Regular readers know that one of our ongoing pet peeves is the idea that more medicine is always better medicine. As Melody Petersen, author of Our Daily Meds put it in a recent interview on AlterNet, “Many Americans don’t understand that all of health care has risks and that too much of it can actually shorten your life.”
Consider: 100,000 Americans die each year just from the “known side effects” of pharmaceutical drugs.
“That is,” Petersen notes,
those deaths didn’t happen because the doctor made a mistake and prescribed the wrong drug, or the pharmacist made a mistake in filling the prescription, or the patient accidentally took too much. Unfortunately, thousands of patients die from such mistakes too, but this study looked only at deaths where our present medical system wouldn’t fault anyone. Tens of thousands of people are dying every year from drugs they took just as the doctor directed.
When you do factor in medical error, as well as deaths from non-drug treatments, you wind up with a total of almost 800,000 Americans killed each year by conventional medicine. Yet skeptics constantly talk only about how dangerous “alternative medicine” is.
Any medical treatment – conventional or otherwise – carries risks. Some risks are more common than others; some, more serious. All should be weighed against the potential benefits before being agreed to or declined. This is key to evidence-based medicine and the crux of informed consent.
One of the risks of too much dentistry is tooth damage that can ultimately lead to its death. As Dr. Verigin writes,
When a dentist drills a tooth, heat is created from all the friction. Though it will be cooled some as water or air is applied, quite a bit of heat remains. Moreover, the spinning of the carbide- or diamond-tipped bur creates a vortex similar to a tornado. This can – and does – suck out the protein processes that are within each dentinal tubule. Such empty tubules are called dead tracts. Repeated dental treatments, such as filling or crown replacements, thus become more detrimental to pulpal health. Eventually, this tooth meets the same fate as [a] toxicated tooth…leading to a root canal.
The greater the number of restorative dental treatments, the greater the abuse of and trauma to the affected tooth – and the greater chance of its becoming a candidate for a root canal.
Root canal teeth, of course, are dead teeth and potential harbors for toxins that can cause illness elsewhere in the body. (Learn more about such focal infections).
For this reason – and just as a matter of good practice – we generally recommend starting with the least invasive, least traumatic treatment needed. After all, one can always ramp up treatment. And while it can also be scaled back, too often, damage caused by aggressive treatment can’t really be undone.
Happily, more dentists are beginning to see the virtue of less invasive treatments. For instance, the American Academy of Periodontology (dentistry that focuses on the health and care of the gums) has taken the position that potentially traumatic procedures such as extractions and implants should be considered only as a last resort. According to a media release sent on behalf of a dental laser company,
The American Academy of Periodontology recently reaffirmed its alignment with a core MDT philosophy – namely, that treatment protocols designed to promote and preserve natural dentition are of the utmost benefit to patients and must always be included when presenting patients’ treatment options. Of course, we’re proud that our own patented treatment – the LANAP™ protocol – was built on that very belief.
MDT is in complete agreement with AAP’s stance that whenever reasonable, efforts should be made to save patients’ natural dentition, leaving surgical procedures such as tooth extraction and dental implant placement as last-resort techniques. The ideal is to provide treatment that offers a “clinically proven regenerative outcome” that allows clinicians to save previously “unsavable” teeth – treatments such as MDT’s own LANAP™ protocol. It really is all about the patient.
Concern was expressed that periodontists are allowing patients to dictate their own treatment plans, opting for unnecessary extractions and dental implant treatments for the sake of patient convenience. In the case of LANAP™ treatment, the protocol allows clinicians to remove only diseased tissue while stimulating the regrowth of natural bone, all while providing a comfortable enough experience to the patient that encourages compliance. AAP is correct in asserting that clinicians must insist that patients choose not the easiest but the healthiest path when it comes to the treatment of disease.
Indeed, this laser treatment is a wonderful alternative to conventional periodontal surgery. We’ve seen great results in clients we have referred for treatment, such as pocket reductions of more than 5 mm and increased bone density that stabilizes teeth that otherwise might have been lost. The periodontist we refer to for laser treatment, Dr. Douglas Gilio, practices in Visalia, CA, a good 3 hours drive from our office, which should tell you something about how highly we think of the doctor and LANAP treatment in general! (You can learn more about the procedure itself from Milennium Dental.)
In other “less dentistry” news, a new Australian study suggests that “non-invasive caries management” – allowing or encouraging the teeth to heal vs. drilling and filling cavities – may be effective, at least in some cases:
The non-invasive program was effective in reducing the incidence of new and recurrent decay over the 3 years of the study by more than 40 percent. These results were independent of age, gender, medical status, fluoride history, or previous history of dental caries, in a population of patients attending for treatment in private dental practices. Further, it appears in patients categorized at medium to high risk of developing dental decay, that the program was reasonably cost-effective when compared to existing dental care practice.
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Says study co-author Associate Professor Wendell Evans (Head – Community Oral Health and Epidemiology – University of Sydney): “Unfortunately dental care has moved towards a more interventionist model – the current payment rebate and remuneration process is weighted towards rewarding fillings performed, crowns fitted. This newly adopted system for early decay diagnosis has opened opportunities for action to prevent cavities. The shift in resources towards more expensive and cosmetic procedures, while understandable, is creating a resource and access issue that will require the collaboration of the profession, patients, dental funds and researchers – we see this study very much as a first step towards defining and potentially addressing the problem “.
Unfortunately, no details of the intervention were given in this media release. However, just the fact that efforts are being made to limit dental trauma gives some cause for hope.
Of course, you can do a lot to limit it, too, just by taking good care of your teeth: eating well, practicing good home hygiene, getting enough sleep, avoiding drugs and otherwise making good lifestyle choices. You can substantially lower your risk of dental problems this way and not only avoid trauma to your teeth but trauma to your pocketbook, as well. After all, twice yearly check-ups are cheaper than even a single composite filling…