THREE THINGS YOU’LL GET FROM THIS ARTICLE:
1. The psychological reason patients believe crazy things
2. A list of current web advice that you may need to counter
3. Why it can be good for you to fight these ideas on your blog
Dr Kerry Chant is one of my heroes. A couple of years ago, Dr Chant, the NSW Chief Medical Officer, stared down death threats from anti-fluoride activists. Her crime? She advised a local council that fluoridating the water supply was good policy. Her courage is to be applauded. But I also believe her example can teach us a way of fighting bad advice from Dr Google.
I've always had a problem with anti-fluoride activists. I understand people caring about their own health. But the anger and the virulence underpinning some of the anti-fluoride arguments always took me by surprise.
The science backing up the decision to fluoridate water is solid. But anti-fluoride people would accept no argument against their stance. The science is wrong, they would say. If you disagree, you are part of the problem. In extreme cases, they threaten to kill you if you disagree with them.
The reason they argue so strongly is because of a cognitive bias called confirmation bias. This is an error of reasoning we all suffer from—myself included. We all favour information that confirms our beliefs.
That’s true if you believe in the value of the scientific method, or if you believe the government is poisoning your water supply. It’s true of people who deny climate change is happening. There are some good sources of information out there, but also some dodgy ones. And one of the unfortunate side effects of the internet is they are all equally accessible.
Confirmation bias and Dr Google
Confirmation bias is tricky to fight. If you’re putting a message out into the world that contradicts the bias someone already has, it’s hard to get them to even see the message.
But one of the ways you can fight it is to contribute to the group effort of getting good information out there on the web.
Even though you operate as an individual, keeping your patients healthy is a group activity. But up until recently, educating one patient at a time was the only thing you could do. Now, as the ADA has noted, patients tend to educate themselves. Why can’t you be the source of some of that education?
What your patients are reading
There are some poor oral health ideas floating around on the web which are gaining currency on health blogs. If you haven’t encountered them yet, you may soon. They are (in no particular order):
Apple cider vinegar can whiten your teeth—some websites will advise people to make their own at home whitening treatments using acidic ingredients such as apple cider vinegar. While this may be fine if you have a degree in oral health and an understanding of what happens when you bathe your teeth in acid, for most punters it’s a bad idea. Similarly, an internet-based recipe for baking soda and lemon juice will most likely do more harm than good.
Coconut oil rinse or oil pulling with sesame oil is a cure-all for oral health—the claim is this is an ancient Ayurveda technique for fixing everything in your life. It is unlikely to do that, but the absence of any evidence for or against it, most advice is “don’t use this as a replacement for brushing your teeth”.
Rinsing with salty water will whiten teeth—it’s probably not going to hurt you, but it’s not going to help that much either.
RCT causes cancer—the (mistaken) theory here is that root canal treatment causes cancer because it creates a safe haven in the shell of the tooth for cancer-causing microbes to hide in. To quote the American Endodontists Society: “This false claim is based on long-debunked and poorly designed research performed a century ago by Dr. Weston A. Price, at a time before medicine understood the causes of many diseases.”
Beating the bias
There are some theories that suggest ways you can mitigate conformation bias. But most of them rely on the individual wanting to test their own theories of the world. Most people don’t want to do that. For example, we currently have a chap in our office who seems to genuinely believe that smoking will fix his atrial fibrillation. He doesn’t want to hear any counter-arguments.
What we all can do, however, is tip the balance of good information. For example, by listing the dodgy whitening theories above, I’m hoping that this article may appear in the Google search results of anyone trying to inform themselves about those topics.
Similarly, if every dental practice had a blog post where they talked about why these methods are not good for your teeth, search engines would find the keywords and return those results to people who are trying to educate themselves.
The net effect of you doing this on your practice's blog can only be positive. If yours is one of many proposing the rational point of view, that rational point of view will seem more sensible to readers. If your views tally with the confirmation bias of existing patients, they’ll see you as an authority.
And if they are dead set against the views you espouse, then they’re not going to want to come to your surgery anyway. They’ll probably be off trying to oil-pull their own teeth, or rubbing crushed strawberries on them or something.
The next step
If this post inspires you to go out and start blogging, you might quickly run out of ideas. Luckily, there’s an easy way you can use Google to generate story ideas. Or if you’re a more strategic thinker, you might want to come up with a plan and work out how much of this you can do yourself, and how much you can outsource. Either way, these articles we’ve linked to have you covered.
And if any of that is unclear, please feel free to leave a comment. I do read them and comment back, and I’m more than happy to discuss it with you.
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