Trends in Dentistry: Dental Schools Forge New Educational Initiatives

By Jason Mazda

Dental education is witnessing a new trend as dental schools reintroduce dental laboratory education curricula and incorporate digital dental laboratory facilities. The University of Pennsylvania, Boston University, University of Oklahoma, Stony Brook University, and other dental schools across the country are investing significant amounts of money in upgrading their laboratory facilities in order to educate dental students on digitally driven laboratory processes. CAD/CAM dentistry has created both a need and an opportunity for an increased level of collaboration between the dentist and laboratory, and the appreciation for this is clear through the capital investments they have made. This trend promises to result in dental graduates who are well versed in laboratory processes and knowledge, which will ultimately create a solid dental team environment that provides better restorative outcomes for the patient.

The University of Oklahoma College of Dentistry was featured recently in an American Dental Association (ADA) article spotlighting its new digital laboratory, which includes scanning, milling, and 3D printing capabilities. Inside Dental Technology spoke to the college's Dean, Raymond A. Cohlmia, DDS, and the college's dental laboratory manager, David Dembinski, CDT, about their perspectives on this trend.

IDT: Why are dental schools around the country investing in digital laboratories for their students to utilize?

Raymond Cohlmia, DDS: Schools of today need to consider relevance—meaning that what we are doing on the inside must match what's going on outside. Schools traditionally have lagged behind when it comes to implementing the new technological processes to prepare our graduates for today's practices and those of the future. Updating 2,000 to 3,000 computers with multiple integrated systems is challenging. Many of the products available in dentistry today do not meet the HIPAA and electronic security demands of a university. Couple that with the costs of purchasing and maintaining this equipment and software, along with the shrinking budgets universities are experiencing due to decreasing state support, and you can understand why investing in technology for tomorrow is difficult.

Despite these challenges, universities are still investing in the laboratory technology of tomorrow because our job is to prepare our graduates for integrating good foundational skills with both current and future digital technologies. I want them to learn these skills from us, not from the first salesperson who walks in the door. University faculty, staff, and researchers are the most qualified to teach these skills, so there is a widespread movement across the United States among schools to incorporate digital technology into their curricula; different schools are at different stages of that initiative.

David Dembinski, CDT: Working effectively with a laboratory is as important as ever, because the more informed the dentist is and the more effective their communication is, the better product the laboratory can fabricate for the patient. The majority of large laboratories today utilize digital equipment, so if our students do not know anything about those processes when they graduate, then they will not even know how to write a prescription for what they need. At that point, educating themselves will cost even more money. Fortunately, today's "digital native" dental students are eager to embrace and take an interest in laboratory processes, creating a new level of excitement and willingness to learn; in the past, that was not always easy due to the hand skills needed for waxing up a crown or setting denture teeth.

IDT: What benefits have incorporating digital dental laboratory education provided your dental students, and how will it impact the way you educate tomorrow's dentists?

Cohlmia: Our students are able to see the changing landscape through our own laboratory. Our laboratory is growing, but the knowledge base and skillset are shifting somewhat to engineering or information technology. The laboratory of tomorrow needs to integrate traditional skills with moving forward at the same time. Traditional laboratory processes will not be replaced entirely; they will still be needed. We still have ceramists, model fabricators, and denture technicians in our laboratory, but those individuals are learning the digital processes as well. Grasping those changes is important for dental students as they prepare to work with laboratories in their own practices eventually.

IDT: How is digital laboratory education impacting the relationship between the dental students and laboratory? Do you see this impacting chairside options once they graduate?

Cohlmia: Actually, communication between dentists and laboratories is increasing, so I believe that relationship will improve dramatically. Much of the equipment that many of today's laboratories have is not affordable for a typical dentist. Dentists do not have the volume of work that laboratories do, and these machines do not achieve adequate returns on investment if they sit idle for extended periods of time. Perhaps that will change 10 to 15 years from now if prices drop to a certain point. Currently, however, a significant amount of communication is involved in the electronic transfer of information for the laboratory to fabricate a prosthesis. Personally, whereas I previously sent a case to the laboratory and got it back with very little communication, I converse much more with the laboratory now about our digital cases; the more digital my practice has become, the more I have needed help from the laboratory.

Dembinski: Most students will realize that working with an experienced laboratory is more cost-effective and yields a better product, especially for complex cases.

IDT: As educators, how do you see this approach building a collaborative dental team relationship?

Cohlmia: Our laboratory technicians provide insights to our students on how best to handle some of these advanced digital cases. These cases have created an air of fun and an air of challenge as our students embrace different ways to provide more services to patients. We also do a fair amount of traditional work that requires technician expertise. Overall, our laboratory technicians are more integrated into our processes than ever before. The result of that, of course, is that younger dentists will require their laboratories to keep pace with technology.

Dembinski: More than ever, there is an appreciation of the laboratory technician as part of the dental team.