Contribution

How to contribute to other people? Being helpful to others is worthwhile for living. They say three forth of people hate their jobs. Luckily, I love my work. As a dentist, treatments for patients are contributions themselves. Clocks are ticking and my days as a dentist are numbered. That’s what I am thinking after birthday of 60.

I have been working at the biggest business town in Tokyo. Because of Corvid 19, the number of patients has decreased to 70 percent. Business person are working at home, not at office. They come to their office only once or twice a month. They changed their dentist near their home instead of coming here.

But I have a few patients who watched my clinical case reports and read my blogs and wanted my skills, saying “I want my devastated teeth fixed like your cases in the homepage”. That’s my big motivation to work. They come from countryside by train, contrary to the office workers around here. Consequently, I have lots of time for them, enough explanation, treatment planning, and of course treatments themselves.

A female patient came and rejected surgery which I proposed, at first. But, she gradually changed her mind and accepted my proposal through many time’s conversation. She will have the best quality of functional chewing by the surgery, I believe.

I am not sure what the future holds for me. However, I will keep learning and control what I can control, not focusing on uncontrollable things such as the coronavirus and the number of patients. Be patient for patients.

before and now

before and now
pink arrow indicates missing teeth area which needs sinus lift before implants

before and now

during sinus lift

before and just after sinus lift

Learning from failure

Trying to save a tooth which is strictly in a bad condition is occasionally a mission for a dentist depending on a patient’s character, dentist’s skill, etc. It is sometimes difficult to make a decision whether the tooth can be saved or is hopeless and should be extracted.

This case was the molar tooth astride the bone defect, only the tips of three roots were hemmed in by remaining bone, which caused loosening a little. It seemed to be challenging to get complete bone fill in this case, because of complexity in shape at the site, which means difficulties of complete debridement before applying bone graft and Emdogain which is medicine for tissue regeneration. During 5 years, it had kept in a better condition after the surgery. However, bone loss and loosening happened in the end. The partial bone fill may be just a happenstance and temporally. In a challenging case, being craven should be avoided, however, eternity of the tooth was delusional as a result. If I encountered the same case, I would apply deferent incision lines and materials. Learning from failure must be kept in mind.

The photos are ,during surgery, X-ray before surgery, 1 year after, 3 years after, 5 years after, 6 years after, respectively.

possibility of gaining dental license of other countries

 Can a Japanese dentist get a license of dentist in other countries? Each country has its own rule. To get a license in US, you have to study in a dental college for designated years and pass the exam of each state, like a native student. It sounds the long and winding road. But, some countries are giving an easier chance for foreign dentists. In Australia, the number of dentists is said to be relatively small. Actually, Australia has welcome mode to immigrants of dentist from other countries.

  I went to Gotanda Tokyo to attend an explanation meeting from the tour company”M.I Studies Abroad”. The shortest way to get a license of Australia is sending the application form, (if it’s accepted), sending IELTS score certificate (reading, listening, writing, speaking score must be over 7(1-9) respectively), written exam of dentistry, and final clinical exam. The clinical test takes 6 days. If all procedures are successful, you are enrolled in Dental Board of Australia and can perform there. Visa is necessary to perform. According to the company, no Japanese dentists has got the license through the process. Foreign dentists who could attain the final are always Korean, Indonesian, Chinese, and other south east countries’ dentists. The whole fee of the tests is around 1,000,000 yen except for staying fee.

 The staff said “You can maintain three wives if you succeed as a dentist in Australia”. hahaha. Sounds intriguing? Me? My bottleneck is age. They say it may be difficult to get Visa for people over 50. The only thing I can do is just study English and get high score in IELTS. Will dream end in dream?

Combination of skills, it’s fun!

Collapsed bite cases, which require wide varieties of skill to fix, are challenging for dentists. However, I am excited whenever I face them. In such cases, thinking process for treatments is really fun for me. The case below is the combination of techniques such as diagnosis of occlusion, implant, orthodontic treatment, gum surgery, and crown restoration. The treatment took 2 years. I want to thank the patient for his understanding and cooperation. Without them, I couldn’t have reached the goal. I will describe the prosess, step by step later.

before

 

after
before(lower jaw)

 

after(fixed by implants, bracing, crowns)

Memory of Michigan

When sorting out photos in PC, I found some in Ann Arbor. It’s 10 years ago when I went there to study dental implant skills using cadaver at University of Michigan School of Dentistry. In Japan, education using cadaver is prohibited. Whenever Japanese dentists want to learn new techniques, models and pig jaws are only materials. Dr. Wong who is the first Asian professor in dentistry of US university opened the door to us Japanese. The seminar was designed to satisfy my thirst for knowledge and experience. When the tour to Ann Arbor was announced, I applied at the drop of hat. I was impressed to the fact that University of Michigan was like a small town, having various shops and crossroads. Japan does not have such a huge university. The dental course? It was very useful, of course! I wish I went back someday.
Detroit airport

 

University of Michigan is like a small town.

 

lecture by prof. Wong