Dentistry 3.0

by Steven Lamberg, DDS

 The context of this new term, Dentistry 3.0, is derived from Dr. Peter Attia’s recent book Outlive in which he introduces the emerging philosophy of Medicine 3.0. Our drive to be great fixers of what’s broken has supplanted the practicality of prevention. Although Attia’s major theme is about longevity, the concept of approaching one’s health status more proactively is essential. Interwoven into this thinking is the reality that medicine and dentistry have evolved into a somewhat unnatural professional separation that is helpful to no one. It seems however that, driven by our greater understanding of the links between medical and dental outcomes, we find ourselves in a unique period of what we could call “healthcare self-awareness”. A recent push to integrate the two fields will undoubtedly prove beneficial for fulfilling our patient’s needs.

Attia’s thesis rests on the distinction between the current approach of Western medicine, “Medicine 2.0”, and an updated framework, “Medicine 3.0”. The former focusing on treating what’s broken while the later has optimal health as its target. Optimal health is dependent on prevention and the appreciation of treating the root cause(s) of existing conditions. As an example, Attia lists the most common medical conditions causing death which include the following: Cardiovascular disease, Cancer, Neurodegenerative disease, and Metabolic disease.  Medicine 2.0 provides treatments to mitigate their impact. Medicine 3.0 tries to prevent them by working upstream.

Why the need for this new term, Dentistry 3.0? In the current world of dentistry, Dentistry 2.0 is focused on treatment of problems which can be nicely separated into categories such as; periodontal conditions, biomechanical conditions, functional occlusal conditions and esthetic concerns. The progress Dentistry 2.0 has made within the last 40 years has been nothing short of meteoric. Technology and our understanding of biologic systems have led to a new age of proficiency in restoring patients to a place superior to their natural dentitions. Although we know how to diagnose and elegantly plan treatment, the missing piece is the why. Why did this particular patient have the problem becomes the question which should lead us to exposing the root cause. The importance of this step cannot be overstated. This is the essence of Dentistry 3.0, and is parallel to Attia’s Medicine 3.0. Intervening as early as possible always leads to a less invasive solution. As the earliest intervention and prevention are essentially first cousins, we need to up the ante on screening for medical conditions based on evidence uncovered in the mouth.

Intervening as early as possible always leads to a less invasive solution.

My book Treat the Cause…Treat the Airway examines every system of the body and connects the dots between the medical conditions and sleep related breathing disorders “SRBD”. There are many ways dentistry can help patients achieve optimal health by improving the airway and sleep. Dentistry 3.0 recognizes airway problems as a root cause of most dental problems. Clinicians who focus on treating a specific symptom without considering what caused it may allow that root cause to take down other systems in the body. Treatment becomes less predictable. Noticing whole-body disruptions, such as chronic inflammation, and looking for what’s causing them, is what is bringing medicine and dentistry closer together.

As Dentistry 3.0 focuses more on prevention and early intervention, there is a need for more robust data collection and screening tools. Because most medical conditions correlate with airway problems, the Lamberg Questionnaire v 16 is an excellent way to use the patient’s medical history to screen for airway problems. Although data collection is related to screening, it goes well beyond that. In Dentistry 3.0 data collection is used for the purpose of revealing the root cause of the problem. Dentistry 3.0 realizes we cannot treat an AHI and focuses instead on what is causing an increase in the number of apneas, hypopneas, and respiratory effort related arousals. The concept of treating what’s actually causing the airway problem elevates the discussion to Airway 3.0 which will be explored in a follow-up article. Both the Lamberg Questionnaire v16 and Data Collection Form v4 are available on my website for free.

When we have young patients under the curve of orthopedic growth and development for their age, Dentistry 3.0 asks why.

When we have attrition and abrasion of the teeth, Dentistry 3.0 asks why. When the dentition is crowded or the jaws don’t align in crossbite relationships, Dentistry 3.0 asks why. When our dental patients are on cholesterol medications or have prediabetes, atrial fibrillation, hypertension or reflux, Dentistry 3.0 asks why. When young children have problems sleeping which translates into behavioral or learning problems, Dentistry 3.0 asks why.

Are you ready to look at a complex medical history of a patient and then look for signs or symptoms of an airway problem? Do you think yourself a sentinel for airway disease as a dentist?

Do you appreciate the impact of mouth breathing on not just the mouth but the entire body? Is the opportunity to help people maintain a high level of health, free of disease, as significant to you as doing Dentistry 2.0?

As medicine 3.0 and dentistry 3.0 find their paths merging more and more, perhaps the unnatural separation of medicine and dentistry is self-correcting. Hopefully the 3.0s will lead us to a new era where our lifespan and our health span will be much closer than they are today. It is only through prevention and early intervention that medicine and dentistry can join for the benefits of all of our patients. This new mindset will forever change how you feel going to your office each morning. Optimal health is a worthy goal and I believe the juice is worth the squeeze.