Dr James Robson, Principal Dentist at Identity Dental Care, discusses the value of specialised equipment when it comes to treating elderly patients during day to day practice.
Increasing life expectancy and the rising demographic of older people has greatly impacted dentistry. As such there is a greater need to keep more teeth for longer. In Europe, people aged 65+ make up 16% of the population – this statistic is expected to reach 27% by 2050. Elderly patients are more likely to be affected by tooth loss, tooth wear, dental caries, periodontitis and oral cancer.
Dental caries, in particular, represents a major cause of the treatment delivered to elderly patients, with xerostomia (dry mouth) having an impact. As a disease, caries remains curiously active, with an observed mean increment of approximately one surface per year. These new sites may be wear facets which have decayed or root surfaces which may be trickier to access. This is where miniature dental handpieces such as NSK’s S-Max Pico come in, allowing improved access and being very suitable for treating our increasing elderly demographic.
The need for precision
When I first began my career in dentistry twenty years ago, my first introduction to an NSK handpiece was of course the NAC-E slow speed contra-angle handpieces which were ubiquitous at the time. However, my move into private practice a few years later left me seeking more refined handpieces and in particular I came across the NSK Ti-Max range. The precision engineering, durability, light weight and excellent air and water spray make this range indispensable to how I practice.
The problem of restricted access
The majority of my work deals with cosmetic adult restorative dentistry. For me gerodontology is a major part of this. This element of practice presents more challenges than simply polypharmacy and oral-systemic health links. In my experience, a large number of my elderly patients may not be able to tolerate or may not wish to be reclined as fully as I would like, or may not have the stamina to remain open-mouthed for long enough to perform essential treatment.
Restricted dental access is perhaps more commonly associated with children as they have small mouths. As such, paediatric dentistry sees high usage of miniature handpieces. However, such precise technology has significantly benefitted the oral care of my elderly patients, where oral access remains an issue due to limited opening and patient posture.
Gerodontology and the S-Max Pico handpiece
The S-Max Pico handpiece makes my life easier. Its streamlined body shape and miniature head have provided me with predictable access to the mouth, in particular whilst treating root caries and has improved access to the mouths of my elderly patients. This eases the frustrations of the dental team and patient alike.
The S-Max Pico has become essential to how I work. Initially developed for Minimal Intervention Dentistry, the S-Max Pico has been designed with precision in mind. It is hard working and reliable, as I have come to expect as a Ti-Max user. I find that the small head of the S-Max Pico allows for broader viewing, which is essential when addressing restricted oral access, in particular the buccal root surfaces of posterior teeth. This handpiece feels good in the hand and although steel (opposed to titanium) does not feel significantly different to use due to its smaller size. The S-Max Pico is air driven, making it a lighter and far easier to use handpiece than its weightier, electric counterparts.
Advances in innovative handpieces are paving the way for dental procedures to be better tailored to the needs of each patient. The S-Max Pico, in my opinion, is greatly beneficial to those delivering paedodontics and gerodontology. To access narrow and restricted operational fields, whether due to size or limited opening, dentists should look to handpieces such as this, to improve the delivery of care.
James Robson qualified from Newcastle University in 1998 and spent six years working in NHS general dental practice on Teesside, followed by a similar period in private practice in York, before purchasing his own practice in 2010. James also enjoys teaching dentists, hygienists and therapists or writing for the dental or local press. He has lectured in the UK and throughout Europe. He is most passionate about tooth-coloured fillings and oral systemic health