Interdisciplinary Dentistry

Last week I was invited to attend the annual North Eastern Society of Orthodontists (NESO) meeting in Boston. You may ask why I attended an orthodontic meeting when I am not an orthodontist? The reason I was invited was because of the strong interdisciplinary component of the meeting. What is interdisciplinary dentistry?
I’ll use the example of a 38 year old woman I saw just yesterday as a new patient. She had not been to a dentist in a couple of years and wanted to have her teeth cleaned. She saw one of my hygienists, had her teeth cleaned, and then saw me for an examination. My examination of new patients usually includes a set of photographs of the teeth. Over the years, this has proven to be invaluable for me to be able to discuss a patient’s dental status. It is much easier to show and explain than just explain.
I evaluate 4 areas in every patient. Those areas are the biology, esthetics, function and structure of the teeth. The biology is the health of the gums and bone that support the teeth. This is important because this is the foundation of good health. I always evaluate the esthetics of the teeth because the smile is the most prominent feature of the face. The function of the teeth is an evaluation of how the muscles, joints and teeth are working together – does the patient have any muscles or joint (TMJ) issues and do the teeth show any signs of wear? Lastly, the structure of the teeth is the condition of the teeth themselves – what is the patient’s dental history and what is the condition of the existing restorative dentistry in the patient’s mouth?
As I was taking this new patient on a “tour” of her mouth, I simply described what I saw. As often happens, my patient started asking a lot of questions. The bottom line is that she always wondered why she had repeated dental problems and had a list of things she did not like about her teeth. Her dentists in the past had never looked this deep into her dental issues, so she was never given the opportunity to do anything about it. In the past, if there was a problem, the problem would get the quick fix, a crown or a filling, and life would go on until failure occurred again.
This patient, who came in just to have her teeth cleaned, announced that she was ready to fix her teeth correctly. As her dentist, I need to be able to deliver the level of care she expects. This is only possible with effective collaboration between a group of dentists. Her treatment will probably be phased over the course of a few years. It will require collaboration between me, an orthodontist, a periodontist and an oral surgeon. This is interdisciplinary dentistry.
Much of the NESO meeting was about treatment like this. The dentist must have the educational background of the many different disciplines of dentistry and be able to communicate their findings in simple terms that patients can understand. Doing a complete exam and reporting findings is the obligation of the dentist to the patient. This at least gives the patient the opportunity to choose the level of health that is right for them as an individual.
When it comes to actually doing the dentistry, it is essential that the general dentist, the quarterback of the team, has the right players assembled to make the entire treatment a homerun.