I
am well known amongst friends and colleagues for an unerring sense of geographical dyslexia. Undeterred by previous failings, I will gaily announce a quicker way to get somewhere (even if I’ve never actually been there) and inevitably get lost, or at the very least arrive half an hour after everyone else.
Short cuts are indeed seldom so effective when viewed in hindsight. A quick read of the General Dental Council’s (or Dental Protection’s) collection of salutary tales reveals all too often that Dr X failed to take a pre-operative radiograph, read the medical history properly, or indeed have one at all.
So when reading recently that a gut bacterium had been identified in mice which prevents them from putting on weight – even when fed a high-fat diet – I did think that “here we go again”. Bariatric surgery – the so-called gastric band and bypass operations has been shown to be far from a short cut to weight loss, and fad or crash diets are largely ineffective. There are no real short cuts in healthcare.
As health professionals we get in on the act too. Dental advertisements in glossy magazines all focus on the ‘confident smile’ or ‘perfect whiteness’ and once again I see the words “lost before you start” swim before my eyes. Wonderful promises designed to lure in those who have the cash, but not necessarily the sense, to know what they are getting themselves into.
It is of course promoting or taking advantage of that most widespread human frailty. We all want to be healthy, live longer, be more successful, more attractive. But the old adage of happiness being not ‘having what you want, but wanting what you have’ is still true.
Those who undertake instant orthodontics don’t always recognise at the outset that retention is not just for Christmas but for life. That veneers will fail – some sooner than others but all will fail in time. That fixed prosthodontics means a seriously committed oral hygiene regimen if it is to last. Or that the follow-up to failure may mean even more drastic action or a path to accelerated edentulousness.
I worry about the old – I’ll be there one day too. I worry about a population afflicted with dementia and carers who know little about restorative dentistry, advanced both in years and complexity. About people with rheumatoid arthritis who can’t hold a power brush, let alone and interdental widget to keep their implants clean.
I worry that to the burden of a longer old age we add the burden of complexity. In a time when everything is OD (on demand) whether it’s movies, food or healthcare, we don’t always take the time to get to know our patients before embarking on a major voyage of reconstruction. There is some brilliant advanced dentistry out there, but it wasn’t learned in a few hours, days or even months. And the definitive treatment plan probably wasn’t arrived at in that timeframe either.
It’s probably time for my medication again, but at least I know a short cut to the chemists.