THE PARADIGM SHIFT
The past 40 years of my life in dentistry has been a period of equipping and refining myself as a prosthodontist, a teacher and to a greater extent, a period of realization , that I was, but a small speck, in this great Universe, born with a definite purpose like the rest of my brethren, in this great sea of humanity. As a clinician, my clinical practice taught me that whatever I did in earnest fetched results, only when the divine force “willed it “.
As a teacher, the students whom I encountered in the college and in my clinic, learnt what they were destined to learn. They had the innate wisdom to grasp what they saw and learnt and I was only the instrument to pass on the knowledge.
It was in 1982, with a lot of apprehensions and misgivings that I joined for my postgraduate course- the MDS in prosthodontics at the College of Dental Surgery, Manipal. I knew that it was a physically and mentally ‘draining venture’-an intellectually challenging 2 year period and an uphill task, dealing with the vast intricate “ oral rehabilitation scenario“. Besides the basic chemistry of Dental materials, and their various ‘setting reactions ‘I knew that I had to bring in my basic knowledge of physics relating to the ‘jaw movements’- what the two volumes of Max Kornfeld’s text book of ‘Mouth Rehabilitation: Clinical & Laboratory procedures explained.
We post graduates knew that we had to deal with the precision attachments, the cast removable partial dentures, the fixed partial dentures, and the maxillofacial prosthodontics. It was a daunting task to digest the emerging fields of preventive prosthodontics, the concepts of implant, the immunology and allergic concepts involved and last but not the least the group of elastomers. In the 1980s many of these were just ‘theoretical concepts’- all in their embryonic stages. The subject was vast and quite bewildering.
Those were the days when we were instructed to use Gold alloys, technic alloy, Chrome Cobalt alloy, All porcelain, Platinum-Gold Alloy for Porcelain fused gold crowns, Electroplating of poly -sulphides, copper band impression, Swaging procedure for Tinner’s Joints, Vacuum mixing of Investments…. the list was endless. But we had the “feel” of all these only because of a group of dedicated teachers who kept on prodding us incessantly to work, work and work !! The teacher-student relationship was something, which was very delicate. The teacher was an integral and indispensable part of our curriculum.
In the 1970-80s there were only 9 to 10 dental colleges in India, which had the post-graduate courses and CODS, Manipal was the first private dental college with the PG program. Being a private college, and flush with funds, Manipal was one of the good colleges that offered departments, with all modern facilities, technologies and a well-equipped library with many journals and periodicals in its subscription list. Another advantage was the presence of the Medical, Engineering and pharmacy colleges with reputed departments to help us in our dissertation works. So, when I chose for my thesis “Beta-Tricalcium phosphate ceramic as immediate root implants for the maintenance of alveolar bone in partially edentulous mandibular jaws- A clinical study” it was well accepted and encouraged by my thesis guide- late Dr. Suresh Chandra. We had a good faculty with whom I could discuss the study topics. The Subject Index and the Author Index, the two books in the library, were all that I had to get my references. And as was usually done those days, I got few reference articles from abroad, from Indian Institute of Science, Bangalore, Centre for drug research Institute, Lucknow. and also from National Medical Library, New Delhi. The long arduous wait of getting a reply after writing a letter and sending it through our Indian postal department, was something which most of us went through. The joy of getting those reference articles was worth the wait !! After passing our MDS exams, all of us went through the ritual of getting our thesis condensed and getting published in journals of reputation. When my thesis work got published in the Australian Dental Journal 1989;34(5); 421-6 it called for a small celebration in the dept !!! Those were the days when, we found joy and happiness in small things.
Times have changed now. The digital era has done away with the “ teaching process” by human teachers. The internet has swept away many that was good and many that was bad. The library is a thing of the past; Technologies like Cad-Cam and 3D printers have revolutionized dentistry. The prosthetic lab and technician who was an integral part of a prothodontist is slowly becoming irrelevant. The impression scanners have replaced many a steps, which was done in the prosthetic lab.
What I have learnt is just a simple philosophy of life- “When you have set beliefs, no matter how enlightened, you are not growing. Even teachers go back to school. Share your understanding. Keep in mind that what you consider as knowledge is only your current understanding, of that which is ever unfolding……. Knowledge in its absolute term is ever unfolding, ever flowing. It is something which does not have any dimensions !!
Dr. Mathai Joseph K.,
Kannur