The birth of a book

To balance out all the perio in my life, I should probably take up golf or hang gliding, but instead I've been attending book publishing courses and reading books on writing, publishing, and marketing.

By Trisha E. O'Hehir

To balance out all the perio in my life, I should probably take up golf or hang gliding, but instead I've been attending book publishing courses and reading books on writing, publishing, and marketing. I've met successful authors and others working on their first book. The publishing gurus suggest picking a title that lends itself to a series. You may only write one book, but this way you have the option of adding more if you want. Successful series names you might recognize are Chicken Soup for the Soul, the Dummies series, the alphabet series — 'A' is for Alibi, 'B' is for Burglar, etc. and the numbered books — One for the Money, Two for the Dough. You get the idea.

Following that advice, I'm writing books in the Dental Secret Series. The Toothpaste Secret, is set for publication the end of February and I'm so excited I just had to tell you. It's been an interesting adventure. Do you have a book you'd like to write? I've heard that everyone has a book inside. What's yours?

The Toothpaste Secret is a 48-page, full-color cartoon book destined for the New York Times best sellers list. I'm counting on you to help me get it there. In exchange, I'll buy your book as soon as it's published. Just let me know when and we'll both have best sellers. Maybe you've already written and published yours. The first hygienist-authored book I bought, other than a text book for school, was A Room With No Window, by Linda Krol, RDH, back in 1985. Since then the list of hygienist authors has grown to include Terri Brisbin, Cat Schmidt, Leslie Craig, Vicki McManus, Sandra Senzon, Cynthia McKane-Wagester, and now our own RDH columnist, Kristine Hodsdon. Who's missing from this list? Let me know.

The Toothpaste Secret was really written for adults, but since it's a cartoon book, everyone assumes it's for kids. Never mind, as parents read it with their kids, they'll get the message, too. But why are fun, colorful, cartoon books limited to kids? There's so much information out there these days, I'm much more likely to respond to humor and cartoons than to pages and pages of boring stuff. Hygienists don't distribute boring, word-filled pamphlets, but I've sure gotten my share from the physician's office. It's time to lighten up and have fun with oral health. If it's fun, people will definitely be more interested. We learn when we laugh.

The book illustrates the concept of "dry brushing — inside first," not something I learned in school, but picked up from other clinicians during my early years in practice. Combining the two concepts produced amazing results — practically eliminating all lingual calculus. I was so excited — I told everybody about it, whether they wanted to hear it or not!

I remember telling my brother-in-law in New York about it. A year later, he told me he'd been brushing that way and was pleasantly surprised that he didn't have any buildup on the inside of his bottom teeth. What impressed him even more was his hygienist's reaction. She accused him of seeing another hygienist between visits!

In the early 1980s, I hired a cartoonist to capture the images conjured up by patients describing how their teeth feel when they wake up in the morning. He really enjoyed creating pictures of teeth wearing sweaters, the bottom of a birdcage, and the army marching through. He gave bacteria fancy homes, condos and stores in the calculus buildup on the lingual of the lower anterior teeth.

The cartoons were used in my first dry brushing articles published in 1985, as a feature article in RDH, and the following year in Dental Assisting. The book idea was there, but just didn't come together because I was so intent on getting scientific research to support the idea. A search of the literature came up with nothing. My friends in research were polite, but declined any interest in taking on the project. Instead, they encouraged me to do the research. Finally, I did.

In the early 1990s, Perio Reports subscribers and RDH readers were invited to participate in the "dry brushing — inside first" pilot study. Interested dental teams were sent forms and instructions for the project. They selected recall patients with lingual buildup and measured both calculus and bleeding on the mandibular lingual surfaces. Patients were instructed to start brushing dry, on the lingual surfaces first. Rather than teaching a specific brushing technique, patients were simply told to brush until their teeth felt and tasted clean. Calculus and bleeding were measured at their next visit to compare results.

Twenty-nine hygienists sent in before and after data on a total of 129 patients. Some tested the method on just one patient while others sent data on up to 10 patients, with the average being five patients for each hygienist. By 1994, all of the data were collected and analyzed. Calculus was reduced by 63% and bleeding by 55%. These results were presented in a poster session at the International Association of Dental Research meeting in Orlando, Florida in March of 1997. At that meeting, the editor of JADA, Dr. Larry Meskin, asked me to submit my findings to JADA, where it was published in 1998. We now had published, scientific research to support "dry brushing — inside first."

I was so excited about the results, I contacted Prevention magazine and Bottom Line to spread the word to the public. Prevention didn't print my article, but used the information for a short article in August 1996. Nothing happened with Bottom Line.

Now for the interesting part. After the research abstract was published with thousands of other abstracts in the Journal of Dental Research in 1997, it took on a life of its own. Reuters News Service picked it up, thus spreading the word to news outlets worldwide. Prevention magazine was the first to pick it up and write another, full-page article on dry brushing — inside first. Bottom Line also published the information this time.

Across the Atlantic, it was spotted in The London Daily Mail newspaper, on September 9, 1997. That led to an article in a British dental publication, The Probe. Meanwhile, articles appeared in Men's Health, Glamour, Shape, Remedy, and other magazines.

It was also covered in many newspapers. My father called one day to say I was quoted in the Minneapolis paper and my name was spelled correctly. He wanted to know how I managed that. Kristy Menage Bernie called to tell me that my research and name were mentioned on the Dr. Dean Adell radio program.

Joyce, a friend of mine living in Canada, was catching up on her reading one night in bed when she started reading the Prevention article. She told her husband, a periodontist, "Listen to this, it says dry brushing inside first reduces tartar and bleeding." His response was, "Yes, I know, Trisha's been teaching that for years." Imagine her surprise when the next line said "... findings based on research by Trisha O'Hehir." If it hadn't been so late, she would have picked up the phone right then to call me — she was so excited.

Next came the television camera. Yes, right into my living room. Seems it was sweeps week and a Phoenix station needed something juicy to keep viewers tuned to the news. This was a good lesson in what editing can do to your message. Since "sex sells," as the saying goes, the announcer prefaced the piece by saying,"Is it sexy to brush without toothpaste?" or something like that. "Stay tuned and find out."

My serious research was now being manipulated for ratings! Never mind, it got the message out one more time!

Despite all that news coverage, "dry brushing — inside first" is still a well-kept secret. According to advertisers, people need to see or hear a message seven to 10 times before they act on it. That's where the book comes in. It's taken a long time to finish the book, get a publisher, and now, most importantly — sell the book and get it read. If The Toothpaste Secret is available in all dental offices, bookstores, and toothbrush aisles in the stores, the message will get out and people will hear it more than once.

How many people can you reach if you tell all your patients to dry brush — inside first? Together we can spread the message, reduce calculus buildup, reduce bleeding, and improve oral health.

This can be done with fun and laughter using the funny cartoons drawn by John Furman. As the cartoon project progressed, John became a strong supporter of dry brushing — inside first, teaching anyone who would listen. He became an oral health missionary.

I dedicated this book to the memory of John. This talented young man whose self-portrait is the bubbling toothbrusher on the cover, died at a very young age, leaving a wife and five-year-old daughter. John was diabetic and needed a kidney transplant. Since he was an orphan and didn't know his birth parents, or any blood relatives, finding a donor took some time. Eventually, the surgery was performed, but the kidney was rejected.

Although John isn't here to see the book, his memory and keen interest in oral health lives on in his delightful cartoons. To see John's self-portrait, now on the cover of the book, visit www.toothpastesecret.com. Go ahead and order books for all your patients and be sure to let me know when your book goes on sale. I'll be the first to buy it.

What the critics are saying about The Toothpaste Secret.

"Who said dentistry can't be fun?"
— Linda Miles

"A hilarious approach to a very important subject."

"Fantastic book — this belongs in every dental office."
— Annette Ashley Linder, RDH

"Hilarious images!"
— Anne N. Guignon, RDH

"About time! A book that explains it all!"
— Kristy Menage Bernie, RDH

"Funny cartoons + Trisha's wisdom = radiant smiles"
— Mark Hartley, Editor, RDH

"This book is lighthearted and wonderfully funny!"
— Dianne D. Glasscoe, RDH

"A must read for anyone with teeth!"
— Dr. Joe Blaes, Editor, Dental Economics

"Adorable! Kids will be glad they have teeth to brush!"
— Beth Thompson, RDH


Trisha E. O'Hehir, RDH, BS, is a senior consulting editor of RDH. She also is an international speaker and editor of Perio Reports, a newsletter containing news about periodontics for dental professionals. The Web site for Perio Reports is www.perioreports.com. She can be reached by phone at (800) 374-4290 and by e-mail at trisha@perioreports.com.

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