Around 1900 a famous author, Maurice Maeterlinck, made a profound statement which, I am sorry to say, continues to prevail. “Each progressive spirit is opposed by a thousand mediocre minds appointed to guard the past.”
Mediocre minds constantly challenged Einstein early in his career doing everything possible to discredit his theories and ideas. It seems that whenever a progressive spirit comes up with an idea that challenges existing ideas, out of nowhere come the critics, not only challenging their theories but wanting them chastised and penalized for daring to present them.
Someone once declared that you should not judge a person by his friends but by his enemies. If you are making a difference you will be challenged and probably disliked.
In medicine I am beginning to see a little light at the end of the tunnel. The pioneers in alternative medicine, little by little, are gaining respect. Such medical schools as UCSF, Stanford and Harvard are beginning to respect ideas that were laughed at just a few years ago, but there is still a long way to go.
One example is the rejection of acupuncture because it is not “evidence based.” Isn’t 6,000 years of successful use more evidence than the pseudo scientists should need? Complex surgeries are done in China without general anesthesia. The patient can talk during the procedure and can get up and walk to their bed. How many patients die from anesthesia each year in our country?
Hans Selye, an MD that pioneered the idea that stress caused disease was laughed at in the 1950s. Now all physicians agree with him.
When I see a patient for TMJ I look at the whole person, not just their teeth and jaw. I thoroughly review their dental AND medical history for certain medications, health issues or other things may be contributing to their symptoms. I then refer the patient to the appropriate professional if needed. Every once in a while I get opposition from another health care professional who questions why, as a dentist, I am asking for a medication review; making a sleep study referral; referring to a hormone specialist; discussing foods and dietary habits, etc.
The holistic approach requires stepping outside the box and patient participation, which can be one drawback, but the results are well worth it. I have many patients that, after going to several other “specialists” for their TMJ/TMD, have found relief from their symptoms in a relatively short amount of time.
The dental appliance to treat obstructive sleep apnea was not accepted by medicine until just recently when a federal study of over 3,000 patients showed that fewer than 200 were not helped by dental appliance. Some doctors still insist these appliances can only be used on mild to moderate OSA. If a patient isn’t using their CPAP, something else must be done. There is proof in the pudding. One example is our patient who went from 78 apneas per hour (AHI), severe OSA, to AHI=3 per hour, using a dental appliance. Taking into account the lack of acceptance of the CPAP, many are going untreated because of this misinformation.
Unfortunately, too many dentists are labeling themselves as “sleep apnea specialists,” having the patient hold their jaw forward and then making an appliance to that position. It is this guesswork and lack of follow up care that gives oral appliances a bad reputation. ALL of my patients have the optimal position of the appliance determined by an acoustic pharyngometer, not by guesswork. Once they are comfortable with the appliance, each patient is referred for an efficacy sleep study to prove their OSA is effectively treated.
Let’s drop the Egos and concentrate on caring for the patient.
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