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Many technological advances, such as the new Dental School simulation lab used by second-year students, provide the opportunity for clinical training before students work with patients. Read the “Excellence in education and technology” story for more information about the school’s many technological advances.
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SAN ANTONIO (May 4, 2010) — How is a visit to the dental office of today different from 1970, the year the Dental School opened at The University of Texas Health Science Center at San Antonio? As the Dental School officially celebrates its 40th anniversary on May 7, we asked several faculty members to recall the changes and discuss the notable contributions the school has made to the way we all receive oral health care.

The gala celebrating the 40th anniversary will honor Methodist Healthcare Ministries of South Texas Inc. for its unwavering support that has brought millions in funding to the Dental School and other Health Science Center schools.

Related links: MHM to be honored as longtime Dental School partner Excellence in clinical training Excellence in community-based education Excellence in patient care Excellence in research Excellence in education and technology

In addition to recognizing Methodist Healthcare Ministries contributions, this package of stories gives a taste of the changes that have happened in and through the Dental School over the years. These advances encompass a number of areas, including clinical training, community-based education, patient care, research and informatics in dental education.

Clinical innovations in dentistry
Infection control is a major development in dental offices. In 1970, masks were worn occasionally and gloves only rarely, a far cry from today’s protective personal equipment and universal precautions, said Gary Guest, D.D.S., assistant dean, predoctoral clinics.

Remember saying “aahhh” and the dentist angling down the mirror for a look? Today many more imaging tools are available, including the routine use of magnification (binoculars) in patient care. Fiber-optic lighting and intraoral and endoscopic video technology are other significant enhancements. “This has created an environment in which you can actually see in high definition what you are working on,” Dr. Guest said.

Implants are a new and exciting development, as well. To replace missing teeth in the 1970s, dentists could only install crowns or dentures by anchoring them onto existing teeth, which became more difficult and less effective as more teeth were lost, said Thomas W. Oates, D.M.D., Ph.D., assistant dean for clinical research in the Dental School and vice chairman of periodontics. Today, crowns or dentures fit on top of implants, which are artificial tooth roots. Implants allow for a more direct way to replace missing teeth and can provide dramatic improvements for patients with crowns or dentures.

All predoctoral dental students enter the program with laptop computers and software that includes electronic access to a comprehensive set of course syllabi, more than 100 manuals and all required and recommended textbooks. The software includes a search engine, subject area collections and graphics, digital video and animations.

The advent of aesthetic dentistry has given patients more options. In 1970, dentists primarily used metallic restorative materials. “Today there are bleaching agents and composite tooth-colored restorations that are lifelike, enhancing the beauty of the smiles we treat,” Dr. Guest said. In addition, restorations and preventive measures such as sealants are cured with light rather than a chemical reaction, he said. Adhesion agents to hold crowns and other restorations in place have improved dramatically to enhance the effectiveness of care.

Exact measurements
Cone beam CT (computed tomography) has revolutionized the field, enabling better treatment approaches and outcomes. Medical CT scans are used to obtain exact measurements of skeletal structure but with a high radiation dose. “Cone beam CT is providing the same accuracy and reliability of medical CTs, but with a remarkably lower radiation dose and an accessible-to-all technology,” said Marcel Noujeim, D.D.S., M.S., assistant professor of dental diagnostic science.

Dental laboratories produce restorations using CAD/CAM (computer-aided design/computer-aided manufacturing) machines that match cone beam CT measurements, Dr. Noujeim said.

Dentists treating periodontal (gum) disease not only work to eliminate the infection, but now have a number of products that can regenerate or replace the gum and bone tissues lost in the disease process, another remarkable advance unheard of in 1970, Dr. Oates said.

Care for those with systemic diseases
Dentists have expanded their care of patients with systemic conditions such as lupus, heart disease and immune deficiency. (HIV/AIDS was not known in 1970, but other patients were at risk). Patients are living longer with various diseases today, including cancer, and dentists are employing new approaches to their oral health care. “Oral care for these patients has become increasingly critical, as oral disease has been shown to be a risk factor for complicating these systemic diseases,” said Spencer Redding, D.D.S., M.Ed., professor and chairman of dental diagnostic science and holder of the Castella Dental Chair in Aging Studies.

Practice changes include the advent of electronic medical records. Public policy has resulted in more water supplies becoming fluoridated, so that today, in contrast to 1970, tooth decay affects a smaller percentage of the population.

Throughout its first 40 years, the Dental School has remained on the leading edge of all the advancements and is training students to be constant lifelong learners. “In dental education, we have incorporated the latest standard of care into the curriculum,” Dr. Guest said. “We have stayed in tune with the current materials and advances in dental care, coupled with infrastructure training (networks, computers, classrooms) and the ability to leverage information technology along with evidence-based health care to better prepare our graduates for successful careers in the profession of dentistry.”

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The University of Texas Health Science Center at San Antonio, one of the country’s leading health sciences universities, ranks in the top 2 percent of all U.S. institutions receiving federal funding. Research and other sponsored program activity totaled a record $259 million in fiscal year 2009. The university’s schools of medicine, nursing, dentistry, health professions and graduate biomedical sciences have produced 27,000 graduates. The $753 million operating budget supports six campuses in San Antonio, Laredo, Harlingen and Edinburg. For more information on the many ways “We make lives better®,” visit www.uthscsa.edu.