Susan Paurazas, DDS, MHSA, MS

Sharing evidence-based principles

What can you tell us about your background?

My dental experience started as a dental assistant. I have strong ties to the Detroit area. I attended the University of Detroit Mercy and continued to work as a dental assistant. I completed dental school and a general practice residency. I received a master’s degree from the graduate endodontic program at University of Detroit Mercy. I received a master’s in Health Service Administration from the University of Michigan, spent several years teaching and practicing endodontics, and recently became a full time educator. I am a board certified endodontist and current program director of the graduate endodontic program at the University of Detroit Mercy.

What originally attracted you to the specialty of endodontics?

I became interested in endodontics initially in dental school. Dr. Robert Steiman was the graduate endodontic program director who sparked my interest. He stressed the importance of proper endodontic diagnosis, which can present challenges in cases of vague  pain. During my general practice residency at the Veterans Administration Medical Center, I was exposed to more advanced endodontic procedures. Dr. Thomas Stein had an influential impact on my endodontics education and provided the residents with a strong foundation on the essentials of endodontic treatment. He emphasized the complexity of the anatomy of root canal systems and the associated treatment challenges. My co-resident and I went on to specialize in endodontics. While teaching at the University of Michigan, I worked closely with the endodontic department and was intrigued by the challenges of endodontic treatment.

What aspects of your training inspired you to add “educator” to your list of accomplishments?

I had experience as an educator at the University of Michigan School of Dentistry. Subsequently, I entered the graduate endodontic program at University of Detroit Mercy. I was encouraged to consider contributing to the profession by Dr. Robert Ellison. His teaching focused on the importance of scientific literature to support treatment decisions. Drs. John Braud,  Michael Hoen, and George Goodis served as educator role models and encouraged me to consider teaching, and fostering my interest in academics.  I am focused on using evidenced-based principles to support treatment recommendations.

What are your proudest moments in the clinical and teaching aspects of your life?

I find it particularly gratifying when I see a student experiencing the “aha” moment when they see the big picture and are able to put the pieces of the puzzle together to understand a concept. My goal for students is for them to reach their full potential and encourage them to be lifelong learners. A proud moment is to see the completion of a resident research project that will make a positive contribution to endodontic knowledge. As new techniques, concepts, and treatments evolve, it is important to be open to new ideas, use evidenced-based principles, and utilize critical thinking. This will help the profession evolve to higher levels. It is also particularly gratifying to provide comfortable, quality endodontic treatment and help preserve the structure and function of the natural dentition.

What do you think is unique about the topics you teach?

The material that I teach is constantly being updated with the most current scientific literature. I emphasize evidenced-based learning. The studies we review are ranked according to the level of evidence.  With that being said, there is an emerging concept of the integration of both quantitative and qualitative studies for clinical decision making, as well as new applications in teaching methodology. I am involved in exploring various teaching methodologies to encourage student involvement such as ‘flipped classrooms,” inter-professional education  and problem-based learning. The ultimate goal is to promote critical thinking skills in the application of scientific concepts to clinical treatment, thereby improving treatment outcomes.

As an educator, what have you learned from your clinician-students?

I consider it a privilege to teach students from a variety of educational, clinical, and cultural backgrounds. The graduate endodontic residents bring a variety of experiences and strengths to the program. It is important to identify the students’ strengths and build upon them to maximize their educational experience. By sharing their unique experiences, I can learn from the students, and they  can learn from one another.

What has been your biggest challenge in sharing information and educating endodontists?

The sheer volume of information is increasing exponentially. There are multiple sources of information, including printed, electronic, and video sources. It can be challenging sifting through a large volume of material to select what is the most important and relevant information that should be included. Another challenge is to present material in different ways, incorporating various teaching methodologies such as team projects and interactive learning.

What is the future of endodontics?

There are many exciting developments in endodontics. Regenerative endodontics is an area that I find exciting and promising. It utilizes tissue-engineering principles to help replace damaged tissues and repair teeth with immature root development. The goal is to promote development of the root apex and increase thickness of the root canal wall in immature permanent teeth.  The role of dental stem cells is critical in this process. The future of endodontics will include expanding other tissue-engineering applications to improve prognosis.

What advice would you give to budding endodontists?

I would encourage those interested in endodontics to continue to develop their skills through continuing education and study clubs. Consider talking with the endodontists who they work with about mentoring opportunities. The American Association of Endodontists’ ENDODONTICS: Colleagues for Excellence Newsletter  is a great resource for dentists. The AAE Endodontic Case Difficulty and Assessment Form is used in education to determine the potential risk factors and complications related to the level of difficulty of the tooth to be treated. Case selection is important when expanding one’s clinical skills.

What would you have become if you had not become a dentist?

I enjoy writing, so I may have explored a career associated with journalism. My interest in writing is manifested by reading, exploring creative writing, and the publication of research articles.

What are your hobbies, and what do you do in your spare time?

Not only do I read a large volume of material for school, but I also enjoy reading for pleasure. I like to fit in a round of golf when possible. I also enjoy photography and find yoga both relaxing and invigorating.

Top favorites

• CBCT imaging is having a significant impact on diagnostic findings, which can influence the suggested treatment and prognosis.
• Bioceramic materials such as mineral trioxide aggregate (MTA) and Biodentine® are excellent materials. These materials are used for vital pulp therapy and perforation repair.
• Surgical microscopes are essential in the practice of endodontics. Particular uses include facilitating minimally invasive endodontics and identification of canal orifices.
• Trauma apps — these mobile apps are very helpful to provide a source of information on how to manage dental trauma for both dental professionals and patients.
• Intraosseous injection aids such as Stabident and X-tip can aid in obtaining profound local anesthesia. There are a multitude of nickel-titanium rotary files to choose from to help preserve the natural canal curvature.
• EndoActivator for sonic activation of irrigants or EndoUltra™ or UltraFlo™ for ultrasonic activation of irrigants.
• Apex locators such as Root ZX, ProMark, and Detect are useful in verifying the position of the apical foramen.