By: Dr. John Korolewski
Health has been defined as the absence of disease and health care as the maintenance and improvement of physical and mental health, especially through the use of medical/dental services. If we diagnose and treat your disease, are you healthy? I believe what presents as health care in our country is actually disease care, and it is not making us healthier.
By focusing on the diagnosis and treatment of disease, traditional dental and medical care tends to overlook the importance, scientific basis, and clinical process of promoting the overall health of individuals. Diagnosis and treatment of disease will always be important aspects of health care, but increasing emphasis should also be placed on the preservation and enhancement of health. There are specialists who undertake research, teaching, and clinical practice in the field of preventive medicine, but prevention is no more the exclusive province of preventive medicine specialists than, for example, the care of older people is limited to geriatricians. On the contrary, prevention should be incorporated into the practice of all physicians and other health care professionals like dentists.
I would suggest that in most medical models, the time with your health care provider is a 15-30 minute visit spent on a brief history and examination; a review of your tests and medications; and recommendations how to alter those medications or have procedures done to manage your disease. Given the high rate of the lifestyle diseases in our nation, such as high blood pressure, heart disease, diabetes, cancer; is this working? Does your visit with your physician include a discussion and a plan of what you can be doing to prevent these problems? I would suggest that people looking to get at the prevention of disease are looking outside of traditional medicine to naturopaths, nutritionists, chiropractic, fitness trainers, yoga, etc. They are looking for a “coach” to help them towards their goal of health as opposed to “experts” telling them how to fix their disease.
In dentistry, the typical model is a visit to the dentist (“expert”), the hygienist “cleans” your teeth, the dentist diagnoses your problems/disease and gives you a plan to fix/treat the disease. There are also a few minutes of how to brush and floss your teeth. Believing that fixing your disease alone gives you health, you have the treatment completed. But without uncovering, exploring and correcting the causes of your disease, you continue to have “treatment” most of your life to fix your “problems.” That is disease care; but is it making or keeping you healthy?
In our model for dentistry, the dentist (“the dental health coach”) begins by asking about your goals for health; and then discusses the causes of dental disease (primarily decay, gum disease and bite issues) and how to prevent them. Prior to “cleaning” your teeth, an assessment of your own oral hygiene effectiveness is done (our Dental Fitness Program), you receive feedback on your efforts to keep yourself healthy by removing plaque from your teeth. Your diagnosis and treatment plans are created along with a plan for prevention, you can then act on the causes of disease long before they need to be “fixed.” Yes, you may need treatment, but by understanding and preventing the causes of disease, you may experience less treatment in your lifetime. This is “health” care in dentistry.
Our team summed this up at a recent meeting when we agreed on the following statements: We believe helping our patients create health takes a plan, and a relationship; just fixing disease may not. We believe when you create dental health you have less cost, less repair and more control over dental health. We believe addressing the causes of disease leads to health more effectively than treating disease.
What do you think – is it “health” care or disease care? Your comments are important to us, we would love to hear from you on this topic, please leave us a comment and Dr. John will.