Fighting the wrong fight

Dec 19, 2010

Editor's note: Helaine Smith's column, The Mouth Physician, appears regularly on the DrBicuspid.com advice and opinion page, Second Opinion.

A few blogs ago my sentiment was "enough is enough" with the amalgam debate. Now last week there was a new two-day review by the FDA that spurred many contentious arguments and grandstanding.

If we stopped using amalgam, we would no longer have to debate this issue. It's funny -- I have not found reason to use it in more than 12 years.

I really wish dentists would have passion about other aspects of being physicians of the mouth. For example, OralDNA has three diagnostic products that test genetic susceptibility to periodontal disease, the pathogens found in periodontal pockets, and human papillomavirus (HPV). The test for HPV is the only one on the market that allows us to catch this potential killer virus, which is found in 50% of oral cancers.

We should be infuriated that insurance companies do not pay for these screening tests. We have a critical role to play in our patients' lives and even to help save their lives. This is our area of expertise, and we should be doing all we can to provide the best care for our patients.

Most infections are cultured by physicians; why are we not culturing our perio patients? Gynecologists screen for HPV; why are we not screening for HPV in the oral cavity?

Providing preventive care and screenings with these kinds of tests needs to be incorporated into our exams. Our energy should be focused on learning what's new and how we should be practicing as dentists in the 21st century.

I recently came across a great article that Dr. Louis Malcmacher wrote in October 2009 in Dental Economics (Vol. 99:10). He wondered if dentists have low self-esteem, and he concluded yes. I concur.

It is time we stop putting ourselves down and thinking like second-class citizens. We need to attend proper continuing education courses. We need to be proud that cosmetic dentists are doing dermal fillers and Botox. We need to be proud that we can screen for oral cancer and help reduce our patients' risk for heart attacks and strokes by properly treating periodontal disease. We should not be putting our colleagues down who have the confidence and education to perform advanced procedures.

These are the causes we should be engaging in with every insurance panel and speaking to every local television station about to educate the public. Then perhaps our self-esteem would rise to the level it should be, as that of a true mouth physician.

Helaine Smith, D.M.D., owns and operates two dental offices -- a cosmetic dental spa and a family dental practice -- in the Boston area and is a passionate advocate for educating consumers about dentistry. A fellow of the Academy of General Dentistry, Dr. Smith writes and lectures about dentistry frequently and is actively involved in several volunteer organizations, including Operation Smile, Cape CARES, and Give Back a Smile.

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