I attended the Chicago Midwinter Meeting last weekend, taking 15 hours of continuing education as well as conducting some business (supplies ordering, mostly), and meeting up with friends.

I titled this post "Dentistry in the Future" because the first courses I took were on the use of implants in dentistry and on the current state of restorative options in dentistry. (Those aren't the course titles, but a reasonable summary of their content.)

Implants are here to stay. They're still pretty pricey for the average patient; most can't afford them, and that's the sad truth. They don't appear to be getting a whole lot cheaper as time passes, either, which is unfortunate. I thought that parts might come down, but they've done the opposite. And placement by oral surgeons and periodontists, both specialists, have become the norm, possibly inflating prices a bit also. If general dentists were doing them, the cost might be a bit less...but then again, to me, it's one of those things where, if you aren't doing a whole bunch of them, and aren't used to working with the soft tissues and bone, it's better left to those who are - the oral and periodontal surgeons.

Not that they're new, but there is a technology out there called "Mini-implants", which are simpler to place and less expensive also, possibly by half or more, than conventional implants. These would seem to have great promise for helping to retain full and partial dentures, even in patients who have severely resorbed bone where their teeth used to be. The main problem is that for supporting a single tooth or a fixed bridge, it may require two of them to do the work of a single conventional implant, thus negating the cost advantages.

We're also working with several alternatives to metal as we look for materials that aren't allergy-causing and are highly esthetic, and a few are on the horizon. Most of this technology is CAD CAM (computer aided design, computer aided milling or manufacturing) technology. It has the potential to give us better looking, stronger and better fitting restorations as the tech evolves.

Another thing that was mentioned was digital radiography. According to this lecturer (he is one of the most respected voices in dentistry) the conventional x-ray, where a film is put through a processor to be developed much like old 35mm film from a camera, is going to go away in favor of digital radiographs, and probably fairly soon. It's getting to be just about the time to make the plunge, I think.

It was also mentioned that there are other types of digital radiographs, in particular, cone beam and tomographs, that may come to play a much larger role in dental care, as will in-office CAD CAM machines, digital impressions, and lasers. Of course, all of this stuff costs a LOT of money. The CAD CAM machines out there are in the 100 grand range; lasers can be anywhere from 10-15 grand (not very useful) to 50-60 grand (more useful), and the digital impression technology is going to cost about 25 grand currently. Some of these costs WILL come down, but it's a pretty substantial investment, and of course the costs would have to be passed on in the form of higher fees. So much for controlling or bringing down costs via better technology. I've yet to see technology provide a venue for lower cost treatment in my field.

All in all, a very interesting weekend.