Oral Health Group

Solving The Puzzle

December 1, 2014
by Oral Health

We all love puzzles — jigsaws, crosswords, cryptograms, word searches, Sudoku, and other brain bashers and teasers. They are fun and they keep us sharp and engaged.

We are wired to take great pleasure in pattern-finding. Neuroscientists have found that a large part of the human cortex is primed to spot patterns. Once we spot them, we assimilate them into our pyramid of knowledge and build more layers of strategy. The act of solving a puzzle gives us a feeling of control of our world … a way of creating order from chaos. And it is fun!


The one place where we do not want to be puzzled, is at work, in our practices. We want defined, stable parameters at work. Unfortunately, things are never stable, since they are always changing and evolving. This adds stress to the dental work day. We can counteract this stress by a change in our approach — by trying to see things the way our brains want us to see them. We need to bring fun and control back to work by accepting, and even embracing, the challenge of solving our patients’ treatment dilemmas as puzzles.

Everyone knows that to solve a puzzle efficiently and effectively, you first need a framework and a system, to see the patterns and to get the big picture. When it comes to treatment dilemmas — we need diagnostic parameters and treatment options. These are our puzzle pieces and building blocks.

There are also further challenges. Diagnosis and treatment for oral conditions are multifactorial. Diseases start and progress differently in each patient depending on a host of factors. There is no “one-size-fits-all” approach.

Both caries and periodontal disease are dynamic processes. The process of dental demineralization and remineralization is in constant flux in each patient and periodontal disease may become active or inactive due to specific triggers during a patient’s lifetime.

This issue of Oral Health will provide some of the puzzle pieces necessary to solve patient diagnostic and treatment dilemmas … How to approach radiographic findings like Sherlock Holmes would … Using the most conservative approach in treating deep caries lesions in the new era of bioactive restorative materials and with our new found confidence in the healing capacity of dentin and pulp … Understanding the most easy-to-use, patient-friendly option in periodontal treatment — the oral rinse … Using DNA in saliva (both from the patient and the bacterial squatters) to diagnose periodontal disease and to provide options for personalized treatment … and … Probiotics for enhanced dental health — a concept that is gaining momentum.

What makes this puzzle different is that it is likely to never be completely solved. There will always be new tools and treatments to shake things up a bit and unhinge some of the pieces. If we accept this added challenge with an open mind and a craving for knowledge, the pieces will be rearranged, our patients will be treated with the best proactive approaches, and we will be challenged and fulfilled. What a wonderful world of possibilities!!

Dr. Fay Goldstep has lectured nationally and internationally on Proactive/Minimal Intervention Dentistry, Soft-Tissue Lasers, Electronic Caries Detection, Healing Dentistry and Innovations in Hygiene. She has been a contributing author to four textbooks and has published more than 60 articles. She sits on the editorial board of Oral Health (healing/preventive dentistry). She has been listed as one of the leaders in continuing education by Dentistry Today since 2002. Dr. Goldstep is a consultant to a number of dental companies, and maintains a private practice in Markham, Ontario. She can be reached at goldstep@epdot.com.

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