Director's Message: Are we smarter than dentistry?

April 27, 2007
Who's really the odd man out in the evolution of dentistry? The answer may surprise you.

Is it just me, or has the new wave of evening game shows energized water cooler discussions? Out are the game shows where contestants battle a 20-foot, glittered and spiked wheel. Now the shows have evolved into having an adult go head-to-head with a fifth grader.

The show I'm referring to is, Are you Smarter than a Fifth grader? For readers who are not familiar with this reality program, it is hosted by Jeff Foxworthy, who is best known for his comedy line, "You know you're a redneck when . . ." The format consists of questions taken directly from fifth grade textbooks, and — you guessed it — the adult contestants have to answer the questions correctly to win.

The entire concept got me wondering: Are we smarter than dentistry? Lately it seems that organized dentistry has increased their strategic maneuvers to paint registered dental hygienists as bin Laden disciples with organized cells whose main mission is to cause harm to our patients. Let's look at some recent examples.

• In May 2006, the ADA adopted a proposal that details the duties, training and "core competencies" of a Community Dental Health Coordinator, who would aid dentists and other dental team members in bringing care to the needy in remote and underserved areas.

• In January 2007, an "action alert" was issued from the Illinois State Dental Society in response to SB 1144. If passed, the bill would allow dental hygienists to provide fluoride treatment, teeth cleaning and sealants with supervision. The dental society's remarks state that this will put Americans in harm's way.

• In March 2007, a survey from the Wealthy Dentist determined that four out of five dentists are opposed to expanding the role of dental hygienists as independent practitioners, A full 81 percent of dentists felt that many of these proposed changes could harm dental practices and offer patients a lower standard of care.

• In April 2007, the Arizona Dental Association is supporting a bill that would allow preceptorship-trained dental assistants to scale a Type I periodontal gingivitis prophylaxis, place palliative interim restorations, and coordinate dental care with the supervising dentist.

• Dental societies are spending their dues dollars on high-end glossy brochures. These are being mailed to the homes of registered hygienists, soliciting them to join as allied members.

Why is organized dentistry working so hard to dumb and dissect the hygiene profession when their profession is up for disassembling? The developing trends in dentistry and dental hygiene show that this could easily happen.

Esthetic and general dentists are placing more of their restorative fabricating responsibilities in the hands of lab technicians-partners. Look at the technological advancements that allow computers to straighten misaligned teeth or make crowns and bridges. It comes to anyone's attention that via evolution, these practices may someday eliminate the middle person, the dentist.

On the other hand, how about a laser that can diagnose decay or a gel that can re-mineralize tooth structure? Who may be eliminated if patients can repair their own decay? Chemotherapeutics are only a few generations away in their ability to dissolve calculus, resolve perio-infections, and allow patients to perform their own salivary diagnostic tests. Consider the weekend programs that teach implant placement; can't a medical doctor eventually be allowed to attend and add this service to his or her repertoire? Finally, extractions — medical doctors can step in and perform this service. Isn't it already being done in rare cases through emergency room visits?

Insurance carriers are beginning the crossover of medical and dental benefits. How long do you think it will be before dental insurance is obsolete and medical insurance is all-inclusive? Future oral health treatment may not even include a dentist.

Since organized dentistry will still be on the playground fighting for the chalk in the hopscotch game against dental hygienists, they may not even be aware that a well-directed beam on the head with the medical model dodge ball is slowly annihilating their foot soldiers.

The inevitable truth is that if dentistry continues to play the juvenile games that make dental hygiene the enemy, then those who are smarter will win. For every successful initiative that appears to weaken the dental hygiene profession, I challenge that it will actually weaken dentists and the dental profession.

Why? Because other health professionals recognize the oral-systemic connection and the large numbers of underserved in our communities. They do not have the sacristy mentality or a legacy of protectionism that plagues the dental profession. Hence, non-dental providers will begin to provide the needed care. This will ultimately change the oral-health show and the non-dental providers will win the game.

Kristine A. Hodsdon RDH, BS
Director, RDH eVillage