Dentistry has advanced from a very primitive stage of dental extractions and denture work being done on the pavement sides to a state of highly evolved and advanced art and science of very great significance to mankind. Once upon a time, extractions were the only solution to dental problems, whereas today, so many advancements have come in where we are able to retain the diseased dental apparatus after correction of the defective portions in a fully functional and esthetic manner. A stage has come where the total personality of a person can altered to attain a desirable personality with the help of specialized dentofacial treatment.

There’s the story which took place about 35 years ago, of a senior dental surgeon visiting a grand old astrologer to test him. He challenged the astrologer to identify his profession. The only details offered were his date of birth and name. The astrologer took up the challenge and started calculations. He could not come to a clear conclusion even after calculating for about half an hour. Finally, the astrologer told the dentist… “You have a very peculiar profession… I’m wondering what it is !”. The dentist requested the astrologer to come out with whatever he could assess. Whereupon the astrologer said… “ Well…I’ve never come across a profession like this… you do the work of a doctor… treating ailments, prescribing medicines, doing surgical work and simultaneously you also practice something like what blacksmiths and goldsmiths do - making impressions, pouring casts, making metallic components.. etc. Not only that… you also work as an artist and also as a tailor ! You manage to integrate all these jobs into one profession ! Which profession is that ?” The famed astrologer cannot be expected to know about dentistry which was in its infancy in those years.

Importance of dental health is indisputable. It is well known that an unhealthy mouth can cause a wide variety of illnesses. Moreover, dental surgeons are also instrumental in detecting many systemic illnesses in the initial stages which have very clear oral manifestations, one of the prominent one among them being diabetes. The importance of elimination of dental focus of infection in the treatment of various diseases including heart disease is now common knowledge.

Fear of contracting infections from dental clinics is one of the major fears of patients who are aware of the dreaded diseases Hepatitis and AIDS. It is indeed true that improper sterilization measures of instruments in the dental clinics can be a potential cause for transmission of infection to patients. Use of disposable needles, use of gloves and masks by the dental surgeon and assistants, and application of principles of sterilization and disinfection in a meticulous manner in the dental office can help eliminate such hazards.

Fear of pain is another major deterrent in patients requiring dental treatment. Fear of injections, fear of the dental drills etc. are indeed very depressing before you visit your dental surgeon. However, advances in the field of anesthesia … and the principle that it is not enough if local anesthesia alone will suffice, but “vocal anesthesia” too is essential holds good. Good communication of the dental surgeon with patients and a warm and affectionate approach during the period of treatment will certainly eliminate fear of pain among patients. Use of advanced equipment such as high speed drills, ultrasonic scalers etc. have helped eliminate the discomfort felt by the patient during procedures.

The third deterrent in patients seeking dental treatment is the dental treatment costs. Dental treatment remains expensive because of the expensive equipment and materials being used in dentistry besides the formation and maintenance of a well organized dental set up. Many materials and equipment being used are imported and this is a major factor for the increase in treatment costs. With the opening up of the insurance sector, we should be able to look forward to a solution in this matter, just as mediclaim policies are able to cater to the medical bills. It will take more time for a comprehensive dental insurance policy to be formulated as the parameters for implementation of such a policy will be much different from the medical insurance facilities. However, we could take cue from the dental insurance facilities being offered by companies abroad.

Myofacial pain dysfunction syndrome (MPDS) is a disease detected after the industrial revolution. The stress and strain of modern day life has increased the tension in the lives of common man making him a jaw clencher… the more he clenches, the more his jaw joints suffer and finally he becomes a victim of MPDS characterized by acute pain in the jaw joint, limitation in mouth opening and difficulty in executing normal jaw movements. The food habits of modern man is much different from his predecessors. Now he has more refined food which is more soft and sticky in nature which decreases the workload of the jaws and teeth. This has led to problems such as increase in incidence of dental decay among the population. During the process of evolution it has been found that the braincase has been expanding at the expense of the jaws the workload of which has been decreasing steadily. This has been associated with the increase in incidence of impacted wisdom teeth in the population, which has never been to such an extent in the earlier generations. AIDS and oral cancer are diseases which are significant in dental science, and they have resulted from aberrant lifestyles as is common knowledge. 

Specialists in dentistry such as periodontists perform complex procedures to improve the condition of the periodontium, which forms the foundation of the dental apparatus. Oral medicine specialists and Oral pathologists are skilled to diagnose and treat rare diseases which afflict the dental, oral, perioral and facial tissues. Pedodontists specialize in dental treatment of children, while endodontists and conservative dentists deal with conservative management of teeth afflicted by caries and other anomalies.

Dentistry has advanced to such levels such that surgical specialists in dentistry (Oral and Maxillofacial Surgeons) perform complex surgeries of the facial skeleton and soft tissues in cases of dento-facial trauma, deformities and tumors, besides aiding specialists such as ENT Surgeons, Neurosurgeons, and Plastic Surgeons in performing complex surgical operations in the cranio-maxillofacial region. Prosthodontists aid in preparation of prostheses of organs such as the eyes and ears in cases where they have been surgically removed following injuries, tumors etc. They are also specialized in replacement of missing teeth. Orthodontists correct malaligned teeth. They institute treatment during early childhood if a dental / or facial deformity is expected to develop.

Cosmetic and cosmogenic dentistry is one field which is in great demand today. Effective cosmetic dental treatment can be carried out only with the interactive treatment by specialists in the field depending on requirements of each individual case. Major advancements have been made in the field of dental implants. Dental implantology deals with replacment of missing teeth by taking support from the underlying bone alone. Forensic dentistry has also developed at a rapid pace in the recent past with advancement in forensic dental science enabling to detect and identify victims of various accidents, violence etc. Forensic odontologists also aid in reconstructing faces of such victims using computer imaging and such other techniques helping identification of such victims. Theatrical dentistry is also slowly coming to be recognized in the field of arts, cinema and theater. 

Nowadays centers are available which are able to provide complete treatment solutions as far as dental and oro-facial problems are concerned. Ranging from dental care and treatment such as oral prophylaxis, scaling and fillings, to complex dental and oro-facial treatment procedures such as orthognathic surgery, dentofacial orthopedics, management of dentofacial trauma and deformities, oral cancer are now available under one roof. Specialists in dentistry and allied sciences are often members of the team of doctors in such institutions which include medical specialists like plastic surgeons, physicians, ENT specialists and anesthesiologists, besides specialists in dentistry. Such centers are also attached to hospitals so that medically compromised patients are taken up under the care of medical specialists and operation theater facilities are utilized in cases requiring surgery under General anesthesia such as orthognathic, trauma and tumor surgical procedures.

Now, with the advancements in the field of information and technology, dentistry has grown by leaps and bounds. Meticulous record keeping of patients in the clinic has become possible with the advent of the computer age. Doctors can hold discussions about patients with colleagues abroad and the best possible treatment can be rendered to the patient in no time. X-rays and photographs of patients can be transmitted over the internet to colleagues and specialists abroad from whom suggestions about treatment may be obtained. Treatment planning can be done with the aid of the computer. Advanced diagnostic imaging techniques such as Radiovisuography (RVG) have also been introduced recently with the advent of computers. Dental treatment units are also becoming fully computerized. When a patient goes for followup treatment in such a set up, the outpatient card inserted in the appropriate slot of the dental unit helps the unit to identify the patient. Immediately, the details of the patient appears on the computer screen attached. The dental chair adjusts itself to suit the operator and the patient as predetermined in the previous visit. Great strides have been made in the technology of dental equipment and materials creating provisions for very high quality dental treatment standards. Continuing Dental Education programs (CDE) meant for practicing dental professionals are of immense value in updating the knowledge and skills of dental practitioners. Apart from this there are also continuing educational programs for specialists in the field. More and more practitioners actively participate in such programs ensuring they are up to date with the latest developments in the respective fields.

Genetic engineering techniques are being devised which helps repair damaged teeth with natural materials. There will be a day when it will be possible to grow new teeth to replace lost ones.

Many more advancements are taking place in the field of dentistry in developed countries. India is never behind…it is catching up at a rapid pace. Whatever the advancements may be in the field of dentistry, the golden rules for a healthy mouth remains the same - Brush twice a day in the proper way, have wholesome food rich in fiber and roughage and get a dental check up done once in six months. Remember that if treatment is instituted in early stages, it saves you a lot of time and money. A stitch in time saves nine. And not only that…. Don’t be penny wise and be pound foolish.

Beware … Be true to your teeth, lest they be false to you.

Dr. K.S.Prasanth Pillai
Dental, Oral and Maxillofacial Surgeon

Email :drprasanth@pramodclinic.com