Everything changes; it's unavoidable. In the dental industry, it's the ever-present battle of new school vs. old school. Throughout my experience in the laboratory world, I've seen a noticeable difference in the mindset of new technicians compared to those that are more seasoned. And the more I experience the dental practitioner world, the more I see that this phenomenon exists here as well: today's dental student is different than he was a decade ago and changing more and more every year.
As you know, dental students are learning less about laboratory procedures than ever before. As the dental school curriculum has expanded to incorporate many new medical aspects, the amount of laboratory-related training has drastically decreased.
At the University of Louisville, I'm also seeing several other trends. And while they're based on my personal experiences, I suspect they're very telling of patterns across the nation regarding recent graduates and their education.
We're more medical-minded. Each year, the quantity and quality of applicants to dental schools rises. At my school, the number of applications has increased about 10% each year in the last two years and the admission department finds the applicants are more impressive. Why is admission getting so much more competitive? I have an idea. Many of my classmates have spent their entire lives preparing for medical school--during their high school and undergraduate years, they were the book-smart overachievers who earned perfect grades. Interestingly, during undergraduate studies and after shadowing physicians, they became uncertain about the lifestyle and decided that dentistry was a better choice. They perceive it as a less-demanding career in the medical field that doesn't require them to work nights, be on call and or be unavailable to their future families.
We want to specialize. This increase in "medical-minded" dental students has translated into a greater percentage of students who plan on specializing, as is done in medicine. Many of my peers wanted to be surgeons since they could walk, but are now opting to be oral surgeons or periodontists instead. This shift could translate into dental specialty programs becoming even more competitive in the future.
Also, since specialty programs only have a certain number of spots per year, many students won't get into the programs and will end up practicing as GPs. This is where I see future dentists changing to some degree. I believe these GPs will be more fact- and research-driven than their predecessors and more interested in "scientific data" like facts about a material's compressive and flexural strengths.
We're learning a new standard of care. The use of new technologies is also changing the standard of care we're taught. For instance, we recently learned we have a legal obligation to present an implant, where possible--not a bridge--as the preferred option for replacing a missing tooth. When we graduate, implants will probably be one of our most common procedures. There's been no mention of custom abutments yet, but we have an entire class on implants during our junior year and I'm sure that topic will come up then.
I was surprised by a comment during a recent lecture in our treatment planning class. Instead of instructing us in the tried-and-true techniques, the professor told us that all-ceramic crowns are the superior choice for the majority of situations and that PFMs are really only indicated in the posterior when they're not visible in the smile line. These new standards will change the types of restorations we prescribe and the types of cases you fabricate.
We embrace technology. Today's dental students were raised on technology and show an unprecedented level of comfort with it. When my class is presented with the digital side of dentistry, everyone gets excited.
The University of Louisville is also embracing technology. For instance, our school has completely transitioned to digital radiography--our class has no experience with film radiographs, and we're happy about it. Our prosthodontic department also has digital impression systems and my classmates can't wait to use them.
We're also receiving an education in both traditional and new, automated techniques. For instance, in addition to what we've learned about building up wax copings by hand, we've also learned about 3-D wax printers. And while we haven't yet been formally instructed in digital impressions, we're told about them often. When we learned how to take VPS impressions, for example, the professor said, "You guys probably won't do these as much because digital scanners may replace this technique." In other classes we've heard the same sentiment: that the digital technologies will replace many of the techniques we're now learning. In addition, we've also learned about CAD/CAM RPD systems, stereolithography, milling, zirconia and "no-prep" veneers and I expect new graduates to gravitate toward these new technologies.
However, as excited as we are about new technology, I don't think many students are interested in doing digital lab work in their offices. When professors talk about in-office CAD/CAM systems, they don't promote them and I think the initial shortcomings of the in-office machines are having a lingering effect in the dental schools. While, in general, the faculty respects the precision and predictability of automated systems and think these technologies can benefit patients, when it comes to in-office CAD/CAM systems the professors don't seem excited about them and they still emphasize laboratory-fabricated restorations.
What This Means for You
As labs, the more aware you are of these new types of clients, the better you can build and maintain relationships with them. And, ultimately, better relationships help the dental team deliver a superior level of patient care.
I believe that building a good relationship with these new graduates will be easier than ever. Given our limited exposure to laboratory procedures and the wealth of available materials, dentists will rely more and more on the expertise of their laboratory-partners. Technicians are in an ideal position to be regarded as a master of their trade and have more of an opportunity than ever before to advocate the use of the materials and techniques they feel are superior. I also believe the education we're getting on new materials and techniques will make it easier for labs to introduce cutting-edge materials and have new technologies adopted more quickly.
While the modern dental student is highly tech-savvy, many of us will graduate with only a basic understanding of the new digital technologies available and will want to learn more. In your role as technical advisor, we'll look to you for input on how these systems can provide a higher quality of care, make our jobs easier and allow us to earn higher profits without compromising patient care. If a lab can educate its clients and instill confidence that it's doing its research and using the best new technologies, technician-dentist relationships will be stronger than ever.
Editor's Note: If you have a question or concern you'd like Eric to address in a future column, please e-mail Kim Molinaro.
