THE EDITOR'S CORNER
A friend of ours looked at himself in the mirror a couple of years ago and saw a 47-year-old blimp, who could easily have passed for 55, and he decided to do something about it. He began jogging and watching his diet. He enjoyed the feeling he got from jogging several miles a day and bicycling to work instead of driving. He decided that he would enter a marathon and he has since completed numerous marathons. A marathon covers 26 miles, 385 yards. The other day he completed a triathlon--a 10-mile run, a 20-mile bicycle ride, and a half-mile swim. He thought that his time of 2 hours and 52 minutes would have been better if he had trained for the swimming part. Why does he do these things? It is not only that he looks better--slim, trim, and looking ten years younger. He feels better physically and mentally, and he feels better about himself--spiritually, you might say. It sounds like a definition of holistic health. It also sounds like a definition of wellness.
Most orthodontists would not have much trouble understanding such a concept of wellness. Our understanding is challenged when people like Avrom King suggest that orthodontic practice should be conducted on a wellness model rather than a remedial or fix-it sickness model of traditional dentistry and traditional orthodontics. Worse still, it is suggested that those who cannot accommodate to practicing wellness will find it difficult to survive in the private practice of orthodontics as early as 1990.
Perhaps the key is that you cannot practice wellness for other people if you do not practice wellness for yourself. At least it would be more difficult and less rewarding. In addition, one need not be an overweight blob in order to achieve the benefits of wellness for oneself, although such a condition may be motivational. The program of wellness for the individual is simply stated--physical exercise, good nutrition and health habits, and control of stress. One should add, as Dr. Shealy has, having spiritual ideals and living up to them in dealing with people. It would be difficult not to accrue significant personal benefits from such a program, including a feeling of physical well-being and a psychological euphoria coming, in part, from an improved self image and appreciation of others. If these are the possible rewards of wellness, the individual orthodontist has a great deal to gain from it, in addition to it being Step 1 in the progress toward a wellness model for an orthodontic practice.
Step 2 is the inclusion of the office staff in the wellness model. Each must practice wellness for himself or herself, and acquire the potential benefits for self. Step 1 and Step 2 might easily be combined into one step.
When doctor and staff have achieved a certain level of wellness, it might become easier to understand what may be involved in practicing orthodontics on a wellness model, which King calls health-centered dentistry. The difficulty we have with the concept of health-centered orthodontics is twofold. For most of us, orthodontics is the mechanical correction of a morphologic problem--in short, straightening irregular teeth; and for all of us, orthodontics is a transient practice--a one-shot
corrective process, albeit a prolonged one. Until it is proven that orthodontic therapy can prevent caries, periodontal disease, and TMJ dysfunction, we are likely to continue to feel that orthodontics is different from a medical wellness model and from a general dental wellness model as it relates to disease; because the practice of wellness would not seem to help people to avoid the usual orthodontic problems, as it may help people to avoid illness.
So, some offices may achieve a level of wellness for doctor and staff and not effect a significant change in the remedial practice mode. But, others may find a subtle evolution occurring as a result of their wellness example and the spilling over to patients of positive feelings that flow from the personal practice of wellness. A community of wellness--doctor, staff, and patients--should result in a community of interest and a community of effort. One could expect patients to take more responsibility for their treatment and its success. While a concerted program to teach patients physical exercise, good nutrition and health habits, and the control of stress may be inappropriate, there may still be changes in the way that orthodontics is practiced in some offices.
Many orthodontists may get away from the practice of looking at diagnostic materials and not at patients--of looking at orthodontics as an isolated problem of irregular teeth; get away from looking at the relationship only of teeth to bone--and pay more attention to soft tissue analysis; get away from looking at orthodontics as a functional and cosmetic therapy--and extend the concept to the contribution that orthodontics can make to an individual's physical, mental, psychological, and spiritual well-being--to his wellness.
