So You Wanna Be a Dentist?

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So, what’s up with dental education? you ask. OK, so you didn’t ask. I’ll tell you a bit anyway. As a private practice dentist for 25 years, as well as a visiting associate professor at VCU School of Dentistry for half that time, I feel at least somewhat qualified to comment.

First off, when I started practicing in 1985 I wondered if there would be a need for much dentistry by this time in the future. Well, now I know, and the answer is a big yes. In fact, there is as great a need for dentists now as there has ever been before. People are living longer and keeping their teeth longer, and those teeth need care from the wear and tear of life.

It’s true that many if not most of our dental problems are preventable, but, human nature being what it is, most of us still don’t take very good care of ourselves. In general, most folks’ oral hygiene could be described as inadequate, and furthermore, we continue to engage in all sorts of activities that accelerate the normal deterioration of teeth over time, not the least of which is consuming a diet which is most definitely not in our dental health’s best interest.

Unfortunately for our teeth –and the rest of our bodies- our modern diet is dominated by what food writer Micheal Pollen describes as “edible food-like substances”, that is, highly processed and modified stuff high in fat, refined flour, salt, and of course sugars of many varieties. Consuming such a diet makes it more difficult to avoid dental problems like cavities and gum disease, and therefore tooth loss, especially over the long term. Beyond these issues, there is more and more demand for aesthetic dental procedures.

Humankind has valued a handsome, beautiful smile probably since back to the time of Lucy, the pre-homo Sapiens, and modern dentistry offers more options than ever to help attain and maintain such a smile.

So much for the background information. So yeah, dental care is and will continue to be in significant demand stretching far into the foreseeable future. This is where dental students and the dental education process come in.

Virginia has one dental school, a state-run institution that’s part of Virginia Commonwealth University in Richmond. There are about ninety students in each dental school class. The dental school curriculum is four long years. Well, it seemed long at the time. Typically, the dental school applicant will have earned an undergraduate degree in a science such as biology or chemistry. It’s a little more challenging for the applicant without a science degree; more scrambling will be necessary to do well on the Dental Aptitude Test, as well as to satisfy the basic dental school entry requirements. Every dental class, however, seems to have its token political scientists, anthropologists and philosophers. Come to think of it, the philosophers probably survive dental school better than anyone else.

At first, the dental education consists of so-called basic science study in areas such as gross anatomy, neuroanatomy, physiology, pathology, and histology, to name a few. Along the way, dental-specific courses such as dental anatomy are introduced. In this traditional and time-honored course the dental student is challenged in carving out specific teeth from blocks of hard, white wax. Many a student’s hands have been thrown up in dismay upon realizing that his or her hours of toil have resulted in nothing more than a still-unrecognizable blob. Other dental courses such as prosthodontics, periodontics, endodontics, orthodontics, pediatric dentistry, occlusion, and restorative dentistry are all addressed along the dental school path.

Not far into the first year of school the students are involved in patient care. Each student has a lab partner and at least some of the initial dental care and experimentation with procedures is directed toward said partner. As one can imagine, learning to give anesthetic injections to each other is kind of exciting, as is making impressions and models of each other’s mouths.

By the start of the second year the dental student is practicing –yeah right, that “practice” will continue for the dentist’s whole career- on real live patients, not just on each other. Basic procedures are performed at first, of course, like oral exams and polishing teeth with rubber-cup polishers, then with increasing experience more involved treatment is introduced.

The patients that come to the dental school for treatment are from all walks of life. It’s true that the services are offered at a reduced, state-subsidized fee, and this is an attraction in itself. Others come for the higher-than-average quality of care available at the school; they feel they’re getting the most current techniques and technology. So, thankfully, our eager dental students have plenty of patients to treat and from whom to learn.

By the time the student graduates from the dental school and successfully passes the state and national board exams he or she is ready to enter the profession as a qualified dentist. The direction one may take from this point varies. The graduate may continue with specialized post-grad study in fields such as orthodontics or oral surgery for instance. Or one can enter an existing practice as an associate, purchase a practice from a retiring dentist, become a military dentist, or start a practice from scratch.

Then the real learning of the art and science of dentistry begins.

By John Robinson
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