To pen or to probe prescribing versus treating, how to decide

Abstract

The question of wellness was explored in Part 15 of this series, based on the definition of health proposed by the World Health Organization (WHO). However that description is now over 70 years old and does not fully address the more holistic approach to oral health, first proposed by Dolan in 1993, which defines oral health as “having a comfortable and functional dentition that allows individuals to continue their social life”. Others have added that “It is the ability to chew and eat the full range of foods native to the diet, to speak clearly, to have a socially acceptable smile and dento-facial profile, to have a fresh breath and to be comfortable and free from pain”. In 2016 the FDI proposed that “Oral health is multi-faceted and includes the ability to speak, smile, smell, taste, touch, chew, swallow and convey a range of emotions through facial expressions with confidence and without pain or discomfort and disease of the craniofacial complex”. For most clinicians and patients, this may have seemed like an unrealistic and unattainable ideal. It was thus later modified by adding the proviso that: “It (sic. Oral health) is influenced by the individual’s changing experiences, perceptions, expectations and ability to adapt to circumstances”. In the endeavour to secure oral health for a patient the dental practitioner may invoke any of the many ways of treating pain and disease, but a frequent choice is with medication – in particular antibiotics and analgesics. This may be prior to, in place of, in conjunction with, or after some form of physical intervention. A poignant question is: which is the best treatment for each situation, i.e. what to do and when?