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Doctor thoughtful

Are we aware of what we are doing?

It is not a question to make us feel guilty. It is just a thought-provoking question, to think about the impact we can have on our patients. We are dedicated to moving teeth, to improving people's smiles. And this change that we can generate in them is not only going to have an impact on the mouth, it will also affect other aspects of that person to a greater or lesser extent. The other day I was talking to Javier Lozano from Lozano Orthodontics and Shinoi and we were reflecting on the duty of our profession and how fortunate we were to be able to help people with their dental treatment.

Professional deformation is a phenomenon from which we can hardly escape. Whether unconsciously or not, our point of view or our opinions on an issue will be influenced by our work. This is why, faced with the same problem, each professional will have a different approach. Let's take an adolescent with scoliosis as an example. In a case like this, a dentist will find the solution to his problem in the placement of a disjunctor to solve the crossbite, while a podiatrist will determine that orthopaedic insoles will be the treatment that will alleviate his problems. 

Without going any further, specialisation in dentistry also means that we dentists have certain biases or "absent-mindedness" that are inherent to this specialisation. It will not be the first time that an orthodontist has failed to diagnose a cavity in time (myself included) because he was focused on the movement of the teeth, nor the last time that an implantologist has failed to notice a functional deviation of the patient and has placed the implant in a position that is, shall we say, not optimal for correct occlusion. This observation does not seek to criticise, but only to clarify the virtues and limits we have as individuals. That is why it is so important to work as a team, to ask other professionals and to keep on learning. The body does not understand protocols.

Knowing this, within our "field of action", it is important to know that the orthodontic (or orthopaedic) movements we perform on our patients can affect other areas of their physical and mental health. Small details such as chewing better, breathing better, smiling with confidence... will improve that person's quality of life. Be careful, although we know the possible benefits of orthodontics, it is not advisable to use them as an advertising claim, as they will not be the same in all patients and we do not have strong scientific backing to corroborate them. We cannot state categorically that 100% of the patients to whom we place a disjunction will breathe better or that improving the bite will make TMJ pain disappear, although in practice we sometimes see these effects. 

In short, what we do in our mouths has an impact on the rest of our bodies and what we do with our bodies can also have an effect on our mouths. This is where it is most difficult to focus, as the consequences of these habits are not immediate. I remember a talk by Dr. Mariano Follana in which he spoke about the number of young patients he saw who breathed with their mouths, walked with their heads down looking at their mobile phones, were weak... although they came to see him to improve their smile, their main problem was not in their mouths. Faced with this situation, professionals can act in two ways:

  • Quick solution: Give the patient (or the parents) what they want, fit them with the appliance we think they need, solve the problem they came to us for and leave them with a nice smile.
  • Complete solution: Explain to the parents that their child, in addition to having bad teeth, could do with a change in lifestyle. Being more active, doing sport, taking care of their diet... all of this will help them, together with orthodontic treatment, to develop better and become a healthier person.

As you might expect, the complete solution is the most difficult and at the same time the most attractive. As health professionals, we are fortunate enough to see many people every day and we are somewhat obliged to pass on to our patients the guidelines to help them be better with themselves. We won't be able to "change everyone's mind", but if our message gets through to any of them, it will be worth the effort. There is a world beyond teeth. 

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