‘Open wide’ to the possibilities in the dental profession, and do please keep your jaw cracked open, too. We’re almost done with the soft tissue exam.
At Harvard School of Dental Medicine, we have one minor obsession: three-letter acronyms. POH [Principles of Oral Health]. SOH [Scholarship in Oral Health], OSS [Oral System Sciences]. Each of these three-letter acronyms stands for a course we have completed, and each of these courses is truly incredible!
But one three-letter acronym truly stands out among the rest, and not just because it comes first alphabetically.
ECE, Emergent Clinical Experiences, is a course of rotations through each of the dental specialties. Before ever holding a drill, before treating a patient, we have the honor of assisting and shadowing trained surgeons, pathologists, periodontists, and more. And that privilege is a marvelous thing!
Because very quickly, as ECE students, as observers and colleagues in the field, we come to learn ten very valuable lessons from ten dental specialties:
1. Dentistry is all in the details. Of a root, of a crown, of a patient’s question. As an assistant rotating through the Endodontics clinic, I will admit, I couldn’t quite see the detail of the procedure. But, I could see just how much attention to detail we need in this field in order to obtain good outcomes! And I could see that the importance of detail extends beyond the root canal, and straight to the patient’s experience!
2. Dentistry IS a branch of medicine. And not just in the sense that dentistry concerns itself with oral and systemic health – because that it does! When rotating through the Brigham and Women’s Hospital Oral Medicine clinic, I had a first-time peak into the kind of dentistry that occurs within hospital walls. And it was amazing! Collaborating with medical doctors, planning with oncologists, paging in the consult of a social worker. Dentistry – both in and out of the hospital - is far from an isolated profession. In fact, with dentists seeing patients more than some doctors, dentistry may just be the canine of the medical world.
3. Dentists are visionaries. And I’m not just talking about the incredible innovations that have come from the dental world. Rather, I’m talking about the daily innovations of the oral surgery team, the daily planning and care they take to reconstruct a jaw. I am talking about how they consider the patient’s teeth and occlusion, and how they fit that occlusion to a patient’s dreams. Astoundingly, they are using dentistry to empower a patient, and to realize a dream!
4. Dentistry can be a bloody joy! Listen, nowhere will you see more blood than the periodontist’s office. It’s gooey. It’s slimy. It’s messy … and it’s wonderful! Because, beneath all the blood, behind all the granulation tissue, is a foundation of health. And we as dentists have the tools and knowledge needed to uncover a patient’s health.
I can’t think of a bloodier joy in the world!
5. Sometimes, dentists have to start over. When a patient comes to the prosthodontist without teeth. When a denture doesn’t fit quite right. Spending a glorious few days in the prosthodontist’s bay at Harvard School of Dental Medicine, I never once saw a complete prosthesis delivered. In fact, I only ever saw the ‘construction job’ being fixed!
And yet, I probably learned the most valuable lesson from that rotation: there will be challenges. And there will be situations that set the treatment plan off course. The lab may not deliver the ideal crown, and the patient may not like the size of the teeth. You as a dentist may venture a shade too dark when creating a veneer. Challenges happen in dentistry – all the time! Of course, with practice, the goal is to minimize those challenges and maximize success for our patients, but, practicing with the chutzpah of a prosthodontist, we must never let challenges deter us! In fact, these challenges might just excite us!
6. Dentists are educators. Every day, with every patient and every member of the dental team. In every interaction with medical colleagues and in every conversation at the dinner table. We as dentists are educators for the public, teaching the world how to preserve those pearly smiles.
And there is no better place to see that than in a general dentist practice - or on the American Dental Association Mouth Healthy website! No matter what a patient needs – a cleaning, a filling, a consult or referral – the patient can benefit from a little one-on-one education, and we can learn so much from sharing what we know! In fact, in only two years of dental school, I think I’ve inspired about 8 Uber drivers to start flossing again!
7. Dentistry is hardcore. Hard as Titanium, in fact! One of the cornerstones of the 21st century dental field is implantology. And the field is filled with questions: what markings on the implant make for better bone integration? What source of bone graft is most successful?
Shadowing in the implantology department at Harvard School of Dental Medicine, I observed implant specialists making all these fine choices, and discussing the options with their patients. And I was reminded just how hardcore-incredible this dental profession really is. Because how many other professions combine patient care with materials science with research and surgery?! And all with a focus on smiles! I can only think of this one.
8. Dentistry is about accepting the things we cannot change, but knowing there is A LOT we can still do! And nowhere does this hold greater truth than in the orthodontist’s office. Take, for instance, the woman with teeth too small for her jaw. Her jaw isn’t changing size, and without restorative dentistry, her teeth aren’t changing size either. But the malocclusion is something an orthodontist can possibly fix. And the function of her teeth is something orthodontic treatment can certainly help restore.
So, although we can’t change everything, we as dentists – with a touch of creativity and a band of NiTi – can sure do a lot!
9. Some aspects of dentistry are not so clinically straightforward. Like whether the patient has anxiety or medication-induced xerostomia. Or whether the patient’s leukoplakia will progress into malignancy. And some parts of dentistry – quite a few, actually – we just can’t see with our two eyes and two loupes. I don’t care what magnification you order!
Which is why we have oral pathologists. And microscopes. And histopathological guidelines. This is why we as clinical dentists work in teams with colleagues who know the fine details of ghost cells and viral inclusions. After spending a day with a microscope and slide in the oral pathology clinic, I came to realize that, while almost all of dentistry happens in the scale of a few millimeters, some of dentistry takes a dive a few nanometers deep.
10. But mostly, dentistry is about the smiles. And fostering the next generation of smiles.
One of my favorite rotations was the Department of Dentistry at Boston Children’s Hospital. Pediatric Dentistry is where my heart thrives! And not just because I love the children – though, really, I do – or because I love working with the families – because, the parent-child dynamic is incredible!
Spending the greatest days of my year in the pediatric dental office, I came to realize that we as dentists – in any specialty – have one goal: seeing our patients smile. Whether that’s through stickers and high-fives or fast and no-nonsense drilling, we are in this profession to help people. And to inspire people. And to foster a world of healthy smiles.
Truth be told, long before dental school, I looked into my options: there’s no better profession in the world!
The doctor said she would live in a nursing home, confined to a wheelchair, crippled by pain. Instead, Mirissa D. Price is a 2019 DMD candidate at Harvard School of Dental Medicine and future pediatric dentist, spreading pain-free smiles, writing through her nights, and, once again, walking through her days.
© 2017 Mirissa D. Price: A Dental Student, A Writer, A Journey to Share.