1996-3-Editorial - Saudi Dental Journal

ISSN (Print) 1013-9052
EISSN 1658-3558

The Saudi Dental Journal,
P.O. Box 52500,
Riyadh 11563,
Kingdom of Saudi Arabia

Tel.	966-1-467-7328
Fax.	933-1-467-7308 / 966-1-467-7534
Email	saudidj@ksu.edu.sa

Editorial

Excellence in Clinical Practice

The Hippocratic oath states that "I will prescribe regimen for the good of my patients according to my ability and my judgment and never do harm to anyone." As Doctors of Dental Medicine, we are entrusted by our patients to render a high quality of clinical management. Our duty is not to just treat patient s teeth, surrounding tissues, oral cavity or even their stomatognathic systems, our duty is to treat the patient in a wholistic manner. Our approach should be treating the patient, not only his mouth. Little and Fallace (1988) stated: "The dentist is no longer treating teeth in patients but patients who have teeth." Among health care providers, we are in a unique professional position to not only treat patients but to also influence their long-term overall health care and their overall outlook on life and living. In many instances we have the opportunity to do so from the cradle to the grave, not only to the single patient but to the whole family and friends of that patient.

We are in a technological age where major advances in dental materials, instrumentation, and techniques are ongoing rapidly. However, "excellence in clinical dentistry" involves much more than mechanical skills to perform a dental procedure on a patient, or to use the latest dental materials product. Professor Tahawi, in the September 1995 issue's editorial emphasized mental dexterity. Excellent practice requires an understanding that treating the "effect" of dental disease (such as dental caries) with a high quality restoration without treating the "cause" of dental disease (such as a high sugar diet) will subject the patient to unending cycles of pathoses. Such causal treatment approach demands current awareness of all basic medical sciences covering the human body.

Professor Bergenholtz's, in the last issue's editorial, aptly stated that "high tech" dentistry, without instituting causal treatment to eliminate oral disease, is not in the best interest of the patient. The importance of basic medical science knowledge necessary to effect causal treatment was asserted by Dr. Bagieh in the May 1995 issue's editorial.

Excellence in dentistry involves many areas including, but not limited to, the following:

Be a doctor who treats the human body as one entity not just a dental specialist or even a general dentist. Be interested in and helpful with the overall health of your patient.
Be a careful examiner who uncovers not only gross oral pathoses, but also manages subtle, ensuing entities such as incipient caries, incipient periodontal disease, teeth wear, incipient temporomandibular disorders, and oral manifestation of systemic diseases. Call in other experts as needed.
Provide the best restorative/prosthetic dentistry that you are capable of performing. Test yourself, as Dr. Allen Brewer, a renown prosthodontist said "If I can't prove it is wrong, I will accept it provisionally as being correct." Always strive to render better care based on contemporary knowledge and training.
A mouth with long-standing bacterial plaque is not a healthy mouth and is every dentist's nemesis.

Causal therapy must be instituted and can be managed several ways. One way to begin with is to inform the patient of each others responsibility, in words such as, "It is my responsibility to restore your teeth and gingiva to health. It is your responsibility to keep regular checkups, to daily remove all
bacterial plaque from the teeth, and to maintain a high level of body health, including a proper diet, exercise and periodic medical checkups." An excellent adjunct is to provide the patient with a "plaque chart" on each visit to serve as a blueprint to remind and encourage the faithful removal of bacterial plaque. 5) Establish a cordial relationship with your patient built upon mutual trust for each other. Emphasize your dedicated interest in his overall health and well being. Healthy bodies are enhanced by a positive and cheerful "state-of-mind." As stated by Dr.
Al-Shammery in the January 1996 issue's editorial "... dentistry has made significant contributions to the quality of human life." Excellence in clinical dental practice can only further enhance the status of the profession, the dentist and the quality of human life.

N. Joseph Nassif
DDS, MSc, FACP

H. Mohammed-Al Tahawi
Member, Editorial Board