Academy Connection Volume 19 Issue 6 : Page 18
m embers in the n eWs Dental eDucation’s emerging neeDs & trenDs in Developing markets: a Q&A with Dr. Frank Milnar, AAACD frank MiLnar, ddS, aaaCd, froM St. Paul, Minneapolis, and an AACD Accreditation Examiner, recently traveled to speak at the National Scientific Dental Congress in Hanoi, Vietnam, about the differences in dentistry between the U.S. and developing countries. At the 2013 National Scientific Dental Congress in Hanoi, Vietnam, Dr. Milnar emphasized minimally invasive treatment planning and, provided an impromptu live patient demonstration to a clinic of dentists and dental students in Hanoi. As an educator, he noticed the strong desire they had to learn, as well as their need for basic training and knowledge (Fig 1) . FIguRE 1: dr. milnar presents to the national Scientific dental Congress in hanoi, vietnam. A mericAn A cAdemy of c osmetic d entistry ® AACd: how is teaching continuing education courses on composites and esthetics different in Vietnam than in the united States? Dr. Milnar: My travels to the Philippines, Thailand, Singapore, Malaysia, and now Vietnam continue to demonstrate that many of these countries lack materials consistent with what we have here in the United States. Different product assort-ments, instrumentation, finishers, and polishers all lead to confusion when determining which tools to use and when to use them (Figs 2 and 3) . This lack of uniformity increases FIguRE 2: view of assorted materials for use in a dental clinic that dr. milnar encountered during his visit to vietnam. FIguRE 3: a dental operatory in a clinic in hanoi. 18
Dental Education’s Emerging Needs & Trends in Developing Markets: a Q&A with Dr. Frank Milnar, AAACD
Dr. Frank Milnar, AAACD
Frank Milnar, DDS, AAACD, from St. Paul, Minneapolis, and an AACD Accreditation Examiner, recently traveled to speak at the National Scientific Dental Congress in Hanoi, Vietnam, about the differences in dentistry between the U.S. and developing countries.
At the 2013 National Scientific Dental Congress in Hanoi, Vietnam, Dr. Milnar emphasized minimally invasive treatment planning and, provided an impromptu live patient demonstration to a clinic of dentists and dental students in Hanoi. As an educator, he noticed the strong desire they had to learn, as well as their need for basic training and knowledge (Fig 1).
AACD: How is teaching continuing education courses on composites and esthetics different in Vietnam than in the United States?
Dr. Milnar: My travels to the Philippines, Thailand, Singapore, Malaysia, and now Vietnam continue to demonstrate that many of these countries lack materials consistent with what we have here in the United States. Different product assortments, instrumentation, finishers, and polishers all lead to confusion when determining which tools to use and when to use them (Figs 2 and 3). This lack of uniformity increases the challenges within the country associated with consistently teaching and performing the same basic treatments.
Another difference between the U.S. and Vietnam in forms of education involves the basis of knowledge, terminology, and training. Unfortunately, Vietnam lacks basic dental terminology that we take for granted in the U.S. When I performed a live patient demonstration at a private clinic in Hanoi, the questions that dental students and dentists asked demonstrated that they didn’t understand certain concepts that we assume our dental universities address (Fig 4). Vietnam is just starting to move toward more comprehensive education.
AACD: How is it the same as the United States?
Dr. Milnar: Vietnam today reminds me of the emerging dental climate that the U.S. experienced in 1993. At that time, I joined the AACD and a revolution was taking place with tooth-colored composite inlays and porcelain veneers, the awakening of esthetics in general, and products that were probably not tested to their fullest capabilities, but we had access to them and we had great teachers. The awakening of esthetics, similar to what occurred in the U.S., is slowly creating an environment for growth, information, and education in Vietnam.
It is encouraging to see that their dental professionals are evolving their skills and their materials. In everything I saw in Vietnam and Asia, the expense of products and materials creates the biggest problem for growth (Fig 5). However, as dentists from all over the world share advancements and emerging technology, the spread of education and techniques can only enhance their knowledge, their practices, and the affordability of supplies.
AACD: What is their view of dental esthetics, and how does it compare to ours in the United States?
Dr. Milnar: As I mentioned previously, their knowledge of dental esthetics lacks depth compared to the U.S. Their understanding of stratification of composites, hue, chroma, and value, finishing, and polishing is in its infancy (Fig 6). I witnessed that first hand during my time in Vietnam. When I performed a live patient demonstration, I noticed that my students (15 dentists and 10 dental students) possessed a deep desire to learn and perform cosmetic treatments, but they lacked the technical ability.
After touring a university in Vietnam, I realized a drastic difference in practices and saw things that I would never see in a university in the U.S. Teachers in Vietnam are either educated through their home country or come from around the region. Very few U.S. dentists have come to speak, let alone practice in Vietnam. This limits the availability of hands-on training here.
Dental practices in Vietnam also experience a lack of profitability due to material expenses. With no extra capital, every investment for dentists is a large commitment. Without the ability to buy new equipment and invest in technology, dental practices cannot advance (Figs 7 & 8).
With recent investments in Vietnam, more people from all over the world are moving to this country every day. The influx of foreigners requires that Vietnam keep up with new standards of living, including the dental care that new residents are accustomed to. These new standards of living will hopefully provide dentists with the capital, support, and impetus to receive more training that focuses on dental esthetics (Fig 9).
AACD: What are dental students or continuing dental education students in Vietnam learning about esthetic dental treatments?
Dr. Milnar: Due to efforts by the Vietnam Odonto-Stomatology Association, the National Hospital of Odonto-Stomatology, and the World Dental Federation (hosts of the conference), many dentists in Vietnam have the opportunity to learn about the latest in esthetic dental treatments. At the conference, I happily represented the United States and spoke about minimally invasive esthetic treatments. Other speakers at the conference included dentists from Australia and Israel. The introduction of new teachers who bring diverse experiences and knowledge helps to propel Vietnam’s dental community into the future.
AACD: Have they embraced the concept of minimally invasive or responsible esthetic dentistry?
Dr. Milnar: Minimally invasive treatments and restoring a tooth from the inside out requires planning before the preparations, as well as an understanding of adhesive, chemistry, and material properties. The dentists in attendance seemed inquisitive, but they haven’t discovered these ideas yet. I don’t believe they are being taught, at least not to the extent that we see in the U.S.
Another reason that minimally invasive techniques aren’t yet mainstream in Vietnam stems from their unfamiliarity with the topic. Just like in the U.S., the “minimally invasive” phrase is quite popular, but many dentists are uncertain about what it really means. Dentists in both the U.S. and Vietnam lack knowledge about what responsible esthetic dentistry is and how to incorporate the materials and the chemistry of a treatment into practice. Minimally invasive treatment continues to grow in popularity, but its practice isn’t mainstream just yet.
AACD: What made the biggest impression on you during this lecturing experience?
Dr. Milnar: I really enjoy traveling to other countries and meeting fellow dentists. My commitment to education stems from my passion to constantly learn and help others do the same. My hope for the global dental community is to be informed about the best treatment options and technology for our patients. The National Scientific Dental Congress provided a platform for me to share my thoughts on minimally invasive tooth restoration, and I am grateful to not only speak, but also to meet and hear from my colleagues.
The moment that left the biggest impression on me was the live patient treatment at the clinic (Fig 10). With 25 dentists and dental students watching, I saw their universal desire to learn. This encouraged me and energized my teaching. I began to recognize their need to understand basic concepts, which fueled my demonstration and ability to relate to them. They desired knowledge and skills that only more experienced dentists could share with them.
On occasion I expect people to know what I know, and it’s a rude awakening to realize that not everyone knows that information yet. When I joined the AACD, I was at the same place that the dentists in Vietnam are today. I was looking for something because I was dead-ended by my knowledge from 1976 when I graduated. The AACD opened so many doors by providing opportunity and education. It is important for me to remember where I was at the beginning of my career, and help others with education, mentoring, and encouragement in order to create a legacy of dental education and to better the global dental community.
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