All about new Frontiers in Dentistry

Dr Mitali Bora, Principal of Regional Dental College, Guwahati shares a detailed and comprehensive overview with MELANGE

The Assam Government has signed a MoU with various empanelled hospitals under Atal Amrit Abhiyan and Arogya Mitra to provide health assurance at a nominal amount. Treatment of Oral Cancer, Oro-pharyngeal Cancer and Nasopharyngeal Cancer are covered under this MoU. Under NOHP, the Government of Assam has taken initiatives to provide complex dental procedures such as RCTs and prosthetic rehabilitation etc at a nominal cost. These services are provided free of cost to the economically weaker section. Projects like Smile Train India, have been made available and advocated for the free treatment of cleft lip and palate. What are the latest breakthroughs (in terms of research and study) in the field of Dentistry? Can you share some recent/or ongoing research initiatives undertaken by Regional Dental College? In recent times, the latest breakthroughs of Dentistry have been in the field of regenerative dentistry or stem cell research, biomimetic materials, computer aided dentistry or use of Artificial Intelligence. Regenerative dentistry mainly focuses on regeneration of damaged dentin, pulp, resorbed root, periodontal tissue regeneration and repair perforations using Dental Pulp Stem Cell (DPSC). Biomimetic materials mimic biologic tissues with excellent biocompatible properties. Various materials like SDR (Smart Dentin Replacement material) and use of bioceramic sealers in the field of endodontics are a few examples. Robotics and use of AI has come into vogue to aid practitioners plan treatments for a more predictable and stable outcome in the field of orthodontics and implantology. Dentistry is also evolving in terms of use of technology such as Near InfraRed Imaging Technology (NIRI), CBCT for the assessment of extent of proximal caries, periapical lesions, missed canals, planning dental and zygomatic implants. In Orthodontics, CBCT is used to aid the treatment planning in case of impacted or transposed teeth. Micro-endodontics and development of microsurgical dental instruments have been of great interest to endodontists. The recent and ongoing researches undertaken at RDC include: - Salivary Osteocalcin as a biomarker of skeletal maturity. - Comparative evaluation of different chelating agents on mineral content of teeth in RCT. - Comparison between bioceramic, resin based and calcium based intracanal medicaments. - Assessment of anatomical variation of lingual foramen and mental nerve to estimate safe zone for implant placement using CBCT. - Stem Cell Applications in Prosthodontics - Association between craniofacial, shoulder and vertical mandibular asymmetry in Temporomandibular Disorder patients and its effect on age and gender - Inter-relationship of Bond Failure of orthodontic brackets and oral hygiene in 6 months of treatment - Assessment of readiness to quit tobacco among patients with oral (potentially) malignant disorders using theoretical model - Validation of betel quid dependence scale among a population in Kamrup (Metro) What are the subjects taught under the BDS and MDS Courses? Has the curriculum been updated in recent years? If yes, when and how has this update happened? If not, what is the way forward in terms of upgrading (in tune with the latest trends of dentistry) We are currently following the 2007 DCI regulations for BDS course which include 13 dental subjects and 8 medical subjects divided into 4 years of theory and clinical training with one year of rotatory compulsory internship. The last and eighth amendment was published in 2017. The specialties taught under the BDS course are Oral Medicine and Radiology, Oral and Maxillofacial Surgery, Periodontics and Oral Implantology, Conservative Dentistry and Endodontics, Pedodontics and Preventive Dentistry, Orthodontics and Dentofacial Orthopedics, Prosthodontics, Crown and Bridge and Implantology, Oral Pathology, Public Health Dentistry, Dental Anatomy and Dental Histology, Dental Materials and Pre Clinical Operative Dentistry and Prosthodontics. In addition to these, General Human Anatomy, Physiology, Biochemistry, Pharmacology, Microbiology, General Pathology, General Medicine and General Surgery are taught. For MDS, we are currently following 2017 DCI course regulations, which were amended latest in 2018. Please elaborate a little on periodontics, prosthodontics and orthodontics as these are emerging fields? Periodontics is the study of the tooth supporting structure. Procedures like osseous surgeries, bone graft, implantology, tooth lengthening, laser therapy, cryosurgey are covered. This department mainly deals with crown lengthening procedures, root coverage, splinting of mobile teeth, gingival hyperpigmentation, supportive periodontal therapy, implants, placement of Titanium mesh and bone grafts, guided tissue regeneration (GTR) and guided bone regeneration (GBR) procedures. Prosthodontics and Crown and Bridge is the branch of dentistry which involves rehabilitation of missing structures of the jaw and face. It includes the study of facial muscles, biomechanics of the edentulous state, craniomandibular relations and movements and the concepts of occlusion. Rehabilitation of missing teeth, eyes, nose and also structures lost in case of oncosurgeries constitutes this branch. Orthodontics is the branch of dentistry involved with the correction of malaligned teeth. It mainly deals with preventive, interceptive and corrective procedures of correcting and aligning teeth and jaws. It includes the study of growth, biomechanics of tooth movement, jaws, myofunctional appliances for the correction of hypofunctioning or hyperfunctioning muscles during growth, cleft lip and palate rehabilitation, orthognathic surgery and fixed mechanotherapy. Recent advances in Orthodontics include the use of implants for anchorage (Temporary Anchorage Device), lasers, virtual treatment planning, invisible orthodontics and use of CAD-CAM for bracket customization. These are among the many innovations in this field. Please elaborate on the scope of cosmetic dentistry Our smile is always the first thing that a person notices. Cosmetic dentistry is one of the branches, which have recently gained a lot of attention. Cosmetic dentistry or Aesthetic Dentistry constitutes the enhancement of the smile, face and reversing the signs of aging through dentistry. People today are conscious about their looks and wish for a perfect smile, bright white teeth and a younger looking face. It includes restoration of the broken or discoloured, worn out teeth, correction of occlusion, placement of veneers, correcting the black triangles to give a more balanced, beautiful and functional smile. It is an interdisciplinary subject including restorative dentistry, periodontics, orthodontics, endodontics, prosthodontics and material science. Cosmetic Dentistry is interdisciplinary in nature and often times the most satisfying yet challenging. The North east has a shortage of dentists particularly in rural areas and government hospitals. In your view what measures can be undertaken to address this concern? India currently has 2.7 lakh dentists catering to a population 134 crores. Till recent years, Assam State Dental Council was responsible for registration of dentists of the 7 north eastern states. Assam has three Dental Colleges; the Regional Dental College being the first and oldest in the North East region, established in 1982. Two new dental colleges have been established in Dibrugarh and Silchar in 2018 to cater to the needs of growing population of the state. These new colleges have been established with the aim to inverse the dentist-population ratio in the state. Two other dental colleges in Manipur, viz. Dental College, Jawaharlal Nehru Institute of Medical Sciences (2017) and Dental College, RIMS, Imphal (2013) and the three dental colleges of Assam are catering to the population of entire North East India. All 8 Government Medical Colleges have a Dental OPD where dentists are posted. Dentists are also posted in all district hospitals and also recruited under National Health Mission. The new generations of dentists are educated and equipped with the latest techniques and innovations in dentistry. However, due to shortage of the state-of-the-art equipment in rural areas, the dental surgeons aren't able to offer their services to the best of their knowledge and skill. Moreover, promotional avenues for the dental doctors working in the district hospital and under NHM are very limited. Dental procedures are fairly expensive and out of reach for the common man. Almost all health insurance policies do not cover dental expenses. What are some of the measures that can be taken by the Government and IDA to make dental services more affordable for the common man? Advanced dental procedures are as expensive as the treatment of all other diseases in their advanced stages. Dental diseases can be prevented and are fairly inexpensive when treated at the incipient stages. Various OPD procedures like routine radiographs and scaling, preventive procedures like oral cancer screening and pit and fissure sealant application and oral surgeries which do not require hospitalisation are mostly covered under Dental Insurance Schemes. Various social security schemes are available to the employees covered under CGHS, ESI and Army Dental Corps. Assam Government has signed a MoU with various empanelled hospitals under Atal Amrit Abhiyan and Arogya Mitra to provide health assurance at a nominal amount. Treatment of Oral Cancer, Oro-pharyngeal Cancer and Nasopharyngeal Cancer are covered under this MoU. Various schemes have been undertaken by the Government of Assam under NHM namely National Oral Health Programme to recruit dental officers to render services to the unreached and economically weaker sections of society to make dental services affordable and reachable. Under NOHP, Government of Assam has taken initiatives to provide complex dental procedures such as RCTs, prosthetic rehabilitation at a nominal cost and even free of cost for economically weaker section. Projects like Smile Train India, have been made available and advocated for the free treatment of cleft lip and palate. Moreover, many programmes have been undertaken by the Government of Assam, and IDA too hosts special programmes regularly (by offering free of cost treatment) on special occasions. However, people are mostly unaware and fail to avail the services. Provision of improved quality of dental care in district hospitals, raising public awareness about oral health and the various programmes which the common man can benefit from will help address some if not all the problems.Also Read: Some ABCs of Entrepreneurial EtiquetteAlso Watch: 

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