The Doctor Will See You Now

The role of the D.D.S. may move closer to that of the M.D.

When New York dentist Catrise Austin began offering rapid HIV tests to her dental patients last August, she was surprised at how receptive they were to the idea. "A lot have said, 'Wow, you just saved me an extra trip to the doctor' or 'Not even my doctor has offered me an HIV test.'"

The test, which Austin offers free to her patients, "literally takes two minutes to administer," and involves a quick mouth swab. Results are ready in 20 minutes and easily read by Austin, who went through training and certification by test maker OraQuick.

For Austin, who researched HIV while a senior at University of Maryland's Baltimore College of Dental Surgery, the idea of a dentist branching out from the usual oral health care wasn't so farfetched. "A lot of times, people don't think of us as real doctors, but we go through anatomy and have to know a lot about the whole body, not just teeth," she says.

And dentists have an opportunity to reach patients who aren't plugged in to a health care network, a point that was driven home for Austin in December when one of her patients tested positive for HIV. "He was 23 and there wasn't a medical doctor involved," recalls Austin, who later helped connect the patient to a doctor for more testing and possible treatment. "When would he have gone to get diagnosed?"

Austin is on the leading edge of one trend in dentistry—a shrinking of the gap between dentistry and medicine, says Dr. Christian S. Stohler, dean of UMB, who took the helm in 2003 and has retooled the way future dentists are trained. Dentists already do some early diagnoses—for oral cancer in particular—but Stohler and other experts see tomorrow's dentists playing a far greater role in helping patients manage their overall health, especially when it comes to prevention and early detection of certain diseases.

"It's a changing profession," says Stohler. "In the very near future, we will do dentistry in a very, very different way."

To help move in that direction, Stohler has added non-dentists to his teaching and research staff, including Li Mao, an oncologist who has researched oral cancers extensively. Since many diseases have biomarkers that appear in saliva or in the tissues of the mouth, it makes sense that the person who is already looking into your mouth be given the tools for early detection, says Mao.

So what might the dental/medical experience of the future look like? Your dentist could test for lung cancer or another illness by taking a sample from inside your cheek or a sample of saliva, says Mao, who recently researched such testing. "Many chronic diseases—like cancer or chronic inflammation—have abnormal molecules or proteins in circulation," he says. "By measuring what's happening in the mouth, you can indirectly tell what's going wrong in your whole body."

Issue date: April, 2010