Pretty sure a dentist without empathy would be the last dentist I’d want anywhere near my mouth.
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@David49 Every patient I see gets my compassion, some don’t get my empathy. When I go to the doctor with a malady I want him to be compassionate enough to want to cure me, I don’t want him to feel my pain or feel sorry for me.
Please use your words more precisely, per the admonition of @Brian_BSC
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I couldn’t agree more.
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Hrmm, big internet tough dentist 
Doc77, empathy doesn’t mean you pity people and let them do what they want. those people who don’t brush their teeth might have just given up or have depression or have the beginnings of dementia. my father is that kind of person and i think he has some kind of brain issue going on.
people who can influence me when i am sad (clinically depressed might call for meds) are the ones with a super sunny, optimistic attitude that i might catch when i am talking with them. if they followed up with me later to see how i was doing, then i would feel that someone cared about me, and i might start to care about myself more. when i read jenny ruhl’s writing, she just gives me such a feeling of empowerment that i get motivated. the key is to motivate people- how do you do that? if i were a dentist in your position, i might have an album of photos showing people who made some changes to their diet/dental hygiene and showed improvement over time. where to get these photos? I don’t know if they exist, but maybe if you could find one patient who followed your advice, you could tell them that you wanted to use their success to influence others and so chronicle their improvement in photos.
PS I was just looking at prevention of periodontal disease and came across this: “Use a dry brush. One study reported that when people brushed their teeth without toothpaste first, using a soft dry brush, their plaque deposits were reduced by 67%, and gum bleeding dropped by 50%.” You should use a dry brush for about a minute and a half.
l have never heard of brushing with a dry brush first- is this a good idea?
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I know several T2’s who are basically ignoring their condition, we all know where this leads.
I would argue that giving them a swift kick in the butt is actually the empathetic thing to do. The unvarnished truth and empathy are not mutually exclusive IMHO.
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They certainly aren’t. But affect matters quite a bit. The last thing I need is a smarmy dentist telling me what to do about my medical conditions 
I need my doctors to be honest with me, and I need a dentist to let me know what to do about my teeth and gums (and, where relevant, be honest with what I’m doing wrong). Not everyone is well-positioned to receive “tough love” in a constructive manner. And, at least in my experience, many people use the “unvarnished truth” as a chance to unload on people of whom they disapprove, whether that be due to their weight, their appearance, or their lifestyle.
Type 2 diabetes is complicated, and it’s not a matter of weight or “eating yourself into it.” We all know this (and those that don’t know are safely ignored). Does that mean weight and eating choices aren’t part of successful treatment? Of course not. One of the reasons why I’m active here is because I can share my experience with managing my diabetes. When that is done with love and respect, it is often received well. And if it isn’t (and let’s be straight, there are those who won’t or can’t make the necessary treatment decisions to get well, but that is as true of terminal pancreatic cancer as it is of any kind of diabetes), there isn’t much one can do about it. Ultimately, I can’t change others’ behaviors. No amount of “tough love,” brutal truth, or “swift kicks in the butt” are going to accomplish that: it is beyond my power. So, I’ll continue to share my experience in as kind a way as possible, and reserve my mockery for the internet tough guys who like to pronounce judgement under the guise of “telling it like it is.” At this point, all of us should be wary and sick of those “telling it like it is.”
@David49 I don’t know which “smarmy” dentist to whom you may be referring, so I won’t take offense to that statement by flagging your response and asking @Brian_BSC to ban you for an ad hominem attack.
But you are so far off base on your knowledge of what dental practice entails I just don’t know where to start. Believe it or not, dentists ARE primary care doctors. And, believe it or not, your teeth ARE attached to the rest of your body. And, oral infections DO have a deleterious effect on Bg control. Having specialized and intimate knowledge of diabetes puts me in a very good position to counsel patients with diabetes on their condition.
Congratulations on your good control. Consider yourself fortunate. But not every diabetic has your “can do” attitude. Certainly anyone who seeks knowledge from a Diabetes Online Community has shown the initiative and desire necessary to control their disease. There is no reason to not show empathy to someone like that.
What you don’t see, because you are not a primary medical care provider, is that there is a segment of the diabetic population that is neither motivated nor interested in controlling their diabetes nor their weight nor their periodontal disease. These are the people your empathy will kill. They often require compassionate, but firm, treatment to survive.
Seeing, and knowing, the difference is what makes someone a good resource. If you don’t know the difference you are relegated to simply being a help to people who probably don’t need a lot of help to begin with.
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I certainly did not miss this sort of crap on this site for the past month. That’s uncalled for.
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I definitely don’t believe that, although I can understand why some dentists would like to believe so 
If you want to read an interesting review of the idea of Dentists as Primary Care providers, you can check out this peer-reviewed paper on the subject. It concludes that while dentists could and perhaps should be primary care medical service providers, most aren’t equipped, trained, or qualified to be recognized as primary care physicians at the present time. They suggest collaboration of dentists and actual primary care physicians as being of must utility to patients given the current system.
I’m also a doctor that knows quite a bit about biochemistry, genetics, and treatment designs: I don’t believe that makes me a primary care physician. If I wanted to be recognized as an actual primary care physician, I’d have to get a board to recognize me as a physician, which would likely take some more educational and work experience beyond what I’m willing to do. If it’s important to you to be recognized as such, the same option is open to you! Follow in Dr. Bernstein’s steps, and I’m sure everyone will benefit.
I’m sticking with my overall points in this thread, regardless of what you may or may not have taken personally: empathy is an important quality in medical professionals; and “brutal honesty,” or however one might package judgement, is less useful than kindness in the vast majority of cases. If a situation calls for telling someone “unpleasant truths,” which I imagine it sometimes does as a medical professional, I strongly suspect that kind, respectful communication is more effective than delivering “brutal honesty.” But do whatever works for you.
I’m not sure anything I said could be construed as an ad hominem attack against you, although you do appear a bit defensive. If you feel the admins do not have anything better to do than field spurious requests, then feel free to flag all my posts if it will make you feel better. If you view disagreement as somehow an attack on you, then I’m not sure there is much constructive dialogue we can engage in. Have a good day!
Hey, I did miss you and your contributions. Welcome back. Sorry you don’t feel the same. Cheers
@David49 You evidently have a chip on your shoulder that makes it difficult for you to look objectively at a written comment.
I never said I was a primary care physician. I am, incontrovertibly, a primary care doctor. Dr. is my earned title, and I am certainly primary care.
I am also a long time T1 who gives my experience to my patients. I don’t write them prescriptions it off the scope of my license, but I do give them treatment suggestions to discuss with their physicians. I have a fairly large contingent of diabetic patients who appreciate that I understand their conditions.
And if your “smarmy” comment was not ad hominem, then, pray tell, what was it?
If you choose to live in a cave of ignorance I’m afraid I can’t expect any reasonable response from you. Good day!
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I think you know what I am talking about, some of this snippy back-and-forth between members.
If someone just found this site, and this was the first thread they read, they would probably not come back.
I don’t want to point them all out, but this thread has a lot of comments that seem personal, rather than addressing the issue that was brought up by the OP.
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It’s not just about people taking things personally, the disagreement here reflects the broader Type 2 vs Type 1 disagreement that is systematic in our culture (and our diabetic subculture as well): it is easy to interpret the OP’s remarks and our estimable Dentist’s remarks as suggesting that out of control Type 2s are to blame for their conditions. The OP equates obesity and Type 2. The Dentist conflates poor oral health with out of control Type 2s who don’t brush their teeth (which I’m not sure are logically connected, but could certainly be correlated in some individual patients). The OP knew what was going to happen (“grenade lobbing”) when he started the thread, and welcomed such heated discussion. Presumably, Doc also knew that his comments might spark disagreement.
You’re rightly concerned with what people coming to this thread may feel about members “snipping” at each other. You should also be concerned about struggling Type 2s wandering into such a thread as this and feeling like this might not be the right place for them. Who wants to get “tough love” from random internet strangers who don’t know the situation at all? I’m sticking with my original point, regardless of what others might feel: when sharing experience (or god forbid, advice) with struggling diabetics, it is best done from a place of love and respect rather than from a place of judgement.
People with Type 2 diabetes didn’t ask for their disorder any more than people with Type 1. They didn’t ask for it any more than cancer patients asked for cancer. We shouldn’t treat “struggling Type 2s” any different than any person struggling with any disease or disorder. That’s my philosophy and I’m sticking to it, and I believe it’s rooted in pretty sound science as well.
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Discussion and debate is fine. I didn’t have any problem with any of that. People can disagree about this topic.
But the thing I found offensive was the term “smarmy dentist” when there is a dentist who has been posting on the page.
You said it was not an ad hominem attack. But imagine if I posted a sentence such as: “The last thing I need is a smarmy Type2 diabetic who is a doctor that knows about weightlifting, biochemistry, genetics, and treatment designs, telling me what to do…”
Would that not be offensive to you? I would certainly never make it personal like that.
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Well, you’d not be talking about me! I’m a Type 1, smarmy, Doctor with experience…
You can definitely call me “smarmy,” or whatever else you like in the context of this thread. Obstinate, argumentative, combative are other adjectives that might fit. And I won’t take offense to any of them. I find the whole “If you disagree with me I’ll call the admins” schtick to be rather amusing. I take the whole “you should listen to me, because I’m a Doctor” to be even more amusing, being a Doctor myself.
Let’s talk about the underlying issues. Is it useful to blame out of control diabetics for their conditions? Or, alternatively, when you know a diabetic that is not in control, is it OK to: a) assume it is because of their own lifestyle choices or failure to adhere to a treatment regimen; and b) give unsolicited advice to that diabetic based on what you assume to be true about them? That is what I’m objecting to in this thread. I’m not the only one, mind you.
So, while I suppose I understand your efforts to police my tone of voice in this thread, and I’m willing to take that one on the chin, I’d greatly appreciate if you paid a bit of attention to the content as well. It’s fine for you to come in at the end of a thread and criticize my language: I’ll accept that. But, ultimately, what do you actually think about offering unsolicited “brutal truth” under the guise of doing what’s best for someone else? That is where this started. What are your opinions on that issue? Frankly, I’m not that interested (at this point) in what your opinion of Doctors, Dentists, or Smarmy LADA Scientists is.
Sorry, just based the T2 off of this:
I didn’t just come in at the end, I read the whole thing. But it was the smarmy comment that got me to respond. And now about 2/3 of this whole thread is off-topic, totally hijacked by all this other stuff.
Apologies to the OP.
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Yeah, my diagnosis changed with antibody tests, and I have no idea how to change that information in my profile. I’m LADA.
There, I changed it 
Now it is correct. Diagnosed as Type 2 in May 2016. Re-diagnosed LADA in August 2016.
So, what do you think about “tough love” for diabetics you assume to be out of control. Do you give them the business, or do you assume you don’t know enough to judge? If you get in a conversation, do you attempt to treat them with love and respect, or do you rake them over the coals in order to give them the proverbial “swift kick in the butt?” That is the actual topic of this thread, and I’d like to continue on that theme…
To refine the question further:
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Is it safe to assume that obese diabetics are Type 2?
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Is it safe to assume that a diabetic that is obese is necessarily out of control?
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Do we react the same way to skinny diabetics (of whatever type) that are “out of control?”
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Do we assume that there is one standard of “out of control” that applies to all diabetics?
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How does one who is not an endocrinologist and managing the care of a diabetic know that or why a diabetic is “out of control?”
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