We thank Dr. Andrew and Dr. Amy Tanchyk for their comments in response to our article. Their letter raises an important point regarding our role as health care providers. One of our primary purposes as health care providers is to reduce the morbidity of oral disease. But is that all? Where do the boundaries lie for oral health care providers in medicine? The Drs. Tanchyk argue that it may be appropriate for the "dentist to make clinical recommendations regarding the use of more appropriate current systemic pharmaceuticals to patients with severe oral manifestations of multisystem diseases."
Although we appreciate their sharing their own personal experiences, to make broad recommendations based on this would be scientifically and clinically inappropriate. I do agree that oral health and systemic health are inextricably bound and that we have the potential to screen and monitor medical diseases and conditions. However, our primary role continues to be that of experts in oral disease.
Certainly our patients will be better served if we initiate a dialog with our physician colleagues and play a more active role in monitoring adherence to drug regimens and disease maintenance. But to actively make clinical medical recommendations to patients regarding the medical management of their diseases is inappropriate and serves to undermine the growing relationships we are building with our colleagues in medicine.
