By: Savannah Craig
The separation of medicine and dentistry has always confused and fascinated me.
As a dentist, we are acutely aware of the impact of oral disease on the rest of the body, but why aren’t medical doctors taught anything about teeth?
This question becomes even more apparent when you realize that over a million people a year end up in the emergency department for dental-related infections and are met with physicians who are not trained to address the cause of the patient’s problem.
From the Beginning, Medicine and Dentistry Have Been Separated
In her book, Teeth, Mary Otto explains that from the beginning, medicine and dentistry have been separated.
The tale goes that in 1840 Chapin Harris and Horace Hayden attempted to add dental instruction to the curriculum at the University of Maryland college of medicine. However, the physicians rejected the proposal and destined medicine and dentistry to be forever separated.
Dentistry is treated more as a mechanical and surgical type of profession, whereas medicine focuses on prevention and treatment.
Public View of Medicine and Dentistry
The separation of medicine and dentistry has shaped how the public views the two professions.
Dental care is often viewed as optional.
With access to dental care being such a barrier to care, many people avoid the dentist until there is a problem and don’t focus on preventative or routine dental care. These patients then end up in emergency rooms with physicians who can only treat the symptoms and not the problem.
The only way to stop a dental infection from continuing is to remove the source of the infection by either removing the infected nerve of the tooth with a root canal or extracting the tooth to remove all of the infection.
Impact of Oral Disease on System Conditions
The public perspective of dental care being less important than medicine stems from a lack of education surrounding the impacts of oral disease on system conditions.
Periodontal disease has an impact on blood glucose levels in patients with diabetes.
Dental infections can travel to other parts of the body via the bloodstream and result in endocarditis or infections in the brain.
The biggest misconception I hear from patients is that because their tooth no longer hurts, it is no longer a problem.
Unfortunately, when a dental infection gets bad enough it kills the nerve of the tooth and causes necrosis. When the nerve of the tooth dies, pain signals are no longer transmitted, so patients think the problem is solved.
Often, however, this is a sign that the infection has progressed.
Push for Collaboration Between Medicine and Dentistry
In recent years there has been a push for collaboration between medicine and dentistry to find a way to mitigate the number of patients who are presenting to emergency rooms with dental infections.
This involves finding dentists who are willing to see more emergency patients so that access to care is no longer a barrier.
Additionally, in many cases, dental residents are working to help train medical residents on how to identify and manage dental infections in the emergency department.
Teaching emergency medicine doctors to provide nerve blocks to patients using a long-acting local anesthetic can help buy patients time until they can get to a dental provider.
The benefits of integrating medicine and dentistry are numerous and while much work is being done across the country, there is still so much more that can be done.
Patient care can benefit from a more holistic approach and collaboration between medicine and dentistry can be advantageous for both professions.
Up Next: Why Don’t Physicians Refer to Dentists?
Photo by Anna Shvets
