Comprehensive Dentistry: Attaining Health rather than Patching Problems
Many of my patients are reluctant to undergo dental treatment that isn’t immediately necessary to them. I work really hard to communicate, verbally and with the aid of technology, the signs and symptoms that tell me what is going on in their mouth, and what is likely to happen in the future. Nonetheless, I have patients that choose to only treat their painful or obvious issues, and I am grateful to have the opportunity to help them.
Still, the most beneficial treatment, in my opinion, is the one that enables the whole mouth to work in harmony, and protects the teeth, joints, bone, and gums for the long haul. Many times this can mean rebuilding multiple teeth, orthodontics, gum or implant surgery. Tooth wear, decay, periodontal disease, maloclusion, and missing teeth are not simply isolated concerns. These issues can accumulate: crooked teeth prevent adequate cleansing and lead to inflammation, recession, and tooth-supporting bone loss; a missing tooth can lead to the shifting of neighboring teeth, an uncomfortable bite, jaw joint degradation or pain, or periodontal pocketing; tooth wear can lead to a collapsed bite, cracked and unrepairable teeth, esthetic concerns. While these things don’t happen overnight, they will certainly occur over time. I treat thousands of patients, and I observe the diseases and conditions of my patients’ mouths over months and years. What appears to be a series of small, inconsequential issues can lead to a seriously poor oral health situation.
The interrelation of problems in the mouth suggests that comprehensive dentistry is beneficial, and indeed, this is my preferred modality for treating my patients. But what does that mean? It means that I strive to team up with my patients so that we can improve their oral health in its entirety, in an optimal, timely, and financially attainable manner. I know that if we can achieve a level of esthetic, functional, structural, and biological balance, then we can go into “maintenance mode.” Surely, things will fail over time (no dentistry is forever–we are up against human biology, bacteria, and massive forces in this profession), but treating a smaller problem in an otherwise healthy mouth is much more predictable than trying to deal with a problem in a patient with suboptimal oral health overall.
One of the barriers to this type of dentistry that I encounter is affordability. Comprehensive dental treatment is an investment that is not typically accomplished within the budget of dental “insurance.” I would challenge anybody contemplating the investment to consider that, while the upfront cost of comprehensive dental treatment is expensive, it will allow you to confidently enjoy the beauty and function of your smile for a lifetime, with minimal upkeep.
One of my mentors asked every patient in his practice “Do you want to keep your teeth for the rest of your life?” Invariably, patients answered that they did. When he saw patients who would decline optimal dentistry, he would say to them, “When we met, you told me you wanted to keep your teeth for the rest of your life. I can see that you are making some decisions that suggest you no longer feel that way, what has changed?” Though I find it challenging to be as confrontational as my mentor, I share his philosophy: who wouldn’t want oral health that is beautiful, functional, maintainable, and lasting?
-Bradford Mattison, D.M.D.