When I say “Flying Blind” no, I’m not talking about the air-control issues at Newark Airport. I’m talking about how we practice oral health care.
Having taught in two universities, I have a pretty good idea of the curriculum dentists and hygienists receive. “Basic Sciences” dominate those early years: microbiology, immunology, physiology, anatomy, and pharmacology. Why? Because understanding the why behind disease matters.
So here’s the real question: Why are those sciences all but abandoned once we’re in practice?
When the Formula Works
I recently visited yet another physician—my growing medical entourage now rivals a baseball team. This time, the doctor was younger than my own kids (humbling, yes). But what impressed me wasn’t his age—it was his process.
He introduced himself, asked smart questions, performed an actual exam, and reviewed my chart. Then, with impressive clarity, he walked me through the long-term progression of what was now officially diagnosed as gout. Yep. Me. Gout.
He even laid out a plan that included medications and diet adjustments.
But most impressively? He followed the full 9-step diagnostic formula we were all taught in dental and hygiene school:
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- Chief Complaint
- History of Present Illness
- Past Medical History
- Medications & Allergies
- Review of Systems
- Physical Examination
- Diagnostic Data
- Assessment
- Plan
It was a clinic in clinical thinking.
Why Don’t We Dig Deeper?
Let’s be honest: because there’s little financial incentive to spend extra time gathering data or solving puzzles. Most dental and medical practices still operate in a system where revenue comes from what you do—not what you think. Diagnostics and discovery take a back seat to drilling and billing.
But should they?
We rightly expect rheumatologists to be master diagnosticians—they don’t do procedures, they solve puzzles. But we deal with chronic inflammatory diseases every single day in dentistry. Why aren’t we approaching them with the same level of scientific rigor?
What If We Practiced Like Medical Detectives?
What if every periodontal consult included salivary analysis? What if every high-risk caries patient received a full microbial workup before we started placing restorations? Would it change our treatment plans? Our outcomes? Our credibility?
Absolutely.
Diagnostics don’t replace clinical skill—they amplify it. They let us tailor treatment to the patient, not just to the pocketbook. They help us shift from a reactive model to a predictive, preventive, and personalized approach.
So here’s the challenge: stop flying blind.
As Dr. Goldberg so clearly states: we can’t afford to keep flying blind.
Patients deserve more than routine—they deserve precision. Salivary diagnostics is a powerful step in that direction.
Stay tuned for Part 2, where Dr. Goldberg shifts the spotlight to what happens after the diagnosis—and how practices can build lasting value by better supporting patients beyond the chair.
Click here to learn more about how Dr Goldberg/Practice Perfect Solutions can benefit your practice of true medicine.
Michael built a prestigious group practice in Manhattan where he focused on comprehensive, whole-body care. As he treated so many physicians, his colleagues dubbed him “The Doctor’s Dentist.”
He is a Fellow of the AGD, International Academy of Dental-Facial Esthetics, The New York Academy of Dentistry, the American College of Dentists, and a charter Fellow of the American Academy for Oral Systemic Health.
Michael teaches practice management at Temple University and speaks nationally and internationally on a variety of subjects. He and Practice Perfect Systems are the official practice management consultants to the Spencer Study Club, their Business Elite Groups.
Michael has authored 3 books, including “What the Tooth Fairy didn’t Tell You”, “Beyond Ahh: A Guide For Physician’s” and “From Here To Where; a guide for dental practice success”. He’s recently had been the chief editor of a book on Sleep Dentistry written by 24 of North America’s finest dental sleep practitioners.
Michael is on the board of 3 charitable organizations that help provide care for the indigent and people with special needs around the world.
His mission: help people who help people help more people.
- Flying Blind: A Wake-Up Call – Part Two - July 11, 2025
- Flying Blind: A Wake-Up Call – Part One - June 27, 2025
- The Hidden Threat to Dental Implants: Why Ignoring Bacteria is a Risky Gamble – Part 2 - March 14, 2025