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.
|