Carlos Lopez

ENC2135
Erin Workman
Assignment #2

When taking at a look at a particular field of profession there are a lot of

aspects to a particular field, whether its a specialized profession within the
medical field or not. Different medical fields have their own specific set of
procedures in which they get their job done. As time passes the ways that
these procedures get done change and evolve over time as a results of
technological advances. Some of the advanced procedures in include the
Better ways for storing files, innovative ways for perfect teeth alignment,
and the whitening of teeth. These advances In the procedures that dentist
partake in are supposed to make procedures more efficient and a lot quicker
then what they were before. In the past decades, dentistry has experienced
a complete overhaul in the ways that they perform procedures on peoples
teeth. Although these advances are supposed to make the practice of
dentistry a lot simpler, there are problems such as procedures in the mouth
that can arise with the integration of these advances. All of the research
done in this paper will explore the advances that have been integrated in the
practice of dentistry.

Dentist recently coming out of dental school in the past 5 years are most
likely to have been exposed to these new technologies like CADs/CAMs that
have been made a part of the the practice of dentistry, but what about the
dentist who have their own practices established? How would they be able to
get their hands on these new procedures when theyve been accustomed to
a particular set of procedures their whole career? Are these new advances in
the practice of dentistry beneficial at all or is it just a product of fancier
equipment? Finally does it really make a difference if a dentist choose to
stick to the old fashion way?
D.M.D and Ph.D. Anthony M. Iacopino got his BA from Rutgers university
and has been practicing dentistry since 1986. Lacopino proceeds to go into
detail on the advances of dental education and information that have
occurred in the twenty-first century and how these new advances has helped
the practice of dentistry maintain its high level of respectability while also
presenting problems to already established practitioners. Anthony Iacopino
believes that the advancement In the field of dentistry has put a lot of the
traditional practices in into question which presents a problem to already
established dentist. Lacopino notes that most established practitioners prefer
not being involved in anything that may interfere with their office hours, due to
the rigid demanding of their schedules. Learning and acquiring intuition of
these new advancements in dentistry requires full attention and is really time
consuming, thus it would be an economical disadvantage for them and their
office. Whats the point of having these of these new procedures in dentistry

when a dentist doesnt even have time to get to learn them? Does this mean
that already established practitioners are at an disadvantage compared to
recent graduates that do have knowledge of these new practices? or does it
really matter if a dentist acquires this new technology for use in their office.
Ive been in two completely different dentistry settings where each of the
dentist practice completely opposite procedures of cleaning teeth, numbing
of the gums, and a whole multitude of other procedures. Completely different
settings in the fact that one practice office was old fashioned in contrast to
the other office that was advanced and modern. The old fashioned
practitioner used file cabinets to store his files, and used less sophisticated
tools compared to the mordenrn dentist who used more sophisticated tools. Even though
both dentist were completely different from one another, I definitely noticed
one hugely important similarity. That similarity is the fact that both offices
were always busy from the time the offices opened till the last appointment
of the day. The reason why I wanted to point this out is because I believe that
dentist dont necessarily need to have all of the new fancy innovative
technology in order get their job done and have the equal amount of
patients.
Whats the point of using new innovative technology in dentistry when
either can be used to get any procedure done? New technology is a
something thats inevitable because change is a part of everyday life. When
talking about the different advancements in dentistry, it applies to the
technology integrated in looking at teeth models, the different instruments

used to perform on peoples teeth, and even the ways In which dentist to
records of their patients. All of these advancements make a dentists life
easier, quicker, and most importantly more efficient.

One hugely

innovative procedure that has drastically changed the landscape of dentistry

forever is the integration of computer technology in the field of dentistry,
specifically orthodontics. Back in the day, for a dentist to get a complete
model of a patients teeth they would have to use plaster models. The
process in making the plaster model includes having the patient bite on a
sort of unpleasant tasting clay using spacers so that the dentist could have
the most accurate model of ones teeth; these plaster models could be used
to in the creation of retainer for someones teeth, and detect any movements
that your teeth might have undergone. While these methods are still
required for the making of retainers, it can really be futile in regards to uses
for patients teeth model. The reason I say its futile is because dentist now
use new advanced computer technology for digital imaging and threedimensional models of patients teeth. Digital modeling is a better
alternative compared to using plaster models, for the fact that it avoids all
the messy components that come with using plaster models. The different
authors for the research article Disciplinary Decade in Interdisciplinary
Orthodontics believe that all the evolutions in digital technology has
become an intricate part in Interdisciplinary Orthodontics that its
indispensable. In their study, they evaluate the different applications of
computer technology that are now used in Orthodontics and their different

accuracies. Two of the different applications that they evaluate in their study
are Cone-beam computed tomography and the Three Dimensional Face
Scanner. The CBCT provides a 3D imaging software that displays the different
positioning of teeth in people who have an supernumerary teeth, that is
more teeth then the regular set of teeth in a human. The CBCT along with
the Three dimensional Face Scanner provides dentist with new more detailed
information that was not available back then with a regular x-ray scan of
teeth. There are other ways in which advancements in computer technology
has changed the landscape in which dentistry, and that is other factor has to
do with the ways that dentist store their information on patients. Dentist can
now store the records of their patients through electronic storage of data,
which allows for a more fluid and accurate cataloguing of information.
Although not all dentist prefer use these new advantage of storage of
information, it can be beneficial if a dentist decided to implement these
techniques. Steering back to the point of why dentist use innovative
technology? Well some specialities in dentistry like Interdisciplinary
orthodontist simply require technology like Three Dimensional Face scanners
to perform their job, it becomes an essential component of their job rather
then a choice or preference. Without these computer technology
applications, Interdisciplinary orthodontist wouldnt be able to perform their
job as well as they do. So does this mean that new innovative technology in
dentistry is completely beneficial? Well like I said some technology can be
beneficial and sometimes becomes a requirement in the field but there can

be flaws that are presented when a dentist thats using more digitalized
technology.
One thing that a dentist strives on is having the having the best possible
care for their patient because its what they make their name out of. Providing
good service to the patients and leaving them with a huge smile when they
step out of the office is the most important thing that a dentist should focus
on. There are a lot of factors that contribute to patient satisfaction, whether
its providing the patient with service that she/he might preferably want , the
way the dentist interacts with the patient and so much more other factors.
Anatasios Karydis and a couple of other colleagues conducted a study in
which they noted the expectations and perceptions that Greek patients have
on the quality of dental health care that they receive. They believe that the
quality of service that a dentist provides is an undeniable crucial factor in
the world of today regardless of the quality of service. Its noted that the
there are four dimensions that a patient looks at evaluating the quality of
dental health care that they get and those are assurance, reliability,
responsiveness,and empathy. The first dimension, assurance, has to do with
the freedom regarding danger or risks, and the sense of security. Reliability
refers to the ability of dentist to perform the service accurately and free of
any mistakes. Responsiveness is the dentists willingness to help their patient
when in need. The last dimension empathy is the dentists willingness to
listen to the patient and showing interest in the patient. All of these
dimensions is what patients usually look at when looking at the quality of

dental health care that their receiving. Which make me wonder, what do
dentist think when looking at all of these dimensions that potentially
influence a patients perception of the quality that their receiving? Is this a
reason why dentist opt to stay with the same procedures that known since
graduating dental school?
One author in particular, M.kirshner believes that the role of information
technology and research has changed the dynamics of the Dentist-Patient
relationship. He stated that The advent of communication and information
technologies has greatly affected the way in which health care is delivered
and the relationships between doctors and patients. He describes three
types of communication and information technology; Internet,
administrative, and clinical applications in which he believes are contributing
to the to the relationships between patients and their doctors. The internet
application affects the quality and quantity of health information that the
patient receives. The clinical applications includes softwares like electronic
oral health records (EOHR) and Digital imaging. The last application is the
administrative application in which its associated with a patients experience
with the dental practice as a whole. I think that the best application that
greatly impacts a patients relationship with his/her dentist is the clinical
application. Michael kirshner describes the electronic oral health records as
being greatly important because it provides information on the patients past
experience with other dentist, the condition of the patients teeth, and also
the patients financial situation. This application in particular can greatly

impact the dentists understanding of the patients situation which opens a

gateway for better communication on a personal level. these applications
contributes to a dentists relationship with a patient which is highly important
for the fact that it can enhance the outcome of the care that is getting done
on the patients teeth, a patients understanding of what is getting done on
their teeth, and getting to know the dentist on a more personal level. If there
wasnt a good relationship between the dentist and the patient then there
would be a lot of patients seeking for a new dentist. Good health care
involves has a certain comfort level with a doctor because no patient wants
to a doctor who doesnt care for their health to get perform any kind of
procedure on their teeth. This goes to show that new advancements in
technology can be beneficial instead of it just being a product of new
technology especially when it greatly contributes to the relationship between
a dentist and their patients.
Although I do believe that it doesnt really matter if a dentist decides to
apply new procedures in their practices , I do feel like its necessary to go
into detail on the new procedures that have arrised and to further expand on
the question of how in fact have these procedures completely changed. Are
there less risks when using these new procedures? Or more risks?
People who love to have the best results when brushing their teeth are
probably always looking for the best ways to keep their teeth as whitened as
possible. In the recent years , mechanisms for teeth whitening werent as
common as they are now, and these mechanisms probably werent as well

developed either. Dr.Edmond HN Pow explains how high demand for tooth
whitening mechanisms has led to the development of finding new ways to
further expand on this field. Dr.Pow point out that now most tooth whitening
techniques employ the same mechanism through the process of bleaching.
He describes two teeth whitening processes in which have developed in the
recent years for use at home, and thats the night guards and gel strips. Both
of these processes apply peroxide gel when performing its job, so that after
gradual and consistent use of either process youll be able to see the results.
I think these processes are great for anyone trying to get extra whitening on
their teeth , but I feel like these processes will refrain people from going to
the dentist. One should always go to the dentist regardless of how well they
keep their teeth maintained, because the use of peroxide gel with either
process might not work with more severe cases. These are probably some of
the risks that wary me of these new at home whitening processes. Going to
the dentist allows for a more intuitive observation from the dentist himself.
The dentist could decide what type of bleaching procedure you might need
depending of the level of the discoloration of the teeth, and what other
alternatives could be considered depending of the bleaching procedure is
working or not.
Dental ceramics are used for people who need restorations in their teeth
like crowns, and bridges due to damage to the teeth. Advancements in the
techniques of ceramic materials has allowed for the development and
discovery of new ceramics like slip-cast ceramics, heat-pressed ceramics,

and glass ceramics. Isabelle L. Denry provides some insight on the different
techniques that has allowed for the strengthening of the ceramic material.
She describes three different ways that has helped dental ceramics be more
efficient because dental ceramics are fragile and tend to fracture during the
process of placement. The first is strengthening by way of crystalline
reinforcement, which involves a good portion of crystalline into the ceramic
to prevent any potential crack propagation during their placement in the
mouth. The second procedure is chemical strengthening which allows the
exchange of small alkali ions for larger akali ions below the strain point of the
ceramic , leading to stronger fracture resistance. The last is thermal
tempering which produces the same results as chemical strengthening; a
surface compressive layer for increased strength. With out the discovery of
these new procedures, dentist would still be having a hard time trying to put
these delicate ceramics in people mouth without having the fracture.
Orthodontist focus on the peoples crooked teeth and bites that impairs them
from having perfect teeth. When people explore the different ways that they
can their teeth aligned they usually look at dental braces. Braces have
probably been the most common way that people get their teeth aligned.
The installation of braces on peoples teeth and the process of dental braces
in general is very sophisticated in the fact that it involves many steps before
the patient actually gets their braces implemented on to their teeth and full
alignment of the teeth. These steps involve extracting teeth that may hinder
the teeth alignment with braces, numbing of the gums for when the braces

are getting glued to the persons teeth, and the monthly process of going to
the dentist to get the braces tightened. Although dental braces are capable
of getting peoples teeth aligned perfectly, there are other simpler ways that
are capable of getting the job done just as well without including all of those
annoying procedures that involved with dealing with braces. This new
innovative process that perfectly aligns teeth is Invisalign. Invisalign are a
series of aligners that were created in 1998 as an alternative to dental
braces. These series of polyurethane aligners are preferred by people who
dont wanna have metal contraptions visible on their teeth, and people who
wear who use Invisalign tend to go unnoticed when they wearing them. The
advantage of Invisalign is that it avoids getting your inside gums cut up that
would have been a possibility if they patient were to get dental braces
because of the sharp edges, and all of the annoying processes that would
have been inevitable if a patient were to choose dental braces. In all, Dental
braces are more complicated and involves a bit more work then Invisalign
does, but what does that mean? Even though Invisalign and dental braces
serve the same purposes , do they both provide the same efficient
outcomes? Just because Invisalign is a newer and simpler treatment than
dental braces doesnt mean that theyll get the job done as efficiently. In a
research study conducted by Neal D. Kravitz and a bunch of his colleagues
they investigated how well Invisalign actually does work by noting how well
the teeth moved and if any relapses occurred. Kravitz and his colleagues
noted that Align Technology reported that 20% to 30% of people who used

Invisalign for perfect teeth alignment underwent a refinement corrections

during the middle of the treatment process because outcomes were not
coming out the way it was supposed to work. They also noted how
orthodontist reported the same problems but only this time its by 70% to 80
%. After the study was conducted , Neal and his colleagues concluded that a
lot still needs to learned about the regarding to the limitations of Invisalign.
Even though I didnt like the unpleasant tightening of the braces along with
the countless amount of times that I got a small cut inside my gums from the
braces, I could conclude from personal experience that I would have rather
preferred dental braces than Invisalign. This goes to show that just because
something is more innovative and newer doesnt mean that it will get the
same job done or even more efficiently.
Why are there more dentist skeptical about using new technology then there
should be? This wouldnt be such a problem if this technology is supposed to
make their life much easier right? feel like there are more risks in trying to
get these new processes integrated into the dental community then there
should be. When coming up with new ways in which dentistry can be
improved, several experiments should conducted prior to the release of new
these new advancement to ensure the maximum efficiency for when these
new techniques and processes get put into work during office hours. It will
not only guarantee the best results out of these new advancements, but it
will lead to dentist to be more open in using these advancements in their
practices. Dr.Carlos Flores-Mir conducted a study in which he sent out

surveys to dentist from all over Canada to get their perspectives and
attitudes toward digital and electronic technologies in dentistry. He found
that if new technology were to be widely used by the dentistry community
then there would have to be a strong perception indicating that the new
technology would offer significant improvements over current practices.
Based on the usefulness of new technology, more than 30% reported that
electronic or virtual models were useful or very useful. More than 60% of the
dentist reported that new computer technology was quite or very capable of
improving their practices based on factors like patient satisfaction, practice
efficiency and other factors. A lot of the Canadian dentist indicated that
comfort with the new technology and the cost of the equipment were the
biggest obstacle seen as insurmountable, 63% for cost of the equipment and
47% for the comfort level with new technology. Its not to a surprise why a lot
of dentist are not even willing to consider these advancements in their
profession, theyll be losing more money on these new procedures rather
then making profit and most importantly losing their patients.
With all of these different views in regards to how dentist feel about new
technology and the different benefits and restrictions that they provide Ive
decided to conduct a small interview of my own to get answers from an
actual practitioner. The Dentist that I interviewed was Dr.Luis M.
Santamarina, DMD. He graduated from dental school at The University Of
Florida, and he was the dentist that let me shadow in his office for two
consecutive summers. I asked him a set of four questions that would allow

me to further my understanding on how dentist feel about new technology

and procedures.
1. What do you think about all of the new advances in dentistry? Great
question , I think that some of the advances that have occurred in the past
decade has allowed dentist to approach their profession with more options at
their disposal, ive only used a couple of the new things that have been put
out there but its definitely useful
2. Why do you think dentist arent willing to try out the new things that are
coming out for dentistry even when its supposed to make their job easier?
Well it could be a lot of things like the prices of the new technology, but it
usually has to do with the amount of time a dentist has available for him. I
would have to go to seminars and to learn to use these things aside from the
fact of buying the new technology, which is not favorable for me because I
work everyday from 9am to 6pm
3. What are some of the new advanced procedures that you yourself have
been able to implement into your practice? Theres a couple of things that I
use in my office specifically when it comes to whitening of the teeth. I
recently started using this thing called Venus White Max thats a faster and
more effective way to whitening the teeth. It can get peoples teeth
dramatically whitened in less then 40 minutes. I usually only use this when
its requested by a patient.
4. Do you think that implementing these new technologies and procedures in a
dental office is necessary to get a favorable amount of patients into your
office? No I dont necessarily think that using all of this new fancy
technology is necessary. It really all just depends on the dentist and his
preference. To be honest Ive been using the same procedures that I was
taught in grad school because In the end of the day all that really matters is
that it helps me through get my job done efficiently. Plus patients are usually
more attentive to how dentist treat them rather then the new technology
When these new techniques and technologies get introduced into the
community of dentistry, there are a multitude of ways that they get
introduced. New teeth whitening technology, alignment procedures and
other stuff get introduced through magazines, websites, and even through
the propaganda of the dentist himself. Magazines for particular professions
and subjects like the medical field, fashion, and even the guitar industry

focus on the latest findings and news that in the field. One particular
magazine that focuses on all things dentistry is Dear Doctor Dentistry &
Oral Health Magazine. Dear Doctor focuses on dental hygiene, orthodontics,
even restorative and cosmetic dentistry.This magazine allows the reader to
have a better informed mind about the complex treatments and technologies
in the field of dentistry. By having this not only will the readers interested on
oral care be well informed in the world of dentistry but this will allow them to
make the best oral health care decisions. Another source of media that is
involved of in the field of dentistry is the website Dentistry today. This
website provides well detailed news articles that focus on all the latest news
and findings in dentistry.
In all, dentistry has come a long way from what it was when this profession first started. New
technological advances like advancements in teeth whitening procedures, better techniques for
teeth alignment, and the different ways that digital technology is used in dentistry has allowed
for dentist to practice their profession in a really reliable way. I believe that dentistry doesn't
need all of the fancy equipment to get the same job done. A dentist has the right to stick to
whatever has been taught to them during the time they attended graduate school.
Great work, Carlos! I definitely learned a lot about dentistry that I didnt
know before, and I appreciate the nuanced way in which you approached the
uses and limitations of new technologies and procedures in the field of
dentistry. If you choose to use this paper in your ePortfolio, I think one
revision you might consider is restructuring the paper a bit. It might be
helpful to describe the new technologies first and then move into why
dentists might or might not want to use them. Also, you point to a few useful
technologies and procedures in your paper, but in your conclusion you seem
to gloss over these useful technologies and procedures. Maybe a more
nuanced approach to the conclusion would better represent the great work
you did in the body of the paper?

Citations

1. Lacopino, Anthony M. "The Influence of New Science on Dental

Education: Current Concepts, Trends, and Models for the Future." Journal of
Dental Education 71.4: 440-60. Print.
2. Denry, Isabelle L. "Recent Advances for Ceramics in Dentistry." 7.2 (1996):
134-43. Print.
3. Kirshner, M. "The Role of Information Technology and Informatics Research
in the Dentist-Patient Relationship." Adv Dent Res 17 (2003): 77-81. Print.
4. Ogodescu, Alexandru, Cosmin Sinescu, Emilia Ogodescu, and Meda
Negrutiu. "The Digital Decade in Interdisciplinary Orthodontics."
ResearchGate. Print.
5. Pow, Dr.Edmond HN. "Advances in Tooth Whitening." Dental Bulletin 9.10
(2004): 18-19. Print.
6. Mir, Carlos Flores. "Perceptions and Attitudes of Canadian Dentists toward
Digital and Electronic Technologies." Proffesional Issues 72.3 (2006): 24343b. Print.
7.Karydis, Anastasios. "Expectations and Perceptions of Greek Patients
regarding the Quality of Dental Health Care." International Journal for Quality
in Health Care 13.5 (2001): 409-16. Print.
8. Kravitz, Neal D., Budi Kusnoto, Ellen BeGole, Ales Obrez, and Brent Agran.
"How Well Does Invisalign Work? A Prospective Clinical Study Evaluating the
Efficacy of Tooth Movement with Invisalign." ScienceDirect 135.1 (2009): 2735. Print.