"Medical nihilism is the view that we should have little confidence in the effectiveness of medical interventions."
https://en.wikipedia.org/wiki/Nihilism
When I graduated, I was well and truly versed that most dental problems were caused by dentists intervening.
Patients who went to the dentist, we were told, ended up with less teeth. We got failed if the pulp was exposed during a restoration. If the tooth was lost it was because our root canal failed. And of course, posterior composites were never going to work (1997 
).
Such guilt and despairing negativism was built into us largely by those who taught us, but did not practice dentistry to any large extent. Perhaps they did not like clinical dentistry. Or perhaps they sought to be a "physician of the mouth", that catch-all phrase which calls those insecure about being a proceduralist.
Whatever, it took a long time to shake off.
It took time to realise I did not cause the pulp exposure. People with healthy teeth never get pulp exposures, mechanical or carious (as if you can always tell which was which).
It took time to realise you cannot always be a physician. Some patients, despite intense efforts to use minerals, medications, motivations, and meditation, cannot be treated non surgically. For some patients, the best thing you can ever do for them is a radical toothectomy.
It took time to realise the tooth did not fail because the root canal wasn't good enough. It failed because the patient left a disease continue until it was at a late stage and difficult to repair.
It's not your fault that the patient needs expensive treatment. It's not your fault that dentistry is not subsidised like the rest of health care.
I have noticed that it is becoming trendy even in continuing education to adopt this nihilist attitude. Everything we do fails. Our interventions are mostly pointless. Modern medicine is doing more harm than good.
To this I say, nonsense!
People have always had access to sleep. To food. To Exercise.
The modern longevity we have is due to vaccinations, antibiotics, and routine life-saving surgeries that have success rates so high that we are surprised when anyone actually has a bad outcome.
Modern comfort is due to hip replacements, dental implants, hernia repairs, and medications that stop arthritis crippling us.
Our ears still work at ninety because of incredibly well tuned hearing aids and regulations that stop us getting deafened in workplaces.
People do not constantly suffer tooth ache because regular checkups allow interventions to be smaller, easier and less costly.
People have much better dentitions than they used to
Do not fall into the trap of despairing, depressed, nihilism.
You do good work for your patients and they (despite their massive levels of anxiety which manifests in strange behaviours) appreciate it.
What are your thoughts?
