Book Review: The Shift

by Pat Mc Bride, PhD, CCSH

The clear and present danger of the American healthcare system is that it is siloed and broken. Medical costs are skyrocketing for consumers. Physicians and Dentists practice with hands tied by mandates from the system. Quality of overall care and physician confidence has declined because of the seven minute medical appointment where one may address a “single issue” with the doctor. And, most frighteningly, mass media fans the flames of failed health with Big Pharma ads promising a quick fix for everything from balding to blood sugar control.

The trend to “managed care,” with its unfulfilled promises of equality and equaniminity in access to care, leaves physicians expected to provide interventional care for sick people by managing symptoms instead of searching for causality. Sadly, managed care has not reached a consensus that assigns inflammatory processes as the root cause for most of our chronic diseases. As a reader of Dental Sleep Practice, you know there must be a better way. Enter: The Shift: The Dramatic Movement Toward Health Centered Dentistry. Authors DeWitt Wilkerson, DMD, and E. Shanley Lestini, DDS, offer a comprehensive look at a broken system which does not take into account patient responsibility for overall good health and vitality. In other words, taking from the great 20th Century thinker and philosopher Thomas Kuhn, a paradigm shift in thinking and practice is presented to empower both patients and providers alike.

The detailed and well-cited chapters show the futility of managing disease using only symptoms. Wilkerson and Lestini show how oral and systemic infection and inflammation, airway and breathing disorders, and TM Joint and dental disorders affect not only health and wellbeing but actually change the overall trajectory of an individual’s clinical outcome and lifespan. Issues concerning children and older adults are given specific focus. Chapters need not be read in exact order (I actually jumped to areas of particular interest first). Using a root-cause medical model, each chapter provides a logical pathway for physicians, dentists, and the interested layperson with examples of collaboration, documented studies, case histories, and forms used in their system for examinations and treatment planning. Each and every step of their plan offers means by which you can adapt the information personally and in your practice to empower the demographic you serve.

Understanding how a shift toward whole-health dentistry may work and implementing the step-by-step guide may be challenging, but the ground work is there. It remains for each practitioner and patient to decide which pathway is best for them. Finally, the comprehensive reference section is worth its weight in gold. If one only reads the the books referenced in the blue-boxed inserts throughout The Shift, an amazing education is to be had. Wilkerson and Lestini offer a lifetime work of love, passion and belief that each of us can provide a better and longer life to others.