The Digital Dental Surgeon

Soon I’ll be completing my three year compulsory service. If you’ve just started your service, you might think three years is such a long way to go. Perhaps you might even be terrified of the horrors that await young dental officers such as yourself. Three long years in a distant and foreign places..

My advice is, enjoy the three years. It is not all that bad really. Yes, there are the bad times but if you let these things make you feel down, it definitely will.

Getting posted to places not of your choice is one of the top three bad things that might happen. Say you’re a KL boy and you get posted to East Malaysia. It would be harder if you’re a Mama’s boy and knowing that your Kelantanese friend got a place in KL just because her hubby is working in KL or she’s got some mighty fine cables to pull. Frankly, I went through those times albeit I got posted to Johor (which is fortunately my kampung, so it wasn’t too bad). Friends who got KL through pulling cables got me quite frustrated and envious, but there wasn’t anything that I could do. So I just stuck with my guns and soldiered on.

After reporting duty to the Johor Bharu office, I headed to Batu Pahat. Upon arriving with a tired face, the boss told me to jump directly into the line of fire. Imagine, a young officer with patient experience only under high supervision being thrown into the frontline handling a crying and anxious 6 year old. I felt like a bumbling buffoon trying to get the child to open her mouth.

These days, I laugh everytime I remembered the first day. I still have some reservation when I treat paediatric patients, just because I think I don’t have the patience my paediatric lecturers have. Fortunately, most of the children I treat and had treated during the course of the three year compulsory service are quite angels to begin with, so examination and treatment usually gets done without any dramas.

Dental extractions actually require more brain than brawn. It’s all about the technique, the leverage and the anatomy.

Unlearn what you have learned and the tooth fill remove itself.

I was like many other male dental students, complete 2 extractions during the Extraction Clinic and we’d just lounge around (without the lecturers noticing of course). Having only two teeth out per week is not good enough training to prepare you for the service really. On a usual day, I had to take out say.. twenty, no make that thirty teeth. And that would be just between eight in the morning till lunch time. I had to learn to do fast extractions especially when I’m faced with days when there are more patients than the clinic can handle (eg. school holidays, etc).

After three years, dental extractions are a cinch though there are a few cases that do break a sweat now and then. One thing that concerns me, Malaysians especially those in the rural areas still have the understanding that the solution to dental problems are only through extractions. So as a result, dentists could only take their tooth out and do nothing more. Frustrating this, as after 5 years of dental school there is much more that I can do to help with their oral health rather than be a tooth slayer.

Dentists, or Dental Surgeons as I prefer to call my self, are trained in diagnosing, treating and reconstructing the oral health to its normal aesthetics and function. I try not to extract teeth if there is a chance of saving them. The technology in replacing lost teeth has much evolved making dentures almost obsolete with dental implants which are near-tooth perfect but I still retain my belief that the God given teeth are the best in both function and aesthetics.

I like to do fillings, most of them are composite-resin based fillings. These fillings are the tooth-coloured ones, favoured for the front teeth and sometimes the back ones as well. Recent technology has made the composites good enough to be placed on the back teeth, usually used for munching with high stresses. There is much hoopla over the mercury content in dental amalgams. I rarely use them because of the high strength, much higher than natural teeth have. Large dental amalgams are strong and they rarely fracture, more often than not the remaining tooth structure would crack and I’d have a bigger problem in restoring those teeth. The mercury content do not endanger the patients upon completion of the restoration, it’s only during placement or removal of the filling that mercury vapours get released and this is a very very minimal threat. You would get much more exposure to amalgam eating fish really.

After two years in Johor, I got transferred to Putrajaya. This posting is quite unique, there are only three U41 dental officers in the country which have the designation of Assistant Director. As you might guess, it is a deskjob. Have you ever seen a dentist pushing paper? I’d never imagine it myself and yet I’m here. I’m doing more of the ICT stuffs, updating the webportal of the Oral Health Division, MOH. I’d prefer Mambo or Joomla, but the webportal is using Xoops which in my opinion is less user friendly (needs more coding skills really which needs more time).

In the Division, I got the chance to dwell more on the Public Health side of the service. Dental Public Health, besides doing administration, do not directly deal with patients but promote and improves health in a large community-based scale. I’m more interested in Orthodontics and Restorative dentistry but during my stint here, I see Dental Public Health as another interesting option. I could see that a dental professional could do much more service to the community rather than pinpoint treatment of patients as other specialties could (but of course having both clinical specialist training along with DPH is ideal).

I developed my specific interest along the three years of compulsory service. I don’t think a freshly graduated dental officer would know their interest that well during the early days of service, give time for it to develop and evolve before you make a choice.

I’ve met quite a number of impatient freshies, claiming that certain specialty is their destiny. My advice to these people, try not to grow too fast.. enjoy your development in their dental career and see where it takes you.

The service is a lifelong learning.. during these years you not only relearn what you have been thought in dental school, you will gain experience in which you would apply what you have learnt and develop you interests and ultimately be a person.

Oh, you should have a life as well. All work and no play does make Jack a dull boy. And CSI Las Vegas is starting. Till another time..

Cheers..

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