During my 3 weeks stay in central Florida, I was granted the resources to shadow in two dental offices with specialized treatment in root canals and restorative dentistry. With a total of 80 hours shadowed, I saw care for countless patients. Given Melbourne, FL is a retirement destination, I experienced a unique look at many geriatric dental treatments.
My aunt and uncle kindly let me reside at their place during the duration of my STEP experience. Perhaps unlike most students my age, my aunt and uncle are senior citizens in their early 70s. Both dental offices where I shadowed were also operated by wonderful men from the same generation as my aunt and uncle. It was the juxtaposition of my daily settings and the Baby Boomers that facilitated them that altered my perception of adapting to technology with age.
Rather than single out one example of this, the multiweek experience was full of them. I selected Dr. Brown’s office because of his specialty in implant dentistry. Implant dentistry is a progressive form of treatment that replaces lost teeth with a post that is drilled into the bone that has a false-tooth attached to it. When I walked into his office I was very impressed with his equipment and facility. The wrinkled, grey-haired man behind the dental drill was the very man who had the most current dental gadgets I have ever seen. Every room had a TV monitor and a high-tech Sirona chair with a back-massage feature. Dr. Brown worked with expensive drills and wrenches. His crowning jewels were the chairside CAD machine and CEREC Omnicam. These tools make the patient a custom onlay, veneer, crown, etc. in less than an hour. They are expensive as can be, but a huge technological advancement in the field of dentistry that I was excited to see. Dr. Brown’s practice was not all glam and no substance though. The staff were great and the dental artistry inspiring; but, the way he is embracing modern tools and technology is exceptional. Meanwhile, once my 8-hour day shadowing at the office had concluded, I would return to my aunt’s home and see the opposite side of adapting to technology. Whether it was watching my aunt struggle with the DVR for minutes or having my uncle stare blankly at me when I asked him for the WIFI password, it was evident that the adaptation to technology was not consistent throughout their generation.
In the second office operated by Dr. Scott, I learned that sometimes there is no need to pursue every technological improvement. One similarity I have seen in every dentist I have shadowed is the eagerness to learn more and Dr. Scott was no exception. He knew that I had previous shadowing experience with another endodontist in Ohio. During many of his root canals he would look up and ask me if I noticed any difference in technique or tools. Dr. Jensen, the endodontist I shadowed previous, was a newly graduated doctor, yet I was continually surprised by how similar their work was. The diagnostic tests, the instruments, the decision making was all they same. Dr. Scott stressed to me how eager he is to find a better instrument or new technique, but that he never hears of one when he asks observers like me. Of course, I am not expert, and he knows that, but he got his point across in that sometimes the new, shiny equipment is only that. New and shiny are only worth it if they provide better results for the patient; and since nothing has, sometimes the smart thing is to stick to what works rather than what is progressive. Dr. Scott, Dr. Brown, and my aunt and uncle alike, granted my unexpected insight to the varied approaches Baby Boomers may has to technological advancements.
As a 20-year-old, I have not had many dental problems. Sure, I had braces for a year and it was not comfortable, but in the end, it was voluntary, not to mention paid for by my parents. The side of dentistry I have experienced has had little pain and no consequences to my wallet; however, I saw the opposite during my STEP experience and it has transformed my understanding of the human condition of oral health and money in relation to age.
As previously mentioned, I pursued shadowing opportunities that would lend more toward elderly patients. In Dr. Scott’s office, of all the procedures done, about 80% of them were treatment of people 65+ and in Dr. Brown’s office, it was around 50%. No one wants to have a root canal and certainly no one wants to pay $1000+ dollars for it, but the patients who seemed the most bothered were the elderly. Often at their age, they’ve had countless dental work; much of it from a time that was far less medicated on top of it. One patient was nervous about her root canal people that tooth had a gold cap on it from way-back-when and she did not want Dr. Scott drilling through it to save her tooth, just to add an example of stubbornness born out of watching the wallet, but with a twinge of irony at the fact that she would rather save her failing, outdated dental work to keep a bit of gold. In Dr. Brown’s office I saw several cases with denture fittings. Nothing made me want to floss more than observing these patients expressing their frustration, discomfort, and embarrassment with their dentures. After one of the appointments I stood in the hallway and realized as fully as I had ever understood how important it is to take care of and keep your 32 teeth for as long as you can. Once these patients started losing teeth, they are embarrassed at the gaps or have trouble eating, so they want to replace them. It is great that restorative dentistry is available, but it is expensive and not timely. Dentures are the cheapest option, and often result is continual discomfort. Dr. Brown has the skills to give implant surgery which is a great option for most people. But, if someone has gone years without proper dental care, they’ll have too much bone loss to hold the screws and the option is out. And even if the patient is a qualified candidate, no one wants the see that bill in 9-month treatment plan. The dentists were as kind and professional as you could expect to patients living on retirement money and trying to save their smile, but they were 50 years too late and they knew it and now so do I. I have a better understanding now of the hard conversations in dentistry, because the services are not free and are often painful; I have a lot of respect for the professionals like Dr. Scott and Dr. Brown who handle tough situations like these every day.
I went into this STEP experience knowing I wanted to be a dentist and I still want to be a dentist upon reflection, so nothing ground-breaking there; but I did learn a lot about the profession from people who have plenty of experience. Dr. Brown taught me about the balance of owning a business and doing dentistry. He was a huge proponent of continuing education and practicing the newest skills. Implant dentistry is progressive and reflects his approach to his profession and it was fun to watch, but I do not see myself in his chair someday. Although Dr. Scott did not speak of pushing forward and being on the forefront of dentistry, he spoke of doing what works and has always works. I discovered endodontics is a redundant form of dentistry. Root canals vary a little, but endodontics allows for repetition and perfection in ways other specialties do not. It was not about new tools, it was about skills work the first time and every time, which is the direction I see my career going. I have always had a heart for the elderly, still do; and, despite my initial assumptions, I saw a lot more elderly patients come though the doors of Dr. Scott’s office. I am incredibly grateful for the procedures I got to see and the wisdom I gained from the time I got to spend with Dr. Brown and Dr. Scott.