Enhanced Dentistry is just starting to become available in India. It will soon become a standard feature in advanced dental
clinics in the future here in India as well as around the world.
Enhanced Dentistry is a new service which is spreading across the globe, slowly but
Teeth are normally small structures like the eyes, ear & nose. ENT surgeons, ophthalmic surgeons & neurosurgeons
nowadays routinely use an operating microscope or magnifying loupes/spectacles to do surgeries of greater precision and accuracy.
Cataract surgery is nowadays routinely done with a microscope nowadays.
It is a stunning treat to watch teeth which are only 1 sq.cm in size magnified to fill a TV screen 14 or 21 inches cross!!
And the joy of seeing a smile is all the more gorgeous to watch on a large TV screen. A big smile is made much bigger by the
magnification provided by the microscope. And the highly improved quality of the fillings, RCT’s, crown and bridge preparations
and various other procedures which can be done with the microscope make the patient smile even more! The patient’s confidence in his dentist is hugely increased as he can see the
problems in his teeth very clearly under brilliant light and magnification. They co-operate better during the treatment as
they are able to see on a TV screen the whole procedure being undertaken on their teeth, and it also ensures better compliance
with advice given.
who uses the microscope is much more comfortable and avoids un-due strain on his neck and back. The up-right posture can be
maintained during almost all procedures, which is otherwise impossible. Occupational stress and strain on these 2 areas are
very high and there are some incidences in the USA where some senior and experienced dentists have only been able to continue
working after starting to use the microscope, thus enabling more patients to continue to benefit from their huge experience.
The microscope can be used to magnify almost all the procedures which are done routinely
by dentists. Since the eyes are not seeing the work area directly as before, a lot of training has to be under-taken to master
the use of this new device effectively.
The use of the same operating microscope in the field of dentistry has just started recently in Western Europe and parts
of America. The American Dental Association has made it mandatory and compulsory for higher post-graduate training in endo-dontics
or the root canal treatment speciality to be trained in the use of the operating microscope. It is estimated that 75% of the
endodontists in the USA now own or use a microscope at least part of the time. A select few dental colleges have started to
introduce microscopes at under-graduate level. But many general dentists and other dental sub-specialists like periodontists,
oral surgeons and prosthodontists have also pioneered and mastered the use of the microscope in their practices. This is a
revolution in the dental world – the amount of improvement of care in dentistry done under magnification with the use
of the microscope is very very high.
Since microscopes have been used for endodontic RCT’s , extra canals called MB2’s and other minute accessory
canals have been found and treated effectively which were not possible before. Thus, the chances of failure of RCT becomes
much smaller. Doing complicated procedures like failed RCT and removal of broken files deep inside the roots of teeth are
challenges which demand the use of a microscope. Teeth will failed RCT’s can be re-treated with a second RCT and successfully
saved, when done very carefully, and the chances of success are much higher when done under the microscope.
Some teeth have decay which almost require a RCT if done with the naked eye. But with a microscope and a special caries
detector dye, only the decay can be removed and a RCT avoided. No normal tissue is removed because it is possible to see the
difference much better and clearer under magnification.
cleaning of the teeth done under the microscope affords better removal of tartar and stains and cleaner teeth at the end.
Periodontal flap surgery when done under the microscope, is able to remove much more damaged tissue, with much less damage
to nearby healthy tissue, and hence give a better result. Suturing of wounds done under the microscope is much finer and delicate,
hence better scars, faster healing, less post-operative pain & discomfort is possible.
of teeth to fit a metal or ceramic artificial crown is a routine procedure done in every dental clinic routinely. If a microscope
is used for this while preparing the tooth, the margins of the teeth are much more neater and precise, thus allowing a much
better fit of the artificial crown, better esthetics and longer life with less problems like leakage and failure. The crown
can also be checked before fitting on to the tooth under the microscope to check for defects in shape, size and irregularities
as well. Less tooth structure is removed as well if possible, because we can see more clearly.
The fitting of crowns and bridges is made very precise and hence the longevity of these is hugely increased.
practice in most areas of surgery are aimed to deliver a smaller incision, smaller scar, reduced pain, faster mobilization
and a much better quality of outcome. To achieve this, advances like laparoscopy in general surgery, arthroscopy in orthopaedic
surgery, endoscopy in urology have all played their part. Similarly, the use of the
microscope in neurosurgery, ophthalmic surgery, plastic surgery etc is also helping in giving such benefits to the
patient nowadays. The operating microscope is used in so many areas of surgery and medicine nowadays, it has almost become
mandatory. The twin benefits of fantastic shadowless illumination and higher magnification make it un-beatable.
At a meeting held recently in Coimbatore on Microscope
Enhanced Dentistry, a well known plastic and microsurgical reconstructive hand surgeon
remarked, “You can only treat what you can see well. You have to use the microscope to know how good and useful