Are dental technicians passé?

Computer technology may make yet another profession obsolete.

By RX FOR READERS/JUDY SIEGEL-ITZKOVICH
Dentists Chair 370 (photo credit: Wikimedia Commons)
Dentists Chair 370
(photo credit: Wikimedia Commons)
I am a 48-year-old dental technician. I have read articles from abroad predicting that my profession is doomed because CAD/CAM technology will make it possible for dentists to make their own crowns, bridges, veneers and false teeth without the need for dental technicians. This worries me. Will this happen in the foreseeable future in Israel? W.F., Ashdod
Recently retired Jerusalem dentist Dr. Steve Sattler replies: Computer-aided design/computer-aided manufacturing for dentistry was introduced abroad back in the 1980s in a handful of dental technician companies to produce crowns, fixed bridges, veneers, dental implants and orthodontic appliances more easily than doing so by hand. At that time, however, making them was not efficient and took an impractical amount of time.
In recent years, the technology has become much more advanced. A digital scan is made of defective teeth, which is transferred to a CAD/CAM computer system that can digitally produce a 3D form of the needed crown or other dental restorations, milled from solid chunks of composite resin or ceramics. The “new tooth” – one or several – can then be attached permanently into the patient’s mouth. So far, as the system doesn’t work under the gum line, implants cannot be produced this way.
In traditional making of crowns and the like, a metal substructure forms the base attached to the stump of the old tooth, and porcelain is layered onto them. These block access to X-rays to investigate possible decay or damage at a later time. The porcelain or zirconium that advanced composites used for CAD/CAM teeth present no X-ray problems.
CAD/CAM technology is good and practical. It is already available in Israel as well as in modern countries abroad. However, the big problem is matching the color for front teeth. In his office, the dentist has about 20 blocks of porcelain for different colors.
He uses his color palette – the Rembrandt or similar systems – to best color the front tooth. The artificial tooth is then placed in an oven for an additional hour. But many patients cannot spend three or more hours in the dental office to get a front tooth fixed.
This CAD/CAM technology is still in its first generation. In another five to 10 years, it will be much improved. Dental technicians are already getting the message. A new generation of them is being trained for super-complicated lab work, as technicians will not be needed for the old, run-of-the-mill work. And some will look for new professions, including those that allow them to work with their hands.
I am a 35-year-old mother of four. I work part-time as a secretary, and I do all the cleaning at home. I have been suffering from bouts of eczema on the palms of my hands that come and go. My dermatologist didn’t say much to explain it and how to get rid of it for good. What causes it to return, and is there any way to prevent the condition from coming back? R.A., Karmiel
Prof. Avner Shemer, a senior dermatologist at Sheba Medical Center, answers: Hand eczema is a very common condition that affects about 10 percent of the population in various degrees of severity, but it is hardly talked about. In many cases, it is mild, but in serious form, it can upset daily routine and reduce the quality of life. There is no official cause for an outbreak, but it may occur following exposure to chemicals, allergy and even stress.
In more serious cases, the skin on the hands becomes very dry, red and itchy, and blisters and deep cracks or cuts may appear. Chronic hand eczema can make it very painful to touch things, and contact with water is one of the worst triggers of pain. Some sufferers are too embarrassed to go for a diagnosis and do not get treatment. I know of some sufferers who even decided to change professions so they wouldn’t be in contact with substances that caused the symptoms to erupt – and it happens that patients may go into depression. However, it can easily be diagnosed by a dermatology specialist, and there are effective treatments.
Ordinary emollient creams that soften the skin and reduce contact with substances that trigger the symptoms can help. If they are not effective, your dermatologist can prescribe cortisone creams to ease symptoms – but these cannot be given over the long term because their efficacy is reduced over time. In addition, topical cortisone can cause the skin to become thinner, which makes the palms more sensitive.
There is also an oral drug made from Vitamin A that is a systemic treatment. Consult an expert dermatologist for help.
Rx for Readers welcomes queries from readers about medical problems. Experts will answer those we find most interesting. Write Rx for Readers, The Jerusalem Post, POB 81, Jerusalem 91000, fax your question to Judy Siegel-Itzkovich at (02) 538-9527, or e-mail it to jsiegel@jpost.com, giving your initials, age and place of residence.