Consider this hypothetical and morbid scenario. You happen to be American (No offense meant, American friends). You, or someone dear, were diagnosed with a heart condition that requires an operation. You do not have insurance, or you have partial coverage for what the surgery and materials your physician proposed. You then say to your doctor: “..but Doc, that sounds way too expensive, what can you do for half of that amount? Are there any cheaper prosthetics you can use, perhaps?” I hardly think many people, given the absence of other confounding factors, would bargain their health away. Would YOU bargain it away? I highly doubt it.

Yet so many people have no problem bargaining away the health of their teeth. Those same people often forget that teeth are tiny organs. Teeth are living tissues! Imagine if our endoskeleton was an exoskeleton, and our vitality depended on keeping it intact. Wouldn’t you expend a lot of energy to protect it from the elements? Think about it. Think about all the harsh things we bathe our teeth in and bash them against day in and day out; hot things, cold things, acidic things, crunchy things, spongy things, hard things, not to mention the interminable number of unintended, exotic tasks like ripping tape or cloth, biting nails or pens, and some might even go as far as carrying objects with them. Still, you might say, “You’re right but they’re still just teeth you know.” To which I respond by saying: “What I definitely know is that I want to keep enjoying bread well into my 70s and even 80s, and how I want to remain agile and active at that age too.” Tooth health is total health. It is a state of mind.

As a provider, it is my duty to forecast the health of patients’ mouths. A good provider, is arguably a clairvoyant one too. I had a patient come in to see me at my hospital practice not too long ago. A board executive, who appeared to be in good shape, except he recently needed a kidney transplant due to idiopathic kidney failure. He had, incidentally, had 6 angioplasties done as well. And over a period of just two years, while he was dealing with his medical condition, He lost 3 out of his 4 main masticatory molars, due to incomplete dental treatment. All three were root canal treated but not properly restored with a crown. He now had to deal with the relatively undesirable experience of getting multiple teeth extracted, bone grafting, placement of implants, waiting for the bone around them to maturate and still get the three crowns they should have gotten prior to the original unfortunate failure. Now imagine the added cost of the new treatment, and I am not talking just financial cost here, but emotional and logistical cost as well. An unfortunate ripple in someone’s health had a seriously deleterious effect on their teeth in a relatively short time.

Even if you were to defer or decline this kind of recommended treatment, wouldn’t you want your practitioner to be the kind of dentist who discusses the potential consequences of inadequate treatment? Better yet, wouldn’t you want your dentist to be that one who reflects on and reconstructs the events that may have lead to the ultimate condition of a tooth or a whole mouth, be it medical, social, dental or even the idiopathic? I certainly would. That dentist not only embodies value, but in fact, values you as a patient; as a fellow human, in the trajectory of time.


I am a general dentist and hospitalist with an expansive interest in education research. I come from a basic science, and immunology research background, and am currently pursuing a master in community health with a health practice education focus.

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