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Our mission of reporting on all aspects of "dentistry in transition" was never more poignant; or to be more relevant, incisive and penetrating than an article I recently read which dealt with the "terror of tooth loss" not exclusively from a clinical aspect, but covered, a broader and strangely emotional aspect of handling bereavement of "loss" of teeth, which up until now, I had honestly never thought of the fairy god mother in such literary penmanship. The added skill of merging psychiatry with another branch of the healing sciences lends credence to my motto that dentistry is not sedated and is every bit conscious.

Dentistry as it defuses deeper into non traditional ways of reducing fear of the dreaded needle, and while the paradigm of involving the specialty of psychiatry and dentistry may capture one's imagination initially, as being a stretch; loss of any part of the anatomy is of course mentioned in Freudian teachings of his Oedipus Complex where there is some similarity to the brisk circumcision where loss or removal is part of Yeshiva ceremony.

When there is loss, bereavement is one of the appropriate phases that signify one's autonomic nervous system is alive and well, the psyche must deal with it appropriately even if the response is below the radar of one conscious perception. In other words the exercise is so benign; it does not play a significant part in one's day to day life.

Dentistry is synonymous with saving or restoring teeth. However, such skill usually encompasses a change or replacement for the purpose of improving or correcting loss of masticatory function, but of equal importance these days, that of oral cosmetic quotient. Unfortunately if you are a subject who will require dental cosmetic treatment, certain disciplines of dentistry can now outfit you with all the bells and whistles, or alternately as few as is necessary to completely and for hereafter to discard the glass of water at your bedside which once held your partials or the full quadrant.

In 2009 we will for the most part see many changes at your next dental appointment. These small insignificant changes can be likened to what is in keeping with all health care treatment. Mention an "eight-track" tape to your kids and they may suspect you have flipped back into medieval times. Yet there are many such tapes still sitting in attics or the garage. To make my point more relevant, I never could have imagined just five years ago of having a knee or hip titanium surgical implant being performed and retaining consciousness throughout the routine two hour operation. Or having a cataract removal in 20 minutes and capable of resuming regular office work the next day.

Change is complex. Schelling not unlike Albert Einstein with their autistic characteristics, among others, attaches to human existence a fundamental, inescapable sadness. More particularly, this sadness provides the somber ground on which consciousness and cognition are founded. This somber ground must indeed be the basis of all perception, of every mental process even involving the change of administering dental treatment with local anesthetics or conscious sedation.

Thought is strictly inseparable from a "profound, indestructible melancholy." Current cosmology provides an analogy to Schelling's belief. It is that of background noise or autism which may be the missing link or the code to the keystone of the Holy Grail? Sadness is so often associated with change.

So how is it those modern dentists (classes of after 1990) have been successful in shredding this legacy of change? The answer partly lies with the personalities of dental assistants. Behind every successful dentist is a secure and sensitive assistant. These almost invisible muti-taskers are like the very sponges they use to soak up substances, whereas it's their grey matter which is soaking up the clinicians newly acquired knowledge of using safe pharmacological interventions to decrease that age old fear of avoiding the dental needle.

However in the world of molecules and compounds, there is rarely a free lunch. With every change there is a quid pro quo. As we the scientists find a new compound, the ugly head of side effects appear. Now it is a question of how much one is willing to trade the upside for the downside. That has always been the sixty-four million dollar question. My bet is on change. The snowball has reached the point of mobility and as the "ball" gains in size then the mere mass will have again confirmed the famous equation E=MC2.

Here is a sample of what dental assistants do over and over each day and with little recognition:

  • Radiography.
  • Anatomy.
  • Physiology. (think of older patients and plumbing situations).
  • Charting .
  • Tray set-ups .
  • Sterilization .
These are all very exacting and stressful run-ups. Some of the better schools even teach the skill of positioning one's body to ensure and give the patient reassurance all without sending the wrong message. A touch can do wonders for that anxious or up-tight patient. These are all well planned and practiced techniques that well trained dental assistants do receive during training. Let us be considerate of them.

Comments to M.Sc. PharmD. CCPE Please visit WWW.AnestheticNews.comAuthor: M.Sc. PharmD.

Haynes Darlington M.Sc. PharmD. (CCPE) joined the pharmaceutical industry in 1969. In 1982 he was selected to the dental team to make submissions to regulatory agencies (FDA) and HC (Health Canada) to obtain acceptance for Articaine hcl into North America for Dental use as a local anesthetic. He is highly respected among peers in the field of pharmacology and bio-chemistry. In 1999, Haynes received The Team Excellence Award from The City of New York. The award recognized the value and professionalism of a continuing education program.

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Haynes Darlington M.Sc. PharmD.
Family dental issues and problems. Keeping lifestyles.
Haynes Darlington M.Sc. PharmD.'s web site

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