High Performance-driven, Precision medicine
It is the type of medical care that costs … more while delivering superior results. It is perceived as Investment-grade healthcare. The term longevity medicine is becoming more focused these days and is very similar in attributes.
To help us understand the positioning of precision medicine in today’s world, I will outline the two major categories that emerged in healthcare.
- Reactive medical care—we must get it because it hurts or affects our performance or well-being.
- Elective care — because we want it because it prevents diseases, keeps us younger and fitter, makes us look better, or improves our lifestyle.
The second category (elective care) has to be investment-grade and usually requires the highest level of precision, complexity, sometimes newer technology and techniques, but most importantly, know-how. Reactive care has also evolved considerably, but the simple approach limits its performance.
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Health became a valuable “commodity,” though. I say commodity because medical care is a very hot subject; nobody wants compromises regarding their health. Unfortunately, access to premium-performance medical care comes at a very high price. The socioeconomic and political environment also influences the perception of healthcare, especially the expectation of availability and access. Having lived in different Eastern and Western European countries and the U.S.A., I noticed that market penetration of ideas and access to performance medicine differ. Today, borders do not significantly prevent people from traveling, so the concept of medical tourism developed in two directions: cost-driven medical tourism and knowledge- and technology-driven medical care. Unfortunately, the first is much more prevalent, but the second is also growing fast due to rising differences between healthcare systems. One thing is clear: healthcare globalization, especially in matters of know-how, is in progress and accelerating significantly, being fueled by the desire to live longer, better, and happier.
Precision dentistry, how is it different from classic dentistry?
Teeth, gums, and jaw joints…. are the classic “subjects of interest” of dentistry. Precision dentistry is more about health risk management involving the oral microbiome, salivary biomarker monitoring and diagnosis, teeth, gums, bones, muscles, the smile’s facial integration, and jaw joints. We live easily over 100 years of age nowadays, and considering that teeth do not regenerate at all, dentistry is one of the medical specialties in which longevity medicine is deeply needed. Considering what wealth of information we can get nowadays from salivaomics (saliva diagnostics) and the nefarious non-healing property of tooth structure, which turns out to play an essential role in the precision monitoring of functional developments (through time-lapse scanning, we can identify the minute form changes in tissue, teeth, and position). We can monitor systemic and local biomarkers to quantify biological vs chronological age.
In the last hundred years, dentistry's term “precision” changed its meaning. It started initially by characterizing the detail level at which dental restorations (crowns, dentures…) were manufactured. It maintained “its character” for about 50 years through the rapid evolution of dental materials, and then, around the 60-s and 70-s, it started to morph into knowledge-based concepts. While manufacturing precision was still the primary descriptor, with the advent of the internet and access to research data at a global scale, “precision” started to mean something else: data- and research-driven medical care. The last 20–25 years have been marked by the rapid growth and affordability of computing power, so “precision dentistry” is now more in the realm of data collection, correlation, and visualization for the purpose of health risk profiling. In dentistry, this is quite welcomed, while, as I said before, teeth don’t possess extensive healing and compensation capabilities such as other bodily structures but still have to survive — structurally, functionally, and aesthetically pleasing — longer than ever before, in a body which nowadays can easily pass the 100 years old mark. The drive for regenerative dentistry is high, but it is still to become a reality.
Another factor driving this change is also expectation. Everyone is a patient sometimes, even doctors. I cannot believe that today, dentists still expect their dental treatment to be limited to teeth and gums when the wealth of data and knowledge collected for precision diagnostics is easily accessible and much more comprehensive (including jaw joints anatomic anatomical and functional status, oral bacterial balance, postural-functional correlations, stress management, social and aesthetic implications of the smile…). Medical professionals know that the half-age of medical knowledge is between 18 and 24 months (https://hms.harvard.edu/news/medicine-changing-world#:~:text=In%20science%2C%20the%20term%20%E2%80%9Chalf,will%20be%20only%2073%20days.), staying abreast with the current developments is not optional. Adopting and implementing knowledge are different matters, but exposure to a new idea is the irreversible first step on the growth path. This drives expectations and, implicitly, the demand for longevity medicine/dentistry. “Minimum amount of treatment in a lifetime” is a “new” concept addressing the need for treatment and is slowly fading in the past. “Health management for a fulfilling, impactful, and long life” emerges as the purpose of longevity medicine/dentistry, enabled by data-driven, precision medical care.
