In July, there was a case presented in Optometry Today that caught my attention. In equal parts horrifying and fascinating, it described how surgeons, about to perform a scheduled cataract operation, discovered an incredible 27 contact lenses in one of the patient’s eyes. Seventeen of these lenses had fused together in what was described as a ‘blueish mass’ whilst another 10 lenses were found individually. Unsurprisingly, the professionals present – including an ophthalmologist with more than 20 years’ experience – were surprised by the discovery; none of them had ever seen anything like it before. In fact, the uniqueness of the case is precisely why it has been presented to the public, as experts had not previously believed it possible for the human eye to retain so many contact lenses without being symptomatic.
The patient, 67, had been wearing monthly disposable contact lenses for the past 35 years, but had not realised that any of them had gone missing. She merely attributed the irritation she felt to her age or dry eye syndrome. In truth, however, the build up of bacteria around the lenses increased the risk of endophthalmitis, which could have severely damaged the patient’s eye. It is a wonder that she was ultimately unscathed after the removal of the lenses. The most striking part of this case, however – and the thing that interested me the most – was the fact that the patient in question had not been attending regular appointments with an optometrist, and this is undoubtedly why she had been able to accumulate so many contact lenses without anyone (including herself) noticing.
Obviously, this highlights the importance of attending healthcare appointments regularly – and it is a story that could easily have come from the dental sector. In fact, there are many similar cases that we read about on a weekly basis concerning patients who have not visited the dentist, for whatever reason, and suffered the various, invariably nasty consequences. One might wonder, therefore, with the ubiquity of such stories, why they keep occurring. Indeed, just recently there was a story reported about a woman who had resorted to using superglue to fix her teeth. Another story hit the news about a man who hadn’t brushed his teeth for around 20 years. Now, it might be easy for us to look at these examples with professional frustration, but we must always be aware of the reasons behind people’s decisions to forgo professional advice and take their health into their own, somewhat questionable, hands.
In dentistry, the most common reason for this type of behaviour is dental phobia. We are all aware of this issue, so it is unnecessary to re-tread such familiar territory – but we should never underestimate the issues that this problem can create. Dental phobia affects many people in the UK and, ultimately, we, as dentists, are probably the source of many of the original problems. We need to work very hard to ensure that patients who walk through our door are treated in a way that does not leave them too scared to come back. We need to reassure patients that we will be doing everything we can to rectify any issues as soon as possible.
The second most likely reason for non-attendance is accessibility and cost – and, again, we are all too aware of this issue. Unfortunately, there is very little we can do to change this – at least individually. The barriers to NHS dental care can only truly be solved by the government, but it is our responsibility to put pressure on them to do so. As a profession, we need to work together to discuss these problems with the relevant regulatory bodies in order to enact change – and we need to do so on behalf of our patients. Without our input, more and more patients may be put off from attending our practices, to the detriment of their health and wellbeing.
I’m certain that we’ve all encountered a patient who has presented with an issue that, had we only seen them a little more regularly, we could have treated earlier and saved them discomfort or pain. As such, it’s vital that we take efforts to encourage better attendance from all patients and investigate the reasons why they might not want to come into the practice to begin with.