Have you ever wondered why dentistry stands out as a separate profession rather than just another specialty within medicine? Despite being crucial for our overall health, dentistry has carved its unique path, separate from the world of medicine. Dentistry has a rich history dating back to ancient times. Dentistry's path diverged from medicine centuries ago, when tooth care was often left to barbers or even blacksmiths!

However, the Greek scholar Hippocrates, referred to as the "Father of Medicine," extensively documented dental topics like tooth decay and gum disease as fundamental aspects of medicine. Pierre Fauchard, called the 'Father of Modern Dentistry' approached dentistry by integrating principles of biology, physiology, and medicine.

It wasn't until the 18th and 19th centuries that dentistry emerged as a scientific field, with dedicated schools and specialized training. Due to the neglect of oral health by mainstream medicine, dentistry gradually pursued its distinct path. There was resistance from physicians at the University of Maryland College of Medicine to integrate dental instruction into the medical curriculum. In 1840, Baltimore College of Dental Surgery, the world's first independent dental college was founded.

According to medical professionals, dentists are unique in their role as both diagnosticians, surgeons and radiologists, catering to patients of all ages and handling a wide range of conditions from acute emergencies to routine check-ups. This breadth of responsibilities distinguishes dentistry as its own discipline, requiring specialized training that encompasses a basic medical curriculum alongside the dental curriculum.

Dentists also study the mechanical, thermal, and chemical properties of the dental materials, as well as their interactions with oral tissues and environments. Some aspects of dental materials may overlap with materials science which may not be directly applicable to the broader field of medicine.

The division between dentistry and medicine has allowed for specialization and expertise in both fields, but it has also resulted in fragmented care and missed opportunities for comprehensive health management. The lack of integration between dental research and mainstream biomedical research represents missed opportunities for risk assessment, diagnosis, early intervention, and disease prevention.

Many individuals receive medical care without addressing their oral health needs, and vice versa, leading to gaps in treatment and potential health consequences. Additionally, the separation of dentistry from medicine has contributed to disparities in access to care, with dental services often being less accessible and more costly than medical services for certain populations.

In the MedBound app, an online platform for healthcare professionals, a question was raised about the potential integration of dentistry and medicine into a unified profession.

This question elicited diverse opinions, with some suggesting that it might happen and others emphasizing the importance of dentistry as a distinct profession. Dr. Pragati Priya, BDS, one of the medical journalism interns at the MedBound Times highlighted that given the prevailing challenges faced by dentistry, particularly in India, merging dentistry with medicine could effectively address this issue.

Dr. Yogeeta VH, BDS, expressed doubt regarding the near-term possibility of a merger. While acknowledging dentistry's potential as a medical specialization, she emphasized its breadth and complexity, advocating for its distinct status in healthcare.

Dr. Nidhi Arora, BDS, suggested that both fields operate in tandem. For example, both fields prescribe the same antibiotics and painkillers. Additionally, instances such as patients developing oral ulcers due to gastric issues illustrate the intertwined nature of dentistry and medicine. Therefore, according to her, rather than using the term "merge," the focus is on working in parallel and together to deliver improved healthcare.

Dr. Sneha. G, BDS, a fellow medical journalism intern at the MedBound Times, noted the repeated advocacy for the connection between oral health and overall well-being. She expressed the belief that integrating oral health and primary care could enhance patient care by addressing their individual needs effectively. This integration, she emphasized, has the potential to yield improved treatment outcomes.

Dr. Vineesha Vasudevan, BDS, remarked that the integration of medicine and dentistry has its challenges. The progress and scope of this collaboration will be determined by progressive healthcare infrastructure and systems, as well as interprofessional training and coordination aimed at fostering teamwork, alongside robust public awareness efforts.

According to Dr. Manav Chaturvedi, MDS, merging dentistry and medicine is not anticipated. However, he observed that dentistry and medicine will continue to be correlated with each other, particularly in the future. He emphasized the existing correlation between oral diseases and other systemic diseases.

Dr. Munish Kumar, MD, the founder and CEO of MedBound & MedBound Times, and an attending Neonatologist, expressed skepticism about the likelihood of merging dentistry and medicine. He also highlighted the distinction of other fields like podiatry, which remain separate professions. According to him, these specialized fields serve specific purposes and have proven effective in their current formats.

While the opportunity to integrate dental and medical education was missed a century ago, the focus now should be on establishing multidisciplinary teams in interprofessional teaching environments. There is a need to enhance the oral health content in medical education and incorporate more medical aspects into dental education. Harvard is currently implementing several programs aimed at advancing holistic patient care by integrating medicine and dentistry. In these initiatives, first-year dental and medical students participate in joint learning experiences both in the classroom and during primary care sessions at affiliated hospitals and the Harvard Dental Center.

Efforts to integrate the medical and dental practices has been increasingly recognized over the past two decades. driven by the understanding of the interconnectedness between oral health and overall health. Integrating medical and dental care within public and private healthcare systems, including oral health screening during medical visits, co-locating medical and dental offices are being emphasized. Expanding the role of dentists in preventive care can improve access to healthcare and overall health outcomes of public.

There are benefits of incorporating oral health into overall healthcare, particularly for vulnerable populations such as pregnant women and patients with chronic conditions. However, several barriers hinder the seamless integration of dental and medical practices. Addressing these barriers to integration will require collaboration among policymakers, healthcare organizations, and professional associations.

Nevertheless, the cooperative healthcare approach has the potential to enhance cost efficiency, create fresh opportunities for professionals in dentistry and medicine, and ultimately result in better oral and overall health results.

References:

1. Atchison KA, Fellows JL, Inge RE, Valachovic RW. The Changing Face of Dentistry: Perspectives on Trends in Practice Structure and Organization. JDR Clinical & Translational Research [Internet]. 2022 [cited 2024 Apr 23]; 7(1_suppl):25S-30S. Available from: http://journals.sagepub.com/doi/10.1177/23800844221116836.

2. Donoff RB, Daley GQ. Oral health care in the 21st century: It is time for the integration of dental and medical education. Journal of Dental Education [Internet]. 2020 [cited 2024 Apr 23]; 84(9):999–1002. Available from: https://onlinelibrary.wiley.com/doi/10.1002/jdd.12191.

3. Mouradian W, Lee J, Wilentz J, Somerman M. A Perspective: Integrating Dental and Medical Research Improves Overall Health. Front Dent Med [Internet]. 2021 [cited 2024 Apr 23]; 2:699575. Available from: https://www.frontiersin.org/articles/10.3389/fdmed.2021.699575/full.

(By Dr. Nirainila Joseph)

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