Monday, June 13, 2011

The Dose is the Poison

We live in a society which thinks if something is good for you, then more must be better.   Or is something is bad for you, then none of it can be good for you. Science has failed to make people recognize what Paracelsus, the sixteenth century philosopher, recognized, namely, “The dose makes the poison.”  This is perhaps the most valuable and critical point for any person to understand.  Consider some essentials, like water, oxygen and salt.  Clearly these are needed by the human body.  Yet last year a college student died in a stunt by drinking too much water.  It so severely diluted his electrolytes, he could not be revived in time before his heart stopped functioning.  Similarly, we know the tales of shipwrecked sailors who imbibed sea water only to need to drink more and more because the salt concentration prevents the alleviation of thirst, and ultimately causes death.  And Aquanauts like Jacques Cousteau learned long ago you can’t breath pure oxygen for sustained periods.  That is why helium was mixed in so it could dilute the oxygen but not contribute to the bends.
As dentists, we often hear of people refusing a fluoride treatment because it is a poison.  And a certain high doses this is true, just as salt, oxygen, and every other substance can be.  Again, to quote Paracelsus, “all things are poison, and nothing is without poison, the dose permits something not to be poisonous.” We health practioners have to make sure people understand the dose they receive is a safe dose for a given treatment.  People must evaluate the risk/reward ration with Paracelsus in mind before succumbing to knee jerk reactions to buzz words and hyperbole.  We as dentists must help people understand this important concept so they can accept treatment or face the consequences which could result from the lack of such treatment.