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My View: Paradoxes

October 19, 2015

By Robert Darling, D.D.S.

Photo of Robert Darling, D.D.S.
Robert Darling, D.D.S.
Earlier this year, researchers in northern Ethiopia uncovered hominid teeth and jaw fragments estimated to be more than 3.5 million years old.

News of this discovery reminded me of a “dental paradox” a forensic dentist shared during a lecture years ago: “The part of the human body which is most likely to be lost in one’s lifetime is the part which will last the longest after we are gone.”

These seemingly opposite statements make a point about the durability of our teeth.

Paradox might be a good term to describe the contradictions in the relationship between medical care and dental care in our present health care environment.

The health of the teeth and the oral cavity is essential to systemic health and personal well-being, but is treated as an optional accessory when it comes to society’s willingness to pay for appropriate care.

Insurances, both private and public, will pay thousands of dollars for a knee replacement to improve an individual’s mobility and quality of life; but, the same level of coverage would not be extended to rehabilitation of missing or damaged teeth to also improve a person’s function and quality of life.

Two opposing pieces of acrylic might be deemed the least expensive but clinically acceptable remedy for a compromised dentition.

I cannot imagine an insurance plan recommending a wheelchair as the least expensive, but clinically acceptable way of addressing a bad knee.

It is essential that we continue to explore different ways in which medicine and dentistry can work together.

The recent collaboration between the Wisconsin Dental Association and the Wisconsin Chapter of the American Academy of Pediatrics regarding promoting a dental home for children by age one is one example.

Another example is the WDA support of Children’s Hospital of Wisconsin’s grant application from Children’s Dental Health Project to raise awareness and improve access to oral health care for pregnant women and infants.

We also need to be mindful of instances in which medicine and dentistry are not exactly in sync with one another, such as the diversity of opinions among physicians and their respective professional organizations regarding antibiotic prophylaxis for dental procedures, especially in regards to artificial joints.

As dental professionals, we are in a unique position to educate our physician counterparts. After all, we receive more training in systemic functions and diseases than they receive in dental/oral conditions and treatment.

It is important we continue to reach out for the benefit of our mutual patients.

Over the course of my career, I have seen great changes, especially in the past decade. The recognition of the role of circulating C-reactive proteins (as part of the chronic inflammation in periodontal disease) and cardiac disease is one example.

In the future, I hope there will no longer be a distinction between “dental care” and “medical care.”

Instead, we will speak of “health care” realizing everything in the body, from teeth to toes, is intimately connected.

This editorial, reprinted with permission, originally appeared in the September 2015 issue of the WDA Journal, the publication of the Wisconsin Dental Association, of which Dr. Darling is the editor.