On 4th December 2019, dentist, Dr Rima Hassan came to do a talk about the Science Behind Dentistry. The talk included her passing round a series of materials and instruments used in the dental profession and explanations of their properties and uses. As her talk was more of a free discussion and she didn't use a presentation, here is what she spoke about:
The scientific approach begins for dentistry from A level foundation subjects of biology, physics, chemistry and maths. These subjects are integral to understanding how the human body works. Dr Hassan trained at the Royal London Hospital and graduated in 2000. One of the topics studied during the dental course is Dental Materials. This involves the study of the many different restorative and impression taking materials which are used on a day to day within the job. The main materials dentists use can be divided in to 2 groups:
During the talk, Dr Hassan brought in a few materials, and described their uses. She talked about alginate impression material used for more general impressions, and silicone materials for more high detail, less distortable impressions. Restorations vary from those placed in the mouth, direct restorations, and those constructed out of the mouth and fitted into the mouth - indirect restorations. Direct restorations: mainly involve fillings, amalgam (a metal alloy including mercury to allow it to be mouldable into the cavity in a tooth), glass ionomer cement (used for temporary fillings or to patch up a chipped tooth) and composite (a plastic resin which is mouldable and polishable so has better durability and aesthetic results). The benefit of composite is that it can be shaped into the form required and then set with the UV light, as she demonstrated in the session. Indirect restorations: include dentures or removable prostheses, which are normally made of acrylic plastics or a metal framework. These are needed to replace missing teeth, either partially or completely. The material needs to be comfortable to wear in the mouth and have retention so it doesn’t always fall out while the patient is talking or eating. It also needs to be easily cleaned and maintained by the patient to prevent development of fungal infections etc. Crowns/Bridges are used to cover a heavily restored tooth which would not be strong enough to support a simple filling. They are also used to improve a patient’s cosmetic appearance and to fill missing teeth gaps when required. Biology is important in Dentistry as during the first couple of years in the course, the main topics all involve anatomy and learning about the structure of the human body and all the main systems. A dentist needs to know their way around a human head after all. Even though dentistry may seem to be only about teeth, but in fact, when you go to the dentist, they're actually checking your whole head to make sure everything is healthy, though mostly it's inside your mouth that they're really interested in. Anatomy is also important for dentistry as many of the medications prescribed alongside some treatments need to take into consideration any additional medications (and any side effects) that the patient is taking - this pharmaceutical side incorporates Chemistry as well. Radiology is vital to their practice, to enable dentists to get a clearer diagnosis, particularly for diseases they can't see directly in the mouth. So, physics plays a big role in their ability to do their jobs properly. Teeth are made of a very hard material which luckily shows up very clearly on x-rays. They can then diagnose if there is a cavity due to decay or a deficiency in the bone levels around the teeth i.e. a dark shadow where normally there wouldn’t be would indicate a softer material, decay, rather than hard enamel or dentine. Cysts or tumours are also usually fluid or less dense and can also be similarly diagnosed from an x-ray. The final, and possibly most important, science dentists use every day in their work is Psychology. Fear is a big deterrent for a lot of people for visiting dentists in the first place. As dentists, they learn to manage a patient’s psychological issues in a very skilled way. Even the most confident, able person can be nervous of the vulnerability one feels when you have someone messing around in your mouth and the potential for pain is real. Getting a patient to trust their clinician and allow them to do what is needed is a vital part of the job and can be quite challenging at times. However, it is so rewarding when it works and is a big part of why she enjoys her job. Dentistry is a subject which has such a vast overlap of many scientific foundations, possibly more so than medicine in a lot of cases. However, it also allows artistry and vocational skills to be used as well, which is not always possible in other scientific careers. Dr Hassan feels privileged that it's a job in which she genuinely feels she can make a difference to people’s lives every day, not just to treat disease and remove pain, but to provide a safe and trusting relationship with the patient to help empower them and improve their confidence and working with her local community over the years.
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