DDS Lister

Dental patients, accustomed to seeing sharp tools and paper bibs, should get used to seeing a computer nearby. The digital age has hit dentistry, and patients can see that change in the way crowns are built and X-rays are taken.

The new technology is radically reducing the amount of time it takes to create a crown, and it’s also giving dentists faster, more precise views inside their patients’ mouths.

In a classroom at Dallas’ Baylor College of Dentistry, a computer screen showed a 3-D digital image of a patient’s teeth taken by a wand with a laser sensor. A light green tint on the screen marked the soon-to-be crown to set it apart.

Dr. Paul Nelson moved the cursor around and suddenly, the crown on the screen became skinnier or fatter until it filled the gap between the teeth.

He clicked the mouse again. Then in the next room, a machine the size of a large printer came to life. In it, two diamond-studded drills carved into an enamel block. In about 20 minutes, the machine produced a crown that fits exactly into the patient’s mouth.

The traditional process of creating a crown means forming a mold of the patient’s teeth and shipping it off to a lab that produces the crown, which could take weeks. Complicated crowns might require multiple visits, taking even more time from the dentist and patient.

“With something like this in a normal dental office if somebody knows how to use it, the patient would go home the same day,” said Nelson, an assistant professor.

The technology is pricey, part of the reason why in 2004 only 3.3 percent of dentists nationwide used digital impressions, according to the American Dental Association. The system used in the Baylor example costs more than $100,000, Nelson said.

Dr. Stan Ashworth, another assistant professor, admitted he was skeptical of the technology until he saw how accurate the final products were.

“With this technique, the first 50 of these that we did in here, 49 fit without any kind of adjustment at all, which is just amazing,” Ashworth said. “Dentists in private practice would love to have that level of success.”

That accuracy persuaded Dr. Mark Palmer, who has a private practice in North Dallas, to get digital impressions about five months ago. With his system, the images are sent to an outside lab that makes the crown and sends it back to him.

“The only reason that I got it is because it improves the quality of dentistry that I do,” Palmer said. “It’s an amazing technology.”

Patients are more familiar with digital X-rays, which have grown in popularity among dentists nationwide.

Rather than film, a digital sensor is placed inside a patient’s mouth to capture an image, which appears instantly.

Digital X-rays look similar to film, but they’re easier to transfer, and dentists can optimize the image to make a better diagnosis, said Dr. Byron Benson, who heads Baylor’s radiology division.

“If you were doing something where you needed high contrast or low contrast, you had to know that before you took the picture,” Benson said. “Now, you take a digital radiograph and, with the software, you can change the contrast.”

The ADA said about 16 percent of dentists used digital X-rays five years ago, but Benson figures that has grown to about 25 percent or 30 percent.

Palmer has used them in his practice for about five years and saved money on chemicals, film and processing.

“As far as I’m concerned, it’s a no-brainer,” he said. “There’s no reason not to be in digital X-rays.”

However, Benson points out to dentists who can’t afford the technology that film X-rays have the same quality as digital. He teaches his students both methods but makes clear that digital is the future.

“We teach them to a level of familiarity with film, but we teach to a level of competence with digital,” he said.

Chris Whitley is a Dallas freelance writer.

Source:

• Dallas News

The robot, called Simroid, has sensors in its teeth and body which feed back on how well the dentist is doing.

Movements such as blinks and muffled gurgles are designed to show normal patient responses such as fear, discomfort, pain and tension – without putting any real person’s mouth at risk.

“I made this robot so that students can understand patients’ feelings,” said Professor Naotake Shibui of the division of pediatric dentistry at the Nippon Dental University Hospital in Tokyo.

“Then they become a dentist who doesn’t just concentrate on technique but also understands the patient. Everyone is a little afraid when they come to the dentist, and we should appreciate that,” he told BBC World Service’s Digital Planet programme.

Red light

Sensors in the robot’s teeth trigger red lights to illustrate when a drill has gone too far.

However, the robot, which is designed to look like a female, has sensors in other areas on its body too, to provide feedback about the patient’s whole experience.

Digital Planet’s Gareth Mitchell with Simroid
The robot patient’s open mouth simulates communication with dentists

Dr Shibui explained that when a dentist accidentally touches the robot’s breasts, for example, it is indicated that the patient would feel uncomfortable.

“The whole training session can be recorded and you can review it anytime you want,” he added. “We can stop the video and tell our students, ‘you had a red light because you touched the patient here’.”

The robot has also been designed so that when it speaks, it does so with the open-mouthed series of grunts familiar to anyone who has sat in the dentist’s chair with a mouthful of foam.

Dr Shibui, who has been working on the project for two years, said that treating the robot as a real patient was essential to training.

“Actually talking to the patient makes you understand their feelings,” he said.

A new version of the robot, Simrod II, is now being worked on by the same companies that created the first – a combination of J Morita WFG, Nissin Dental Products and Kokoro Company.

Simroid II will have an improved response, automatic voice recognition and speech synthesis.

Source:

• BBC