Like a decathlete

“Dentistry is work of love.” Kanzo Uchimura (evangelist 1861-1930)

“Life is too short to suffer.” Tony Robbins


Most of Japanese dentists are general practitioners unlike US dentists who are specialists, such as endodontists, periodontists, implantologists, orthodontologists, oral surgeon, etc. I heard a story of one of famous dentists of Japan. When he attended at a dental conference in US, he was asked by a US dentist, “What is your specialty?” and he replied “general practitioner”. The US dentist gave him a disdainful glance and went away. There may be a tendency where a specialist looks down on a general practitioner in other countries. I suppose it is not right or wrong, but just cultural difference.

As a general practitioner, I, like many Japanese dentists, am making effort to get overall skills including ones of root canal treatment, periodontal surgery like guided tissue regeneration, implant therapy including guided bone regeneration, bracing, extracting wisdom teeth, etc. And our final goal is making an ideal occlusion for effective chewing function. A general practitioner is like a decathlete, who may be in lower level in each field than a specialist. But, a general practitioner can make a total planning and execute it by himself, or sometimes with cooperation of specialists, which is rewarding. Brushing up each category is enjoyable, which takes time and money for learning in various seminars.

The case above was a female patient whose chief complaint was difficulty in chewing. She came to my clinic by an introduction of her friend who has been one of my long-term patients. When they had a party, the friend realized her mouth condition looked deteriorated and said she should go to my clinic. She swallows food, not bites. She had given up her teeth problem because she thought it’s too bad for a dentist to cure.

My imagination began to work. I was very excited to face the challenge. She did not accept an implant treatment plan. What I performed here were root canal treatments, minor tooth movement, the crowns covering natural teeth, and the removable dentures which were well accepted by her. She confessed she had depression before the treatment, but it almost disappeared because of this full mouth reconstruction, and made a great smile.

Continuing education is necessary because progress of technology is always happening. There is no final goal in learning.


Helped by system 2

According to the international bestseller “Thinking, Fast and Slow” by Daniel Kshneman, psychologists have been interested in the two modes of thinking evoked by multiplication problem. The two systems in the mind are referred to System 1 and System 2. System 1 operates automatically and quickly, with little or no effort and no sense of voluntary control. System 2 allocates attention to effortful mental activities that demand it, including complex computations. The operations of System 2 are often associated with the subjective experience of agency, choice, and concentration.

When I have a new patient, I sometimes am trapped by the first impression to him or her. And I judge character of the patient and decide if I will treat only the part he pointed, ignore other problems, and finish ASAP, or make a treatment plan of whole mouth after solving his initial chief complaint.

A guy, aging nearly 70, came to my clinic, showing a grimace with pain. He said he went to a dental college hospital because of an acute pain in his lower front tooth. The pain didn’t subside after the hospital’s treatment. By his wife’s introduction, he decided to come here. After all, the problematic tooth causing his pain was not one treated in the hospital. I treated a neighboring tooth which had pus at the edge of root. After the root canal treatment, eventually the pain subsided. He looked like a fastidious guy and my intuition, namely my system 1, worked dominantly in my mind, made me think I should finish and will not do further treatment to avoid emotional trouble.

But, a dental hygienist who is experienced and competent looked at his memo pad filled with lots of schedules, when she made his next appointment after the first visit. She told me that he must be a household name and I should research Wikipedia. She was right. My system 2 began to work and found that he worked in Ministry of Foreign Affairs, engaged in Scandinavian, became a professor of a private university, is an author of international relationship books, and is working as a commentator in TV news program.

After the root canal treatment and subsequent erase of the pain, he showed trust and asked full mouth treatment, and accepted my treatment plan which includes sinus lift, implants, and prosthesis for natural teeth, as you can see photos and X-ray. He was impressed and satisfied to see the before and after photos.

If I had not had the dental hygienist’s attentiveness, I would have missed a chance of full mouth reconstruction which inspires my imagination and creativity. Without her precious advice, I couldn’t have got the successful case.

The problem is when I must activate my system 2 in decision making, avoiding bias caused by system 1. I’m going to study psychology more to solve the problem, to make a better decision.