The times they are a changin’

Bob Dylan wrote that song title in 1963, but he could just as well be talking about today. 2020 was a strange year — unavoidable chaos and turmoil from all sides. Everyone was affected. Everyone was off-balance. Having lived through the 1960s, I can say without reservation that 2020 was a bad year, maybe the worst.

But life went on. While our overwhelming health worry was a virus, people still got tooth decay. People still got gum disease.  People still got toothaches. And in the middle of this chaos, the dental profession figured out how to get treatment to people.  Not as efficiently perhaps, or as comprehensively. But treatment nonetheless. We learned, we adapted, and we served the population as best we could.

Everything changed. The parking lot became the waiting room.  We sterilized everything … twice! We wore scrubs on top of our scrubs. We worried about airflow. We bathed in hand sanitizer. The patients’ fears expanded from, “Is this going to hurt?” to adding “Am I going to get sick?” Their expectations expanded. “Did you clean this surface/doorknob/etc.?” “Can I get this done today?” We adapted.

Underpinning our efforts was ubiquitous technology helping us along the way. We don’t even notice it most of the time, but it’s there. The patients email in their health history. We retrieve the patients from the automobile “waiting room” with a cellphone. We record their faces with a dot on the side of a little square on the top of our computer monitor. No germ-infested money anymore! Just put the end of that little plastic card in this box here, wait for a minute, and we’re good-to-go. Better yet, do it online.

This technology help is hitting our clinical lives as well and is changing the way we treat patients. CBCTs allow us to see the anatomy in 3D with a 30-second scan. We can use that scan information to aim our handpiece.  We can do routine one appointment endo treatment with exquisite quality now. Technology can help us in this “new normal” we are living. Let me give you an example.

A friend recently had a patient who presented with pain and swelling from an upper premolar that had been neglected because of COVID-19 fears. It needed immediate treatment. Rather than a conventional approach, he chose to use Sonendo’s GentleWave^® device he’d recently adopted since it was optimized for a single-visit treatment and was virtually aerosol-free. Surprisingly, when he removed the rubber dam at the end of the procedure, the swelling was gone! The negative apical pressure feature of the device had actually drained the pus from the swelling through the tooth during the cycle. The patient was thrilled that the procedure was comfortable and relieved that he was finished and didn’t need to come back.  Everyone was happy except the assistant who found a big bolus of pus in the waste receptacle when she was cleaning up the machine! Kind of gross for the assistant, but this case shows how a novel technology advance can help us give quality care in a “new normal” of fear and anxious expectation for the patient.

And the advancements keep coming.  Sonendo is introducing a new procedure instrument called CrossFire™, which cleans the canal system from the outside of the tooth through just an access cavity. I wonder what the opinion leaders from 1963 would think of that?

The chaos of 2020 has forced a fast-forward on what new technology can do for us.  These devices are moving from the “nice to have” luxury category to the “need to have” items. Maybe that’s the silver lining of 2020.

Dr. Eric Herbranson