today GNYDM 25 Nov

By Mark Duncan, DDS n It has often been said that he who asks the questions controls the conversation. This couldn’t be truer than when we are performing a comprehensive exam; even as dental students, we were exposed to the tre- mendous interconnection between medicine and dentistry. The unfor- tunate reality is that for the majority of the profession, the day-in and day- out practice of dentistry is directed toward comprehensive care, but it often comes up short. Our profession has bickered over the concept of “over-diagnosis,” and lay media has produced hatchet jobs about how dentists are diagnosing patients purely for financial gain. In my experience, this couldn’t be fur- ther from the truth! After having met clinicians from across the globe and talked with thousands of dentists, it is painfully obvious the issue we face isn’t over-diagnosis but rather that of under-diagnosis. Quite simply, we don’t ask the right questions most of the time. In dental school, we are charged with learning in four years the breadth of what dentistry has grown through during the last 150 years. Dental schools are charged with teaching us the foundations required to pass board exams and attain our licensure,andtheytrytostaycurrent with a constantly changing frontier. The interesting thing, though, is that especially now, the most important lessons are not at all about new tech- nology and not at all about advances in the profession; the most important things to consider happen during the health history — and most of us aren’t even asking the right questions to find out! There is an absolute connection between the health of the oral sto- matognathic system and the rest of the body, and it is imperative to our patients that we delve into issues suchasheadandneckandfacialpain. In fact, the vast majority of what has been diagnosed or called migraine is in reality a dental issue. The patients with fingertip numb- ness more often than not are dealing with a bite issue. Those people who suffer with atypical endodontic pain with no evidence of pulpal pathol- ogy are suffering from issues that are not addressed with endodontic therapybutratherbitetherapy.There are more than 500 systemic conse- quences of a poor bite and nearly 100 that are so common they should be screened for in every single patient seen. The practice of dentistry is based on the foundation of a healthy peri- odontium and a physiologic bite. Most restorative work done today is lack- ing on one or, more commonly, both of these factors. Medicine discovered decades ago that about 90 percent of pain in the body is muscular in origin. Dentistry should be addressing that same prin- ciple. As oral physicians and not simply doctors of the hard tissues, we can dramatically improve the quality of our patients’ lives. We can end chronic pain. We can extend the lifespan of our restorations. We can make our patients whole again. We will cover some of these topics from the floor today and Monday here at the meeting, and we are always looking forward to the next Core I program at LVI to discuss these con- cepts — and help our patients to live healthier and happier lives! speakers10 Greater New York Dental Meeting — Nov. 25, 2012 What questions should we really be asking? Attend today’s session Today from 11:15 a.m. to 12:15 p.m. and Monday from 3:15 to 4:15 p.m. in aisle 5000, room 3, Dr. Mark Duncan willpresent“Dentistry’sDirtyLittleSe- crets … What Is It That We Don’t Know” as part of the DTSC Symposia. In his session, he will discuss the variety of signs and symptoms that are quite of- ten related to dental issues and help to create the base of conversation to help thesepatientsdiscoverhowtogethelp. About the author MarkDuncan,DDS,istheclinicaldirec- tor at the Las Vegas Institute for Ad- vancedDentalStudies.Heisafellowof theinstituteandstartedteachingthere in 2002. He has lectured on esthetics, occlusion, CAD/CAM technology and practice management internationally and serves as development consult- ant to several dental manufacturing companies. ▲ ▲ AD