The roles of a dental technologist in oral health care
1. THEROLES OF A DENTALTECHNOLOGIST IN ORAL healthCARE
DELIVERYsystem
A WELCOME LECTURE TO FRESH STUDENTS OF DENTAL
TECHNOLOGY
@
OGUN STATE COLLEGE OF HEALTH TECHNOLOGY ILESSE, IJEBU-ODE, OGUN
STATE ON 20TH NOVEMBER 2013
BY
EYAREFEo. STEPHEN (HND,ADV.DIP,PGD,MSC,cdt,rdt)
Department of dental Technology, School of Health Technology
Federal university of technology, owerri - imo state
2. 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.
3. INTRODUCTION
Every 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".
4. 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.
5. 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.
6. 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.
7. 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.
8. 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.
9. 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.
10. 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.
11. 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.
12. 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.
13. 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.
14. WHO IS A DENTAL TECHNOLOGIST
Subject 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.
15. 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.
16. 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.
17. • 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).
18. 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.
19. 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 SECTOR
As 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”.
20. 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.
21. 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.
22. 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.
23. 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.
25. THANKS FOR YOUR RAPTATTENTIONAND GODBLESS DENTAL
TECHNOLOGY IN NIGERIA
Further information/suggestions/comments about this
paper could be forwarded to:
EYAREFEO. STEPHEN
Department of Dental Technology
School of Health Technology
Federal University of Technology
PMB 1526
Owerri, Imo State.
Email: eyaresteve@yahoo.com or ayarefe@yahoo.com
Tel: 08032091758, 08055465560