EDITORIAL

Avoid the voids... or minute the minutiae?

Bill Evans

Managing editor, E-mail:bill.evans@wits.ac.za

It may on occasion be observed that dentists tend to survey their world by looking through a telescope in reverse, so that the view becomes condensed and diminished. That is a perfectly understandable result of the prime need for careful attention to be paid to the minutiae …dentistry deals with the minute, and the philosophy is readily transferred to everyday life! Perhaps we do not always see the broader picture, the wide view, and may even resort to "nit-picking"!!

As the precision of advanced and often computerized technology takes over more and more of the tasks in dentistry so the appreciation of the considerable importance of minutiae escalates and is respected. The margins of a crown or inlay are closely, nay, minutely, inspected and the criteria for acceptance are high. A lower premolar rotated at five degrees out of alignment is not readily accepted at the conclusion of orthodontic treatment. Extractions demand the most meticulous attention to atraumatic detail if the objective of minimal alveolar damage is required to enhance the success of implants, which themselves must be precisely positioned. Dental materials do not escape the interrogation and their chemical and physical properties are meticulously inspected. Minuting the minutiae is relevant indeed. All to the considerable benefit of the patient.. and perhaps adding considerable demands on the dentist.

All these challenges may be described as "voids" in meeting the requirements set in contemporary Dentistry. A void is generally understood to be an emptiness, a space.. but the word used as a verb may also imply to dismiss or to expel.

This issue of the SADJ, the last for the year, includes two papers which may exemplify voids in the dental context. Consider the first: when dealing with restorative materials, the presence of voids in the final structure is of considerable clinical relevance, even with voids of minute dimensions. Accumulatively their effect is detrimental to longevity of the restoration and may even lead to further damage to the tooth. The paper most importantly draws attention to the manufacturing process and to the clinical handling of the material in the endeavours to minimize these untoward outcomes. Avoiding the voids becomes a central objective.

A second paper emphasizes just how detrimental it may be to dismiss consideration of ergonomic principles in Dentistry. The issue of Occupational Health is inextricably involved in how we practice, how we arrange our instruments and equipment, how we actually operate. Many ills are the result of voiding - or dismissing- this aspect of " the dentist looking after the dentist." Whilst the more obvious consideration involves the physical aspects of practice, a recent paper emphasizes that ergonomics is in fact much more than ensuring good postures to avoid musculoskeletal problems.¹ Successful application of proper principles may help to ensure a whole raft of benefits.. high productivity, sustained good health, enhanced satisfaction. The authors relate a series of reasons for the early retirement of dentists..leading that list are musculoskeletal disorders at 29,5%, with the next most frequent reason being cardiovascular disease at 21,2%.¹

Avoiding the Voids in Dentistry appears to be a sound objective!! If we are successful in this perhaps we can look forward to a state of what the Danish have termed "HYGGE" a state of convivial and comfortable atmosphere. Latterly the Scots have extended the philosophy.. and there is another delightful word to be appreciated …CÒSAGOCH. This is taken to mean "snug, sheltered or cosy".

Those are desirable objectives for the Holiday Season, whatever the weather.. and our readers are all wished the most Còsagoch and Hygge holidays!

But to revert to the theme.. another interpretation of Còsacogh is given as "a wee nook or hole such as very small creatures may live in" (Mark Wringe). And so we are back to voids.. an empty space just waiting for bacterial invasion or for structural deficiency.

Lets avoid the voids!

Reference

1. Gupta,A, Bhat, M, Moahammed, T, Bansal,N, Gupta,G. Ergonomics in Dentistry. Int. J. Clin. Paediatric Dentistry 2014; 7(1):30-34.         [ Links ]