Refurbishment of Student Pros Lab November 2015

The first time the place was opened to students was 1998 and since then no repair until now. Looks like tetfund is working. Photos show before and during refurbishment of the lab which was 40 seater but now 56 seater.

CONVERSATION 2: DENTIST and TECHNOLOGIST

Dentist: Mr John how are you?
Technologist: I am very fine and was just reminisce  on our discussions in the last meeting.
Dentist: What is it to talk about or deserving so much attention?
Technologists: Suggestions and discussions on forming a discussion group/forum to chart a new course for the future of dentistry. It was heated and interesting.
Dentist: That was a thoughtful reminder. I think we need to really discuss the future of dentistry. It cannot be done successfully except in a larger house.
Technologist: All hands must be on deck but one thing I observed is apathy towards meetings and it cut across. Sometimes I wondered what is the problem with dental professionals top to bottom
Dentist: I do agree with you but what do you think is the way out?
Technologist: Tenacity of purpose, focused leadership and mutual regard for every member of the team.
Dentist: Suggestions on a common regulatory body has been muted by some of us but how prepared are we to make this happen?
Technologist: Big question.
Dentist: In Britain a good example has been laid. Although there are dissenting voices but on average dentistry faired well. We cannot compare our dentistry with theirs in all ramifications. They have their own issues though but they were reduced to surmountable sizes.
Technologist: It will take a huge sacrifice and mutual respect. Honestly, the dental profession suppose to be the most lucrative profession given our population and the poor prevalence of oral hygiene in our population. Every human being has teeth and hence he is a potential patient.
Dentist: I am not sure we are prepared to leave Medical and dental Council. Feelers show that there are many benefits accruing to us and leaving for a general dental council might rob us of the those benefits.
Technologist: I said earlier that it will require a huge sacrifice by all. Other members of the profession already have regulatory body and if they have to merge to form a general dental council it is indeed a huge sacrifice.
Dentist: Leaders of thoughts in the dental profession would have to get the process started.
Technologist: Who then will bell the cat? I observed painfully that dental departments in our establishments nationwide are treated as second fiddle when compared with our medical counterparts. Our demands for facilities and things to work with generally are often placed behind the burner. This is obvious truth if we are prepared to face the truth. Sometimes I wonder what is the problem with the dental profession.
Dentist: Indeed we have an axe to grind.
Technologist: Let me suggest we approach some of our elders in the profession for advice. But if we eventually have a general dental council in Nigeria do we all have the right attitude and mutual respect for one another to foster a great future for dentistry?

NOISE POLLUTION

It is incredible the level of pollution we experience in our cities in Nigeria. Noise pollution is a global problem especially in cities around the world but it is annoying when noise from man made equipment which ought to be controlled is left uncontrolled.

Noise pollution from electric generators across Nigeria forms one menace that is common in knowledge to all Nigerians. Then noise from loud speakers in our bus stops from touts calling passengers' attention to various destinations is another avoidable noise that has not attracted the attention of our governments. It is apparent that no serious attention has been given to this by our governments for along time and that may be responsible for why anyone hardly talks about it. Although the previous governor of Lagos state made efforts at stopping noise from worship centres but little was achieved from this.

One important note is noise from commercial vehicles. This is indeed worrisome. I was returning home one day and the driver placed a big speaker under a seat beside me and the volume was at the highest. All entreaties to persuade the driver to reduce the volume fell on deaf ears. This is a common occurrence in Lagos. Noise from kiosk selling pirated CD of music and play from popular artistes at bus stop and various other places is no doubt a great concern to the city dwellers.

When shall we overcome this?

Another noise pollution concern that  seems unavoidable come from even homes of Nigerians who must own an electric generator as government have tried unsuccessfully to provide electricity for her teeming population.
The picture below shows some electric generators around a building where some computer operators do their businesses. The noise disturbance is better experienced than imagined.
Noise pollution seems to have become a normal thing to many Nigerians. This can be likened to a community near a refuse dump sites where stenches from the dump is no longer perceived by the inhabitants because they got used to it but were surprised when a newcomer closes his nostril when passing by. Anyone around in the community may probably wonder what is the problem with the passerby. Lagosians seem to be used to noise such that they are no longer disturbed by it. No wonder an average Lagosians are always judged as apprehensive, hypertensive and restless. A keen observer will notice this easily. Except the little attempt made by the government of Mr Raji Fashola no government has taken noise pollution serious if am not mistaken even around the country. To those who are not used to noise it is easy to be restless when in a noisy environment. The menace of noise pollution to human health and wellbeing is well established in the literature and that is why it is a huge surprise that the ministry of environment has not been doing anything about it. Do we even have a policy on noise pollution?
I attributed the aggressive behaviour of Lagos commercial bus drivers to a large extent to noise pollution. Can you imagine being exposed to noise every moment of the day? That is the life of motorists in Lagos specially bus drivers and commutters. 

Hazard in The Dental Lab

One of the HAZARDS in the dental Laboratory. A dental technologist trimming a metallic appliance. Serious sparks were generated during this process which can constitute danger in the lab

CONVERSATION: DENTIST and TECHNOLOGIST

Dentist: Good morning Mr John

Technologist: Very well. I hope you had a restful night?

Dentist: Yes. Thank you.
Hope our patient will smile home today?

Technologist: You cannot imagine it, the Plaster we used in processing the job disappointed us-it was slow setting.

Dentist: So what?

Technologist: The processing took a little longer. I am afraid a new appointment has to be arranged.

Dentist: That is very disappointing.

Technologist: The problem was not anticipated. A new supply failed us.

Dentist: What is the new date are you suggesting?

Technologist: Another week.

Dentist: It is sad.

Technologist: I think we need to re- appraise the whole situation.

Dentist: What do you mean?

Technologist: The management has to be advised on the latest technologies in fabrication of dental prostheses.

Dentist: How do you mean?

Technologist: We cannot afford to continue  to stay at the mercy of failed appointments because we do not employ the latest time saving technologies and techniques.

Dentist: You want to be recommended for training?

Technologist: No, but the management should be aware there are better ways of working to satisfy our patients.

Dentist: Please explain further.

Technologist: The world of dentistry is already shifting from Plaster room to digital spaces.

Dentist: Are you suggesting the use of computer to do laboratory fabrication? By the way how many of you in the lab can use a computer that way?

Technologist: Computer and the skills required to operate one is a commonplace these days.

Dentist: Anyway, our system is not supportive of what you are trying to suggest with this no electricity, no water, no material problems we daily encounter.

Technologist: Yes but we have to start somewhere; suggest and recommend the best way to the management and we have done our part.

Dentist: I agree but management too will give excuses on shortage of funds.

Technologist: What then is the way forward? We shall then continue to disappoint our patients-that is not good for dentistry as a whole.

Dentist: We must find a way out of this in the overall interest of the dental profession and the patient we serve.

Technologist: The whole thing look like a quagmire but it is surmountable.

Dentist: Yes. Let's think of some other alternatives while we pressurise the management over our idea.

Technologist: Alternatives?

Dentist: Yes, alternatives.

Technologist:  I suggest we create a forum of dental professionals leaving no one behind that will discuss the future of dentistry in Nigeria. This all-inclusive forum can commence a new direction for the future of dentistry.

Dentist: How, under what modalities?

Technologist: Both of us can start talking to those that may share this dream then we take it from there.

Dentist: Good idea. Let's get this off the ground during break time.

Technologist: I look forward to it.

'ROADSIDE TEACHERS'

When I read in a Nigerian newspaper (PunchApril28 2015) the submission of a Nigerian University Professor about 'roadside teachers' my initial shock was on why the education system in Nigeria tolerated this type of teachers for so long and up till now unless the present government in Nigeria does something about it the problem cannot be said to be over. The learned Professor unfortunately did not identify who roadside teachers were. It is however very apparent that he was referring to those who were teaching in our schools and Universities without formal training in education-No training of any kind to qualify them as teachers.
They are however very qualified professionals in their fields and many of course can explain topics in their respective subject areas to their students. Does this qualify anyone to be teachers/lecturers even to the extent of becoming a professor without a teaching qualification all through a teaching career in the University? For instance if you have a BSc or MBBS you can be recruited to teach in a Nigerian University and become a professor with medical fellowships. It seems if you can just explain a topic to your students you can continue your career as a lecturer. Should we continue to cry of poor quality of education under this kind of circumstance? Education policies in Nigeria have changed as the number of governments we have had so far. Education budget is the lowest when compared with our enormous resources. Nigerian University Commission, the body responsible for accreditation of University programmes once made a policy or proposed PhD as minimum qualification but up till now this has not been implemented especially in medical and dental faculties. The cry of genuine educators continue to fall on deaf ears. Which way forward for Nigeria education? The use of technology has promising prospect for addressing this problem but  the level of adoption is one of the lowest. The rest of the world is rethinking their education systems but we seem to be comfortable with our circumstances. Although it is not all negatives for education in Nigeria as prominent educators have made remarkable marks at their own times but we cannot grow a formidable education with occasional nuggets of development. This is why the observation of the Professor is apt and deserves the attention of the present government. The rest of the world has been helping Nigerian students and educators through scholarships and countless trainings but the  government seems not to bother much about this. It is over several decades ago that Nigerian scholarships boards last functioned even when it was active funding goes to politicians and their cronies. Academic staff of Nigerian universities (ASUU) hardly work for two consecutive years without having at least four to six months face off with the government. Salary agitations, industrial courts and negotiation and re-negotiation have become a common place in university/government relationships. The whole situation is frustrating for the youth who look up to their leaders for help. Government's schools and Universities are just not the best option for a serious student and the cost of education in the private institutions has hit the roof. Where is the future of quality education under this kind of circumstance?

21st CENTURY UNIVERSITY CURRICULUM?

Sometimes I wonder why should full-time  bachelor degree last up to four years. Can't we have the number of years reduced? Those in the health professions should not be left out of this. A student learnt through lectures and other activities provided by the school calendar but how strictly are this adhered to? The number of contact times a lecturer need to have per semester are hardly fulfilled yet university still graduate the student. Who makes up the lost hours? Lecture method is a very poor method for imparting knowledge according to research and yet in the 21st century students are expected to learn this same way as their fathers three to four decades ago. Change is what is expected. From observation lecturers miss several classes and rush to finish course programmes last minute. Is this a productive approach to teaching? Unfortunately, school authorities look the other way. 21st century students learn differently, they learn every moment and everyday. They do not learn new things only in the classroom but everywhere in the Internet, students of this age learn differently. So they learn continually and consistently. Some have argued that what they do with phone is usually social interaction but it has been established that they learn a lot more from social activities and so develop skill that enable them manage their studies in a more productive manner instead of depend on lectures that most times have to be rescheduled. The Internet is a more dependable place to learn at the convenience of the student and at any given time of interest. Stuffs that university lecturers give are sometimes obsolete and are forced down the throat of the students otherwise they will be in trouble. Students are therefore intimidated and compelled to 'download' whatever the lecturer gave in other to pass examination. A look at Nigerian Universities and mostly African Universities will reveal this practice in its quantum proportion.
If you ask me I will tell you straight that this is one of the reasons Nigerian Universities are still struggling to implement fully online courses (not even MOOC) when Universities that have made global marks are already running fully online courses. Fully online courses saves money and resources and very efficient if well managed. A student can play the traditional methods many ways and get away with their wrongs. For example if you are a lecturer that is strict on attendance then student could sign the attendance sheet on behalf of one another. Individual and group assignments could be paid for, project works are done by the most hardworking working student within the group, lecturers are paid to write thesis for students, missed test and  assignment could attract a fee if the student meets a compromising lecturer; you can pay to influence your final GPA and class of degree; someone can sit school examination on your behalf. The list is endless. University curriculum needs to be revisited in the light of the emerging 21st century pedagogy or pedagogy that 21st is compelling us to embrace. Who then will bell the cat when the duration of a full time programme is a measure of its worth?

WAX WORK @ A DENTAL LABORATORY

Dental students during wax work procedure for setting up complete denture testing their acumen in dental laboratory procedure. Dated2/06/15. Modelling wax is an unavoidable ally in the fabrication of dental prostheses but not with digitisation of dental lab procedures. These students are making use of the best the dental industry in Nigeria could provide. How long are they going to wait to join the rest of the world

in the use of computer in the fabrication of dental restorations? The answer is left for leaders in the professions and in government.

CONSERVATIVE DENTISTRY-Still A Relevant Practice?

We often hear of different branches or if you like different specialties of dentistry and when I remember conservative dentistry I wonder if the word conservation is still relevant when we consider what it entails to prepare an abutment or several teeth to fabricate crowns and bridges in order to preserve human dentition. The question is do  we really conserve the teeth we claimed to preserve?
Let's begin this way: when a tooth has a hole or the crown damaged and the clinician considered it vital then he opts for prescribing a number of appliances namely: inlay, pin lay, pin ledges, crowns, bridges etc. Any attempt to make any of the aforementioned conservative restorations results in further reduction of the crown thereby exposing the tooth to more danger by loss of supporting tooth structure. For instance if a crown was prescribed the tooth structure has to be further reduced. A lot of teeth have been lost or weakened in this process. At least a third of the total tooth structure of other healthy teeth is removed if a bridge is prescribed. How can we confidently say that teeth have been conserved? The crowns or bridges made are held to the remaining tooth structure by dental cement which often may lose its grip with time resulting in patient's continuous visit to the clinic. It should not sound as an evil but unless the tooth can not be saved by other means of treatment conservative procedure should be sparingly used. It has been reported in the literatures that 2/3 of a tooth supporting structure is lost when they are prepared for crowns or bridges. Should we still continue to pursue the objectives of conservative dentistry?
Root Canal Therapy (RCT) is definitely a practice that has saved millions of teeth globally but we cannot say of conservative appliances like crowns and bridges. Having said this are conservative appliances no longer suitable in contemporary dental practice? Of course not.
It behoves the dentist to weigh several options before decisions are made bearing in mind the several immediate and long term consequences of conservative appliances.

Dentist's License Withdrawn For Life For Extraction

http://m.actionnewsjax.com/news/news/local/board-approves-voluntary-surrender-license-dentist/nmQt8/

....on till thy kingdom come dental curriculum.

The convention in the fabrication of dental appliances is to make appliances first in wax pattern then the wax pattern could be further processed into either acrylic, porcelain or metallic material and a host of other materials. In the present digital age we are moving away from this sequence to digital production that eliminates physical impression of the mouth, physical replica of the oral cavity (dental model) and all that happens in the Plaster room. This paradigm shift is definitely going to speed production and create new challenges. What does this mean for the entire dental professionals worldwide and especially in Africa? Dental technology students seen in the picture below are fabricating dental appliances in wax and happily doing so but how much of what the future holds in their profession do they know? Even undergraduate dental surgery students who happily returned to the lab with an alginate impression have not realised the enormous changes that await him in the nearest future. The future is definitely very bright but how fast are we responding to the imminent paradigm shift. Whether we like it or not change has come, it is not business as usual both in the dental clinic and the lab. In this century it is archaic to graduate students without them ever seeing or handling oral scanner, milling machine, model scanner, and virtual impression. It may sound ambitious to think this way but it is because we are in a system that is reluctant to change its ways of doing things. Till thy kingdom come curriculum will produce till thy kingdom come professionals and practice. Come to think of it dental patients are not going to remain 'ignorant' forever so the earlier we in the dental profession respond to the present development the better. Students are travelling to take elective courses and on return what impression of their teachers and institutions will they continue to hold when they see the wide differences between what a teacher there could do and what the teacher here is capable of doing. Please no excuses we must rise for a change.
We cannot continue to lag behind, we must make a change so that the coming generation of dentists and dental technologists will not blame their teachers for not responding fast enough to give them the best that this century offer them.

Interns' Senthforth

Reginald Duhu, Jumoke Fadayomi, Eniola, Titus and Kingsley Asogwa

First Experience in Complete Denture Set-up

Every undergraduate dental student commences skill development from the dental laboratory being the first place before clinical years. To this end denture fabrication forms part of the many laboratory procedures that laid the foundation for skill development which continues to clinical years until graduation.
The pictures below show the first attempt a student had after complete denture setup procedure was demonstrated. Although this only shows one of the few examples of a poor beginning but definitely a good start to a long journey in skill development.
The first three pictures show the starting point and the fourth the eventual end which produces a complete denture setup in modelling wax.

RE: TRIMMING DENTAL MODEL

The conventional approach to fabrication of dental appliances is to take impression with alginate or rubber based material then pour the impression in dental stone for subsequent laboratory procedures that will culminate into fabrication of prescribed prostheses. The world of fabrication of dental appliances is fast changing from the plaster/production room to digital spaces. How do I mean? You no longer need to deal with physical impressions anymore in some few laboratories in advanced world but virtual impressions are made and from there virtual fabrication is done and virtual information is passed to the milling machine which eventually produces the prosthesis. Milling machines can handle a number of materials ranging from metal to plastic and others. Although it is not yet bed of of roses for the dental industry but there is hope that in the coming decades fabrication of dental prostheses will move completely from plaster rooms to digital spaces.
Where is Africa in all these tremendous breakthroughs?

TRIMMING DENTAL MODEL

It can be such an unpleasant experience to work in a dental lab and the tap is not flowing. This captures the situation where sachet water is used to supply water to the trimming disc as the technologist positions his model for trimming. It is messy and difficult to coordinate water supply and trimming of model under this circumstance. How many of such dental laboratories do we have in developing countries around the world? How can developed world help even with refurbished dental equipment to offset the the bill of the lab while they face the common problem-provision of water.

New floor made for prosthetic lab

This 14th day of May 2015 marks the completion of the tilling of the floor of dental prosthetic laboratory after more than two decades of having terrazzo floor.

THE NEED FOR SKILLS DEVELOPMENT IN HEALTHCARE (Updated1).

Skills in the healthcare can be viewed from different perspectives. Skills set that involves the development of manual dexterity in the use of equipment, materials and tools for carrying out various diagnostic and treatment procedures are those that this write up will focus. These skills are just required to operate equipment and promote the use of tools that aid health workers in delivery of services to their patients. Unfortunately, health professionals do not want to be associated with tools thinking that it is better associated with vocations like Carpentry, plumbing, and other artisans related vocations. It is not true. On arrival at the hospital anywhere around the world the immediate contact after initial registration with the records is a medical doctor's physical examination of the patient and this require stethoscope and if dental clinic dentist's mirror. For effective diagnosis the laboratory must be engaged. Again the use of equipment, tools and materials become indispensable for quality care. Where then is the use of tools and equipment regarded as belonging to the artisans alone? In the dental care the use of equipment and tools and materials from the beginning to the end of oral care proofs an efficient dentist. Manual skills are therefore very indispensable as it is about handling of tools and equipment for service delivery. Research is replete with the use of tools in healthcare beginning with the use of plants and animal for testing and discoveries of new diseases and treatment options. In the administration of drugs the use of tools and equipment has been identified as aiding efficiency. Despising the notion that healthcare is tool and equipment based is therefore parochial and signifies inefficiency.
Dental Training and practice.
How did dental training and practice start and what do we think about equipment and tools? An indispensable truth is that dental surgery degree programme last for a minimum of four to six (4-6) years depending on country but it is clear that acquisition of manual skills is an unavoidable part of clinical skill development.
When does a dental student begins his journey into skill development? The first four years is a long journey into the faculty of dental sciences but an important stage is when he gets to see in practical terms all that he has been taught in the classroom. The said time was when he gets to the dental laboratory to probably see and handle artificial teeth, dental model of the mouth, variety of tools, equipment and materials needed for the rest of his training. The long journey into clinical training begins with the exposure to skills acquired in the dental laboratory namely: skills for operating and controlling high and low speed machines; skills for manipulation of materials from liquid state to the solid state;  skills for understanding different behaviours of materials for fabrication of dental prostheses and patient care; skills for understanding behaviours of different patients; skills for overcoming fears of handling materials and equipment and the eventual benefits of gaining confidence to handle them; skills for resilience in the face of difficulties; skills for management of materials and equipment productively; skills for mitigating risks in handling equipments and other hazards. Dental laboratory procedures and courses are expected to help undergraduate dental students face the future in further clinical training and the future as dentists.
Skill in Healthcare
Healthcare is replete with the use of materials and tools. A number of them are hereby listed: X-machine, ECG, dental chair, .........; hand tools; scalpel, stethoscopes etc. Needless to list so many of them as they are well-known but certainly they are just many and are evolving. Therefore, it is a simple understanding that manual skills are a must for anyone to work as a health professional. Health professionals are those who are involved in patient care and hence no one working in the health sector is excluded in the use of tools and equipments in service delivery.

THE MERGER OF DENTAL LABORATORY AND CLINIC

Many would wonder how could dental lab and clinic merge? What does it mean by this merger? A time will come that you don't need to train separately as a dental technologist and a dentist but a single curriculum will exist that will train a dental doctor that will either specialise in rendering laboratory services or clinical services. An individual will have to make that choice. At this time dental services will be fully digitised and laboratory fabrication processes will move from plaster room to digital spaces. A careful  look at trends in training and skill acquisitions in developed world by dental companies is blurring the distinction between lab and clinical skills. Even digital dentistry will clearly suggest merger and the involvement of dental professionals and none dental professionals in fabrication of dental prostheses will become a serious concern. The fast changing needs and awareness on the options of treatment by dental patients will be very strong such that patronage will move from the present conventional dental clinic/lab set up to CAD/ CAM theatre where dental clinic and dental lab will share common spaces. In Nigeria we are practicing dentistry as bequeathed to us by the British and as it stands today (in the UK) all cadres of dental professionals can acquire skills related to his specialism ( sometimes a little deviation is observed) by registered education provider after basic training under the present curriculum.  In Britain dentists could acquire one time exclusive lab skills through these education providers if he shows interest while clinical dental technologist are taking clinical training and skills-merger is imminent and will definitely become the norm in the coming decades.  In Britain GDC document on scope of practice for all dental professionals allows other professional to carryout some clinical procedures under the watch of a dentist-for me that is the beginning of the merger. Laws and regulations will allow flexibility in dental treatment and enforcement of law will get rather flexible. Unfortunately, how is Africa responding to this imminent paradigm shift?

DIGITAL DENTISTRY

The buzz in dentistry is digital this digital that. Dental professionals in Nigeria seem to be sleeping except for few talk about it no one seem to be doing something concrete about it. Regulatory agencies are asleep and associations are just showing little or no concern. Software engineers are dictating the way we should practice our profession and when the advanced worlds is done they will dump it on us. TOKUNBO  CAD/CAM will soon arrive and dental professionals will start falling on each other to begin from the obsolete version of the technology. Should we not emulate China who sponsor their citizens to countries where these developments are happening in order to import the latest to their country. Politicians are not looking at that now but how to share the national cake. Believe it on not virtual impression and models are real and milling machines are getting cheaper. None dental professionals who can use those software will soon make the first dental prostheses. May be then we will wake up to the reality that will soon tell both the clinic and the lab that there is need for concerted fight for the survival of our profession.
Should we wait until this start happening before we start doing something? This is a wake up call to anyone in dentistry whether dentist or technologist.

Undergraduate Jnr OP-Tech Exam Session

Undergraduate dental students preparing to submit their complete denture setup in 2015