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1324 Prof. Shlomo Matalon of Tel Aviv University School of Dental Medicine : Dentistry Uncensored with Howard Farran

1324 Prof. Shlomo Matalon of Tel Aviv University School of Dental Medicine : Dentistry Uncensored with Howard Farran

1/2/2020 6:00:00 AM   |   Comments: 0   |   Views: 57
Howard travels to the Tel Aviv University School of Dental Medicine to discuss dental education and dentistry in general with Professor Shlomo Matalon, the school's Director of Dental Clinics.


VIDEO - DUwHF #1324 - Shlomo Matalon


AUDIO - DUwHF #1324 - Shlomo Matalon


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Howard: it is just an honor to be in Tel Aviv Israel with Prof. Shlomo Matalon the what is your title we would call it?

Prof. Shlomo Matalon: head of the school the head of the part of the medical faculty which consists of four schools one of them is the dental school so we are school and and the head of the school since say October this year at the head of the dental have overheard of the dental school actually I am a graduate of this school I graduated in 1986 and since then I remained school is an instructor and then as a lecturers and then I became a professor and I'm now heading the the school in which I graduated and actually I am the first graduate students who is heading the school so does that mean your name was follow me yesterday he kept going back from Shlomi to Shlomo so I am going to paste my close friends cause me show me my the others you know official name is Norma but mostly people call me show me you know

Howard:  I would love to hear the story of the University

Prof. Shlomo Matalon:  it's the story of the school the school was established in 1977 for is school for those students who studied abroad and for those dentist which were not really dentists they didn't graduate dental school it was some kind of a dental technician who could treat the people mostly from Eastern Europe they came from Eastern Europe so in order to elevate their knowledge the school was established and he accepted students who had three years of medical studies behind him so it was a three year old fool for those who studied already three years of medicine I came to the school in 1983 after three years of medicine in Germany and since then at that time the school was supported by the government and by one of the HMOs the biggest HMO the provider in Israel capital in clarity and as a graduate of this school after our graduation we had to go to work in one of the cities in Israel according to the needs of the population it could be in the north in the South in the East in the West and these are all the clinic were the clinics were in are in Israel and we had to serve there for two to three years and that was a very good project because we could supply good dentistry to remote a located population and the population with the low income who couldn't receive a good dentistry at that time so this was still in 1993 in 1992 the this HMO stopped the project and at that time we actually started a six year program as well so a student who came to this school had six years ahead of him and when he finished the sixth year he got the DMD degree it was school of six year and unfortunately at the beginning of this millennium the school was in a very bad situation economical situation and the university intended to close the school in 2000actually almost except students to the school in the 2010 the government decided that the school must exist because there are only two schools in Israel one in Jerusalem and one here in tel-aviv and actually forced the university to reopen the school so the school was reopened in 2010 and since then the school has changed a lot first of all the university started to invest in the equipment and the in the problem of the school and we start flourishing in a way now we are in a position in which we have almost all postgraduate programs here in the school and we have special clinics for people with special needs we have operation rooms for general anesthetics for people who needs general anesthetics we do treat children with special needs as well and we do treat people from low cost low income population which they don't have actually were to go so they come to the school they do pay something just a symbolic payment for the treatment but we do here everything under one roof so if somebody comes with simple things in dentistry so he get treated by these students if it is a very complicated or more complicated case so he goes to the postgraduate students so everything is treated here from the very simple treatment to the verb to the most complicated in cases for a needs for example orthodontic surgeries and other treatments so the variety of what's going on the school is great but still we do need you know to enlarge in our activity we want to be to reach other populations in order to bring into the school the earth elderly people we would like to have them here in the school as well they took um but since there is low now in Israel which covers the dental D the elementary a dental treatment for children between the age of zero today till the age of 18 and elderly people from the age of 75 they can treat almost for free in the different HMOs which are existing in Israel we have four of them and that actually cut the  population who came to the school this is a problem but I think we will overcome on that problem with an agreement with those HMOs that they will send us the patient will treat them instead of the dentist and the Government  in the state will benefit from it first of all the population will get the treatment and second the students who are going to be the next generation dentist will have in practice they whatever they will need in their daily life afterwards if they will not reach children or if they will not treat elderly people during the studies how would they treat them when they graduate that's a question which is now a should be answer and hopefully it will be answered positively by sending the these patients to us but besides a treating gay people we do have a center of research here at the school and we are very proud of our publication the research which is done here is quite novel and it is published in very I ranked journals so we are proud of that as well as we have the clinical a part and the research part and the combination with these two giants is makes a daily school even better what I forgot to emphasize is that our school is one of the very first dental schools which went digital our students do everything digitally they hardly take impressions anymore they scan everything they crownss here they give the patients you know the the prawns or the bridges in this time span of hours and that's really prepares them to the real world because now dentistry goes digital and everything is done digitally even implementation placing implants is done digitally so we are one of the first schools in the world that tell our students a study just from the beginning to work with scanners even in the phantom lab they do that and they of course within the clinic I would have to take you afterwards upstairs and 

Howard: so then they start crying when they found out I never got to wax up a crown and cast 

Prof. Shlomo Matalon: you know that by the way the digital dentistry actually improved the quality of Dentistry because now when you take an impression once when you took an impression of the tooth I mean you could hardly see if it was really  good or bad now when you stand and you see 10 times bigger and you see it on the screen first of all you can correct it immediately and second I mean you can see the the quality of the preparation much better so anyway the quality of Dentistry that we provide and

Howard:  magnification is the key to quality whether you were in loops whether it's right endodontics microscope microscope whether it's digital so um I noticed every country has a different number of specialties how many specialties are in Israel 

Prof. Shlomo Matalon: we have is seven specialty seven we have in orthodontics we have in endodontics we had we have netted aunties we have in oral pathology a dental medicine we call it as well and surgery and did I forgot anything well 

Howard: I'm gonna go back to dental medicine because that's kind of an interesting history in dentistry some countries medicine physicians and dentists are much closer together like they might be a MD odontologist and then in some countries like the United States they're  more separate and in you said that you now have a government program for elderly over 75 now that that was just recent what I'd thought it illegal to do yes and so like you mean I'd say it's the local states help children that's Medicaid but the National Medicare they don't cover teeth is if the teeth weren't part of the human body and now you have especially dental medicine so do you see the future where dentists and odontology gets closer to MDS and medicine and because you're even saying the HMOs that provide the you know that that's the hospital organization

Prof. Shlomo Matalon:  it is actually it is a hospital it's a Dental Hospital what a very residental hospital and I think they should they must go together because these people normally come with the different kind of diseases and illnesses well I wish that everybody was healthy but you know some blood pressure or heart diseases and they should be treated differently and physician and dentist must work together and we do have the department here at the school but it is connected directly with the departments in the hospital with nearby hospitals so they do work together and that's especially dental medicine telemedicine is especially well you 

Howard: will you explain that?

Prof. Shlomo Matalon: more detail a because that's a new one in the medicines is those people treat people with how they say with a different diseases that needs to have special care in a way it's a special care clinic and if somebody cannot be treated by general dentist from for some reason he got a he had cancer and had radiation in head and neck area the extractions can not be done either in only in a surgery room and with a special treat is a special treatment in a different case is a people with the Alzheimer or people with Parkinson they should get the treat the dental treatment in a different way so those people who are specialists in dental medicine they are specialized in the total to be a dentist who treat these special care people so that's a line in medicine in dentistry which is focused on the specialty and

Howard:  how many students are in your class size 

Prof. Shlomo Matalon: we started when I was a student we started this 24 students per class now we are heading to 70 students per class and the systems here is starting three years ago that the students work in pairs one from the fifth year at the last the to last clinical to last the last to use our clinical use out of five years out of six years six years so we're in high school twelfth grade and in high school we have the army normally okay and three years okay good they enroll to the dental school so how old's a every freshman pride 28 only 122 some go after the service abroad for a year but it's around twenty one twenty two and then it's a sexual partner sixty program in the the graduate window 27 or 28 and what year did this school start sixty seventy seven seventy sevens we celebrated the was 42 years and then the other dental school is in Jerusalem is in Jerusalem and I started at 50 in the 50s 13 50s and they hit their 60 problems starting from the beginning I mean we're a little bit different 

Howard: what is your biggest challenges taking 75 kids babies that are 21 22 and six years later giving them a license to turn them loose on society well what are your biggest challenges

Prof. Shlomo Matalon:  listen the school is known for its best graduates clinical and clinically we are very good clinicians the graduates of the Tel Aviv dental school they are known in Israel is very good clinicians because we practice a lot and they have to practice about our requirements our clinical requirements are quite high when you mind saying what they are like 18 crowns they have to do they have to do it two crowns of implants they have to plan the implants they have to do the casting they have to do almost everything at least 120 fillings I'm filling it on compositor Romano Amanda we still use amalgam and composite as well in some hours in the ISM only the required to do at least four or five only some inmates in the studies they have to do at least two pairs of dentures which we are now in a bit of problem with the these other people who go to the HMOs hopefully they will remain in this school 18 root canal treatment so they are really our requirements are high higher than in Jerusalem

Howard:  so um an interesting observation Israel for me from the United States's um it seems like almost every dentist places implants are me a lot yeah a lot of dentistry some compared to United States so some countries like Korea Israel Brazil maybe one in four dentists place that implant last month and the United States that might only be ten percent why  do you think so many dentists in your country place implants more so than other countries 

Prof. Shlomo Matalon: we have a dental implant companies here in Israel how many you think I don't know but tens I think what would you say so 60 companies sell implants but only 12 are the original manufacturers so they manufacture for some of the other companies and we are in their well known in the world it's not in a very small company which supplies only the needs of the country of the implant producers are exporting in a couple of very well-known companies or Israelis and even a couple of them were both by Giants is alpha Bo I'll be honest both by Lobel by ocher every known and it was M is Bob I know about care -  

Howard: so why do you why do you think that is why did this country spawn so many implant companies

Prof. Shlomo Matalon:  we are the startup nation is you know we are known as the startup nation so some good ideas were invented here and the proof is that our implants those companies implants are were bought by other companies that means that our very high quality and they are innovative so that's why Israel is known for its implant that is to place implants here I think because they want to control the world if you send the  patient for example to a surgeon to face the implants without a jig so either you get it where you wanted in oh you guys did a little bit further a or nothing the exact place that you wanted it to be if you do this by yourself and you know that you have to restore the implant you most probably would put it in the right place a that's I don't sometimes

Howard: I want to go and I am in a different direction I have one of the things in America I find absurd is that eight and a half percent of emergency room visits or odontogenic and origin and for the most part they'll just give them antibiotics and pain meds so if I go into a hospital with a broken leg they can fix it a tumor in my brain they can fix it a heart attack it can fix it but I have an abscess tooth and they give me NBK and an opioid and you and we don't have especially dental medicine and then when you talked about DSOs in America know one of them is associated with the hospital and here you know you have especially dental medicine your dsos are associated with a Dental Hospital right I don't think there's a quote Dental Hospital in America so I wish you would explain to the dentist more how your dsos are connected more to dental hospital or an HMO and maybe that's a solution going forward I mean I've always advised tso that I was gonna start a DSO in America I put one in every emergency room at him in America if eight-and-a-half percent of people walking in have a toothache what better place to  be yeah so why do you think you got a dental medicine specially why do you think your DSOs are connected to a hospital and why do you have dental hospitals ?

Prof. Shlomo Matalon: we don't have Dental hospital I called the school dental hospital because it has everything what dentistry means so all field of Dentistry are done here almost why almost because orthodontic surgeries we don't do here in the school we do it in the are in the hospital because we people do not stay here overnight we don't have overnight a possibility here to control or to supervise the patients so we are that's why we are connected to hospitals which are close to the University we do have good they're all over there in the hospitals there is a department of all surgery in all these out in male hospitals the departments of oral surgeon and we send our students to these departments in order to see things which are not done here in the school the a question of dental medicine or what we could specialty in dental medicine is to treat people as I said before with special care oh they need special care order are in every from the medical situation they cannot be treated in a normal dental office HMO even the HMOs they send us people to be treated here instead of sending them to the hospital to be treated so we have very good connections with the HMOs the different HMOs a concerning these people these patients who are need specially dental care 

Howard:you also have a rich history with a dental fortunately yeah with that for Alpha Omega

Prof. Shlomo Matalon:  Alpha Omega was one of the establish of this school and supported the school since then I mean without this fraternity I don't know where the school could reach its I mean Alpha mega supporters all along the way in our good times and our bad times and whatever you will see here in this school was donated most of the things here in the school were donated by Alpha Omega fraternity or actually yeah I could say almost everything here because the some were some a equipment were donated by the Alpha Omega in the states but some in alpha Megan Canada or France but it's still the same fraternity which portes school I mean remarkably really remarkably a the bad times that we had at the University intended to close down the school a some of the Alpha Meighan are in the world in the board of the university actually convinced the university and put a lot of pressure in order to stop this clothing and finally we are here and we are sitting here and you're talking and 

Howard: so I believe America has 56 tunnel schools and I think fiber the deans are graduates from Israeli running dental schools which say that we don't have such a big dental schools

Prof. Shlomo Matalon:   I think five at least couple them I know personally some are extremely prestigious I mean the Dean of us see that that's gotta be one of us yeah right so original Newton in Cleveland days given do we have a lily of the off with the Dean over there and we are proud of our dentist and we are proud of them they are really great ambassadors to Israel and we talk to them I thought I know them but some of them personally there are good friends of mine and they really help the school know money wise but the academic wise and some good advices so what do you 

Howard: do you still have the old fashioned textbooks or is even that go and everything so they don't even for example we have lectures we do do you have a sense about

Prof. Shlomo Matalon:  most of our lectures by videos they go by Moodle texts are existing but they you know do you think stop saying go extended the decks the textbook was written five or six years ago curve everything now is you want things up to date it takes everything in five years to even write the textbook and then they use the textbook perfect I cannot say not but they are less relevant now everything is by the everything you can find the internet in pub made a articles we it's not the same way that I was taught I was taught to learn by hard things and to know by hard things and we teach them to thing we give them the basic but we teach them to think and if they know the basic and they know how to think they be a very good and they practice a lot so like 

Howard: we call our podcast dentistry uncensored because we like to talk about everything that people argue about not we don't want to talk about anything they agree on one of the biggest controversies in America is the treating pain with an opioid after a root canal or surgery is that a is that a big issue or controversy in Israel 

Prof. Shlomo Matalon: no it's not it's not it's thought to be but it's not in as much as I know a Israelis are not very big consumers of not a bunch of painkillers so opioid abuse okay our Syrah rope what do they call it battery yeah you 

Howard: substance abuse time I call it substance use disorder mhm so opioids isn't a big substance use disorder new in Israel it's not due but if I if I if you were gonna pull my for wisdom teeth mm-hmm after the procedure would you give me what would you give me for pain so 

Prof. Shlomo Matalon: just you know I'll tell you something which is very like you it's a thank you like oh actually we got opt a game you party term or so and see the minimum yeah nothing which should normally not only not and I won't even even in antibiotics we are now is the tendency to shorten the time of free antibiotic treatment so we do that here as well so you usually don't prescribe and hope you adapt another issue

Howard: I call it the  esthetic health compromise this seems like I get a school in 87 you graduating 686 yeah um my gosh and when it seems like dentistry was better back then because all the fillings were amalgam and they lasted you know they're metal every ingredients antibacterial gold crowns cemented with zinc phosphate cement and then we had the aesthetic revolution where everybody said oh I want it to colored and they replaced that metal amalgam with a inner plastic which is so ironic because the the research shows they last maybe six and a half seven years but every dentist you talk to you thinks is last forever and so is that a challenge for you here if he's flicking from amalgam to composite it is a challenge because

Prof. Shlomo Matalon:  there is no right or proper replacement for Malcolm it's my opinion and for my 33 years of practice I do think see my amalgams still in most of my patients that I did when I was a student and then I see less composite restorations who survived this period of time those amalgam is fading out that's by the Minamata agreement and in some countries in Europe they don't allow a the use of amalgam at all for example in the Scandinavian countries and Israeli is following the European how they say do European low and slowly  it fades down the at the use of amalgam where the composite is the right choice say for the time being that is the only choice that we have or inlays and onlays from between the silica for example but not everybody can afford england's anomalies and so the the cheapest solution is composite composite has proved it improved during the last couple of decades but it still has his growth robux and it's a very aesthetic placement a but whether it's a replacement I doubt it 

Howard: well Raphael we talked to a company we met with a company called nob you know view has developed composite that is antibacterial proprieties and this will allow to solve this issue and it's really new company how how close or how promising is it and have you done have you seen the material do you think you will be evaluating it or looking into this 

Prof. Shlomo Matalon: yes of course I mean one of the problems of a composite is inspiration that is that they leak and when everybody is leakage bacteria and the Salavat can penetrate installed the action of carriers and if you have a material which can stop the action of the bacterial material which is anti bacterial so it won't overcome the problem of shrinkage in leakage but it won't allow the bacteria to proliferate and cause damage so it's quite renovating material you  have a planet and yeah I've seen the material and what I've tested it in the school as well and I know that the results were very good we tested n't in vitro not in vivo I mean not on patients but on you know in the lab and it's it looks really promising we do I mean not a little but it will make a change in it will improve the composite 

Howard: when do you think it will go start human trials 

Prof. Shlomo Matalon: I don't know I'm not in the company so I don't know but I know it got the a DA of the improvement the composite have passed the FDA so I think if we passed the ad the FDA it should pass the clinical trials and then the European equivalent of the FDA is the CE mark is it C Mon C Mon C Mon or 2c e stand for okay

Howard: so it's passed the C II mark and the after you I think so but we're going to meet them tomorrow yeah that's exciting because I've always thought dentistry a good analogy was like you you build this beautiful barn out on your farm and you tell everybody to brush it and wash it and clean it every day but at the end of the day it's eaten by termites and you listen to Dentist talk their languages like engineers they build bridges but it's really more biology there are restorations are eaten by unicellular organisms and fungi and eukaryotes and prokaryotes so I always like dentistry is more a game of biology than a game of engine like civil engineering

Prof. Shlomo Matalon:  I think it's a combination true if you cannot if you don't have the  engineering knowledge it's very difficult even to build simple or to understand how a simple bridge stands and what kind of forces it should absorb in the direction of the forces I think dentistry is a lot of engineering and of course is being medicine after all it's a lot of biology so it's a combination of biology in engineering by the 

Howard: fail because biology recurrent decay that's been structural that's true it's I'm really excited about tooth colored restoration getting an active ingredient that's antibacterial it's the new Buell is what we've been after since the aesthetic health compromise of switching from amalgam and even and it's so bizarre because gold like all the women here have gold rings and gold earrings but they won't put I have seven gold on ladies in my teeth and I can't get anybody in America want to do that well while they have a gold pin in their nose and the gold earrings and gold jewelry so they really want to colored so tooth colored restorations really need an active ingredient yeah it does

Prof. Shlomo Matalon:  I agree with you I agree with you as long as composite regime which means maybe one day they will find the material which is antibacterial and it's safe physical properties are a little bit better than the companies so it will overcome even the problem of shrinkage whenever it acts I mean you get one day just it's slightly expander you have percent maybe it's even better and it's much better rather than the main shrinkage of a percent or five percent 

Howard: so there anything the problem of the school the aims of the school it's a challenges 

Prof. Shlomo Matalon: actually it's my first house I am spending here more time that I spend in my home and that was since 1983 which I and when I entered to be a student so I spent at that time I spent eighty percent of my time here in the school but since then I'm I was always here so I knew what I'm going to and it was not a surprise or it's hard job to do and it should be done and I have to continue the great job I must say that my a previous heads of schools did and I hope to fulfill the wishes in the challenges which I dentist have you know 

Howard:so many years in college there they all are sold thing in it it's so hard to get them to all agree I mean like if you go to the American Dental Association you couldn't get ten donors to agree that today is Wednesday so how do you as a leader if so many strong opinionated dental minds to all agree to think and going the same way is would you say would you say getting dentist all on the same page is always going to be the hardest challenge?

Prof. Shlomo Matalon:  I don't think really I don't think so I think it depends on the personality of the leader for example when I enter the school I talk to the heads of the departments that for me there are the board of governments I am just to see you so they decided I will raise the cry will raise the problem they will decide and whatever they will decide I will execute in that way even if somebody does not agree if the whole I mean in PA minority is still accepted because he was involved in the decision and bringing the people to be involved in the decision make them very cooperative even if they don't agree with a result and since most of the heads of departments here are my good friends since I spent with them a lot of time and they that's the way I run this school so it's quite easy 

Howard: one last question Rafael has been training swinging to me DSO’s connected to HMOs or and we've been having a just whenever our time we want to ask the question or to those organizations provide members and generally be killed we have everybody in Israel must be a member of one of the 

Prof. Shlomo Matalon: HMOs okay it's literally you cannot be independent every director citizen know every citizen every citizen not a member not the dentist every citizen has to have insurance health insurance but in one of the HMOs and there's four five  as much as I recall Maccabi Tel eat Lou meet credit phone and so everybody's in food now dentistry was not under the cover is not covered by the government who was not covered by the government once it was covered by the government children from zero to 18 in elderly people from 75 to 120 the state gave these HMOs the possibility to treat these people and to get was funded by the government besides the obvious HMOs opened their own clinics dental clinics which are actually private companies owned by these HMOs and they provide dentistry to everybody who wish to come their members are getting discount but they are treating everybody so there are a competition to the private sector each and every one of these HMOs have some sort of a company or partnerships with a dentist or they have their own dental clinics and some of them are really wonderfully equipped and most of our brad meds when in the first years of practice they work for these HMOs they don't open right away the private clinics still the majority of the population of Israel is treated by private dentist but slowly  it goes I mean HMOs are getting more and more patients that's about the HMOs

Howard:  it has been an honor and privilege to podcast you thank you for making time it's really I'm honored to have you here and I hope you have a nice stay in Israel and you enjoy your stay in Israel it's been fantastic Rafael's and very good very good thank you very much thank you
 


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