New and innovative
Dentists turn to latest technology to improve patient experience
Traditional X-rays, crowns made at an offsite laboratory and those uncomfortable, goopy trays used to make dental impressions still have a place in dentists’ offices, but doctors are increasingly turning to new technology for more precise and more pleasant ways to treat their patients.
Innovations in the field require financial investments — often $100,000 or more — and sometimes extensive training, but the benefits are worth the costs for many dentists, says Dr. Tom Schripsema, a practicing dentist and executive director of the New Mexico Dental Association.
That has been the case for Dr. Chris Morgan, who practices in Santa Fe. Morgan uses digital radiography, intraoral cameras, CAD/CAM dentistry and hard- and soft-tissue lasers when treating his patients.
Morgan says his aim is to help patients but adds that using the latest technology also “keeps dentistry interesting.”
Dr. Michael Sparks of Albuquerque Periodontics and Implantology has changed the way he makes and places implants by using cone-beam CT scanning and other high-tech tools.
“We were very early adopters of the cone-beam technology, and it’s just been one of the most important tools we have,” Sparks says.
Many of the advances in dentistry have been in the area of imaging.
Most dentists have upgraded to digital radiography, or digital X-rays, over the past 10 years, Morgan says. For patients, that means half the radiation exposure and a chance to review their images with their doctor on a computer screen. Doctors also are able to easily share images by email.
“The downside is they can be less
comfortable,” Morgan says. “The sensor is a bit thick.”
Another technology, conebeam CT scanning, produces a three-dimensional image.
“It allows you to essentially construct a 3-D patient,” Schripsema says. “It allows you to go in and look at specific locations. … I think you’re going to see more and more of it in dentistry because it’s so rich in detail.”
Dentists can use cone-beam scans to diagnose bone damage from gum disease, for root canals and to precisely place implants, he adds.
The scans do expose patients to about four times as much radiation as a traditional dental X-ray so they’re not warranted in all cases. The exposure is 1,000 times less than from a traditional CT scan, Sparks says.
The equipment also is expensive, so it’s used by a majority of oral surgeons and periodontists but only a small percentage of general dentists. Even for Sparks, the technology has not replaced traditional 2-D images for such things as diagnosing decay.
When it comes to implants, though, cone-beam is the way to go. Implants are essentially artificial tooth roots, similar in shape to screws, that are placed in the jawbone as the base for supporting one or more crowns.
The technology also can be used to create a guide to ensure precise placement of an implant during surgery, particularly in cases where several teeth in a row are missing.
“It inspires a lot of confidence, it’s a great communication tool,” Sparks says. “I think it easily pays for itself in getting a better result. … I have people telling me all the time this was such a difference experience.”
Morgan also is striving to improve his patients’ experiences with a third advanced imaging technology. He uses intraoral cameras to make digital impressions, sparing his patients the trays of putty.
“A lot of patients gag, they don’t like it, it really makes a mess,” he says. “We’ve eliminated that with the digital impressions.”
The wand-like camera also can be used for orthodontia such as Invisalign, for diagnosing and for patient education, by showing pictures of a cavity halfway through a procedure and then afterward, for example, Morgan says.
The traditional procedure for a crown, or an artificial tooth, goes something like this: numb the mouth and reduce the existing tooth to a stump, make a model using putty, put on a temporary crown, send the model to the lab and wait two to four weeks for the permanent crown to be completed.
These days, Morgan numbs and preps the tooth, takes a two-minute digital image, designs the crown himself using computer-aided design and then sends it to a milling chamber in his office where a block of porcelain is turned into the crown.
He then tests the fit on his waiting patient, fires the crown and installs it. The whole process takes about two hours.
“You get the crown done all in one day. You can be extremely accurate. … The fit is extraordinary,” he says. “I like designing the crowns myself as a dentist. I like knowing the bite is going to be accurate. I like making my patients happy.”
The downside is the sizeable investment in equipment and training. In addition, crowns made by a lab technician can be a bit more aesthetic, Morgan says.
Lasers are less common in dentist’s offices, but Morgan uses them in several ways, including to diagnose cavities on chewing surfaces earlier than he can with the traditional method of pushing on teeth to check for sticky spots.
He also uses the lasers in surgical procedures such as removing annoying or suspicious bumps for cleaner incisions, reduced bleeding and faster healing with less pain.