Grin Doctors

'Phantom' patients and other high-tech teaching tools are changing the way UM students are learning their field

Dental School


The dental drill looked a little unsteady in Christine Allen's hand.

"I'm going to drill the tooth now," Allen, 23, said through her surgical mask. With a tap of her foot on a pedal, the drill whirred.

That cringe-inspiring squeal has been one of the few constants over the past few months at the University of Maryland Dental School. In September, the school moved into a $145 million building in Baltimore and in the process entered a new stage in dental education.

The most visible aspect of the shift is a $3.5 million simulation facility where 172 artificial patients, dubbed "phantoms," recline in computer-equipped chairs. The units enable Allen and her fellow students to access course materials and search for information as they work.

The units are the first fully digital simulators being used by a U.S. dental school, according to Christian S. Stohler, dean of the school. "This is the beginning of a long development that has to happen here," he said.

Change is in the air at dental schools. The rapid pace of progress in technology and medicine has forced dentists to rethink their role as health care providers. They are increasingly playing a part in diagnosing, treating and preventing diseases - and not just those of the mouth.

Gum disease, for example, has been linked to heart disease and stroke. The inflammation also makes diabetes more difficult to control and increases the chance of rejection in organ transplant cases. HIV infection can be diagnosed by testing a person's saliva, and other saliva-based disease screens are in the works.

The logical place for such diagnosis, many experts believe, is the dentist's office.

"We really need to connect oral health care with the delivery of health care," said Dr. Richard Weaver, who directs education policy and research for the American Dental Education Association.

Educators, in turn, are chewing on how to train today's - and tomorrow's - dentists in a field that is in flux.

"The students are going to be prepared for the practice of today, but they're going to be in practice for 35 or 40 years," Weaver said. "They need to be able to keep up with change."

He said dental schools must shift away from the classic model in which students are passive learners and instead teach them to teach themselves.

"In the past, and still in many schools, the faculty are lecturers," he said. "The students just sit there and absorb. But you want them involved in searching for the information they need to solve problems."

He said scientific advances and the Internet expand the amount of information available, requiring dentists to become discerning users of the knowledge. "They need to learn to evaluate and assess the literature and technology," he said.

Stohler said the new facilities will enable Maryland to turn out graduates capable of adapting throughout their careers.

The school plans to make another high-tech lab with eight chairs available to alumni for continuing education. The "dream room" will enable them to try out new technologies.

Among other innovations, the school is testing drawers that open with the wave of a hand and is considering a device that projects a computer keypad onto a sterile pad using a laser beam. Both technologies are designed to prevent the spread of germs.

The school is also testing a machine that can take a 3D image of a tooth and produce a composite crown to replace it within minutes instead of days.

But while students appear to embrace the high-tech environment, Stohler said, faculty members are still struggling with how to make use of new teaching tools.

"For the students it's easier," he said. "They feel very used to the digital technologies. But for some of our faculty that is difficult."

Dr. Karen L. Faraone, a professor who teaches students to make dentures, said acclimating to the new facilities may take several years.

"It's incredibly exciting," she said, "and it's scary at the same time. We have a dean who's leading us [the faculty], sometimes kicking and screaming, into the 21st century. A lot of his ideas are working nicely, but it just seems a little strange to us."

In the simulation lab, the white and red chairs are styled like something from the starship Enterprise, all sleek curves and ergonomics to help students work more safely and efficiently.

Allen, a sophomore, said the setup is a great improvement over the one in the windowless basement of the old building, which stands vacant next door. Before the move, she and her peers mounted sets of fake teeth known as "typodonts" on steel rods attached to a bench.

"We would move the rod around into all different places so we could get to all areas of the teeth," Allen said. "But then you realize you can't work through a human throat."

Now the artificial choppers go inside the phantom's heads, which have articulated steel jaws. "They don't have tongues," Allen said. "But it's still more difficult than before. It's so much better, because it's less of a transition [to the clinic]."

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