Relating as Applied to Dentistry

By  Louis G. Barrett, D.D.S.

            Visualize fifty thousand dentists busy for fifty years. Sinbad, in the world of the wondrous, might well imagine them to be endeavoring to discover some mysterious solution whereby dental caries and pyorrhea might be at once terminated for all time. In reality, however, these men are laboring to keep aware of the ever changing cinema of facts, to discover their structural significance and so help each other and their patrons in their application.

An electric sign flashes to millions of people on Monday, “Eat Blank’s Bread.” Tuesday, many will do so. We are so constructed that we may increase the rate of our living upon symbolic levels far beyond our ability to keep adjusted to on physico-chemical levels. There is a time factor! Whether acid-base imbalance or mental-physico-chemical problems are the business of the moment these fifty maintaining a harmonious relation between ourselves and the ever changing world.

Now such a symbol as “Eat Blank’s Bread” is accepted by the American people as representing certain physico-chemical vitamin facts which they consider desirable to their health. Accordingly, Blank’s bread is consumed in great quantities. The dentist notices the acid-base imbalance and advises raisins. Maintaining dental health has become his work, and he is certainly busy.

This business often necessarily takes the form of highly technical gross mechanical and physical procedure; materials are shaped and visible structures created. These are related and adjusted to the tooth or teeth.

Accompanying this behavior of these fifty thousand men is a less visible, and therefore, perhaps less conscious activity quite as important to dental health. I refer to our lectures and dental literature; to our relating or thinking.

We have discovered the relation of acid-base imbalance to dental health, both highly symbolic near fictitious, yet valuable tools in actual removal of dental decay. We may discover the relation of alcohol to the daily diet to gingival delicacy, and why fear of infection and sodium perborate may add to this gingival delicacy. Work with what tools we will, it is necessary to maintain dental health. It is the value in the process of relating that I wish to call attention to and see used more and more.

In our thinking, which, after all, is a structural relating process on symbolic levels, why do we limit ourselves to one “ology?” However perfect we may think we “know” this “ology” of what use is it until we relate it to something else, and get it moving and so working?

There exists a tendency to look at one part so fixedly that we neglect to relate it to the whole. Dental literature exhibits increasing evidence that we look to the mind more and more for the solution of the eternal dental problem. The mind affords us an organ whose function is specifically that of relating. What gets related depends much upon whether we concern ourselves with the manipulation of gold or Blank’s bread and the patient’s dental reactions both equally and necessary.

Perhaps we are adequately  educated for the time being in anatomy, physics, physiology, bacteriology, biology and so on that we may pause and become aware that we have, like the worm in the geometry book, seen each figure but never the book as a whole. We have entirely overlooked the relations, the little connections or connectors which tie these matters together; complete the electrical circuit so they all may function. There is evidence of some attempt.

We have studied calcium metabolism and even fed our patients “lime.” We know something of hormones. One “endocrinologist” has obligingly tied up gonadal hormones with calcium metabolism. Dr. Quimby and Dr. Briggs have encouraged this relating of well studied parts. Let us connect these facts; isolated because of some Mr. Aristotle two thousand years back, for good purposes then, but static in a world of motion today. We dissect and separate to analyze but, once understood, synthesis is necessary to use the facts.

A knowledge of colloids is useful to dentistry for in understanding colloidal behavior we are able to sense significant responses to general colloidal changes in our patients. The casual, the tense; fears, desires, etc., all instantly changeable.

It is well to be ever aware of the degree of abstraction which we deal. It is one thing to be related to the patient on physico-chemical levels with “only” the burr between, and quite another but equally potent circumstance when words are the bond. We must be aware of the tools we are using.

The patient experiences an event. Say two pounds of candy are eaten, or living ten years with an over hearing wife or husband. Certain objective physico-chemical results are abstracted and readily observed. These in turn may be further abstracted and definitely symbolized by words. The words may be the only part we get of the original event which accounts for the result we endeavor to treat.

We must consider more the words given us by the patient, take more case histories, use all our various senses to understand each new and always different case. We cannot afford to assume that we know “all” about a patient and the causes of the existing dental illness by a few hastily interpreted “signs”. Only by knowledge which, after all, is a matter of structure and related structures, therefore can we deal successfully with dental problems without over looking seriously important facts.

This knowledge is not “possessed” by the medical world or already completely accumulated by anyone. It is an activity inherent within us; a sort of exploring ability. Upon it, effective diagnosis and the welfare of our teeth and bodies are dependent. Need we simply strive toward a “medical” point of view. Perhaps in looking to medicine as our superior and guide we not only automatically express our subordinate position but overlook the fact that medicine too, commits the error of insufficient rating. How many physicians consider of a case how much is structural, how much functional, how much constitutional? Should we stop with gross physical structure and abandon the microscope? Should we fail to admit submicroscopic possibilities or events greater than their physical results which we observe as signs?

Let us not so childishly hero-worship “medicine.” In that attitude lies a danger of limiting ourselves to dependence upon its scope which never can be “all.” Rather should we respectfully recognize our, at present, dependent relation to the vast medical structure, experience what we can of its fine accumulation of knowledge, the do our own thinking, which is relating.

8 West Park St.,

Lebanon, New Hampshire.