why do have to learn all this science?

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mike05tusdm

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Hi all,

There's a lot of material we learn that we will NEVER use or need. For example-we find the branches of the Superior Mesenteric artery and trace the brachial plexus in gross-why do we need to know it? Why do we need to know renal physiology? Why do we need to know liver histology? Why do we need to know about the P, QRS and T waves? Why do we need to know fatty acid synthesis? I could go on and on listing coursework that seems to be a waste of time.

It seems to me that a lot of our time and energy is wasted learning material that we will never use or need. My dentist admits that he *never* uses any of this information and that if he took National Boards Part I again right now, he would fail it.

I'm sure I'm not the only dental student who's thought this-but why do we have to learn all of this basic science material that we will never use except on National Boards Part I? It's not the fault of the dental schools that this material is on the curriculum because we need it for Boards Part I, but after that, we will never use it or need it again-so why do we need to waste time learning it-maybe dental school could be shorter if we cut all of the useless science out of the curriculum? We could probably save an entire year of time and money if the curriculum was cut so we learn only the science we need to know to practice dentistry. What are the powers that be that decided that we need to learn all of this stuff that seems totally not relevant to clinical dentistry and we will never use?

Just my thoughts-what do others think about this?

Mike

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I thought the same thing while I was going through it in dental school. However, now that I've been out practicing for a while, you actually can use quite a bit of the information. Granted, 95%+ of the time, you're not using all the loevly basic science that you learn in dental school, but you do use it. Let's hit on a few that you mentioned. Let's start with the Liver and Kidney, 2 of the main organs where all the drugs that you administer in your office and prescribe to your patients are metabolized and/or excreted. When you factor in that the average senior citizen(who make up an ever INCREASING segment of your patients) are on roughly 5 to 6 prescription meds, which can alter the drug metabolizing ability of the Liver and Kidney, or heaven forbid your prescribe something that can potentially have a hepatotoxic or nephrotoxic effect, knowledge of the workings of those organs is needed.

P, QRS, and T waves.... Become ACLS certified, and you'll know why they are important. Even though we as dentists are only supposed to be certified in BLS, frankly as a safety precaution, take the extra time and effort and obtain and maintain your ACLS certification. If a cardiac emergency ever occurs in your office, or even if your out and around town and something happens, you'll be much better prepared. It's an added safety measure, which you can actually turn into a small marketing advantage. Display your ACLS certification prominently at your front desk. A few of your patients (especially the older ones who have a few medical problems, and a few dollars to spend) will ask you about it, and feel alot more comfortable with you. For example, the front door of my office is literally 200 yards from the entrance to the Emergency room of the hospital in my town. I've had a few of my patients ask me about my ACLS certificate thats in my reception area, and why I have it with the hospital that close. I tell them, if in the incredible unlikely event that a cardiac emergency happens in the office, that this extra training that I have obtained will allow resussitation to start atleast 1 minute sooner than bringing them to the ER directly. Your patients suddenly think that if you take the time to do this to prepare for such an unlikely event, that you must be the best thing to hit the dental world.

The main reason though that I now appreciate the perceived torture that the basic science portion of dental school was at the time, is in the area of systemic diagnosis. Just understanding the basic physiology of some common systemic diseases and their manifestations, and being observant, and actually listening to what your patients say about things can let you pick up on some early signs of many diseases. Remember most of your patients will see you twice a year, whereas maybe (especially with men) see their MD once a year. In the last 5 years, I've actually picked up on some signs and symptoms of some of my patients that have turned out to be numerous cases of Diabetes, Hypertension, skin cancer, and 1 case of Leukemia.
 
Dr. Jeff is right. Lots of patients come in office will list about half of the pharmacy as their daily medicine and you better be prepared and know what they take for what functions. And you need to know how everything funcions so when you precribe something you expect to know how will the drug affects on your patient. I occasionally hear some people die in the dental office. So, going the extra mile like Dr. Jeff might be very well worthwile..
 
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When I was a pharmacist, it was easy to observe prescribing habits of dentists as a group, and the drugs you guys prescribe regularly have great capacity to cause life-threatening interactions. So, I think it's only a positive thing if you have to learn metabolic and excretory pathways.
-ok, back to the med pages, where I belong...
 
The Basic Sciences and the lot are what give you the ability to call yourself a Doctor. Otherwise you would be a Lab Tech. You can teach a monkey to cut on teeth. That is the easiest part of our job. It is the thinking part that makes you a Doctor !!!!! Microbiology, Histo., Physio., Path., etc. are what we use to diagnose and determine treatment for our patients. Frankly, I believe dentists don't get enough medical training. Luckily for most general dentists MOST of what they do can't kill the patient. So many people want to take the thinking out of dentistry. You are a Doctor because of what you know not what you can do.
 
Right now, as a student, the hardest part of what I'm doing is what JML1DDS calls the "easiest part"-that is-cutting teeth and carving amalgam in operative. For me, learning how to cut a prep just right and to condense and carve and amalgam just right is much, much, much more difficult and challenging than learning gross, biochem, neuro, histo, etc. I guess I've been doing bookwork all my life as a student so dental school bookwork is just more of the same old memorize and regurgitate that I've been doing for years-but the technical skills are really a struggle.

I have to disagree with the "can teach a monkey how to cut teeth" statement since I find learning technical skills to be the hardest part of dental school.

I can see some examples of how some of this info seems relevant-it's just hard to see how relevant a lot of it is when you're a student, I suppose.

I guess when you're out and have been doing the hands-on stuff long enough, the hands-on stuff becomes routine-like riding a bike and the biggest challenge is deciding what procedure to do, not actually doing it.

I remember a statement from a medicine professor before a pharmacology lecture-he said, "You can a lot more damage giving someone the wrong drug than if you leave a ditch in an amalgam."

Mike
 
Mike, assuming your school is like other schools, you have already had a whole year to cut and restore preps, and you sound like you are still having problems with them (maybe you are humble and exaggerating). At my school we are coerced to practice upwards of 8-10 hours a week, so for the last month (April) nearly everyone's got the hang of it. I'm not saying my class is great, but through hard work we've been able to make preps to a high degree of precision.

I'll agree that not all courses are totally useful, but if you can get through a few years of undergrad this is just more of the same cramming. I'll sidestep that "monkey can do preps" statement for now, but claim that if we integrate all our knowledge it might have a cumulative and positive effect on how we diagnose and plan treatment for the myriad of problems our patients may present to us.
 
Yes, we've been cutting and restoring pretty much all year. For me at least, I've found acquiring technical skills to be the hardest part of dental school-much, much harder than coursework which is memorize and regurgitate.

I don't think we've been coerced to work 8-10 hours a week in operative. Actually, if you combine the amount of time we spent doing wax-ups for dental anatomy, it may be close to 8-10 hours a week, though probably not that much. In the fall we had operative and dental anatomy 9 hours a week and now we have operative 6 hours a week, but we're not doing hands-on work that entire time-maybe about half of it. I usually spend an average of 3 hours or so outside class time in preclin(more right before a practical or before a project is due).

Doing preps and restorations has been difficult, but I've improved quite a bit through the year and I more or less have the hang of it though I could always do some things better. I'm really good at preps but my amalgam carving could still use some work. It's neat to see the #30 occlusal preps I did way back in November and see how much better I am now.

I'm still having problems on practicals though. It's frustrating because when I practice on my own, I do really good work but during practicals, I always seem to do something wrong-I don't know if I'm nervous and it's making my brain freeze or something. I mean I've passed all my practicals but have always been upset because I know that I'm capable of better work than what I do during the practical.

Mike
 
It does get alot easier as you gone on for a number of reasons. First off, I always found the plastic typodont teeth much more difficult to prep than a natural tooth. They just flat out feel totally different when the handpiece and bur hit real enamel and dentin (maybe a pulp here and there too :D ) as compared to when they hit the plastic version, and the real is much easier to cut. Secondly, after you keep on doing more and more preps, first a hundred, then a thousand, then more and more, you really think less and less about the actual mechanical motions and it gets alot easier and incredibly faster. Lastly, and remember this one, the longer your restorations have been in place, the more you can learn from them (especially when they FAIL <img border="0" alt="[Wowie]" title="" src="graemlins/wowie.gif" /> ) You'll end up making alot better preps after you've had a few folks come back with cracked, broken, and missing restorations if you don't panic, and a rationally able to observe where the failure is and what you could have done differently to the tooth(this generally occurs as you're reprepping the tooth and replacing the restoration). I've always found that I learn much more from the occassional failures that occur than from the much more numerous successes.
 
My understanding is that some of the dental students find the book work easier while others find the hands on work easier. If you are in the former group, be thankful. I heard of one situation that existed many years ago in which D1's were quickly sized up by an influential prof as to whether or not they would ever possess the neceesary skills to work on patients. If, in his soon formed opinion, they were not capable, they were given the boot--no appeals. Now days, it is not uncommon for those who fall behind to be given at least one more chance to get up to speed. Fortunatally for todays graduates, there are many options for holders of DDS degrees other than working on the firing line such as research, public policy, acacdemics etc.
 
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