Stephen Richards
Many people, especially our medical counterparts, view dentistry as an easy and laidback job. The most common reason for claiming so, in unison, is – no life-threatening emergencies. To think about only the extreme situation like death and decide that rare fatality rates makes the profession less demanding, is pure ignorance. Healthcare professionals are also responsible for quality and longevity of life. Only once we understand this, we will realise that dentistry can be a testing and challenging profession. The dentist-patient relationship is quite interactive and that makes it more challenging. During treatment procedures, patients are aware of the happenings. Invasive dental surgeries are under local anaesthesia. This makes it more difficult to treat patients, especially those with disabilities and special health care needs. Airway emergencies are a rising concern for clinicians amongst physical, mental or cognitive impaired patients. ‘Airway concerns in patients with special needs’ mentions the protocols of management revolving around treatment planning of these patients.
Another category of patients requiring special care are women, because a woman goes through various hormonal changes during different phases of her life. It may influence periodontium to a great extent and affect their overall health. Pregnant women need to be more careful. ‘Women, Well-being and Oral Care’ talk about gingival alterations during puberty, menstruation, pregnancy, lactation and menopause, associated with physiologic hormonal changes in a woman’s life stages.
‘Shade-matching challenge: a single central incisor’ is one of the challenges faced in dentistry alone. Aesthetically conscious patients have high expectations and are more insistent that they receive high-quality natural looking restorations. During earlier days, dentists preferred restoring both the central rather than single central incisor to accomplish their goal. However, modern technology with higher quality materials, digital photography and better shade options enable us to follow the concept of minimally invasive restorations, wherein a unilateral central incisor can be created to match the artistry of natural dentition and supporting tissues. ‘Another challenge we face, in what may seem regular endodontic cases, is occurrence of pain after starting the treatment.’
Managing such patients can be particularly difficult and painstaking. Besides activation of dormant phoenix abscesses due to instrumentation, ‘Sodium Hypochlorite Accidents’ is an important etiology. The article explains the reasons for its occurrence and pointers for its prevention.
Medical practitioners today, face the biggest challenge to research health science and keep pace with the latest updates, practices and technology. In earlier days, in order to overcome the challenge of displacing dentures while eating or talking by preventing movement of the musculature of the oral cavity, sometimes a skin graft was harvested from the thighs of patients which was applied intra-orally. These pre-prosthetic surgical procedures in the current scenario, will undoubtedly be considered invasive and not performed. This is so because of modernization of implant procedures. They are combined with a contemporary approach of a preventive method for bone loss and has eliminated virtually the need for such drastic measures of approach. ‘A Novel Approach to Grafting around Implants’ talks about three such procedures, namely, socket preservation, block bone grafting and sub antral grafting. How do we know of the success rate of these unconventional therapies?
There is plenty of literature available proving it. As told in ‘Evidence based Dentistry - need of the hour’, while we are immersed in clinical work, let us not forget that giving importance to only practical aspects, without paying attention to theoretical details are doing a blind mechanical job. Evidence based dentistry is founded on clinical research, which we as practitioners may not have time to conduct. This is where evidence based dentistry comes into play, as these findings are already studied on a larger sample size, researched, discussed and concluded – ready on a platter to just be read.
While we may work on our skill set and tackle all these challenges effectively, success depends on various other aspects as well and success plays an important role in any profession. The capability to manage both clinical aspect and daily management in the routine practice hold the highest priority among other factors. ‘The Secret to Success in Dentistry’ talks about how we need to view our practice as an enterprise and our patients as a whole, not a tooth, taking up the necessary means of ethical marketing and efficient soft skills. This is further elaborated in ‘How to Be a Good Dentist You’ll Smile About!’ which gives out handy tips to increase the number of OPD’s at the clinic.
It also mentions use of ethical channels and pharmaceutical marketing and promotion to enhance your daily practice.
Eventually, dentists can face these nitty-gritties of dentistry much better if we get together as a fraternity. This is our consistent effort here at DentalReach, to actively engage dentists in sharing their experience of dentistry and to gain access to innovative techniques to bring the best in their practice. We hope we are successful in our endeavours!
On behalf of the entire team of DentalReach, here’s wishing you a very happy and festive Diwali!
Dr Nupur Shrirao is a consulting Prosthodontist and aesthetic dentist. She is currently in the editorial committee of International Journal Of Innovative Research In Dental Sciences (IJIRDS) and the Reviewer Board of Journal of International Oral Health (JIOH) and IP Annals of Prosthodontics & Restorative Dentistry (APRD).
ABC is essential steps used by medical professionals in differently abled persons. The protocol stands for airways, breathing and circulation. In the medical field, professionals manage any emergency by following ABC. Airway emergencies are a rising concern for clinicians among special need people. During dental treatment, they require medical, mental or psychological special consideration. Airway concerns can be viewed from preventive and operative aspects.
It is rightly said “The mouth is a window of overall health.” It can reveal a number of symptoms, conditions, diseases in our body. Women go through various hormonal changes during different phases of her life which may influence her periodontal health to a great extent and periodontal diseases in turn have an influence on her overall well-being.
Patients today are more conscious than ever of the appearance of their teeth, as a result, have high expectations and are more insistent that they receive high-quality esthetically pleasing restorations. Esthetic restorative dentistry presents multiple challenges for the restorative team. One of the most significant challenges is accurately achieving the unique characteristics of a single maxillary central incisor so that it is perceived as a natural tooth.
In the treatment of implant placement clinicians are more likely to experience circumstances for extraction of a tooth. The procedure is straightforward cases most probably doesn't require grafting whereas, in the residual root socket, the size of the implant is equal to or greater than it. In the bicuspids the shape of the socket will rarely be in the shape of cylindrical shape as between dental implant and socket wall there will be a moderate to the large gap, but it will be of lesser extent . In the molar tooth, the gap will be of larger extent.
A dentist will come across innumerable clinical scenarios during their practice. While working in a chain of dental clinics, I came across a case of Squamous Cell Carcinoma in a middle aged woman. While discussing about the possible treatment options, we all focused on surgical excision and chemotherapy. We had recruited a dentist, who was a fresher, he told us about an alternative option called chemoradiation using Cisplatin. This made realise the importance of evidence based dentistry and continuous dental education.
In the industry of dentistry business, success depends on various aspects and its plays an important role in dentistry. The capability to manage both clinical aspect and daily management in the routine practice hold the highest priority among other factors. Many dental practitioners who own their business, they just focus on either of the one but not both.
A dentist from the common man’s point of view is, “A doctor who has specialized in oral healthcare. Or a person who has qualified to treat diseases pertaining to teeth and gums, replacement and repair or any kind of oral health-related issues where it’s beyond the limit of a common man to solve the problem.” But it also comes along with many other characterizations.
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