Changes in Dentistry Part II

Changes happen

Having covered many changes in the first 20 years of my 40 year involvement in a dental career the second half of my blog probably relates more to advancement in technology and patient expectations.

Dentures are not the end point

Thankfully, gone are the days when people just expected that at some stage in their life that they will have removable false teeth.  Remarkably in the older generations young brides were given false teeth as a wedding present!!! While sometimes false teeth are unavoidable generally speaking most people can expect to retain the majority if not all their teeth and maintain a functional dentition for life.

Prevention is Key

This expectation is due to a number of factors. Prevention is a key factor here. Public awareness of dental health has grown tremendously and active maintenance [scale and clean] and check up appointments have become the predominate reason to visit the dentist. This has resulted in a tremendous awareness in oral hygiene and the need to maintain a clean healthy mouth which provides a strong basis for the teeth and the supporting structures of the teeth– the gums and bone.

Healthy teeth, healthy body

Many studies also reveal the general health of the population is greatly improved by simply maintaining a healthy and functional dentition. It has been proven many lifestyle diseases such as heart disease for example is more manageable with good maintenance of the oral cavity. Preventive visits to the dentist are also an ideal way to introduce young children to the dentist in that they can have a pleasant, educational and stress free experience.  Prevention and check -ups allow problems to be identified early and to be corrected simply.


In the last 20 years a number of the specialty areas of dentistry have become possible within the scope of


general dentistry.  With evidence based and correct training, orthodontics is now available from the general dentist. Instead of travelling long distances for the multiple appointments required this treatment, ninety percent of orthodontic cases can now be performed locally. This allows the local community to have access to an area of dentistry that provides results that give people more confidence in themselves as well as aiding the objective of retaining their teeth for life.

Root Canal Treatment to save teeth

When teeth have slipped through the preventive net so to speak, even to the extent that retaining the tooth has been compromised and extraction is an option, in many cases this can be prevented.  Due to improved technology and increased public expectations another area of general dentistry, previously more confined to the specialist realm, has become possible. This refers to root canal therapy [RCT] also known as endodontics. While always possible under the general dentistry umbrella to a degree, with improved techniques, success rates of general dentistry endodontics has greatly improved.

This is mainly due to, instead of the long tedious appointments of cleaning root canals by hand filing, it can now be done with rotary instruments. An analogy here would be instead of digging a posthole by hand it is much easier and efficient using a posthole digger!!! This has made root canal therapy a more pleasant experience for both the patient and dentist with an increased chance of success.  Another innovation in RCT has been the apex locator which pin points the exact end of the tooth electronically which is vital to the success of the procedure. Before, this aspect of the treatment was a more subjective evaluation. So RCT is another tool in the general dentist’s tool bag.


Digital X-rays

The age of computers and digital technology has revolutionised how dentistry today is delivered. From a treatment perspective such things as xrays, crown fabrication, and implants for example have facilitated new and a much higher standard in the results able to be achieved. Xrays no longer need messy chemicals for the development of xray films and we now have scanned digital images which provide clear magnified images on a computer screens making dental diagnosis more accurate.

Crown fabrication can now be now achieved with a digital scanned image of a prepared tooth followed by a computer designed crown which is linked to a milling machine to carry out the production of the finished product. Amazing technology. When teeth are lost for whatever reason, 3D imaging has enabled implants to placed in the jaws very accurately so that false teeth and crowns can be attached to re-establish a fixed, non removable, functional and life like dental result.

Computers in Practice

The administration side of modern dental practices has been greatly enhanced by technological advances provided by computers and the internet age. Almost paper free patient records can now be created and stored without the need of complete rooms to house the old hard copies of patient treatment information. Appointments can be now made on computers without the need to have hard to manage, alter and maintain hard copy books that were traditionally used in the past. Computers and the internet have also been of great benefit in a dental educational aspect and transfer of dental knowledge. Dentists have now have this facility to help continue their learning and understanding of advances in the dental world at their fingertips. The end result is better outcomes for the patients.


The Only Certainty is Change

Undoubtedly improvements and advances will always happen in all aspects of the delivery of dental treatment. This should be encouraged and embraced.

By Dr Donald Clarke


Dr Donald Clarke