Get Those Requirements!

In my book, Dental School, I mentioned the trials and difficulties of the dental school experience.  One thing I would like to bring out more is the relentless pursuit of "Requirements."  What do I mean?  Requirements are the need number of specific procedures you must accomplish to pass or to graduate.  These are things like a specific number of crowns, dentures, root canals, or two surface fillings you must complete.

It always seemed in my experience and in those with whom I talk to, that it was difficult to get these done in a reasonable time frame.  What if the patient you have acquired or been assigned needs three fillings, one root canal and one crown.  That's great, but you need to do a periodontal surgery crown lengthening, and a post and core buildup prior to the crown, and moreover, the only thing you really need as far as requirements is the crown.  In some schools you have to get all the necessary work done on the patient, much like in the real world.  In some other situations, you may be able to have someone else do the root canal and surgery, then you do the crown, but that can take a while before you get it done.

The thing I want to emphasize is the drive to get the requirements.  It's not always easy.  Some schools are having a more difficult time getting patients as more and more are treated by private practitioners.  I know some pediatric residents that do only one or two premed (sedation) cases prior to graduation.  In practice I do one or two sedation cases a day.  Experience is an important part of developing and perfecting a skill.  The more you do the more you know how to deal with the little variations in each case.  Requirements are just the way schools have of making sure a dental student gets at least some basic minimal experience before awarding a degree.

Dental School Is Exactly Like This

Dental School is Exactly Like This.  Ok, well, maybe not exactly.  Still, dental school was certainly an awesome experience.  I'm sure we could have made such a great video in our day if we had the technology.  In fact, weirder things than this are know to happen.  Hat tip to UNLV School of Dental Medicine.

Buy my book on Dental School click here.

Double click the youtube video for option of full screen.

Corrections and Additions

1.  Ok, I seem to have left off the following ADA approved dental school in my listings in the book.  Probably because they do not have a website at this time.  My apologies; here is the info from the website I did list:

Roseman University of Health Sciences College of Dental Medicine 
10920 S. Riverfront Park 
South Jordan 84095 
Dean: Dr. Richard N. Buchanan 
Phone: 801-878-1400 


2.  In the printed book, the word "you" should be "your" at the top of page 54 and in the "Tip" section on page 69. These two typos occurred only in the print version.


*The e-book kindle version has these corrections as of April 6, 2012.


Improved the weblinks as of may 2012.

Dental Schools Opening All Over

In response to rising demand for a dental education back in the late 1970s and early 1980s there was a large increase in the number of dental students matriculating in dental schools across the nation.  Some of this was due to federal funding increasing the number of slots available.  After a while, this led to what some called an oversupply of practicing dentists leading to a wave of unforeseen changes in the business of dentistry, namely the introduction of managed care dental plans and increased competition.

In time the cost to the schools of providing a dental school education began to rise and some, mainly private, schools began to close; schools like Northwestern, Georgetown and Emory.  

Recently there has been an increase in the number of schools opening or planing to open across the country.  I do not know what long term effect this may have.  It will be interesting to see what happens and how this might affect dental school admissions and graduates.  One planned school at the University of Central Florida has been put on hold. I do hope these new programs will provide a great educational experience and not just become a profit center for the parent organization with little actual training or education for the students.

More information on Dental School can be found in my new book.

See my previous post on dental school admissions applications vs. the slots available

Continuing Education--"CE"

Continuing education, otherwise known as "CE," is a constant in any profession.  School does not end with graduation. A dentist must constantly keep up with not only the newest techniques and materials, but also re-learn what has since been forgotten.  In my state we must complete at least 20 hours of CE every year just to keep our license. This is actually quite a low number, as many I know have many more hours than that.  Continuing education, and the associated credits, is usually be obtained by attending lectures, courses, local meetings, national conferences, and hands on classes.  Online courses are also useful and becoming more common.

Back in the old days physicians and dentists would learn by didactic or "book learning" but also by observing procedures and surgeries.  Anesthesia using ether for surgery was first demonstrated in the "Ether Dome" at Massachusetts General Hospital in Boston.  You can see this lecture hall/operating room still today.  I visited this historic place several years ago.  The benches are quite steep so "students" could observe the activities below.  So, learning is a continuous process.  Your dentist probably is spending more hours in lectures on weekends and evenings than you know.  This is why we call it dental practice.  We are always practicing and learning.

Dental School: Preparation, Survival and Success Now Available

My new book, "Dental School: Preparation, Survival and Success" is now available.

Many times on this blog, people have asked questions about the dental school experience.  They have asked, "How do I get into dental school?"or, "What courses should I take?"  I have compiled answers to these and many more questions into my new book.  It will be available on Amazon starting about February 1st 2012.

Have you ever wanted to become a Dentist or Orthodontist?  This book covers not only how to get in, but what dental school is really like, how to excel, and how to succeed the difficult years of study. Postgraduate residency in specialties like Orthodontics, Oral Surgery and Pediatric Dentistry are covered in addition to business aspects of the profession and options after graduation including sitting up a practice and employment opportunities.  I have also included a section on The Internet, Dentistry and Social Media.

If you or anyone you know is considering dental or medical school, or you just want to find out what it takes to become a dentist, this book will provide lots of answers.  I have included data on tuition and financial costs, the DAT, in addition to personal experiences and advice.

The foreword is written by Dr, Nido Qubein, the president of High Point University.

Please purchase the book and write a great review!  Here is the link:

"Dental School: Preparation, Survival, and Success"http://www.amazon.com/gp/product/0615507891

How Hard Is It To Get Into Dental School?

How competitive is it to get into dental school?  I have addressed this in my book in some detail, but want to add this interesting chart (I hope you can see it-click it to enlarge slightly):

This is a long term view of the popularity of dental school.  The red line is the number of applications, the blue line is the number of positions available.  In the year 2010, there were 12,202 applications for 5089 slots.  There are times where applications fell and other times where the number of applications rose.  You can see the overall trend that there are more applications per opening now than in the recent past.  So, is this a more competitive environment?  Yes.  However, this is data can be somewhat misleading if you are to conclude one has no chance.  Decisions on entrance are made one student at a time.  If all the additional applicants in recent years have a less attractive resume than you, then it does not matter as much whether there are more applicants or not.  The striking thing to me is the greater desire of students to select dentistry as a career and the rather limited number of slots in dental schools to meet that demand.

I have talked to many a physician, and have seen medicine become a less attractive field than it might have been in previous years.  Also, in times of economic downturn, the stability of a profession like dentistry becomes more attractive--and more competitive.

The Future of Dentistry: Technology

How will technology affect dentistry?  Well, technology is already playing in increasingly important role in this age old profession.  Here are the major developments I foresee:

1.  Diagnostic technology such as digital radiography (x-rays) will continue to become more common. Digital Panoramic and intra-oral x-ray machines will completely replace chemical films and developing.  Computerized image management software will be able to store, display and enhance digital images.  3-D imaging will become more common.  Instead of several intra-oral films, panoramic and cephalometric x-rays, yucky impressions for models and photographs, there may only be the need for one imaging machine or technology which can do all of the above.  Computerized diagnostic software will be able to detect and identify decay and other anomalies and pathology

2.  There will be continuing development of information technologies for the business and record keeping end of dentistry.  As in most health businesses, physicians offices, hospitals, etc., there will be even further incentives for electronic medical records (EMC), computers in the dental office for scheduling, management of financial and patient records, and insurance claim filing.  Ipads, flat screen TVs, and digital entertainment will become more common.

If you are in doubt about the impact of robotics in medicine and dentistry, check out how wearable robotics developed by the military are helping paralyzed individuals walk:

                                 click photo for link: Wearable Robots help Paralyzed warriors walk again

3.  Laboratory technology, which I have often viewed as remaining in the dark ages using proven but old techniques, will transition to CAD/CAM (Computer Aided Design/Computer Aided Manufacture).  This may manifest as in office or laboratory fabrication of crowns and other prostheses by computerized milling machines and digital printers.  Intra-oral cameras will advance to be able to easily take virtual impressions of teeth and transmit the information for production.

4.  Currently lasers are used for soft tissue surgery and some hard tissue preparation.  A little further into the future, there may be new devices to more efficiently and simply prepare (drill) teeth for fillings, crowns and other things with more precision and less effort.

5.  Diagnosis of at-risk patients, targeting medications to particular problems will become more sophisticated.  The use of DNA techniques in diagnosis and treatment will continue to advance.  A caries vaccine?  -They have been talking about that one for 20 years so I do not anticipate an effective vaccine in the near term.  Techniques to replace teeth with laboratory grown teeth for a patient's own DNA or tissues may become a reality.  Advances in oral surgery including nanotechnology in the targeting of cancer cells will enable less traumatic and more successful treatment of these debilitating and often fatal diseases.

6.  Newer techniques of anesthesia and the development of new medications will make dental care even more pleasant and comfortable.  Safer and more effective sedative agents and/or advanced anesthesia techniques will enable any surgical procedure to be completed more easily for the patient and the doctor.

What might all this mean for the practicing dentist?  Well, you cannot say that just because a great technique exists that it will be incorporated into daily routine practice.  There are so many other things to be factored into the equation.  Financial issues and/or insurance may or may not pay enough to make these technologies feasible.  Patients may not be willing to cover the increased cost to use a $100,000 machine to do just a few minor procedures.  I do know many of these technological advances will make dentistry more efficient.  There may be a need for fewer laboratory technicians, but the ones remaining will be skilled in these new techniques.  There may even be a reduced need for as many dentists as each dentist becomes able to accomplish more treatment.

St. Elsewhere

While in my residency, I did an anesthesia rotation at Charity Hospital in New Orleans.  As Pediatric Dentistry residents, we spent every day for a month providing anesthesia for all kinds of surgical cases.  Later on, we did a rotation at Children's Hospital.  During these rotations, with often minimal supervision, we started IVs, calculated and administered medications, intubated the patients and provided whatever was needed to keep the patient asleep and alive during surgery.

Video:

It could be stressful, as we were no as familiar with the OR as the medical residents.  Moreover, Charity was a unique place.  It was built like Fort Knox with 24 operating rooms on the 12th floor.  It was an old building and had an eerie St. Elsewhere atmosphere.  In fact, it seemed every time I entered the building, I'd hear the theme song from that TV show.  We didn't get too much help from anyone there and kind of had to fend for ourselves, scrounging up supplies.  If you didn't have an IV setup or a pulse oximeter, you'd just "steal" one from an adjacent unoccupied operating room before someone was the wiser.  We also sat in on anesthesia resident meetings.  Some of the surgeries were interesting to watch.  Of course, we were actually quite busy keeping the patient monitored.  There were orthopedic cases and a few jaw reconstructions, sometimes abdominal surgeries, but mostly minor stuff.

Every now and then they brought in patients from the local prisons for treatment.  One day one of them escaped and somehow in the ensuing melee, was chased outside, where the police promptly shot him.  They brought him right back in the hospital to get patched up and go back to jail.  That was a typical day at Charity.  Of course Charity became even more infamous during hurricane Katrina.  I was so glad to finish with the rotation, but was thankful to have had the experience.  I learned a lot about sedation and anesthesia.