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Howard Speaks: Saving the World One Tooth at a Time by Howard Farran, DDS, MBA, Publisher, Dentaltown Magazine

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by Howard Farran, DDS, MBA, Publisher, Dentaltown Magazine

There is (and will always be) an ongoing debate about what constitutes standard of care in our sacred and sovereign profession of dentistry. Amongst dentists in the United States, the debate is rather difficult and it becomes even more so when the discussion turns to global standard of care. I have traveled around the world, and I’ve lectured to thousands of dentists in 50 countries on six continents, and the difference in standard of care between the 20 richest countries in the world vs. the remaining countries is vast. Standards in Ethiopia wouldn’t pass muster in Germany, however, Ethiopian dentists do what they can with the resources they can get their hands on. Y es, the chasm of what ought to be the global standard of care is immense, but as they say, a rising tide lifts all boats— and the tide of better global dental care is already starting to rise.

For years, Dentaltown has been the go-to resource for dentists who want to practice smarter, faster dentistry that’s higher in quality and lower in cost. Dentaltown currently boasts almost 200,000 registered members, and that really does seem like a lot, but when you realize there are more than two million dentists practicing on Earth, we haven’t even scratched the surface. Dentaltown has an amazing library of online continuing education courses. W e have more than 300 of the greatest courses ever created and they’re in nice, easy-to digest, hour-long increments. They’re approved for ADA and AGD credit. And now with the help of Dr. Ken Serota— one of the most well-known and respected endodontists on the planet— we are attracting and retaining the greatest clinicians from around the world to provide CE courses to our beloved Townie membership.

We have provided a forum where the standard of care debate carries on, but even more, we have provided a place where dentists can learn better dentistry from their peers. W hen you think about raising the global standard of care, dentists in the poorest countries in the world will not learn better dentistry in classrooms. They won’t even learn it on a personal computer. They’re going to learn better dentistry from their smartphones.

In the United States and in most of the countries once occupied by the British empire, it’s standard for a dental program to be four years of undergraduate work, then another four years of dental school. In fact, in most countries it’s pretty impressive if you have a dental program that’s four to six years long. B ut, when you visit South America, Africa and Asia, many of those dentists only went to school for two years. That’s it. Like it or not, the person who went to dental school in China for a couple years is making a living as a dentist, and will be until he or she reaches a ripe old age. It’s not going to go away, and there’s nothing you can do about it. Global standards of dental education are not going to change overnight — especially in those countries. You can’t increase the quality of dentistry today with some arcane conversation about making sure all dental schools are eight years long or that they follow U.S., Canadian or British standards. That’s a long way off, and it doesn’t solve today’s problem.

What can help? Quick answer: You (and I’ll get to that in a sec). As a dentist who practices in a privileged country where dental education takes eight years and you have every bit of space-age technology at your fingertips to do root canals, place implants, take 3D images of the jaw, etc., it is truly our job to provide an arsenal of online continuing education courses, made available for free on our Dentaltown smartphone app.

In lesser-privileged countries, dentists might not have access to a personal computer, but almost all of them have smartphones, and they’re already learning better dentistry on them. In the poorest countries I’ve ever visited, like Ethiopia and Tanzania, their dentists have iPhones and they’re learning from them. They’re learning from as many resources as they can find on their phones— including YouTube! It is so exciting to me that now instead of countries relying on a wealthy dentist from a rich country to fly in for a weekend to do charitable dentistry, where the village is happy and out of pain for a week— local dentists can learn how to do quality dental work from their iPhones, raising the village’s optimal oral health for a lifetime!

But even here lies a challenge. American dentists will pay for and watch continuing education on digital X-rays, lasers, CBCT, etc.—you know, basically Star Wars dentistry. What you don’t see a lot of, even on Dentaltown, is continuing education on simple, routine dentistry. Why? Because we already learned much of it in dental school. When I said you are the answer a few paragraphs back, I’m challenging every single privileged dentist out there to put together what I’m calling bush dentistry cases—basic dental cases that don’t require space-age technology like digital imaging or lasers, but courses that dentists from lesser-privileged countries can learn from. I wish for every Townie to place a basic, simple dental case on the message boards of Dentaltown.com for dentists from around the world to view and learn from.

When I visited Africa, I was approached by a dentist there who was excited to tell me about a case he worked on. He told me a beautiful 18-year-old girl came to him with a black dot on her tooth. The dentist was excited to help, so he numbed her up properly, pulled out his drill and drilled out the black dot —not knowing that he got a pulp exposure. Then he placed the etch on the tooth, but the girl didn’t like the taste of it so she sat up, rinsed out her mouth and spat it out. So now the etching gel was contaminated. Then the African dentist puts on the bonding agent, which she again rinses and spits out because of the taste. Then he cures it, puts in the composite, shapes it, cures the composite and polishes it nicely. Everyone was all smiles. As he told me about it, I could tell he was so proud of that case, but I was thinking inside, “Oh my word, this is so sad. She would have been much better off had she never visited the doctor at all. Now she has a pulp exposure and there’s no bond strength. It’s just sad.” Dentists in these countries need to know how to place amalgam—not composite, yet there are little to no courses on how to place amalgam, even though amalgam has an active ingredient that retards bacterial growth underneath. But more importantly, amalgam isn’t technique sensitive and doesn’t rely on high-tech gear to place it.

Put on your entrepreneurial hat. Start asking yourself, “If I was practicing dentistry in Africa and I did not have access to any of the tools that I have at my own dental practice, what would be the best way to do dentistry?” You really have to think about this, because literally three billion people on this planet exist on three dollars a day. If it’s a cosmetic case and you need to replace the front tooth of a teenage girl, you can’t place an implant—but you can do a flipper. Problem is there are no CE courses on how to do a flipper. That’s why I’m trying to appeal to your heart. Maybe you have always wanted to go on a missionary trip to a village in South America or Africa but didn’t have the means or the time. Maybe instead, you think about dentistry on a global scale rather than locally and contribute some simple dental cases Dentaltown that can help teach dentists from afar the proper way to do dentistry better and with the tools at their disposal.
Howard Live
Howard Farran, DDS, MBA, is an international speaker who has written dozens of published articles. To schedule Howard to speak to your next national, state or local dental meeting, e-mail jenna@farranmedia.com
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April 2024
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