My compliments to Dr. Bruce Baum for his eloquent commentary in January JADA, "Inadequate Training in the Biological Sciences and Medicine For Dental Students: An Impending Crisis for Dentistry" (
JADA 2007;138[1]: 16–26
). Unfortunately, very few in organized dentistry care about this major deficiency in dental education. Fewer still are willing to do anything about it, despite the admonitions and pleas that have continuously appeared in the literature,1 in addition to those cited in the commentary. Therefore, I feel the need to add my opinions to the discussion.
First of all, Dr. Baum mentions, facetiously, his "(unofficial) specialty of oral medicine." Therein lies the core of the problem. The American Dental Association has repeatedly refused to recognize oral medicine as a specialty equal to oral and maxillofacial surgery, endodontics, etc. Who else, except those boarded in oral medicine, will have the expertise to rectify this educational void within our dental schools? Will physicians do it or want to do it? I don’t think so.
Second, the state education departments that regulate continuing education are not guided to mandate that a certain amount of required continuing education credits be devoted to oral medicine subjects. This would suggest to dentists that knowledge of medicine is not essential for the protection of their patients, as well as themselves. Just ask those practitioners who have been sued for malpractice because of a missed diagnosis of cancer or for failure to refer a patient for a diagnosis of other life-threatening diseases or situations if they might have benefited from more knowledge, or a review, in oral medicine.
Third, if medicine is to have a future in dentistry, it must be recognized that knowledge of oral medicine also is essential for medical school students and physicians. They most likely get very little information, beyond what they read in the newspapers, about the fact that oral organisms gain access to the bloodstream and produce metastatic diseases, via biofilm formation, in many organs and other sites. This fact links oral and general medicine irrevocably and is the perfect entree for cooperation between medical and dental education, as well as physicians and dentists.
Also, how many dentists feel intimidated when calling a physician to discuss reasons not to administer prophylactic antibiotics when the patient says, "the doctor wanted me to take it" or, not to withdraw anticoagulant medications prior to dental treatment? We are doctors, too, and we must know what is current and proper and in the best interests of our patients.
Dental education administrators (deans of dental schools, the ADA and state education officials), as well as the medical profession, must wake up, recognize these inadequacies, put aside political agendas, become proactive and make important decisions to provide more medical education to dental students and dentists for their own knowledge and protection, as well as for their patients. This is a life-and-death matter.
TOP
REFERENCES
