About Microscope Enhanced Dentistry

Technology is emerging in all fields and professions at a rapid pace. Dentistry is no exception. The changes are providing excitement and innovation for the dental professional and patient alike. Two challenges today are to be able to choose the advances that are most meaningful to your personal practice of dentistry and to progress rapidly through the necessary learning curves to make technology useful on a daily basis. An important trend is the incorporation of higher levels of magnification and illumination into the operatory and the dental laboratory. This is usually done with the help of operating microscopes.
Microscope Enhanced Dentistry is just starting to become available in India. It will soon become a standard feature in advanced dental clinics in the future here in India as well as around the world.
Teeth are normally small structures like the eyes, ear and nose. ENT surgeons, Ophthalmic surgeons and Neurosurgeons nowadays routinely use an Operating Microscope or magnifying loupes/spectacles to do surgeries of greater precision and accuracy. Cataract surgery is routinely done with a microscope now a days.
It is stunning treat to watch which teeth which are only 1 sq. cm in size magnified to fill a TV screen 14 or 21 inches cross!! And the joy of seeing a smile is all the more gorgeous to watch on a large TV screen. A big smile is made much bigger by the magnification provided by the Microscope. Highly improved quality of the fillings, Root Canal Treatments's, Crown and Bridge preparations and various other procedures which can be done with the microscope make the patient smile even more! The patient's confidence in his dentist is hugely increased as he can see the problems in his teeth very clearly under brilliant light and magnification. They co-operate better during the treatment as they are able to see on a TV screen the whole procedure being undertaken on their teeth, and it also ensures better compliance with advice given.
Back, neck, and shoulder damage are a leading source of physical disability for dentists. The majority of these disabilities are due to years of poor posture and positioning as dentists struggle to see what they are doing. When you see dentists who work without magnification, you notice that they typically work in a bent-over position. Their torsos are twisted, and the lower back and shoulders are strained as they struggle to see what they are doing. The dentist who uses the microscope is much more comfortable and avoids un-due strain on his neck and back. The up-right posture can be maintained during almost all procedures, which is otherwise impossible thus improving ergonomics.
The use of the operating microscope in the field of dentistry has just started recently in western Europe and parts of America. The American Dental Association has made it mandatory and compulsory for higher post-graduate training in Endo-dontics or the root canal treatment speciality to be trained in the use of the Operating Microscope.
Since microscopes have been used for endodontic Root Canal Treatment's, extra canals called MB2's and other minute accessory canals have been found and treated effectively which were not possible before. Thus, the chances of failure of Root Canal Treatment becomes much lesser. While performing complicated procedures like failed Root Canal Treatment's and removal of broken files deep inside the roots of teeth are challenges which demand the use of a microscope. Teeth will failed RCT's can be re-treated with a second RCT and successfully saved, when done very carefully, and the chances of success are much higher when done under the microscope.
Microscopes strongly aids in spotting the fine dividing line between healthy and non healthy. Some times when the tooth decay happens with the help of caries detector dye, only the decay is removed and RCT is avoided , which initially looked that almost require a RCT with the naked eye. But now we can spot the difference because it is possible with the help of microscope to see much better and clearer under magnification.
Scaling or cleaning of the teeth done under the Microscope affords better removal of tartar and stains and cleaner teeth at the end. Periodontal flap surgery when done under the Microscope, is able to remove much more damaged tissue, with much less damage to nearby healthy tissue, and hence give a better result. Suturing of wounds done under the microscope is much finer and delicate, hence better scars, faster healing, less post-operative pain and discomfort is possible.
Preparation of teeth to fit a metal or ceramic artificial crown is a routine procedure done in every dental clinic routinely. If a microscope is used for this while preparing the tooth, the margins of the teeth are much more neater and precise, thus allowing a much better fit of the artifical crown, better a esthetics and longer life with less problems like leakage and failure. The crown can also be checked before fitting on to the tooth under the microscope to check for defects in shape, size and irregularities as well. Less tooth structure is removed as well if possible, because we can see more clearly.
The fitting of crowns and bridges is made very precise and hence the longevity of these is hugely increased.
Needless to say Microscope enhanced dentistry is wonderful revolution and is the direction in which dentistry is moving higher magnification allows the dentist to see better! This is a win-win situation for both patient and the doctor.
(The author is former I/C HoD Opoative Endodontis)