Dentistry has come a long way since the first known filling – made of beeswax – was carried out thousands of years ago. Nowadays the innovations that are revolutionising other aspects of our daily lives are also to be found in the local dental practice, ensuring dental work is easier, more convenient and cheaper, but also more accurate and more precise than ever before.
Patient-friendly dentists
Modern dental practices are very different places, designed and geared around the patient’s comfort and convenience. Dr Mohammed Shirin of Truly Dental, Dublin, says their main motivation is to make a dental appointment or treatment “easier and better for the patient”. Extended opening hours, online booking and scheduling, and digital patient notes all aid in this, he says. “We also have noise-cancelling headphones and weighted blankets available to relax patients.”
Conscious sedation or “twilight sleep” is also becoming popular. Shirin says intravenous sedation can be used which reduces anxiety and allows people to tolerate treatment much better. “It’s great for nervous patients and those who have dental phobia. The treatment seems very quick to the patient because they just wake up and it’s done, and they don’t remember anything of it.”
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Digital scanners
Digital smile design using highly accurate intra-oral scanners has transformed the orthodontic process. “This allows us to show someone a mock-up of exactly what the final outcome will look like on their own face. That’s quite powerful because it’s not just a photo, it’s a 3D virtual design. It gives patients confidence in what their smile will eventually look like, and allows them to make tweaks,” says Shirin. “We can even 3D print the proposed design and show the patient the mock up in their own mouth.” The intra-oral scanner means that with aligner therapy scans are taken and movements mapped out on computer so that a series of aligners can be produced that will ensure those particular movements. This avoids the need for having the traditional ‘train track’ braces,” says Shirin.
Artificial intelligence
Artificial intelligence (AI) is everywhere, and dentistry is not immune to its potential benefits. Dr Rory Boyd, who is president elect of the Irish Dental Association, says the most value so far has been in the reading or diagnosis of patient X-rays. “The artificial intelligence software will actually identify areas of interest to the dentist to aid the diagnosis. This helps standardise the diagnosis from radiographs such as X-rays, which can be somewhat subjective. It helps remove that subjectivity and ensure more accurate diagnosis.” He says this may sound futuristic but is already in use in many dental practices across the country. In the longer term, he adds, AI will be used extensively in diagnostics. “The more we use it the more reliable and accurate it will become.”
3D printing
Boyd is also a prosthodontist. He says 3D printing is set to revolutionise how dental prostheses are made. “The digital scanner allows us to make a 3D model and then use it in computer-aided design (CAD).” This hugely increases the accuracy of prostheses, such as crowns, dentures and veneers. The majority of these are now produced using CAD rather than by hand, as was the traditional fashion; CAD allows for 3D printing. “This has been a revolution in how we manufacture dental prostheses, even something as simple as a dental model to make retainers or bleaching trays or something as sophisticated as dentures or tooth implants,” says Boyd.
Same-day implants
Staggeringly some 15 per cent of the Irish population have no teeth at all. Shirin says the beauty of modern dentistry is that a brand new set of teeth can be delivered in just one day. “Before it used to be a six- to 10-month process, but now we can give them screwed in teeth in just one day.” Advances in implant technology and the screws that go into the jawbone means the implants can be placed and teeth connected on the same day. “It’s a seamless process,” says Shirin. He adds that this used to be prohibitively expensive but now costs less than half the original cost.
Lasers
Most people with a fear of the dentist will hate the noise of the infamous drill. But now it is more likely to be an altogether quieter laser that is used. “Lasers have been used in dentistry for over two decades now so, as such, are not a new innovation,” says Dr Grania O’Connell of Cork Dental Care, part of Portman Healthcare Ireland. But their use in dentistry, such as detecting decay, removing decay, preparing a cavity for a filling and managing hypersensitivity in teeth is now increasing. Lasers can be used to take biopsies of tissue and recontour the gums, and are increasingly used in surgical interventions.
“The real future of lasers in dentistry lies in being able to fabricate an intra-oral ultra-fast laser handpiece – like the drill that we use today – that will fit comfortably in the mouth and do this at a reasonable cost so that it is used by general dentists in their everyday practice of dentistry,” says O’Connell.
Smart Toothbrushes
So-called “smart” toothbrushes have been around for a couple of years, but are now becoming more affordable, with prices starting from around €25. . O’Connell says these use sensors and connectivity to track brushing habits and give live feedback on these habits. “They are a great idea to help us all to improve our habits, and are especially useful in getting children to develop good habits at a young age. They are also a great help for patients with mobility difficulties who find it hard to brush, allowing the user to see where they have brushed well and what areas of the mouth they are missing when brushing.”
Augmented reality
The primary use of augmented reality in dentistry comprises the use of digital information to improve reality, which allows us to effectively communicate with our patients through the use of videos, pictures and 3D models. One of its biggest uses is in tooth alignment and delivery of crowns, bridges, implants, etc. This gives the patient a visualisation of the treatment outcome. It then helps the patient to decide whether to go ahead with treatment or not, and it helps the dentist to manage a patient’s expectations.
It is also very useful in the area of training and can allow a dentist or student to carry out procedures in a virtual world where they can learn from their mistakes without apprehension