Dusk is the New Dawn

Dec 6th, 2018
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It was December 1985. On a cold wintry evening in Mumbai, my mother called out to me, "It's time for your dental appointment. Hurry up!" I dreaded the dental visit as the idea of the huge dentist [Huge drill, perhaps?]using the drill in my mouth. I remember his hairy hands and my tears falling on them. I remember my dad commenting that dentist make so much money and look at the number of patients waiting in the clinic. As my dad was mentally calculating how much the dentist must be earning in a session, nobody could sense the dread I felt waiting to go in. Many years have passed since then, and here I am, a dentist, and as destiny comes a full circle, with hairy hands. Even today, every time I treat a patient, I am conscious of my hairy hands. As another day in the clinic comes to a close, I wonder how dentistry has changed and how things could be different in the future.

Dentistry Flashback
A lot of water has flowed under the bridge since the days of amalgam restorations and air motors. Dentists in the past era did not have technology or the sophistication to explain to their patients about their dental problems. They also did not have as much time to talk to their patients due to abnormally high number of patients they used to see in a day.I remember the doctors take out the time (whatever little they had) to converse with the patients and relieve their anxiety.

But most of all, I remember the patients. The patients, who came to the clinic, were so grateful to the doctor. The doctors, too, remembered the names of all their patients and their family members. Even the doctors, although they maintained a serious facade, were touched by the gratitude shown by these patients. This transformed in a relationship that blossomed over years and everyone knew the dentist.
Circa 21st Century
Beep! A look at the cell phone. Text from AX-DENTST, “Good morning, you have a scheduled appointment at 1030 with Dr. ABCD. Please report to the clinic 15 mins before your appointment. Thanks” Dentistry has gone digital and undergone a sea change in the way services are being delivered. Several dental clinics along a single street trying to compete for a bigger share of the pie. These new age practices have recognized the changes that have occurred in peoples’ lives over the past 20 years. We live in an age where banking, grocery shopping, laundry are done by tapping a few buttons on the phone and within 5 minutes- the same chores which used to take up almost half a day earlier. These technologies were invented to save time for people and make their lives easier, to make them have more time for themselves. But unfortunately, this has resulted in people finding more work to do than ever before. Additionally, people have become more impatient. Their minds and phones are moving at 4G speed but the cars are stuck in 1st G.

In these challenging times, people’s expectations from dentists have gone up. Enter technology, and registration process is done even before patients walk in to the clinic. The moment patient walks in, a customer care greets the patient by name and welcome them to the practice. Wi-Fi enabled practices keeps them occupied during their wait. Doctors ask patients a bunch of questions and type them all out into their computers while maintaining proper codes of professional conduct. The doctors ensure that all investigations are done to cover medico legal complications. Digital radiography provides instant X- rays and the associated software picks up the problems and accentuates images to bring pathologies to the doctors’ notice.

Gone are the amalgam restorations and enter the era of polymer based tooth coloured restorations and atraumatic restorative therapy. Infection control practices have taken a huge leap with B class autoclaves, colour coded pouches for chemical monitoring and perfumed gloves make the dentists’ hands more palatable.

Wider treatment and scalable treatment choices are given to patients and the final decision is left to the patients and not on the doctors to decide what’s best for the patient. Informed consents are taken for all procedures to document patient’s acceptance of all clauses associated with the treatments.

Warranties with dental crowns and bridges and dental implants from the respective labs and companies give patients more confidence than the words of the dentist.A lot of feedback calls and goody bags being offered to the patients before and after the treatments but not many dentists know a lot about their patient’s names or their family.


Which is better?
Well, I am not here to decide which era of dentistry is better. But I do believe, each era of dentistry has something substantial to offer and the dentistry of the future must incorporate the best of both worlds.
One of the key differentiating factors, I believe, is the communication skill, exhibited by the doctors of yesteryear. We must understand that no-one likes going to the dentist. Most people come to us only when they can’t postpone it any more. Dentistry is also probably the only business in the world where patients pay money in return for torture. Under these circumstances, it becomes all the more important to converse with the patient to alleviate their anxiety. The doctors must always maintain a running commentary while the treatment is going on to keep the patient engaged in the thoughts and must positively reinforce the patient at all times to enhance their experience at the dental clinic. A doctor who communicates in an effective manner to the patient, thereby ameliorating the patients’ anxiety is perceived as a much better doctor than someone with extraordinary clinical skills but poor communication skills.

I wish the dentists of yesterday had spent more time incorporating technologies into their practice especially pertaining to infection control and biomedical waste management. At the same time, I feel the dentist of today, driven by skepticism from the patient, has lost the emotional connect that is so important to succeed, with as a dentist and as a dental practice. Establishing an emotional connect with the patient definitely increases the job satisfaction quotient many times over. While accepting western standards of care, we must realize that we as Indians are emotionally connected in everything that we do, whether it’s our job, or friendship or even cricket.

Dentistry in India today is at the cusp of a change and it is the youth of today that must take a stand to bridge the generation gap of dentistry and take our country forward in delivering world class dental care. Younger generations must take the responsibility of being care givers along with being good clinical doctors, because today what is needed is a doctor who is not only clinically competent but also compassionate and approachable.

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