‘Be careful not to drown’: A simple reminder on our responsibilities as dentists

During the last year, we have been swamped with the preparations for our newly built office in San Antonio. Various office design concepts, construction details, OSHA compliance requirements, and numerous systems to improve patient flow and comfort have been our everyday issues these days.

Drs. Najafi and Kheirieh

This is a dream come true! We have been planning for this major step since our graduation in 2010. All pieces of the puzzle have fallen into place for our opening date. Our state-of-the-art office is finally ready. As a periodontist/prosthodontist team, we made up our mind to go digital and paperless, incorporating Cone Beam CT scan, intraoral scanner, and other advanced equipment. We even went the extra mile and modified our construction plans to have negative pressure rooms built as our surgical suites in order to help the entire team amid the COVID-19 pandemic.

Last week, while we were discussing all these matters in front our office building, the middle-aged painter who was busy doing the final touch up came to us and said: “Do y’all pull teeth?

We replied “yes” and explained a little about our services.

He continued: “Yeah my back two teeth are hurting for a couple of months! I’ll be your first patient. Yank them out!

Then he pointed to his two back teeth. His mouth being opened, we noticed that he only has two front teeth in addition to those two back teeth on the right side.

This was an awakening for us! We asked each other: “What are we doing? What’s our responsibility as dentists?”

Practicing dentistry for 10 years, we have both treated patients from different socioeconomic status with various mindsets, expectations, dental knowledge, and homecare. This was another moment of insight for both of us… an epiphany! What are we doing for the general public? How much time and effort do we need to spend on raising oral health awareness and explaining the importance of primary, secondary, and tertiary prevention in dentistry?

Have you ever wondered how little dentistry you see on TV and social media? Other than the commercial ads on colorful toothpastes or fixed implant dentures (either right or wrong), what else do we see on oral hygiene and the importance of prevention in dentistry? The correct technique of brushing, flossing or when to see your dentist? The public does not hear enough about the importance of a small filling in early stages in order to prevent the need for more advanced dental treatments. People do not see or hear enough “non-commercial” dental knowledge, other than rare footage of an actor brushing his/her teeth very quickly with horizontal forceful strokes.

It dawned on us that not only do we have to focus on patient-tailored dentistry and believing in dentistry for all, but also not forgetting our oath as dentists.

Patients are the reason we are at office… not digital dentistry, not insurances, and not the business side of dentistry. Simply put, we are obliged to educate and serve our patients, regardless of race, ethnicity, and socioeconomic status — helping them making an informed decision for their oral care. The basic principles of autonomy, justice, veracity, beneficence, and nonmaleficence should not be overlooked.

It seems some may have forgotten the place of the natural tooth in dentistry! Dental implant or other recent advances in technology, equipment and techniques are extremely helpful for us as modern dentists but should not change our values. It is surprising how some dental offices, spas or studios are being named implant centers or having a “screw” as their logo.

Needless to say, esthetic dentistry, digital advances, implant dentistry and recent minimally invasive techniques have been incredibly helpful in our daily practice and should not be taken for granted. However, these are all tools in the modern dentist’s toolbox in order to make better decisions for patients based on each individual’s clinical best interest.

As my father who is a restorative dentist, always says: “A filling is not just for the sake of filling! A dental implant is not just for the sake of placing an implant!”

We should all remember what our end goal is. We shouldn’t let the excessive concentration on the steps of each technique or company claims of new materials or equipment to occasionally replace the critical thinking of practitioners.

It is crucial not to forget the words of wisdom of some great mentors on “the umbrella of prevention,” saving natural teeth if possible and reasonable, respecting the biologic width and visualizing the outcome of our treatments at the time of diagnosis/treatment planning.

Seeing dentistry in New York, Tehran, Toronto, and San Antonio has shown us that the dentistry sky is more or less the same everywhere. As a moment of insight, our office painter reminded us of our much bigger role in dentistry. It does not matter if I am a leader or member of the American Dental Association, American Academy of Periodontology, American College of Prosthodontist, a faculty member at a dental school, a consultant in a dental company, or a clinician in my small or big office, either rural or urban area; we all have to do our part and remember our responsibilities to the public and serving our patients ethically, caring for them and helping them making an informed decision.

Regardless of the amount of our student loans or the cost of our CAD/CAM machine, we should always put patients first and not allow the business side of dentistry dictate our diagnosis/treatment planning. However, there is no doubt one cannot overemphasize the grave importance of institutionalizing the ethics and morals.

The present commentary was just a reflection of our personal observations. We felt this was worth sharing with colleagues as a good reminder for us along our journey through the churning waters. We should be careful not to drown.

Dr. Babak Najafi is a periodontist who graduated from Rutgers School of Dental Medicine. Dr. Parisa Kheirieh is a prosthodontist who graduated from New York University, College of Dentistry. They are the owners of Origins Specialty Dentistry in San Antonio. In addition, Dr. Najafi holds adjunct assistant professor position in Department of Periodontics, Rutgers School of Dental Medicine. Their involvement in clinical research projects and presentations in regional and national meetings show their commitment to cutting-edge dentistry. When away from their office, they work on their new Dental Educational Series on dental topics for public, “Word of Mouth: The Truth about Dentistry.” Through social platforms and community events, they strive to make dental care more relatable. You can reach them at www.originsspecialtydentistry.com if you have any questions.  

5 comments

  • Well said Doc!

    Takin #oralhealthISoverallhealth to the streets. You’re so right about the need for awareness in particular, and in my opinion (100% biased) dentists need to take the initiative to deliver that information to us. Consistently.

    Social media affords dentists the opportunity to craft & disseminate that content to their patients and surrounding communities – as you have so efficiently illustrated in your Word of Mouth: The Truth about Dentistry content.

    The video camera is already in your pocket, you have the knowledge, and the platforms are free.

    We’ll be happy to help spread your content through our network of dentists & patients.

  • This is a great perspective for all clinicians. Unfortunately, the 2-ton elephant in the room is an industry which is run by Wall Street & the private equity investment industry. This industry of the corporate beneficially owned & operated practice of healthcare dominates medicine, optometry, & may soon take over dentistry. Profits and production are their driving forces, not patient welfare. Lofty platitudes won’t replace enforcement of statutes against the unlicensed & unlawful practice of healthcare by corporate entities.

  • Wow. This is a compassionate and heartfelt reminder of what we should all be about. We cannot forget to care for those society ignores, and when we take action, we become better dentists for ALL of our patients. Thank you for the reminder and inspiration, especially in the midst of a pandemic and social unrest. Your father sounds like an amazing human being!

  • This is an excellent article and so well-written. Thank you.

  • So often we get caught up in the Instagram, Hollywood smile hype that we really forget why we went into this profession in the first place.
    Thanks for the perspective

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