There is nothing that people hate as much as going to the dentist. “It’s nothing personal,” they used to tell me. The baggage people carried with them about their real or perceived dental experiences could keep all the psychiatrists and psychologists in the world busy for the rest of their lives. My experience of being in the dental profession for 30 years had more of its share of biting moments than teeth marks on my operating hands. Not only did I have to deal with a wide-awake patient’s anxieties about invasive procedures in a personally protected and very private space, but I had to experience their aversion to paying for treatment they would for the most part preferred not to have. Pulling teeth was easier. In my opinion, when it comes to dealing with people, dentistry could very well be the most taxing of any profession.
As if Dentistry Wasn’t Bad Enough!
Whether it is visions of Sir Lawrence Olivier in Marathon Man drilling into a live tooth without anesthesia, Steve Martin as the sadistic dentist in Little Shop of Horrors, or a murdering Corbin Berson in the farcical horror flick, The Dentist, the results of such marketing have left indelible marks on millions of would-be patients. Dentists all over the world have always been faced with counteracting such damaging slants to the profession. Children’s dentists have invested in so many distractions to make the experience a positive one early on and adults have found fish tanks, headphones and virtual movies an adjunct to the valium and nitrous oxide. In recent years, however, with the advent of Cosmetic Dentistry, dentists have been able to position themselves much more favorably by appealing to vanity. Veneers, porcelain crowns, tooth whitening and invisible braces have kept more dentists in business than restorations for decayed teeth. The artistry may have quite possibly surpassed durability and functionality in order of importance for the consumer. Even the healthy practice of teeth cleaning is more tempting if the end result promises a brighter smile. The reality, however, is that dentistry needs to be recognized for its importance to overall health and must establish itself as a profession that is well respected and totally integrated into the entire health care community.
The Separation of Medicine and Dentistry
There is a group of health conscious Holistic or Biological Dentists who have filled in the void left by the medical profession over 150 years ago. Physician specialists, once known as Medical Dentists could no longer compete financially with the less trained craftsmen dentists performing dentistry on the masses. Eventually a split of dentistry from medicine resulted. That had the unfortunate consequence of the physicians ceasing to be taught in detail about the mouth, diminishing the dental relevance to health and relegating all repairs to the craftsmen dentists. The dentist, not being able to practice medicine, could only treat the teeth and related structures in isolation and not minister to the effected overall health of the patient. It’s almost as if the mouth was not even considered to be connected to the same body that shared the skeleton, circulatory, nervous, or lymphatic systems. So what if the mouth is at the entrance to the respiratory and digestive tracts or in such close proximity to the brain, spinal nerves and master glands. What’s the big deal that the sinuses sit on top of infected roots of teeth, or the muscles that control chewing, swallowing and facial expressions are used relentlessly? And is there any significance that each tooth sits on a different acupuncture meridian?
Dental Infections: A Systemic Health Problem?
Now add the jaw bones, whose complex functions are not fully understood by even the dental profession. These bones are subject to trauma and infections arising from unhealthy teeth, gums, sinuses, implants, surgical procedures and anesthesia injections. What other bone in the body also shares itself with the outside world? What other bone has as many procedures performed on it? What other bone shares joints and 32 neurological structures? And what other bone can have osteomyelitis and deteriorating joints and not be covered by dental or medical insurance? This very bone, which is not addressed by the medical profession because of dentistry’s turf claim, is probably the one area of the body that can be easily viewed as a gauge to a person’s overall health. The deterioration of the jawbone from periodontal disease is really a systemic problem and a proven risk factor for heart attack and stroke. Upon visual inspection, chronic inflammation is easily detected in gums and buildup of calculus on the teeth is more readily observed than calcium plaques in the arteries. Why aren’t more doctors and dentists getting together over this disease?
For years, dentists have been premedicating patients with Mitral Valve Prolapse to prevent a bacterial endocarditis arising from the pathogenic bacteria in the plaque that could enter the bloodstream during a dental procedure. Surgeons recognize the risk of operating when an infection is present and take the proper precautions Over 70% of the adult population is in one stage of periodontal disease but few safety measures are taken when the bacterial plaque is inevitably disturbed each time one flosses and brushes their own teeth. Are they at any less of a risk for pathogens entering the blood stream and traveling throughout the body?
How to Bridge Medicine and Dentistry
There are several issues here that need to be addressed.
1. Physicians and other health care providers must come to terms with being comfortable looking in the mouth at the teeth and gums. They must recognize that infections, whether in the form of tooth decay or gum disease are most often local manifestations of a systemic imbalance. How many doctors ask in the medical history if their patient has had a lot of dental work, periodontal surgery, bleeding gums, loose teeth or has lost their teeth? Why when having any cardiac procedure is the question of periodontal surgery or the presence of periodontal disease conspicuously missing from the medical history form?
2. The patients need to be educated that periodontal disease is a risk factor for heart attack and stroke. How many people who are so fearful of going to the dentist would be more likely to keep maintenance appointments if they understood that it could increase their life span?
3. The dentists must be considered to be part of the health team and not relegated to be just the restorer of teeth. And think of the importance of drilling into a tooth, a neurological entity imbedded in the lymphatic rich jawbone with proximity to vital structures. Dentists are specialists of the mouth unable to practice medicine. The limitation of licensure, though, should not restrict the level of care due the patient. Working relationships with each of their patient’s physicians and other health care providers must be ongoing. Dentists may need to supply convincing pieces of evidence to help educate the doctors and raise their level of awareness.
Unbelievable as it may sound, knowing the dental history could possibly save many from fatal heart attacks, debilitating strokes or surgical complications. In younger patients, if there is a history of heart disease in the family, knowledge of the connection to dental health is one of the best preventive measures.
Open the Eyes as Well as Open the Mouth
The physician can start by actually looking in the mouth and checking the condition of the teeth and gums. Puffy, red gums generally indicates infection. Gross calculus can indicate acidity and calcium imbalance. Decayed and broken teeth are symptoms of discrepancies in body chemistry, body structure or trauma. Silver colored fillings contain mercury that is out gassing. Multiple metals from crowns, fillings, braces, partial dentures and implants react with one another chemically and electro-galvanically.
The mouth, when full of infections, occlusal imbalances and toxic materials can prevent recovery from any condition in the body. Only the people with the strongest constitution and immune system can stay above threshold if dental distress persists in the presence of compromised health. Working with a Biological dentist can turn out to be indispensable for the physician and a blessing for the patient.
If not already doing so, the physician should add the following dental questions to the health history.
Do your gums bleed when you brush or floss?
Do you have receding gums?
Do you form a lot of calculus (tarter)?
Do you have any loose teeth?
Do you clench or grind your teeth?
Have you lost any teeth due to lack of bone support?
Have you been told you have periodontal disease?
Have you ever had deep scaling and root planning?
Have you had gum (periodontal) surgery?
Have you had any abscesses?
Do you have any root canals?
Have you ever felt sick or noticed a change in your health following a dental procedure?
Holistic Health Means the Whole Body Approach
The dentist must also look upon dental health as an integral part of general health and well being. When the emphasis is on health, dental skills can be utilized to treat an area of the body where no one else has as much knowledge or expertise. Dentists must feel confident when discussing blood chemistries, detoxification procedures and surgical interventions with patients’ physicians. A working relationship between the dentist and other health care providers is not only extremely beneficial, it is conscionable. The communication will not only help to improve the health of the patients, it fosters mutual respect and confidence in services performed by all the members of the health team.
We are all working to improve health and longevity. This is best accomplished by accepting new knowledge and learning from one another. We can build bridges between alternative and mainstream medicine and between the specialists and general practitioners. The only thing that really stops us from making these connections is ourselves. It is our issues and perceptions that tie us down and won’t let us move on. For the sake of our patients and to become true to ourselves, we must use our knowledge and our talents to inspire, connect, challenge and support the purpose of our being in practice.
Dentists and Physicians can enhance the quality of their practices, help the patients in ways previously overlooked and perhaps gain a bonus of new and lasting friendships.
When incorporating Medicine and Dentistry we are offering a true holistic approach and not just giving our patients “lip-service.”
