During the last century clinical curiosity in the human body focussed on what is inside. With the exception of dermatology, interest in exposed surfaces has been outside of the medical domain and frequently only skin deep. In short, attempts at linking the body’s exterior to its inner workings have occasionally surfaced but these have largely been inconclusive and unsatisfactory.
Sometimes clinical demarcation is the problem. Periodontal disease is a longstanding example where dentists and physicians continue to speculate despite dental literature being replete with studies and conclusive literature about the disease’s diagnosis and management.
The incontrovertible fact remains, however, that the mouth is connected to the body. Yet its link to multiple internal problems (including heart disease, diabetes, rheumatoid arthritis, preeclampsia, preterm birth and inflammatory bowel disease) remains relatively unexplored mostly due to an inflammatory or infective emphasis.
Hair is another example of clinical demarcation where we see obesity and smoking associated with premature greying. Those of us who have had our hair professionally coloured will know that hair salons can be defensive about applying highly toxic substances to clients lest a litigable allergic reaction follows.
Despite scouring the literature I am yet to find a medical research grant open to hairdressers.
Indeed, conditions like hairdresser recognition of abnormal scalp or hair manifestations (as occurs in psoriasis and skin cancers) and iron deficiency anaemia with hair loss in women are yet to be reported in the literature – such collaboration may be some way off; despite scouring the literature I am yet to find a medical research grant open to hairdressers.
While greater interaction between mouth (dentist) and body (medical doctor) researchers could increase our knowledge, the lack of integrated research about how prevention and diagnosis can occur outside traditional medical and public health paradigms is only one in a raft of barriers to integrated thinking.
This is because inter-professional rivalries, domain-specific thinking and a lack of colocation are all contributing factors. But pathways that incorporate input from both lay and professional people can strengthen the pathway to efficient and early definition of health problems.
In following a diagnostic trail we now routinely incorporate the views of friends and families so, isn’t the next obvious step to validate the inputs of providers also in touch with the human body?