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ESTHETICS: A H E A L T H C A R E S C I E N C E ?

ur profession will unquestionably be affected by impending changes being considered 0 for the practice of medicine in the United States and beyond. The ongoing erosion of the definition of compensable procedures appears to bode poorly for esthetic dentistry.

As we monitor the complicated swirl of activity and opinion coming from Washington, however, we are cautiously optimistic that the timing of these proposed changes is poten- tially in our favor. Only recently, many in the mainstream health care environment have come to realize that dentistry as a health care science goes far beyond the elimination of decay and the eradication of periodontal disease.

In a guest editorial in the Journal of Dental Research (March, 1993), Goldstein cited the fact that esthetics plays a role in the overall health and general well-being of patients. Consider the following:

The research of Cavior and Howard (1973) on facial attractiveness demonstrates how criminals, in some cases, may not have adopted antisocial behavior had they looked better or had a better self-image.

Increased rates of high blood pressure in girls have been linked to the stress of being plain looking.

Criminologists report that attractive people are penalized less than unattractive suspects.

Self-esteem is a complex dimension of human action and behavior that has been shown to correlare with success and can be enhanced by increased attractiveness.

Luckily, society has evolved in its perception of health and well-being. NO longer is the presence of strong vital signs and the absence of sociopathologic tendencies enough to indicate that an individual is “whole” or well. One area where this change is evident is in the workplace where progressive employers are doing much more than offering free physi- cal examinations. They are providing avenues to reduce stress by permitting workers time off to care for aging parents. Some are now offering paternity leaves. Others are establish- ing Employee Assistance Programs to help workers cope with personal and emotional problems, and many have developed weight loss and smoking cessation classes to help staff members live healthier lives.

Don’t misunderstand. We hardly anticipate that employers will adopt a policy of offering to reimburse employees for esthetic dentistry procedures anytime in the foreseeable future. In fact, the current trend suggests an even tougher road ahead in the area of reimbursement for esthetic treatment. Yet, in light of a growing societal appreciation of wellness and integ- rated good health, it is up to every one of us to fight and fight hard for our right to prac- tice state-of-the-art dentistry, which incorporates esthetics, and to uphold its position as a

fide health science.

J O U R S A L OF ESTHETIC DEPiTlSTRY

We can, and do, help erase the hidden prejudices that exist in a world in which being attractive is a definite advantage. By helping patients achieve their goal of enhanced physi- cal appearance, we also contribute to an improved self-image, which can lead to all the psychological, emotional, and physical benefits associated with feeling attractive. Certainly, then, esthetic dentistry must most accurately be described as a true health science.

We must maintain the momentum and be vigilant that political expediency and prevailing opinion not be allowed to extinguish the progress and recognition that have been so long coming to our field. Adopting a limited definition of acceptable practice such as that being hailed by our leaders in Washington as “progress” threatens to plunge us into the age-old definition of dentistry as pure infection control and to “undo” the true progress that has benefited our profession and our patients.

&- Ronald E. Goldstein, DDS W

David A. Garber, DDS

Editors-in- Chief Journal of Esthetic Dentistry