It was the summer time of 1982, and I wasn’t a dentist but. I used to be a 20-something biochemistry and artwork historical past main on the College of British Columbia. I noticed a e book on my mother’s bookshelf—Life Extension by Pearson and Shaw. I didn’t realize it on the time, however that e book would set me on the trail to practical dentistry—lengthy earlier than the time period “practical drugs” had been coined. It could be a long time earlier than I’d understand I’d be charting a brand new path in dentistry.
The best way this e book talked concerning the physique was not like something I’d seen. This e book wasn’t simply well being recommendation. It reframed the physique as an interconnected system—the place small disruptions may ripple outward into illness, and early alerts mattered greater than late-stage signs. It gave me a framework to assume upstream, to seek for what set sickness in movement lengthy earlier than the signs confirmed up. The authors didn’t use the time period “practical drugs,” however their philosophy anticipated it: intervene early, deal with the basis trigger, view the physique as a system, and use rising biochemical science to remain forward of illness. It was radical for the time—particularly in 1982—and it captured one thing I didn’t know I’d been looking for. I learn it cowl to cowl—all 858 pages. Then repeatedly.
A number of years later, I’d attend dental faculty in San Francisco. In dental faculty, the curriculum is tight. You’re taught to acknowledge signs, outline illnesses, and deal with them effectively. That’s the components: establish, diagnose, code, and invoice. It’s not about stepping again or connecting dots. Dental faculty is designed to get you licensed, to move your boards and to develop into a “protected newbie” and begin treating. When you’re in observe, insurance coverage corporations reinforce the identical sample. The system doesn’t reward curiosity. It rewards compliance. I feel that’s maybe why so few dentists ever make the shift away from typical dentistry.
As a brand new dentist contemporary out of dental faculty, you’re inundated with emergencies that pile up—ache, an infection, necrosis. You’re underwater, and also you need to do extra to assist your sufferers heal, however the insurance coverage mannequin expects you to remain there. In most practices, reimbursements from insurance coverage are fastened. Which means it doesn’t matter how advanced the case is or how a lot time you spend—your pay is similar. The one technique to hold the lights on is to see extra sufferers, quicker. The enterprise mannequin solely works when therapy is predictable and billable.
And it’s the supplier—caught within the center—who’s compelled to decide on. A supplier who needs to do the correct factor however remains to be on the whim of a 3rd occasion—the insurance coverage firm—that determines reimbursement.
When dentists graduate, we’re buried in debt. The amount of illness wears down curiosity, and the strain to pay again a whole lot of 1000’s of {dollars} pushes you towards prioritizing pace and billable procedures.
My first job out of dental faculty was in a high-volume observe the place the main target was pace and manufacturing. I received fired for spending an excessive amount of time with sufferers. My boss pulled me apart and stated, “Simply get again to work, you’re losing time.”
I used to be additionally referring sufferers out—sending them to the correct specialists for procedures our clinic wasn’t outfitted to deal with. The primary time I did it, the periodontist known as me again, confused. “Do you’re employed at South Bay Well being Heart?” he requested. “Is South Bay now sending sufferers out? That’s not like them.”
I instructed him no—it wasn’t them. It was simply me, an worker. He couldn’t imagine it. They wished to know who I used to be.
Then he requested, “And Mr. Ward is okay with this?”
I stated, “Mr. Ward isn’t a dentist. He’s half-owner of South Bay Well being Heart, however he’s not a dentist. He doesn’t get to make these choices about what’s greatest for the affected person.”
No shock, I used to be fired shortly after that. The entire thing lasted about eight months.
Inside months, and with the help from my spouse, I opened my very own observe within the coronary heart of Silicon Valley, successfully within the yard of Apple and Intel HQ.
So, naturally, plenty of my sufferers have been programmers. And programmers, particularly in these early days, have been additionally beta testers. When one thing didn’t work, they didn’t simply have a look at the signs—they went again to the supply code—in different phrases, the underlying logic that determines how the entire system runs. Debugging it meant digging into the origin of the issue and rewriting the directions.
That was the proper mirror for a way I had began excited about dentistry. I wasn’t simply treating the cavity—I used to be debugging the physique. I used to be asking what had gone improper in its working logic. I used to be searching for the supply code of dental illness—the earliest dysfunctions, the prodromal section of illness—the place issues begin to go astray lengthy earlier than a analysis is feasible or signs are apparent.
I wasn’t simply putting fillings anymore. I used to be tracing root causes. The tradition of Silicon Valley inspired that—and I leaned into it.
I used to be nonetheless doing what I used to be educated to do, in fact—and my sufferers have been comfortable. I crammed cavities, did root canals, restored tooth.
However one thing was lacking. It felt shallow, like we have been simply treating the floor. It didn’t matter that the scientific work was technically sound—clear margins, correct occlusion, predictable outcomes—as a result of my sufferers would hold coming in with the identical points.
And I knew it was unacceptable to tread water alongside my sufferers for the remainder of my profession. That’s not what a practitioner ought to do. We shouldn’t be complicit in dysfunction—we should always interrupt it. That is the upper calling of the healthcare practitioner—whether or not you’re a nurse, physician, myofunctional therapist… but it surely requires stepping outdoors the curriculum, outdoors the billing codes, and deciding to assume for your self.
As sufferers and colleagues began to note the unconventional means I used to be practising, they known as it “holistic dentistry.” However that label by no means felt fairly proper. Again then, holistic usually meant power traces and meridians—concepts I couldn’t co-sign as a result of they weren’t grounded in biology or knowledge. And even once I agreed with components of holistic dentistry, the label didn’t match the larger image I used to be making an attempt to work from.
What I used to be constructing wasn’t only a philosophy. It was a framework. A programs strategy to oral well being. And that wanted its personal identify.
For years, I didn’t know what sort of dentist I used to be. I didn’t match into the organic dentistry camp—too targeted on supplies, not sufficient on programs. Integrative dentistry was useful in its emphasis on collaborating with different healthcare suppliers, however nonetheless reactive, and dealing downstream of signs.
I all the time felt misplaced—too scientific for the holistic dentists, and too crunchy for the standard ones.
I didn’t got down to be totally different. It occurred organically—a sluggish collision between the best way I used to be educated and what I knew my sufferers really wanted. I couldn’t ignore the hole between scientific protocol and long-term well being outcomes.
I imagine that that e book—Life Extension—had planted a seed in the way it challenged the belief that illness is inevitable. I didn’t need to simply repair issues. I wished to enhance life span and high quality of life for my sufferers. And, fortunately, as a result of a lot of them have been programs thinkers, they have been receptive and open.
And now, a long time later, my eldest daughter (who was born 5 days early on the day I opened that personal observe) has helped me carry my message to YouTube, this article you’re studying, Instagram, podcasts, and extra. And now, increasingly more dentists are realizing: that is the place the way forward for our occupation is headed.
We’re shedding practically 1,000,000 lives yearly to illnesses we may have prevented. The persistent illness disaster isn’t slowing down. It’s rushing up. And dentistry—the mouth, the airway, the start line for digestion and immunity—remains to be sitting in a silo.
That may’t proceed.
We have to redefine what it means to be a dentist. We should be programs thinkers. Engineers of human well being. We have to go upstream, to the prodromal section of illness. And fiercely advocate for our sufferers.
We have to cease solely treating signs and begin intercepting illness.
That’s the promise of practical dentistry.
If one thing on this clicked, you’re not alone. My CE course, Foundations of Purposeful Dentistry, is constructed from 4 a long time of observe. For those who’re completed firefighting and able to get upstream—hit reply. I’ll ship the main points.
This CE course is for the dentist who’s bored with firefighting. Who finds extra which means in stopping a cavity than in filling one. Who is aware of it’s more durable to quantify illness prevention—but it surely’s the place the true energy is. Prevention means altering the trajectory of somebody’s well being earlier than signs ever present up. That’s not administration. That’s true care.
As a result of the true which means of “physician” is trainer—and healer. And the way efficient would you like your healer to be? Consistently underwater, reacting to signs? Or on the opposite aspect—pondering upstream, taking cost, serving to sufferers rewrite their well being future?
Be a part of a neighborhood of dentists and rewrite the story of what dentistry may be.
We’re not simply treating tooth. We’re treating programs.
Hit reply and let me know if you happen to’re , and my crew will add you to the waitlist.
For those who’re searching for a dentist who “will get it”—begin right here. You deserve a companion who understands airway, vitamin, and the oral-systemic connection.
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