The doctor is a doctor, and the dentist is a dentist. Have you ever noticed why there is such a clear separation?
When you go to the hospital, a doctor will never ask if you use dental floss. When visiting a dental clinic, the dentist never asks questions that overlap with the doctor.
But separation is not as simple as you see on the surface. Right from the university lecture hall, oral health care has almost been separated into a branch in the medical education and training system.
In the United States, both the network of doctors, the medical record system, the payment system of medical services and the oral health care services run in parallel. You have health insurance in the US, not sure you have dental insurance.
This leads to oral health care becoming an entirely different profession, similar to dermatologists. You will hardly find a dentist working at the hospital, and this absence creates a medical vacuum, drawing down billions of dollars each year and sometimes the patient's life.
So where did everything start, for the reason that dentists could not act as a doctor and vice versa?
The history of dentists dates back to the 10th century AD, the period of barber-surgery (Barber surgeon). Yes, you have not heard wrong, medieval barber will carry their tools to work, in which not only scissors, razors, but also tools to perform minor surgery, Typically, tooth extraction.
It was a time when the Catholic Church had a great influence in European society, the monks put absolute faith and spread clean, basic personal hygiene activities, especially by shaving. Head and spit out the deep teeth.
In this period, every monastery had to rent or train at least one barber. These workers will always do the dentist's job – a career that has not yet appeared, and of the surgeon – perform some minor operations such as blood injections, leeches …
Doctors, themselves, consider surgery a profession "poor"Compared to my position. The reason for medieval surgery is only considered to be a mechanical effect on the body. Moreover, surgery also causes a very high mortality rate due to blood loss and infection.
There will be doctors who practice surgery separately, and are not as important as doctors who work in the academic environment, at universities and point to castles to heal the rich.
When a patient has surgery, the doctor only monitors the process and gives advice, not holding a surgical knife directly. Minor surgery such as tooth extraction is therefore even more disregarded, and that is the land where hairdressers get their chance.
Until the 12th century, new surgical guidelines were gathered by doctors, to lay the groundwork for a more safe and academic specialty. Surgery began to be taught in medical school.
At the same time, surgical barbers also reach a certain skill level. They were even able to perform tricks such as placing broken bones, and even, amputation.
In dentistry, these barbers can perform many mechanical repairs, including metal implants. Their level has been improved.
In France in the 13th century, doctors were divided into two levels: those wearing long robes were allowed to practice surgery, and those wearing short robes were not. The doctors wore long robes then became conceited, causing the doctors to wear short robes very uncomfortably.
They turned to surgical and secret barbers who imparted medical knowledge about surgery to these workers, in order to entice their support and threaten the position of long-gown doctors.
As a result, surgical barbers equipped with medical knowledge now competed with doctors until the 17th century – when health regulations were more closely established and submitted. The education of barber workers no longer keeps pace with medical growth.
By the 18th century, it was very inappropriate for a hairdresser to pull a scissors while holding a scalpel. Any good surgical barbers have separated and only practiced surgery. They also received medical training and gradually merged into the world of doctors, leaving ordinary barbers, only practicing hair cutting.
Like a scalpel, dental instruments also begin to disappear from the hairdresser's pocket from there. The work was taken over by a number of surgeons who had a special interest in oral cavity surgery such as Piere Fauchard, a French doctor.
For the first time in history, Fauchard described himself as a surgeon – that is, a surgeon specializing in dental treatment. In 1728, he wrote and published the book Le Chirurgien Dentiste, description of basic oral anatomy and oral cavity function.
The book consists of 2 volumes with a total of 64 chapters that summarize many dental procedures and tools, from surgical removal and deep tooth treatment, periodontal diseases, correction techniques and braces to replacement. broken teeth, dental fillings and dental implants.
Inspired by the tools of the former surgical barbers, Fauchard also improved and invented many dental instruments, such as dentists and pliers, which are still used today.
Fauchard's job has officially removed dentistry from the list of general surgical procedures, to form a new specialty. This makes him considered by today's doctors "The father of modern dentistry".
After Fauchard's pioneering work, dentists began to appear popular in Europe and then the United States.
Dental care officially developed into a separate academic specialty in 1840, after Chapin Harris founded the world's first dental university in Baltimore, USA.
Chapin Harris is a dentist from a doctor. He started working and studying medicine in his brother's clinic since he was 17 years old. With a passion for dentistry, Harris switched to dental health care industry at age 22.
He practiced for 10 years, before receiving an honorary doctor's degree and becoming a professor at Washington Medical University.
In 1939, with the support of his mentor – Horace Hayden was also a dentist, Harris spoke to the University of Maryland in Baltimore about the establishment of an attached dental school and added programs. Dental teaching for medical students.
The request of Harris and Hayden carries a message that dentistry is not only simple mechanical interventions into the human body, it deserves to be developed into a career. Dentists need to be licensed and get a degree like a doctor. This specialization also needs peer-reviewed research and scientific journals.
Unfortunately, the doctors in Maryland dismissed all of that. They believe that dentistry is a simple procedure and does not cause too many consequences for human health. Proposals of Harris and Hayden were eventually rejected.
Undeterred, Harris with the help of Hayden and a group of other dentists set up the University of Dental Surgery in Baltimore to realize their vision. This is the first university in the world to train and issue a dental surgeon (DDS). With his dedication, Harris and Hayden are now considered the father of American dentistry.
So it turns out, it's the refusal of doctors at the University of Maryland with dentists to make the branch history of dentistry. The dentists now still drill and fill their teeth, while the doctors only accept responsibility from the patient's tonsils.
In the US, medical and dental education are two completely separate branches. And it also entails both insurance, services and health care. Once dentistry operates independently of the health sector, it is also difficult to merge it back.
In 1920, after about 120 years the dental system ran parallel to the overall health care, William Gies, an American biochemist realized this inadequacy. After visiting all dental schools in the US and Canada, Gies wrote a long report calling on the health system to consider dentistry as an essential part of it.
"Dentistry should not be considered as techniques that affect normal teeth", he said."Doctors and dentists can fully and effectively cooperate with each other – they should stand on the same plane, intellectually equal. "
However, responding to Gies' call is a protest from both doctors and dentists. Doctors continue to look at dentistry with scornful eyes. While, dentists with their narcissism never want to lose control.
They argue that the entire dental health care system has been operating independently for decades, it will be difficult to integrate yourself into the medical system, where dentists may later be under authority. other groups of doctors.
Gies' persistent efforts lasted until 1945, when he tried to unify the school and medical school at Columbia University where he worked. But again, this intention of Gies failed.
When the dentists and doctors do not have a consensus, the ones who suffer the most are the patients. In the United States alone, more than 1 million people have to go to the emergency room every year because of dental problems.
However, because the dentist does not work at the hospital, these patients often only prescribe antibiotics against infections and painkillers with a refusal to treat: "This is a dentist's problem, you should go to the dentist ".
These misplaced visits put the cost burden on the system, equivalent to $ 1 billion per year. Sometimes, the dental gap in the emergency rooms is smoked down even the patient's life.
In 2007, a 12-year-old boy lived 30 miles from Baltimore, the home of the American dental industry, and died of encephalitis. It is worth mentioning that the tragic death began only from a deep tooth. The boy named Deamonte Driver went to the South Maryland Central Hospital with a headache.
Here, doctors gave Driver a prescription for painkillers, sinusitis and dental abscesses and sent him home. But after only 2 days, his illness did not help but became worse. Mother Driver took him to Prince George Central Hospital, where doctors took CT scans of the brain and spinal cord to discover that he had meningitis.
After 2 brain surgeries and 6 weeks of fighting the disease, the Driver permanently left in February 2018. The doctors spit out the boy's deep tooth, a 6th molar tooth, permanent tooth first rises when the baby teeth fall away and are very deep.
Driver's 6th molars were deep enough to the marrow, bacteria from abscesses here took advantage of that path to attack the boy's brain. If the problem is solved in the first place, Driver can go to a dentist to extract this tooth at a cost of only about 80 USD.
But his mother did not have insurance and dental benefits, perhaps because of that, she took Driver to the hospital instead of the dentist's clinic.
Bacteria in the mouth and periodontal diseases are increasingly placed in close relation to the overall health of people. This supports the inclusion of an oral health care system in connection with the health system.
From the 19th century, Willoughby D. Miller, an American dentist who discovered oral infections can cause fatal diseases. He considered the mouth to be a wet, dark nursery, very suitable for toxic pathogens to multiply.
Most doctors in England and the United States agree with this, inflammation of the teeth and tonsils has nourished many types of bacteria. Even in the medical system, doctors sometimes require patients to extract teeth to solve a range of problems with the body – from hiccups to arthritis, angina, cancer, pancreatitis to insomnia, hypertension and memory loss.
Robert Genco, a scientist at Buffalo University has spent more than three decades focusing on periodontal disease and their relationship to overall health. His new findings suggest that even obesity and diabetes are linked to inflammation in the oral cavity.
With a strong belief, Genco predicts that the process of merging dentistry back into the health system will take place as a necessity, when the biological clues will eventually bring both sectors to a common intersection. .
"The gap between dental health care and medical services needs to be narrowed"Genco said.
"We all have a common background in basic science. We all have similar training. For whatever reason [nha sĩ và bác sĩ] are separate industries. As dentists, we never look at the rest of the body, and doctors don't look at the patient's mouth. "
In the future, Genco hopes that science can bring dentistry together with medicine. "This is the time when we all see patients as the top focus. It is a two-way street. Doctors and dentists really have to work together to manage their patients. "
Therefore, it is necessary to bring the two industries closer together. An abstract way like Genco said: "Attach the teeth back to the body for patients ".