30 Years

“The time has come,” the Walrus said,
“To talk of many things:
Of shoes—and ships—and sealing-wax—
Of cabbages—and kings—
And why the sea is boiling hot—
And whether pigs have wings.”

Through the Looking-Glass

Lewis Carroll

We humans like to take stock and ponder. Introspection is valuable. It aids growth. Socrates said: The unexamined life is not worth living for a human being.

So we reflect, cerebrate and cogitate.

Making lists is also part of our human attributes. Hence, the “greatest this…”, the “best that…”, the “sexiest …”, “ top 10 count down…”, you get the idea.

After realizing that I have had the opportunity to practice dentistry for thirty years this month it was time to reflect.

To avoid boring everyone, my reflections are limited to some of the changes in the profession. [I have an aversion to becoming nostalgic for nostalgia’s sake. Wolfe’s book title, “You can’t go home again”, is all too true, so there is no point in fruitless ruminations.]

When I started, the profession followed the paradigm or model that was that of the surgeon. Find the decay in the tooth ‘cut ‘it out and restore the tooth. Today this perspective is evolving towards a medical model: find the cause of the decay and eliminate it, control it or prevent the tooth from becoming decayed in the first place.

This approach utilizes technology to find and follow changes in a tooth, while using re-mineralizing agents to stop and harden decayed areas. In this way an incipient cavity may never need filling!

Prevention now includes microbiological testing, dietary analysis, varnishes, rinses and technology. That is not to say that these concepts were unknown or not introduced in the past, but rather they were rarely used outside the academic context.

Tooth brushes have improved (reliable electric ones), fluoride is everywhere (yes I am aware of the controversies), floss and its alternatives abound today.

In thirty years we have gone from wet chemically developed x-rays to digital ones – less radiation with more information extractable by way of the software. It’s also environmentally greener. Cone beam CT scanners and intraoral cameras round out the ability to see oral problems. Laser fluorescence and laser thermofluorescence further enhances our diagnostic abilities. I’m sure some of you remember the mouth mirror- in- mirror attempt to show you intraoral problems. Now a thing of the past!

Local anesthetics have gone from the ubiquitous ‘Novocaine’ to a variety of treatment specific ones. Electronic anesthesia units have come and gone; while sedation is now common place for the fearful.

In dental school when we used composite resin filling materials we had to mix to 2 parts (like epoxy cement) and quickly place it in the tooth before it set. Today we have the luxury of time with light cured materials.

Bonding has also been a godsend for aesthetic (cosmetic) dentistry. We appreciate the significance to one’s well being of an attractive smile and the technology now permits us to enhance smiles. Cosmetic dentistry has become a valued and important part of the services we offer. Whitening is common place and affordable today – 30 years past you were stuck with ‘ecru’ or other coloured teeth.

Fillings were prepared with the infamous drill. As a child I experienced an electric motor belt driven drill used in my kitchen by an itinerant practitioner. Compared to today’s high speed handpieces, it’s the difference between a horse drawn wagon and a formula one racing car. Now the Er:YAG laser replaces the drill for most interventions, also eliminating the need for the local anesthetic and the dreaded needle.

The future?

Predictions are rarely accurate – consider the Jetsons’ flying cars that are still dreams and prototypes 50 years later or the decades of leisure time with which we are all supposed to be plagued. However, technology in the dental profession will march onwards like the recently tested laser emitting tooth brush for tooth sensitivity.

The reality is that it will remain interesting and I hope to be part of it for some time to come. Remember “oral wellness, whole health” for the present and the future!


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