A long time ago in a galaxy far far away…you know that line from Star Wars. Well, in dentistry we had our own version and we called it Jaw Wars.
Many of you who practiced years ago are familiar with the occlusion wars between neuromuscular occlusion, centric relation and some of the lesser known philosophies. I remember getting caught up in endless debates about which occlusal method was better. Then the wars seemed to die down.
Other trends seemed to dominate dentistry. Boy—those were the good old days.
A few weeks ago on one of the more popular Facebook groups I saw a post that discussed the impossibility of being able to find and record a true centric relation position. The comments flowed—just like the old days.
The biggest difference that I noted was that many of the dentists weren’t arguing about which philosophy of occlusion was better but rather the difficulty of finding the position was leading many of the dentists to throw the baby out with the bathwater and abandon any occlusal philosophy.
I wondered why? The principles of occlusion hadn’t changed. But dentistry has changed. The way dentists practice today has drastically been altered.
For whatever the reasons, it’s not a good idea to abandon a philosophical approach to dentistry because there are forces that are difficult to control...like the economy, third parties or corporate policies.
I remember debating with a “cosmetic dentist” about his article The Truth About CR. It was a heated debate that was carried on in the dental trade magazines. Today, I look back and wonder if it was about centric relation at all…or was it really about a philosophy of practice.
I liken it the question people ask about “what is the worst breakfast you can eat?” The answer is “no breakfast” is the worst breakfast. In dentistry – what is the worst occlusal philosophy? That’s right…no philosophy is the worst philosophy.
Occlusion is the foundation of complete dentistry. Too many dentists have focused on tooth dentistry and the current trends as they have relinquished control and their freedom of choice to the third parties.
A coherent philosophy of practice – and of life is still within the control of each and every one of us. If we all exercised that right, then maybe we can do something to bring dentistry back to the good old days.
The common denominator in all the debates regarding occlusion is what is the best situation for the patient. It would seem to me that in the course of events of late the more important constant is what is fast, technically flashy and encouraged by the corporate or third party contract. What I hear coming from our local dental school is not encouragement to pursue best case solutions, but rather speed, churn and burn attitudes. This is not unexpected considering the degeneration in professional conduct promulgated by participation in third party groups, the surrender of autonomy of both the patient’s and our’s. I hoped that when I left this life in dentistry it would be in better condition than as I found it. Unfortunately the Dawsons, Pankeys, Tanners, Mahans of our generation are fading in favor of a faceless, cold and uncaring force.
Comment by James (Jim) Craig — September 14, 2017 @ 6:01 PM
Hi Jim–Thanks for chiming in on this important discussion. The loss of autonomy as you point out is probably the most damaging thing for patients and the dentist himself. Losing one’s freedom of choice and disabling the decision making process has had devastating effects on the profession. As observed by the multitude of comments on Facebook—this apparently is a very emotional topic for dentists.
Comment by Barry — September 14, 2017 @ 10:26 PM