A Comprehensive Approach to Dentistry
By Thomas S. Jennings, DDS, Colorado Springs LIVING WELL Magazine
Often, while discussing the concerns and desires that people have about their teeth and smile, it is discovered that many of their issues are in need of evaluation and treatment that is comprehensive in nature. Tooth-by-tooth management of dental needs is not necessarily inappropriate. Many issues, especially those of younger patients, can be addressed by that method. Isolated decay, trauma involving limited numbers of teeth, gingivitis (inflammation of the gums), preventive efforts such as hygiene procedures, pit and fissure sealants, modifying homecare and nutritional issues, and simple orthodontics can all be addressed in a manner that is isolated and narrow in its focus. However, the value of treating more comprehensively and with a wider scope is not only beneficial, in many cases, it can even be the critical factor in achieving a patient’s goals. This is especially true for more mature patients and regrettably goes frequently unrecognized by dentists and patients alike.
Most dental diseases progress at a relatively slow rate and, as such, can be very insidious in nature. On occasion, they can develop over a short period of time, but usually not. People do not go from one day being totally functional to the next suffering from complete breakdown because the incremental deficiencies in question usually fall within the average person’s ability to adapt. And, even if they are noticed, the symptoms are usually assumed insignificant. One can live a significant portion of their life with no obvious issue at hand. Our capacity to compensate both physiologically and psychologically is astounding in many ways. However, this can unfortunately be a significant disadvantage in that it tends to breed a dangerous false sense of security. At issue is the inability of the dentist to illuminate, and the patient to accept, the complexity with which seemingly innocent and isolated issues can present.
The need for a comprehensive approach in dentistry is illustrated very well in two different areas. The mechanics of a person’s dentition and supporting structures, or what some in dentistry call gnathologics, is one of these, and it’s a perfect example of a significant problem that can develop after allowing unnoticed or seemingly simple issues to escalate over time. For the mechanical apparatus of the masticatory system to work properly, and with long-term stability, all parts must function properly and in harmony with one another. When a single component in the mechanism does not, disharmony is created and the system compensates by the recruitment and adaptation of other members. In turn, the stress of adaptation causes them to fail as well, which leads to an accelerating downward spiral to a critical point where total system failure occurs. All too often because of the system’s ability to adapt, people are seldom aware of how close it may be to total failure until it occurs. In order to restore function and stability to these cases, a comprehensive approach must be taken as early as possible, which thoroughly defines all the related problems and addresses them appropriately. As time goes by, issues only become more complex, treatment becomes more involved and more expensive, and frequently with less favorable outcomes. Most importantly, if not done exhaustively, failure returns in short order.
When considering the esthetics of a person’s smile, a comprehensive approach is often required. Often the distraction in these cases is to treat one or two glaring issues while not even being aware of the scope of what must be done to achieve the overall result that a patient desires. It is very common for untrained eyes to focus on singular issues or totally miss those that may have developed slowly over long periods. In reality, esthetic smiles consist of multiple factors that must all be objectively considered. Among them, the shape of each tooth and their relative positions, colors, contours of lips and gums, facial shape, complexion, and even personality can have a bearing on creating the desired result. When all these variables are comprehensively evaluated, and a carefully formulated treatment plan that addresses all issues is carried out, can the desired esthetic result ever be achieved?
As the involved dental patient that you are, or strive to soon be, you should be encouraged to pursue inclusive and comprehensive plans––when possible––toward enjoying the healthy and stable smile that you would like to have. If possible, avoid the piecemeal approach that frequently leads to failure that you do not want. If you do not yet have a trusted dental home that is understanding of all the complexities of what your case may present, please contact my office and allow us to serve you.