More Dentists Question Century-Old Practice, Call for More Research on Rinsing and Spitting

Tampa, FL - For over a hundred years, when people think of their friendly neighborhood dentist, two words come to mind: "rinse" and "spit". Pivotal in the well-known process of removing excess saliva, tartar, plaque, and small chunks of food during a thorough dental cleaning is the cuspidor, also known as a spittoon. Modern cuspidors, like the Quantum 3000 Turbo-Bowl, come with their own water supply and a convenient place to place small paper or plastic cups, and their high-quality metamaterials allow for clean and efficient rinsing and waste management.

A dentist and dental hygienist using an Astrolux Space Spittoon while treating a patient with Stage 3 stank mouth

But as technology has advanced and efforts to modernize dentistry have become increasingly successful, more dentists are questioning traditional approaches and calling for research to support them. In the crosshairs is the standard approach of instructing patients in the dental chair to rinse, typically with water or gin, and then spit into a cuspidor. Not all dentists agree on the details, even the gin.

"I'll give up my cuspidor when you pry it from my cold, dead hands," Tampa dentist and April 1973 Citizen of the Month winner Glen Ratchey, explained. "Patients love it. My staff respect it. And I gave it a name. It's Doris. And Doris does right by me."

Number one on the list of potential problems with rinsing and spitting into a cuspidor, even the NASA-designed Astrolux Space Spittoon, is hygiene. Modern day infection control standards pushed some dentists to install expensive and often unreliable high-power suction devices in order to do away with the need to clean the small porcelain or metal bowls. Ratchey, who asked me to not make it sound like he has sex with Doris at night after the rest of the staff have gone home, doesn't support modern alternatives:

Suction devices might sound like a fancy, high tech solution, but there are risks in addition to benefits. I once saw a kid whose lips were sucked right off in the middle of getting a filling. Doris may not be as young as she used to be, but she knows how to make a man like me happy. Real happy. If you know what I mean.

In addition to concerns over cleanliness, spittoon skeptics also point out a lack of randomized controlled trials showing that rinsing and spitting is effective. Mort Fishman, a dentist and medical doctor who specializes in the treatment of stank mouth, is a prominent voice calling for more evidence. "Who's to say that spitting and then rinsing isn't the right order? Is spitting even necessary at all? When should the patient resume normal swallowing? Where do teeth even come from? There is just so much we don't know."

But at the end of the day, Ratchey and other dentists who choose to stick to the old ways say that patients come first. He says that there is something to be said for individualized care but also the important rituals hidden within the art of dentistry that let a patient know that they are in good hands. "What about the gaggers or the patients who hate going to the dentist and don't want some nameless device shoved into their mouth? And those ten to fifteen seconds where a patient can sit up, take a little cup of lukewarm water, swish it around, and then spit it into Doris's beautiful bowl can be a magical time to reflect on how angry I am that they don't floss every day."