THE ROLES OF A DENTAL TECHNOLOGISTS IN ORAL health CARE

DELIVERY system 

A WELCOME LECTURE TO FRESH STUDENTS OF DENTAL TECHNOLOGY

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OGUN STATE COLLEGE OF HEALTH TECHNOLOGY ILESSE, IJEBU-ODE, OGUN STATE ON 20TH NOVEMBER 2013

BYEYAREFE o. STEPHEN (HND, ADV.DIP, PGD,

MSC, cdt, rdt)Department of dental Technology, School of Health Technology

Federal university of technology, owerri - imo state

OBJECTIVES OF THIS PRESENTATION

At the end of this meeting, all fresh and returning students should be able to:

Understand what dental technology means.

Know the roles of dental technologists in the health sector.

Appreciate dental technology as a course of study.

Understand that they are ambassadors from their respective homes, villages,

LGAs, states and the society at large.

Know how to excel in dental technology course

Create mission statements for themselves that will transform into reality.

Have a purpose driven vision of becoming well informed dental technologists

with high ethical standard mindset.

INTRODUCTIONEvery profession world over has a role to play in satisfying the yearnings

and aspiration of human beings. From time immemorial, professional attainment does not come on a platter of gold but through series of research and development activities on the part of the professionals and allied persons in the related field of practice.

They emanates from the backdrop of continuous innovative minds of purpose driven geniuses within and around the professional setting.

A profession is simply a body of people within an occupation who have related careers, interests, education, knowledge, training and ethics. According to the Australian Council of Professions, professions are made up of

"a disciplined group of individuals who adhere to high ethical standards and uphold themselves to, and are accepted by the public as possessing special knowledge and skills".

You will agree with me after this presentation that dental technology is an enviable profession not just in Nigeria but all over the world. Dental Technology is one of the numerous health professions in dentistry that is playing significant role in the health care delivery system.

Dentistry is a corporate profession involving dental surgery, dental technology, dental therapy and dental auxiliary.

What is Dental Technology?

 

Dental technology can be defined as the Art and science of designing, fabrication, servicing and supplying artificial appliances for a lost or congenitally missing part of the oro-facial structures as well as the correction of abnormalities (such as malocclusion and other pivoted developments) associated with human dentition (Eyarefe S.O, 2008).

In other to give a better comprehension to this definition, the keywords and phrases require due explanation.

Dental: Pertaining or relating to the teeth in the oral cavity.

Technology: Is the application of scientific knowledge to the practical aims of human life or, as it is sometimes phrased to the change and manipulation of the human environment.

It is the study, development, and application of devices, machines, and techniques for manufacturing and productive processes. This has to do importantly with the mental conception as well as innovative creation of ideas, based on application of accepted principle towards skillful production and reproduction of tools, instruments, equipment, appliances etc.

It also deals with the application of scientific principles by efficient utilization of materials and equipment at the technologist’s disposal. It showcases the manual dexterity inherent in the professional.

Art  is defined as the conscious use of skill and creative imagination especially in the production of aesthetic objects. It is a beautiful or thought-provoking works produced through creative activity.

Dental technology is called art because it combines manual dexterity with intellectual ability in the process of designing and manufacturing appliances following accepted principles e.g. outlining models, post damming, contouring, tinting, stippling, trimming and polishing techniques.

In other words, the principles and practice of art is very necessary in the study/practice of dental technology, since appliances are constructed to beautify the patient’s appearance.

Science is the study of the physical and natural world and phenomena especially by using systematic observation and experiment. It is a system of knowledge covering general truths or the operation of general laws especially as obtained and tested through scientific method.

Dental technology is called science because it employs scientific principles (i.e. systematic procedures) in achieving set objectives and goals. This scientific knowledge is enhanced through concise study of the physical, chemical, biological and mechanical properties of various dental materials.

The scientific principle also includes testing for strength, eligibility and compatibility of dental materials in their proper perspectives. The course intimates the potential dental technologist on a wider knowledge of the composition, manipulations, storage of materials and their chemical behaviour.

Designing: This is the process of carrying out or creating a detail plan of what is intended to be carried out e.g. preliminary diagnosis and outline of the model from which the appliance is to be constructed.

It is an important aspect of appliances construction since a faulty design may lead to appliance failures during function.

Fabrication: This is the process of creating a new material from existing substances. It involves utilization of materials, tools and equipment to obtain a target appliance. Fabrication of dental appliances could only be achieved through skillful application of accepted principle.

Skillful application means manual dexterity i.e. manipulation of materials with necessary tools and equipment using natural fingers coupled with conceptual knowledge. Manual dexterity could acquired or inherited. Acquired dexterity is obtained through adequate training while inherited dexterity is obtained from birth.

Accepted principle simply means abiding or following laid down rules and regulations pertaining to the practice of the profession. All appliances construction has guiding principles with which when followed could lead to patients satisfaction.

Servicing: This is the process of providing maintenance and repair for existing appliances. It involves cleaning, checking, adjusting, and making minor repairs to a piece of dental appliance in order to satisfy the patients. Special procedures in this aspect of dental technology include repairs, relining, rebasing and duplicating existing dentures.

Supplying: Is the process of giving or delivering what has been constructed to the client directly or indirectly for onward fitting on the patient. In economics, supply will only take place when the product has undergone normal transformation from the various factors of production (e.g. land, labour, capital and entrepreneur), which work collectively to attain certain goals). In dental technology, the technologist is charged with the responsibility of harnessing human, materials, tools and other equipment resources toward creating a viable appliance that is clinically accepted for the patient.

Artificial  appliances: These are substitutes constructed by the technologist for replacing lost natural and or correcting oro-facial structures due to one reason or the other. These appliances include prosthetic, orthodontic, maxillofacial and conservative appliances. They are made of various metallic and nonmetallic materials. These appliances are artificial because they are meant to replace any defective part of the human body and have no coordination from the central nervous and the circulatory systems (except those simulated) thereby obviating the psychological ill feeling of the patient.

Lost or congenital: Prosthetic appliances are constructed for lost or congenital tissues of the patient. Dento-facial tissues could be lost through accidents or pathological disorder. Congenital structures are defects arising from physiological/anatomical malformation of the tissues concerned.

Oro-facial: Relating to the mouth and the face.

Abnormalities: Refers to a variation from the usual structure or function of the body system due to pivoted developments such as malformed and malplaced oral structures.

WHO IS A DENTAL TECHNOLOGISTSubject to the Dental Technologists Registration Board of

Nigeria decree 43 of 1987 now Act cap D6 of 2004, “a Dental Technologist is one who by his studies, education and experience, and qualification engages or is qualified to engage in the practice of construction and reconstruction of dental prostheses restoration and, such other acts as by universally accepted customs are performed by those in the profession”.

The roles of a Dental Technologist cannot be adequately treated without knowing his status. In Nigeria, the Dental Technologist is listed among the recognized dental professionals and his practice is recognized through the Dental Technologists Registration Board of Nigeria established under Decree No 43 of 1987 now Act cap D6 of 2004. By this Decree, the roles of a Dental Technologist are specifically spelt out and the Board ensures that professionals operate within specified code of conduct.

THE PROFESSIONAL ROLES OF A DENTAL TECHNOLOGIST

A Dental Technologist stands the chance of advancing into any of the five major specialist areas of the profession. These fields or branches include:

Prosthodontics/Prosthetic Technology: This branch according to Ray Mac-Gregor (1995) in his book: Clinical Dental Prosthetics defines dental prosthetic as the art and science of designing and fitting artificial substitutes to replace lost or missing tissues. Appliances constructed in this field include removable partial/full dentures designed and constructed using either metallic or non-metallic materials for patient’s or-facial rehabilitation.

Orthodontics Technology: This is a branch of dental art and science which deals with the study of growth, development and infinite variations of the face, jaws and teeth and particularly with the treatment of dento-facial abnormalities within the limits set by certain biological factors. It is simply the art and science of repositioning malplaced teeth or dentitions using any of the corrective appliances e.g. Active appliances such as retraction arch (Labial bow), finger springs, cantilever spring, goal post etc and passive (myofunctional) appliances such as oral screen, Andresen (monobloc) etc. The aims of Orthodontic technologist are:

• Restoration of proper function of the teeth.• Elimination of pathological condition of the gingival or

periodontal tissues caused by irregularities of the dental arch.

• Reduction of susceptibility to dental caries by proper alignment of the teeth (i.e. elimination of stagnation areas).

• Improvement of facial aesthetics.• Correction of malposed teeth prior to construction of partial

denture and bridge.• Elimination of harmful habits e.g. thumb sucking, mouth breathing• Elimination of abnormal mental attitude caused by poor facial

aesthetics.

Conservative Technology: This is a branch of dental art and science, which deals with restoration such as, inlays crowns, bridges and preservation of the remaining structures. Inlay, crown and bridges are usually small prostheses that replace lost tooth structure but do not cover the mucosa with the exception of spring cantilever (John F. Johnston, 1987).

Maxillo-facial Technology: Is a branch of dental technology complementary to maxillo-facial surgery, which is particularly concerned with the prosthetic restoration and rehabilitation of the facial structures and jaws (Ogude EE, 1992).

It involves the science and skill of construction and production of prostheses designed to replace maxillo-facial defect where surgical reconstruction is not feasible or contra-indicated.

Examples of appliances constructed in this field include prostheses (e.g. obturators, ocular or orbital prosthesis, Auricular prostheses or external ear, Nasal prosthesis (Nose and Nasal implants) surgical appliances that facilitates a normal physiological function without replacing the tissue involved e.g. Jaw Exerciser (cock screw used to bring fused parts into normal functional relationships after a period of disuse as a result of disease or immobilization e.g. the ankilosis of temporo-mandibular joint), feeding plates, surgical plates, head plates etc and Splints used as mechanical means of immobilizing bone or soft tissue in other to assist physiological processes of repair e.g. periodontal splints, gunning splints, cap metal splints etc.

Material Science/Instrument technology: Is a branch of dental technology that deals with the study of physical, chemical and biological properties of materials as well as the study of fabrication techniques, maintenance and control of the numerous instruments and equipment that are in general use in the practice of the profession.

OTHER ROLES WITHIN HEALTH SECTORAs a specialist, the roles of the dental technologist go beyond

Dentistry or dental department. He works with ENT, Ophthalmology, Plastic Surgery, Obstetrics and Gynaecology departments. It has to be emphasized that his tasks are not by any means easy with the latest technologies. Muray Dickson, the author of popular “Where there is no Dentist”, said, “Making dentures is not easy”.

Ophthalmology: People lose their eye balls as a result of trauma or pathology. In this case, the dental technologist is called in for rehabilitation. This process produces better results than obtained by the use of “stock eyes” which are fitted for most of our people. Some degree of synchronized mobility with the companion eye can be obtained. In any case there is no way the eyeball can be replaced surgically. However, the importance of surgery in retention of some of these prostheses cannot be over emphasized.

Paediatrics: What the dental technologist does in this field is the fabrication of Paediatric’s orthopaedic feeding plates for cleft palate babies. This plate is put in place to block the oro-nasal opening to enable the baby feed better until the attainment of the ideal weight to undergo surgical repairs. Retention of the plate is extra oral.

ENT/Maxillo-facial/Plastic Surgery: Both the ENT and Maxillo-facial surgery departments send similar cases to dental technologist. They undertake hemimaxillectomy and mandiblectomy operations for cancer patients. When maxillo-facial operations are carried out fistulae are left giving a prominent link between the oral and nasal cavities, thereby making speech, mastication and drinking near impossible. The dental technologist comes in to fabricate obturator, which would restore the lost functions. Adams Cribs and Roach Clasps retain the obturator intra-orally.

Where the ear or the nose is excised as a result of trauma or diseases, the case are referred to the dental technologist who fabricates their replacements. The ear is a particular case where surgery takes a second place. For mandiblectomy, the portion of the bone affected by the removal of the affected bone is replaced by implants, which can be acrylic or metal alloy.

The whole mandible can be replaced and this type rehabilitation requires a good knowledge of anatomy of head and neck and high degree of manual dexterity. For maxillo-facial injuries, the dental technologist is a major service provider. He fabricates such appliances as splints. The technologist in this field also constructs nasal dilator used as a post-surgery retainer when nostrils have to be surgically opened or expanded to improve respiration.

Obstetrics and Gynaecology: Where alternatives are not available, the technologist fabricates the vaginal mould as a post-operative appliance for patients with congenitally absent opening as a retainer.

PUBLIC ROLES OF A DENTAL TECHNOLOGIST

Olajobi, S & Pollyn, Y (1994) enumerated some of the public roles of a Dental technologist in the society. These roles point to the fact that a dental technologist is a multifaceted person with good social relation characteristics. A dental technologist apart from an expert in the production and provision of dental replacements for patients has other associated roles to perform at various levels of responsibilities. These roles include policy maker, manager, public relation practitioner, lecturer and employment of labour (entrepreneur).

1. POLICY MAKER: He could be in position of responsibility which demands his/her in-depth knowledge of management science, law, economics etc for him to perform this role effectively and successfully. An example of this is serving as Chairman of Dental Technologists Registration Board of Nigeria (DTRBN) or as Head of department of dental technology in a training institution. He has adequately fortified himself with this role to be successfull and earn respect for himself.

2. MANAGER: A dental technologist could find himself as a manager either at the head of a group of dental technologist or taking charge of a dental restoration center. In this respect, the technologist must be knowledgeable not only in his profession but also in the management of men and materials. A technologist with these attributes automatically earns himself respect.

3. PUBLIC RELATION FUNCTION: In both private and professional lives, the way a technologist conduct himself, his demonstration of knowledge of his profession, the ability to communicate effectively go along way in living a good or bad image to himself and the profession he belong. So he is projecting the image of the profession through his conduct, if it is a good one he is held in high esteem, accorded recognition and treated with respect.

4.  LECTURER: It is beneficial to say that some of the technologists practice the profession by imparting knowledge to others in various schools and at different levels. Definitely, one can only teach what he/she knows. So as lecturers, they should endeavour to keep themselves abreast with the current trend in dental technology.

5.  RESEARCHER: A dental technologist who has interest in research and has adequate knowledge in achieving his aim could go into this endeavor. In the course of his role, he would have to relate with a whole lot of people and the type of relationship that exist between him and his counterparts would depend on how he is being assessed.

6. EMPLOYER OF LABOUR: Dental technologist could go into big time business of either setting up commercial dental restoration centers or marketing outlets. In these regards, they will be investor of capital and employers of labour. They must have the where withal to be able to establish a respectable relationship with them.

REFERENCES

Art. (2009). Merriam-Webster’s dictionary and Thesaurus. In Encyclopædia Britannica. Encyclopædia Britannica 2009 Student and Home Edition. Chicago: Encyclopædia Britannica.

Art. (2009). Microsoft Encarta dictionary (DVD) Redmond, WA: Microsoft Corporation, 2008.

Eyarefe, SO (2008). Lecture notes on DNT 202 Introduction to dental technology for 200 level students in Federal University of Technology Owerri, Imo State (unpublished).

DTRBN (1990). Dental Technologists Registration Board of Nigeria Code of ethics for the practice of dental technology in Nigeria.

DTRBN (1987). Dental Technologists Registration Board of Nigeria decree 43 of 1987 now Act cap D6 of 2004.

Ogude, E.E. (1992). Design and construction of maxillofacial appliances for prosthetic rehabilitation. Lecture note on maxillofacial technology (unpublished).

Olajobi, S & Pollyn, Y (1994). The dental technologist as an entrepreneur. Research project work submitted to the department of dental technology in partial fulfillments for the award of HND in dental technology (unpublished).

Technology. (2009). Encyclopædia Britannica. Encyclopædia Britannica 2009 Student and Home Edition. Chicago: Encyclopædia Britannica.

Technology. (2009). Microsoft® Encarta® dictionary. © 1993-2008 Microsoft Corporation.

THANKS FOR YOUR RAPT ATTENTION AND GODBLESS DENTAL TECHNOLOGY IN NIGERIA

Further information/suggestions/comments about this paper could be forwarded to:

EYAREFE O. STEPHENDepartment of Dental TechnologySchool of Health TechnologyFederal University of TechnologyPMB 1526Owerri, Imo State.Email: eyaresteve@yahoo.com or ayarefe@yahoo.comTel: 08032091758, 08055465560