Back to the basics
What is the single most important factor that determines oral health? What do I  as cosmetic dentist in Lebanon do that affects my patients the most? said Dr. Joe Karam
How many times per year do the vast majority of our patients visit our offices for any type of hygiene appointment? Average is four times per year, obviously. Of course, there are exceptions, but let’s put that aside for now. So, for the other 3, who is acting as their hygienist?
What is the single most important factor that determines the health, or the lack thereof, of the mouth? 
It is the population of bacteria, which reproduce every few hours. It is a constant struggle to keep bacteria in check.
Think of my patients whose oral health is pristine ... those whose mouths couldn’t look better. Why is that? Does it have something to do with how they picked their parents? Absolutely. But beyond that it is because their daily home-care regimen is effective, and they never slack off. Think about those patients whom you have turned around, because no one ever told them how to take care of their mouth, and now they are walking billboards for oral health.
When a patient presents to the dental clinic in Lebanon, especially new patients, with any level of periodontal disease, why is that? Every patient’s oral health is a direct reflection of their home care. If they have any level of periodontal disease, something has to change.
We do want to have a lasting impact on our patients and gain loyal missionaries for our practice. We Show them how to brush, floss and give our new patients free consultancy 
to take care of their oral health. 
Dr. Joe Karam: Lebanese Cosmetic Dentist