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We all know
nutrition is undeniably important. In fact, doctors know it’s the single most
crucial element in all of health care. Every act, every thought, every emotion
and every action is a reflection of the right nutrients being in the right
place at the right time; and in the proper quantities; with the right pH; and
correct medium viscosity and temperature. All of those things are controlled by
biochemical reactions and those reactions are the essence of nutrition.
So, why is
this most crucial of items also the single most consistently absent item from
nearly all doctors’ diagnostic and treatment considerations?
The answer
is as astonishingly simple as it is complicated.
•
Dental caries has radiographs.
•
Cholesterol issues have blood tests.
•
Periodontal disease has its clinical
factors.
•
Blood pressure has the sphygmomanometer.
•
Nutrition has...nothing like that
because it is so complicated. In fact, the study of nutrition is as complicated
a subject as is the study of the cosmos. The details of the tiny are as
challenging as the details of the grand. The only way to discuss and understand
nutrition is to look at it from a macro point of view – but with science,
wisdom and reality as the foundation of one’s thinking.
We now have a way to determine a person’s
nutritional status. It used to be virtually impossible to do because even if
one were taken into a sophisticated hospital and had a battery of expensive and
time consuming tests performed, all one would get is a static picture of the
patient that hour or that day or that week; and few hospitals can perform all
of those tests.
A dentist can now accurately determine a
patient’s nutritional status without the need for any lab tests and deliver a
repeatable evaluation of a parameter that is extremely critical in many ways.
He can tell the patient’s nutritional status in the past, currently and likely
what it will be in the future.
Knowing a person’s nutritional status is
important because we never know when we will ask the body to heal.
We know that terrible things happen on the
operating table: heart attacks, strokes, systems shut down and some people die
in the OR. When asked what happened (assuming everyone did everything
properly), the surgeon will tell us that we
don’t know. All we know is that we stressed the body more than it could handle
and we do not know that level beforehand.
What exactly is stress? Stress translates
biologically as the depletion of nutrients. We know the stress nutrients as
Vitamin C, Vitamin E and the B-Complex. Of course it’s much more complicated
than that but we can agree that stress is the depletion of nutrients and when
such depletion occurs, systems can no longer function as designed.
We (sort of) know well approximately 150
vitamins and different nutrients and also know that a single apple has over
8000 different nutrients. Assaying for them all is out of the question and even
if we did that, the “needs graph” for each of us is widely variant even though
we all need the same nutrients.
Now the dentist can tell if the patient is a
high or low risk on the operating table and can do it swiftly and inexpensively
with undeniable results. It is all based on Quin’talano
(the essence of science): Keen
observation with a trained eye and deft interpretation with an educated mind.
The most widely known instance of Quin’talano is the story of Dr.
Alexander Fleming’s discovery of penicillin.
The new oral examination is based on Quin’talano and is the reason dentists
will experience a floodtide of referrals from the medical community.
What surgeon, what hospital, what patient and
family of the patient would not want to know the patient’s nutritional status
beforehand and hence know if the patient is a high or low surgical risk?
Now that we know a dentist can do this, there
is no reason to not make use of this new diagnostic ability. In fact, should
something untoward happen on the operating table and the surgeon is sued, the
prosecuting attorney would ask why the patient was not referred to the dentist
for this evaluation pre-operatively and there would be no good answer – except
that few dentists currently know how to perform this new oral evaluation.
This new oral examination replaces the
under-serving and narrow-scoped dental examination (which never really did hold
up to scrutiny); adds only 2 min to whatever the dentist now does as an exam;
and reveals a plethora of critical information about the patient never before
evaluated. It is an impressive examination; impressive to the patient, to the
staff and to the doctor as well.
There are 30 new items that are evaluated.
The patient who displays 3 or 4 or 5 of the 30 is not telling us the same story
as one who displays 21. Also, which ones and what combinations are important to
the evaluation. No one has any of the thirty because no one is perfect. How far
away from that perfect mark is the result of the doctor’s experience and
training in evaluating the findings.
Our first premise is that we do not believe
that Nature makes design errors – certainly not on a wholesale basis – so the
factory-installed equipment with which we were born should function fairly
well; and if it doesn’t, it is not a design error but a matter of not feeding
those biologic systems what they need so they can perform as they were designed
to perform; namely, keep us healthy and well.
It’s a nutrition problem.
Also, we believe that if you see something
you should not see (edema or bleeding without provocation, for example) or feel
something you should not feel (pain or immobility, for example) it is an
indication that body systems are not functioning as they should for if they
were, you would not see or feel that. Something is wrong.
As I traveled around the country lecturing to
audiences of doctors (dentists and dental hygienists), one of the things I
would ask was a description of a healthy tongue. After some back-and-forth, it
was decided that a healthy tongue had three basic characteristics: it was pink
or pinkish; regularly elliptical, wider posteriorly than anteriorly; and the
anterior 2/3 of the dorsum was homogeneous.
I then asked if anyone had ever seen a tongue
that had a colored coating on it (brown, orange, green, yellow, white, etc.)
and they all said yes; that they see it every day. When asked if that was part
of their healthy picture, they all said no;
we just told you it should be pink. When asked what they did about it, they
all said nothing (admitting that
brushing the tongue did not get to the cause of the problem).
Isn’t the doctor required to respond – at the
doctor level – to those findings that are outside the parameters of health?
When asked if they ever saw a tongue with
teeth marks – making the border a scalloped border, again, they all said yes; that it was not part of their healthy
picture and that they did nothing about it.
And when asked about fissured (scrotal)
tongue, they responded likewise but someone always shouted that it was benign
because the textbook said so. And when asked what the vaunted text said about
its etiology, they said it was unknown. So, how did they know it was benign?
The 30 items are all blatantly obvious yet
are either ignored, looked right past or misinterpreted. No longer. It is time
for dentists to behave as the doctors they have been given the wherewithal (and
responsibility) to become.
And then, we enter that part of the new era
in dentistry that is concerned with how to respond to these findings and do so
at the doctor level. Ignoring them is not appropriate, not professional and not
doing right by the patient who places faith and trust in the doctor.
That is the subject of Part Two.
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