We Have Ourselves To Blame

By Louis Malcmacher, DDS, MAGD

I know this may come as a shock to many of you, and I certainly don’t mean to insult anyone reading this column, but I never watch PBS. I find the programs boring, the people who do the voiceovers talk too slowly, and I can fall asleep for an afternoon nap just as easily without watching it. But when they did an exposé about dentistry, of course I had to watch. I was right. The documentary was relatively boring and the announcers spoke too slowly, but I managed to stay awake. I could write pages and pages about the different aspects of this program, but I want to focus on just one point in this PBS program — the midlevel providers called dental therapists.

I’m not even going to go into the issue of whether midlevel providers are good or bad things. We’ll leave that to the politicos of dentistry to figure out, and I’ll share my feelings another time. What really struck me was when a dental therapist said on TV, “We are trained to the level of a dentist — how I am taught to do a filling, a baby root canal — I am trained to that level. I’m just trained to do fewer things.” My ears perked up, and I believe we all really need to think about that statement. Seriously? How in the world could the person on the show say that with a straight face? Then I remember something that I’ve said many times in my lectures and in this column — we have only ourselves to blame.

Here’s what I mean. Many patients see us as only teeth mechanics. It may surprise you to know that many, many dentists see other dentists as only teeth mechanics. Well, if our patients and our fellow dentists believe that we are only teeth mechanics, then what this dental therapist said is 100% correct. She is as well trained as any teeth mechanic because if all we’re talking about is being able to fill a hole, because that’s all we think we do as dental professionals, then we were big fools to spend four years in dental school when we could have gone to a teeth mechanic school for a lot less time and money.

Dentistry in North America is at a crossroads, and we as dentists have a very serious identity crisis. Some of us call ourselves physicians of the mouth, but truthfully, that also really limits dentists. We are really physicians of the head and neck area, and it’s about time that we start acting as such. It is high time that you, a dental professional, look at yourself in the mirror and decide what you’re going to do for the rest of your dental career. If you’re only going to be a teeth mechanic, then I can guarantee you one thing —dental therapists, other midlevel providers, and technology will replace you. Today you need to start acting like a physician of the head and neck the way you’ve been trained. You need to expand your practice by going to continuing education, and you need to understand once again that the role of the muscles in the head and neck contribute to facial pain and facial esthetics. You need to treat these areas, and get training in frontline TMJ/myofascial pain therapy and facial esthetics, and you need to start providing more services to your patients by improving your clinical skills and expanding the access to care.

I hope that the words of that dental therapist on PBS ring in each and every dentist’s ears, “We are trained to the level of a dentist…” That is a warning shot to the integrity of every dental professional. Since it was on TV, patients will believe that these dental therapists are as well trained as dentists. If you are nothing more than a teeth mechanic, you will be an extinct species just like the dinosaurs. If you are a dental professional who has received advanced training and treats the entire oral and maxillofacial areas, both intraorally and extraorally, then you will have a long and fruitful career.

Louis Malcmacher, DDS, MAGD, is a practicing general dentist and internationally known lecturer, author, and dental consultant. An evaluator emeritus for CLINICIANS REPORT, Dr. Malcmacher is the president of the American Academy of Facial Esthetics at facialesthetics.org. Contact him at (800) 952-0521 or email [email protected]. His website is www.commonsensedentistry.com, where you can sign up for a free monthly e-newsletter.