Of my favorite lessons in written and spoken English grammar was Redundancy. Redundancy is a grammatical error. For example, "TWO twins", "THREE triplets", "UNEXPECTED surprise", "NATURAL instinct" and so on. Why are these grammatically incorrect? Because, twins are always two; triplets are always three; a surprise is obviously unexpected and instincts are natural.. duh. Similarly, I believe the term "aesthetic dentistry" is highly redundant- Dentistry was, is and forever will be Aesthetic.
Yup, dentistry is aesthetic. When you restore and replace, providing a level of healthcare that feels and functions like the rest of the real stuff in the mouth, it is aesthetic. It is aesthetic when you cater to a cleft patient. It is aesthetic when you orthodontically treat malocclusion in an adenoid-affected child. It is aesthetic when you restore a carious tooth. It is aesthetic when you place an implant and do your best to ensure it does not look and feel like a prosthesis. There's no how good, no how bad, there is only how aesthetic the ultimate outcome of the treatment is. Does your patient think it looks and feels natural; if not immediately, atleast gradually? That is aesthetic. And ultimately all our treatment goals come down to, I repeat, how aesthetic a treatment is.
Back at Khan's when I was training, Dr.Mumtaz Khan elaborated on the difference between aesthetic and cosmetic. To put it plainly, aesthetic treatment is all I stated above and cosmetic is a patient demand based on what he specifically likes. Let's take plastic surgery:
Aesthetic demand is - " I want this cleft scar to go away from my upper lip." (It's a human feeling. The patient wants an abnormality removed).
Cosmetic demand is - "I want my lips to burst out like Angelina Jolie's " (Whether it makes me look like a clown or not - this is madness as I'd like to think.)
Now, let's take dentistry:
Aesthetic demand- "I want my teeth to look normal. My centre-teeth overlap and it looks ugly. Make them straight. Also, they are too dirty yellow. Make them a bit whiter."
Cosmetic demand-"I want a hollywood smile makeover and the kind of white teeth that glow in the dark."
That difference between white teeth and glow-in-the-dark white teeth is all the difference between how aesthetic and how cosmetic. It's also, in my opinion, the difference between sanity and madness. It is the difference between a need and a want, in a way. To some of us the line between the two is thin and to those who practice "consumer-centred dentistry" there is perhaps none- give the patient exactly what he asked for as long as you are well-fed. But to a principle-centered dentist there's all the difference in the world- provide the patient what he needs and wants as long as it agrees with sound clinical judgement. Come to think of it, dentistry is principle-centered. Quackery is consumer-centred. *Dr.Irfan's voice rings in my head, "mjhey qanoon pata hai" Oh how I miss debating!*
Any dentist with sound clinical judgement would know that Aesthetics are a component of our treatments. I think it should be so instead of it turning into a separate specialty- a redundant specialty. By creating a whole specialty we are:
A. reducing the quality of work of a general dentist or any other specialist to perform as aesthetically as is required/expected of a dentist. We are leaving aesthetics for a whole different set of practitioners to handle.
B. We are raising the cost dental treatments that are already pretty costly. A whole new specialty brings a whole new bunch of expenses.
C. We are slowly and gradually making the term "aesthetic" ambiguous and the same time synonymous with "cosmetic". We are encouraging madness in a public where aesthetic concerns are already turning into cosmetic ones.
D. Yes, we are in the business of improving health and self-esteem. But we are ever turning into businessmen more than healthcare providers should we continue being okay with "consumer-centred dentistry"
*Breathes. Laughs. Looks around to see what bottom-of-the-food-chain looks like. Puts her head down. Decides not to share on facebook. Daydreams about walking upto the podium and making a grand oration of the script above. Wakes up.*
Off to the kitchen to make some garlic bread. If Edgar Allan Poe can write goth and also anabelle lee.. than I can cook, dream and work to make my dreams come true.
Alhamdolillah for everything. =)
