Amazing advances in dental technology in digital age
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By George Malkemus  October 12, 2012 12:00 am

Dental materials and technology, as well as patient comfort, have advanced rapidly over the last 25 years. When I began practicing, silver-mercury amalgam fillings were the norm. Gloves were only used for surgery. Extractions and dentures were the common treatment. All billing, appointment scheduling and treatment records were hand written or typed. Computers, cell phones, and microwaves were unknown in homes and the dental office. It doesn’t seem possible; things have changed so quickly.

 Now teeth are saved or replaced with dental implants. With new bondable white materials, the ability to make beautiful tooth-like restorations is a reality. Dental implants have allowed teeth to reappear where they have been missing. Dyes can detect decay so it can be completely removed. Sterilization between patients is total; everything is autoclaved or discarded. Dental lasers allow fine precision surgeries. Conscious sedation allows painless, long-visit dentistry.

 Computers have revolutionized the dental office, especially record keeping and dental education. I will touch on a few of the amazing computer generated improvements in the dental office.

Digital x-rays
Digital x-rays have revolutionized x-ray taking, improving performance and safety. Digital x-rays can be seen instantly and inputted directly into computer storage. The images can be enhanced for improved readability in numerous ways. Contrast can be increased. Images can be enlarged and made lighter or darker. Zoom function is available to focus on particular image points. All these enhancement techniques improve decay detection. Computer measurements can be made on the x-ray images, which can determine root canal lengths and space available for implant placement. Traditional x-rays required 10 to 30 minutes to develop before they could be seen. With digital x-rays, the images are ready to view instantly, so a retake can be done immediately if needed. With the enhancement capabilities, the image can often be adjusted and changed so a retake is not even necessary.

Digital x-rays are much safer for the patients, staff and the environment. The radiation level is over 80 percent less than traditional x-rays. A full mouth set of digital x-rays is less radiation than 10 minutes of being in the sunlight. The need for developing x-rays is eliminated, so toxic chemical storage and use in the developing process is eliminated as well. The environment is improved by removing this chemical use.

Cone beam computed tomography [CBCT]
CBCT is an amazing technology that allows a three-dimensional computer image of the jawbones and teeth. CBCT is an important tool in determining jawbone height, width and density, as well as nerve location and position of other structures such as the sinuses. This helps safely determine implant placement and need for additional bone placement during surgery. CBCT is also helpful when treating cancer or extreme bone infections.

Digital photographs
Much like digital x-rays, digital photos have improved the quality and safety of treatment. Digital photos give an instant image, do not require chemical development, can be changed and enhanced, and can be stored into the computer as a permanent record. Dental digital photos can be used in improving the smile. Smile photos can be modified in a smile design makeover to show the patient what their new beautiful smile will look like with whiter, straighter teeth. The patient has the opportunity to see their new improved smile, discuss subtle changes and their desires, before treatment begins.

Video viewing
Video viewing of one’s own mouth during a dental examination is an amazing advancement in patient communication and understanding of their own oral health. During my examinations, a video camera on a pencil-sized wand is used to survey a patient’s oral tissues, gums and teeth, and can be viewed by the patient on a 20-inch television screen. Every comprehensive exam includes an oral cancer screening. As the visual images are being viewed, they are discussed with the patient and questions answered. Patients usually point to some interesting oral feature and ask what it is they are seeing.

I use a laser pointer to pinpoint an oral structure in question, like an enlarged uvula or tonsils. I can recommend treatment after they have seen the condition and let them decide how they want to proceed. Before video viewing was available, it was difficult to try and convince a patient of needed treatment they could not see. Seeing is believing. Video images are then captured and stored into the computer patient record just like digital x-rays and digital photographs.

Patient education
Visual, concise explanations of all aspects of dental conditions and treatment are available on the same television screen as the video viewing of ones own mouth. The dental videos are entertaining and informative. A picture is worth a thousand words. I used to talk for what seemed like hours to explain a procedure like a veneer, and I would draw blank stares. Now with a three-minute video, all is clear. The videos can be made specific for each patient. The education videos can be put on CDs to take home.

Computer record storage

 One of the greatest things about storing all this digital information on the computer is the ability to retrieve it quickly. If I want to analyze and review a patient’s treatment, I only have to click on their name, and I have their entire mouth, medical and dental history in front of me. I can see their mouth as well as if they were in the chair. I can review their digital x-rays, digital photographs and personal video and then make a comprehensive treatment plan. If a patient calls about treatment, one click and there they are, rather than trying to find a physical chart and trying to remember their teeth from the last time they were seen. Computers are incredible. They make life so much easier and efficient when working properly. Of course, they are a nightmare if and when they shut down, but that is why I have a constant backup system. If you have a friend or family member who is avoiding dental treatment from a past poor experience, encourage them to seek treatment. It is a new world of dentistry and your teeth are meant to last a lifetime.
Enjoy life and keep smiling.

George Malkemus has had a Family and Cosmetic Dental Practice in Rohnert Park for over 27 years at 2 Padre Parkway, Suite 200. Call 585-8595, or email info@ malkemusdds.com. Visit Dr. Malkemus’ Web site at http://www.malkemusdds.com.

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