We Were Always Taught

The very smart dog studying old books

Dentists who were trained in the 70’s were always taught that the first instrument used in an operative procedure was the enamel hatchet. Caries excavation was done with spoon excavators and a belt driven low speed handpiece. We were always taught that reversible hydrocolloid was an excellent impression material, especially since you could use the same material on multiple patients. You just had to warm it back up in the water bath. We were always taught that we only needed to use a mask and gloves if you had a cold or some break in the skin of the hands, or the patient had cooties. We were always taught that gold foil restorations were great. We were always taught that film and chemistry radiography was here to stay. We were always taught that amalgam fillings were the best option for everyone because they were around for over 100 years. We were always taught to brush the teeth and not to worry about the gums.

Correspondingly, we were never taught about lasers, digital radiographs, CBCT imaging, implants, CAD/CAM prosthodontics, and many other technologies because these tools did not exist. Did we fail to incorporate some or all of these technologies because we were never taught about them in school? There comes a time when; “We were always taught” needs to evolve into; “Everything I was always taught is now obsolete and I better get with it or I will be practicing on the leading edge of outdatedness.”

DNA testing for periodontal bacteria is also a tool; a molecular X-ray of sorts. These tests allow you to see beyond your senses and find disease early and in follow-up for treatment planning.

So, do we still think perio can be adequately addressed blindly, without knowing the bacteria you would soon be treating? You were always taught to do the best you can for your patients.

Richard H. Nagelberg, DDS

Richard H. Nagelberg, DDS

Dr. Richard Nagelberg has been practicing general dentistry in suburban Philadelphia for 34 years. He has international practice experience, having provided dental services in Thailand, Cambodia, and Canada. He is an advisory board member, speaker, key opinion leader and clinical consultant for several dental companies and organizations. Richard has a monthly column in Dental Economics magazine, “GP Perio-The Oral-Systemic Connection”. He is a recipient of Dentistry Today’s Top Clinicians in CE, 2009-2016. A respected member of the dental community, Richard lectures internationally on a variety of topics centered on understanding the impact dental professionals have beyond the oral cavity.
Richard H. Nagelberg, DDS

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