The Dental Arts

I may be a bridgetender, but like an onion, I have many layers. I also have a degree in Dental Laboratory Technology and Management. I am fascinated with dental appliances and their fabrication. I graduated with honors. I had big dreams.

Not that those dreams went anywhere. After applying to 200 different labs with no viable offers, and after seeing that dental appliance technology is outpacing the little mom and pop labs that I hoped to be a part of, and after having a wrist surgery that would have made it extremely painful to do the fine motor movements required on a day to day basis, I wised up and went back to bridgetending.

But the fascination remains. So when I needed a crown replaced, I was delighted to see it’s entire design and creation chairside. We’ve certainly come a long way from the days when you had to get a gloopy, bad-tasting mold taken of your teeth, then come back weeks later to have a crown fitted that had been fabricated in an offsite lab.

Instead, they popped off my old crown, and took photographs of my teeth from every possible angle, and then, voila! A three-dimensional image of my teeth appeared on the computer screen. It was fascinating.

From there, Mary, the technologist, created a crown for me on screen. Make no mistake, this was no flimsy endeavor. This takes skill in both science and art. She has to have knowledge of oral anatomy and how various teeth interact with one another. And she also must create a final product that will not only be functional but also aesthetically pleasing. That’s an admirable talent.

I watched her create this tooth and enjoyed imagining her thought process. It was like digital sculpting. Leonardo da Vinci would have been intrigued. And proud.

She consulted with my dentist (a big shout out to Dr. Steven Lockett in Renton, Washington, and his entire amazing staff!) and did a few tweaks based on his suggestions, and then sent the data off to the machine for fabrication. I wish I could have seen that. I know that the machine carves the crown out of little blocks of some mysterious substance that is probably trademarked by the company that created CEREC, the CAD/CAM (computer-aided design and computer-aided manufacturing) system that my dentist uses.

I could be wrong, but I think of it kind of like 3d printing in reverse. Instead of creating things from a bead-like substance, this machine carves it down from a cube. I mean, seriously, how cool is that?

In no time flat, my crown was hot off the presses, so to speak, and ready to go into my mouth. In it went, and off I went. Just another thing checked off my to-do list. And yet, when I think of the science and artistry that went into the whole endeavor, I still am filled with awe.

By the way, one of my favorite blog posts is the one I wrote entitled Cool Stuff You Never Knew about your Teeth.  Check it out! If you don’t learn at least one thing from it, I’ll eat my hat. With my brand new crown.

https _upload.wikimedia.org_wikipedia_commons_d_d0_CEREC-kronprep

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A Crisis You’re Not Even Aware Of

I just discovered that the last college I attended, Indian River State College, no longer offers the degree I earned there: Dental Laboratory Technology and Management. This is very sad news. It was the last school in Florida to offer that program. Now, if you’re a Floridian and want to study this subject, the closest schools would be in San Antonio, Texas or Detroit, Michigan. In fact, there are only seven colleges left in the country that offer this degree. Seven.

Why should you care?

First of all, let me clarify what Dental Lab Techs do. They are not, repeat, not, dental hygienists. They don’t clean your teeth. Many of them never come in direct contact with another person’s mouth (at least, not in a professional sense). The majority don’t work in a dentist’s office. They usually work in labs, sometimes one man operations, sometimes large assembly line type outfits, to fabricate dentures, retainers, crowns, night guards, bridges and other dental appliances.

There’s a great need for Dental Lab Techs, as 40 percent of them are expected to retire in the next decade. This career has a faster than average job growth projection, as an aging population has a greater need for dental appliances, and baby boomers visit dentists more often than previous generations did.

Many labs are now resorting to on the job training, and there’s no problem with that if it’s done well. But without an educational system, there are no core standards and there will be no uniformity in the field. (Field trained techs are often not taught basic oral anatomy, for example.) It also makes it much harder for these highly skilled individuals to be considered professionals, and therefore demand adequate compensation. This, in turn, will discourage people from pursuing this career.

More and more appliances, therefore, are being shipped overseas to be fabricated. This is a problem for you on a number of levels. There is no quality control. There have been reports of appliances in third world countries containing toxic substances. The last place you want to encounter lead or radioactive material, for example, is in your mouth. Also, some of the dental impressions your dentist takes of your mouth are heat sensitive and therefore don’t ship well. This means that the device you get back from some far flung location is quite likely not going to fit as well as one created in a local lab would have. The end result is pain for you and/or an appliance that does not function properly. I strongly suggest you ask your dentist where your appliance will be coming from, and urge him or her to source local labs.

Why are Dental Laboratory Technology schools disappearing? The equipment required to adequately teach this subject is extremely expensive. And in order to be certified by the American Dental Association, schools have to maintain a very low student to teacher ratio. From the standpoint of a college, this means more cost in terms of equipment and salary, and very little return in terms of tuition. Can you blame them for not wanting to shoulder this burden?

To be honest, I don’t know what the solution to this problem is. But if you don’t want outrageously expensive dental appliances that are poorly made and potentially dangerous, we had better come up with one, and soon.

dental-appliance
Do you really want some barely trained kid off the street making this for you?

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