Yet again, The New York Times has taken to discussing what must be a most pressing, or at least, popular issue; you and your children’s dental health. This time, the piece is actually from a Physician who is the Associate Dean for Research in the Department of Pediatrics at Indiana University School of Medicine. One of his areas of interest happens to be health care reform.
Again, he quotes the “evidence based” research to justify or debunk some commonly recommended dental practices like flossing, brushing, fluoride and of course, x-rays.
What the article says is irrelevant. I could argue the merits line by line (and bore you). The result of the Times’ dental-related articles is an undermining of the Doctor-patient relationship. In essence they’re asking you to question everything your dentist tells you. And while I agree that a certain amount of skepticism in warranted, I mourn this loss of the Doctor as a trusted advisor, someone you can trust to sift through the “evidence” and make sense of the data as it is relevant to YOU.
This is not just the Times’ fault. I blame the dental profession too.
I want to be your advisor for everything dental. The better I know you, the more personalized, customized and individually relevant my advice, which is based on your specific issues, decades of clinical experience and not on some possibly irrelevant study.
Evidence-based nonsense! This isn’t reform, it’s regression.
Randomized, double-blind clinical studies of sufficient time and size to be truly significant are nearly impossible to run today. People aren’t lab rats where most variables can be controlled and monitored. And, Dental Schools, are under such financial pressure, that the resources these studies require are beyond consideration for most. So, the research is poor in quantity and quality.
Not once does Doctor Carroll use the term risk assessment. Not once!
What’s going on?
Knowing how upset I get at this sort of generalized, unfocused and illogical pseudo-science, perhaps this is some cruel taunt aimed at me by someone at the Times?
The unfortunate joke is on those who believe that what they read in The New York Times has any relevance whatsoever to them.
Conspiracy theories aside, this is just another symptom of our deteriorating healthcare system. Even academic institutions have fallen victim to the evidence-based charade that is used to justify government and insurance industry policy. The new generation of doctors are being taught to rely on this method of decision making.
Individualized Risk Assessment, looking at the totality of an individual’s health puzzle takes time, thought and perspective. It cannot be easily studied or quantified in a research project. Nor can a long-term relationship with a trusted advisor be replaced by a formula, chart, guideline or computer.
Dr. Carroll mentions bacteria and saliva as factors in dental problems and yet makes no mention of testing either, something we commonly do at Manhattan Dental Health. Instead, he discusses the merits of bonded amalgam vs. non-bonded amalgam (Mercury) fillings, both of which should have been banned a long time ago. He doesn’t comment on that (the continued use of mercury fillings), a true public health issue at all! So much for really meaningful reform!
I did respond to The NY Times’ x-ray article of a few weeks ago with a letter to the editor. I didn’t hear back nor see it published. But I wouldn’t see it because I long ago stopped reading the rag during the week because I prefer my news as unbiased as possible. I just can’t give up the Book Review section on Sunday!
Watch, they’ll mess that up too.
To everyone’s good health and wellness,
P.S. Thanks to G.M. for forwarding the article to me and to all of you who read my blog and comment. Please pass these along to people who can benefit from a different perspective. And, please ASK me any questions you might have. I certainly prefer responding to you than the NY Times.