New Directions in Technology

Here we are, two thirds of the way through the first decade of the new millennium, and we are anxiously waiting to see what is next. We survived Y2K with an amazingly low number of problems relative to what was predicted. We have seen some very innovative approaches to dental practice since Y2K, and now that we are used to writing and typing 2007, can we predict what the next 10 years will hold for us? The answer, of course, is an emphatic “no,” but part of the fun of looking into the future is looking at what we have accomplished, and saying, “What if?”

THE PAST AND PRESENT

Figure 1. Assistant uses intraoral camera to gather visual information.

Figure 2. Before-and-after imaging simulation.

Figure 3. Odyssey 2.4G diode laser.

Figure 4. SIROLaser diode laser.

Figure 5. CEREC in operatory.

If we look back at dentistry approximately 20 years, 1985 or thereabouts, we have seen the introduction to practices of intraoral cameras (Figure 1). Many have come and gone, but today a very high percentage of dental offices use intraoral cameras on a daily basis to educate, to inform, and to add interest to our daily routine. We have also seen the introduction of pretreatment imaging (Figure 2), where patients see what they can look like before a handpiece ever touches a tooth. There is one company that thought so highly of the potential for this modality that one dentist devoted his entire life and energy to providing this service to dentists who did not make the leap into purchasing this technology. The company is Smile-Vision, and it is run by Dr. Lawrence Brooks.
We have seen the introduction of soft-tissue lasers such as the Odyssey 2.4G from Ivoclar Vivadent (Figure 3) and the SIROLaser from Sirona (Figure 4). We finally have affordable (relatively speaking) products in the laser world to enhance the quality of our work. These are the only 2 soft-tissue lasers that are actually small enough to be considered totally portable.
We have also seen the development of the world’s leading CAD/CAM system, the CEREC (Sirona), which has allowed us to do inlays, onlays, and crowns in one visit with outstanding accuracy and aesthetics (Figure 5). We have gone from conventional radiographs to digital radiography, which allows us to see our radiographs instantly without needing a darkroom and exposes our patients to a substantially less amount of radiation.
A common thread in everything new that has come along in the last 20 years has been to make things better for our patients, and as a result better for us as a profession. Many dentists I know are not making plans for retirement at the early ages we did in years past. Dentistry has become more fun, more interesting, and more exciting for those who want to take the time to learn the new skills that are needed to adopt many of the new technologies.

A LOOK TO THE FUTURE

What is next, and how will we adapt our practices to continue to be on the leading edge of the exciting things that are yet to come? Dentistry has accepted change like no other profession I know, and change is endorsed by a higher and higher percentage of our colleagues. Early this year (2007), our computer world is about to be shaken up again as we await Microsoft’s new operating system, Vista. We can only guess how much faster, easier, and smoother computer functions are going to be.

Figure 6. VELscope.

Figure 7. VELscope with digital camera.

Figure 8. Normal-appearing tissue.

Figure 9. Dark area with VELscope.

Figure 10. The ILUMA Scanner.

Figure 11. MagnaVu with monitor.

If we look at how far intraoral cameras have come, we don’t have to look too far to see the connection to the newest device on the market, the VELscope (LED Dental; Figures 6 and 7). This device is like an intraoral camera that will allow the profession to make some significant changes in the mortality rate for oral cancer, something that unfortunately has remained stagnant for the past 50 years. By looking through a scope at a field of vision less than 2 inches in diameter, we are now able to spot premalignant lesions before they are visible to the naked eye (Figures 8 and 9). This changes the direction of technology from “interesting” to “fascinating and lifesaving!”
What if we could take all our x-rays digitally extraorally? That is not a misprint. All our x-rays digitally extraorally. Kodak has just come out with such a device. With the use of a new machine resembling a Panorex, radiographs can be made, and the unit provides full-cranial, highly accurate, 3-D radiographic images for the diagnosis, planning, and treatment of orthodontics, implantology, TMJ analysis, oral surgery, and other dental procedures. It is also capable of producing CT-type scans and 3-D images, all from one picture. This unit is called the ILUMA Scanner (Figure 10; manufactured by IMTEC, distributed in the United States by Kodak Dental Systems Group). 
When we look at new directions in technology, I believe the development of items that will make us work with less stress, offer greater  accuracy, and provide more patient comfort will be at the forefront of advancements. How many of our patients dislike having impressions taken? What do you think of a camera that can take virtual impressions, make 3-D models that can have appliances fabricated on them, and do so with more accuracy than we are familiar with today? What about computer programs that will scan a tooth and tell us whether we need to do an inlay, onlay, or a crown, instead of using our historical methods, which are sometimes right and sometimes wrong? I think we will see the day when a patient will be able to walk into our offices and have a tooth removed and replaced in the same day using their own DNA in some fashion. I think we will see the day when we will be able to do our examinations completely by computer-assisted devices, get very acceptable treatment plans from that information, and then use some type of CAD/CAM system to make corrections, or whatever the pa-tient needs.
Will we as dentists become obsolete? Absolutely not. We will need to be trained how to introduce all of the new devices and technology, and in fact, will spend more time on education and less
on treatment. Of course, less stress is a good goal, and when we address technology that helps our patients, we also need to look at technology that helps us. Consider posture and back problems that have plagued dentistry forever, and we have to look at the use of microscopes and microscopes attached to cameras, as with the MagnaVu Dental Scope (Magnified Video Dentistry). This system allows a dentist to sit perfectly upright with his or her head looking straight ahead into a monitor instead of leaning over and creating curvature of the spine (Figure 11). Realize that if we all used devices like these, those of us who have been practicing for 40 years or more would no longer walk around with curvatures of the spine, creating all kinds of problems in our later years.
Consider the fact that many dental schools now run entire curricula without textbooks. For those of us who graduated in the last century, this seems like a Star Trek advancement, and yet it is now being done successfully.

CONCLUSION

Dentistry is becoming one of the most interesting professions in the world. Get involved in the new technology, renew your excitement, and do everything you can to truly enjoy each and every day. Dentistry Today is celebrating its 25-year anniversary, and dentistry today is nothing like dentistry tomorrow will be. Look to this very progressive journal to help keep you informed on what is changing and what is new, and I can guarantee you a lifetime of success and enjoyment. Embrace the future. It is here already.


Acknowledgment

The author would like to thank some of the colleagues who have been influential in making his journey in dentistry so fantastic: Drs. David Garber, Ron Goldstein, L.D. Pankey, Omer Reed, and Carl Reider. He is forever in their debt for their insight and willingness to share.


Dr. Neuman maintains a general practice in Vancouver, BC, with an emphasis on cosmetic dentistry. He is an accredited member of the American Academy of Cosmetic Dentistry. He works with Dr. Gordon Christensen as a CRA evaluator and has earned fellowships in the AGD, the Academy of Dentistry International, the International College of Dentists, and the American College of Dentists. He has also been honored by Dentistry Today as being named one of the Top Clinicians in Continuing Education. He can be reached at This e-mail address is being protected from spambots. You need JavaScript enabled to view it .