routine and I'll never get back on it." Don't give in to those extreme thought patterns. We don't know the future yet! The best possible thing you can do after you miss a night, is to get right back on it. The answer about whether you floss is always YES. Make it a part of your identity!

#4 - Accountability.
Whenever trying to establish a new habit, it is a good idea to have accountability at first. When going to the gym, this could be a workout buddy or trainer. At work you might have accountability to your supervisor or boss. At school you have accountability in the form of deadlines and grades. If you need an accountability partner for your oral hygiene, lets get you set up on accountability checks. Commit to what you'll do to improve your oral hygiene habits. Keep track daily. Come back and report. We'll reward you!

While a popular theory holds that 21 days is how long it takes to establish a habit, more recently it seems that the number is closer to 66 days. That's how long you must persevere before the routine starts becoming automatic.

Your habits make up a large part of who you are, and your health. I covered a lot about negative habits, especially in regards to spending in a previous entry. We all know how much our habits impact our overall health. Don't forget about your teeth, as your mouth is the gateway to your body! Unhealthy pathogens (germs: viruses, fungus and bacteria) store in the teeth and gums, and if your gums bleed, those are entering your bloodstream. At a minimum you are swallowing them. PLEASE do yourself a favor and limit your bodies exposure to them. After all, you wash your hands EVERY time you use the restroom. Think about the fact that you need to properly clean your teeth!

Right now we have our membership plan priced at $20 a month. This includes your cleaning by the greatest hygienist in the quad cities area (I'm not joking), and exams, including 2 routine and one emergency exams and all radiographs (x-rays) are included. This can be the starting point to a new healthier YOU, putting you back on a path to MAKE YOUR TEETH GREAT AGAIN!

Start a new routine. Let us help! After all, at PV Dentistry your Health is Our Number One Priority!!!

Written by: Harold Henderson, DDS May 8, 2019

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