Ask the Experts...
Taking dentistry beyond the drill, fill and bill cycleA health-centered model for dentistry is offered to dentists in a number of continuing education courses at the Pankey Institute. The philosophy of comprehensive dentistry is to have a complete new patient exam, where information about the patient's jaws, muscles, teeth and gums is not only taken, but also co-discovered with the patient. Having the patient understand their problems allows the dentist to become a partner in helping the patient achieve health.
Spending time with the patient allows the dentist to know the patient. "Never work on a stranger" was a credo of Dr. Pankey. Becoming familiar with a patient does not mean knowing his cousins uncle, but rather understanding the patient's goal and desires for his dental health and being able to challenge them to achieve it.
Unfortunately, the drill, fill bill disease pattern is still very popular today. Filling the tooth with the newer 'white' fillings or crowns solves only half of the patient's problems. The tooth is fixed, but why did it break? Which tooth with break next? Often, patients end up having a mouth full of crowns that do not fit together, similar to a puzzle with the improper pieces. This type of dentistry can be frustrating and unrewarding to the dentist as well as the patient. Solving the technical riddle of restoring a patient's mouth involves a thorough analysis of the jaw, muscles, teeth and bite, along with a team of specialists to review all of the patient's options for treatment.
Comprehensive dentistry does take time and the dentist will see fewer patients. Comprehensive dentistry may also appear to be more expensive, however an investment to restore health and maintain stability is less expensive in the long term than patch and fill dentistry, which in most cases will result in pain and emergency care. One advantage of comprehensive dentistry is that it can be staged over time so it can be affordable. Instead of working on patients in 'my' best interest, comprehensive dentistry allows me to work with patients in 'their' best interest.