Dental News - Why orthodontists should be holistic

Dr Dennis J. Tartakow, USA

Fri. 16 April 2010

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Orthodontics is holistic dentistry. Surely that is correct. We, as prudent orthodontists, do not just treat a malocclusion; we treat a human being who happens to have a malocclusion. This is a mind-body-spirit unity, and orthodontists are unique among professionals in this respect.

Attorneys compose legal opinions while accountants get to the bottom line of a balance sheet. However, an orthodontist who does not treat the patient as a whole (holistically) misses the entire point of being a doctor.

These observations are not new concepts; the doctor-patient relationship is omnipotent. Bad relationships can do actual harm. Who would doubt that patients who trust their doctors are likely to do better than those who don’t?

A sympathetic and compassionate doctor is more likely to be diagnostically and therapeutically accurate than one who imitates sympathy or has little compassion.

In our world of dentistry, everything we know about alternative treatment modalities and the healing power of a listening bartender indicate that people are likely to be best treated by doctors who treat them as whole and complete human beings.

Not that I am Asklepios, the founder of medicine and reputed ancestor of the Asklepiades, the ancient Greek doctors’ guild, but the ultimate answer to doctor-patient relationships and healing probably lies deep in a metaphysical labyrinth. It is rather obvious that patients have contexts, and the contexts matter and need to be understood.

Often the whole family of a young orthodontic patient will need to be in the mix of a patient’s treatment for a successful result to occur; the orthodontist is the go-between to the whole nexus in which his or her patient is treated successfully or not.

We might have a duty only to the patient, but in order to properly fulfill that duty for legal purposes, the tentacles of understanding and enquiry must be ubiquitous.

Obviously, it is improper to treat only the symptoms of a disease. Practicing as holistic doctors, we acknowledge that malocclusion is most often a symptom of something else, and our job as orthodontists is to track that problem to its source in order to accomplish effective and stable results.

This sounds almost mystical and, hopefully, exhilaratingly mystical. It makes every orthodontist a psychoanalyst, a detective, a shaman, a priest and a friend; it requires every doctor to be a whole human being, which is a highly romantic but essential calling.

Only whole human beings can treat whole human beings. Being a whole human being is not always easy to demand of anyone, but it is a particularly important demand of all clinicians whose training is so concentrated, who must be knowledgeable about so much and whose time per patient is so terribly limited—and now that is a problem.

How can orthodontists be made whole? How can we be equipped to deal effectively with the complex bundles of contradictions we call our patients? That is the quintessential essence and answer of doctoring!

Editorial note: This editorial was inspired by an original essay: Foster, C. (2009). Why doctors should get a life. Journal of the Royal Society of Medicine, 102, pp. 518–520.

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