Sunday, June 10, 2018

"Why Dentistry Is Separate From Medicine"



"Specializing in one part of the body isn’t what’s weird—it would be one thing if dentists were like dermatologists or cardiologists. The weird thing is that oral care is divorced from medicine’s education system, physician networks, medical records, and payment systems, so that a dentist is not just a special kind of doctor, but another profession entirely... 

the dental profession really became a profession in 1840 in Baltimore. That was when the first dental college in the world was opened, I found out, and that was thanks to the efforts of a couple of dentists who were kind of self-trained. Their names were Chapin Harris and Horace Hayden. They approached the physicians at the college of medicine at the University of Maryland in Baltimore with the idea of adding dental instruction to the medical course there, because they really believed that dentistry was more than a mechanical challenge, that it deserved status as a profession, and a course of study, and licensing, and peer-reviewed scientific consideration. But the physicians, the story goes, rejected their proposal and said the subject of dentistry was of little consequence... 

Otto: One of the most dramatic examples is that more than a million people a year go to emergency rooms with dental problems. Not like they’ve had a car accident, but like a toothache or some kind of problem you could treat in a dental office. It costs the system more than a billion dollars a year for these visits. And the patients very seldom get the kind of dental care they need for their underlying dental problems because dentists don’t work in emergency rooms very often. The patient gets maybe a prescription for an antibiotic and a pain medicine and is told to go visit his or her dentist. But a lot of these patients don’t have dentists. So there’s this dramatic reminder here that your oral health is part of your overall health, that drives you to the emergency room but you get to this gap where there’s no care...

But, yeah, there’s this marketplace issue. Private organized dentistry protects the marketplace for care and the power of private practitioners to provide it but that leaves a lot of people out. Stories like the battle of this dental hygienist in South Carolina, or the battle that’s going on over these midlevel providers called dental therapists in a number of states, really illustrate how fiercely that terrain is protected."



FB: "One dental researcher said at a meeting I was at, “Back in the days of the bubonic plague, medicine captured why people die. We don’t capture why teeth die.” There’s this gap in the way we understand oral diseases and the way we approach tooth decay. We still approach it like it’s a surgical problem that needs to be fixed, rather than a disease that needs to be prevented and treated. And we see tooth decay through a moral lens, almost. We judge people who have oral disease as moral failures, rather than people who are suffering from a disease."

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