Portal de Periódicos da CAPES

Ailing; failing; or just wailing!

2018; Medknow; Volume: 22; Issue: 2 Linguagem: Inglês

10.4103/jisp.jisp_196_18

0975-1580

Nitin Dani,

Dental Education, Practice, Research

”So much time weeping and wailing and shaking our fists; creating enemies that really don't exist” -Don Henley Periodontology, as a specialized branch of dentistry, has existed and evolved for over a hundred years, and it is surprising to hear so many laments about how it is a failing branch. After all, people will not say such things at the drop of a hat! To be brutally honest, our branch was never at the top; it was always a 'rising branch' which has never truly risen to the eminence it was destined for. Let us look at the positives before we proclaim that it is a 'failing' branch. First and foremost, it is what we call as a 'Clinical' branch where we deal with patients and not objects. It is a surgical branch; a great boon for those who have to urge to see red (but not too much of it)! There are avenues open for academics and research. And finally; what we have heard for so many years and so many times; it is a branch that all other branches depend upon for their success. With so many positives why has our branch not risen to the top of the pyramid? Why has it not translated into clinical success, or to put it another way, success in the clinics? Why do we Periodontists still have to depend on doing General Practice and not have the privilege of being Specialists? Why is Consultation Practice still back-breaking and not rewarding? So it's time we look at the negatives! Periodontal disease never hurt anyone and that is the crux of the problem. Very rarely is it the chief complaint of the patient and mostly it is a secondary finding, and that too found by a Periodontist (as general dentists are notorious for either not recognizing the cases or overlooking them for immediate monetary gains). Pyorrhea, as a layman would call it, is also associated with the social stigma of poor oral hygiene and other bad habits. Hence it is not 'self-advertising' as Orthodontics or Esthetic treatments. Moreover, most of the research has gone into understanding etiology and not in treatment. Even after a 100 years we still perform the same treatment; SRP and OFD! And add to all this the dependence on maintenance for gaining success. So our branch is still 'ailing'! With so many epidemiological studies quoting the immense percentage of the population suffering for periodontal disease, and with rising dental awareness among them, why has it not culminated into financial success? Why are there not enough patients opting for periodontal treatment? Why the lack of consults? And hasn't all this led to the lack of admissions in post graduate colleges? With so many of us dependent on colleges, who in turn are dependent on admissions to survive; isn't it here that all the 'wailing' about 'failing' started. So where does the blame lie? I think, the rise of Periodontics has slowed down with the advent of Implant Dentistry. Now, the general practitioner as well as the patient has an (over exercised) option to 'extract and implant' thus negating the need for periodontal treatment. Though, we as periodontists, have embraced this specialty with open arms, most of us are still true to their branch and would rather save the tooth than implant a vacant space. At all debates on 'Tooth vs Implant' it is the tooth that always wins! But with so many dentists, both specialists and general, doing Implants, it is no longer a wonder that we as a specialty have hit a speed breaker, in terms of patients, financial success and PG admissions. Though we have slowed down a bit; we cannot and will not give up our quest to be the most preeminent branch of dentistry, a feat which we will attain one day. Maybe the proclaimed boom of Implant failures or the so called “tsunami of peri-implantitis' will fuel this rise to the top. We have to bide our time and keep up our self-belief and work relentlessly towards a better tomorrow! For all that rises, falls and all that falls, rises like the Phoenix! And this is the rule of nature. Our branch is neither AILING nor FAILING, but all this is JUST WAILING!