In the 1980s, VCU School of Dentistry students would carry specially made storage cabinets — nicknamed "Winnebagos" — that housed their dental instruments. (Photo courtesy Lawrence Kyle, D.D.S.)

Dental education then and now: Teaching students to practice in the future

As the practice of dentistry has evolved, the changes have influenced oral health education.

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“Winnebago” is a word not often associated with dentistry, but mentioning it to members of the VCU Class of 1983 creates a sense of nostalgia. It may be the one thing that reminds them most of their time at dental school. (These “Winnebagos,” named for the iconic Winnebago motor homes, were the specially made storage cabinets that dental students at the time used to carry their instruments.)

“We carried everything in our Winnebagos,” recalls Ellen Byrne, D.D.S., Ph.D. “We purchased our own instruments and operatory chair. Some classmates built their own Winnebagos and many were passed down through the years. We took the rolling cabinets from clinic to clinic with everything we needed. It’s hilarious to think about today.”

From Winnebagos and instrument ownership, to gloves and 3D printing, the dental profession is light-years away from the days of barber-surgeons extracting teeth. As the Virginia Commonwealth University School of Dentistry’s Dental Hygiene Program nears its 50th anniversary in 2019, we look back at how the practice of dentistry has evolved, and how the changes have influenced dental education. 

Gloves, gold and more

Protective equipment such as gloves and masks were not widely utilized in dental practices until the 1980s. (Photo courtesy VCU School of Dentistry)
Protective equipment such as gloves and masks were not widely utilized in dental practices until the 1980s. (Photo courtesy VCU School of Dentistry)

Students today may find it hard to imagine a time when wearing gloves was not part of the culture. This behavioral change, noted in a 2004 article in Dentistry Today, was in response to the HIV/AIDS epidemic.

“It started in the ’80s with ways to help prevent disease transmission,” said Benita Miller, D.D.S., a VCU School of Dentistry alumna and president of the Virginia Dental Association. “We never knew treating patients without gloves. Our professors, especially in endodontics, had more of a transition getting accustomed to wearing gloves. They felt as though they’d lost their sense of touch. They set a good example for us even though they didn’t necessarily like the feel of wearing them. We students didn’t have anything else to compare it to, so it came naturally for us to wear gloves.”

Byrne also recalls buying gold to cast crowns for patients and having to sterilize her own instruments. Today, sterilized instrument sets are checked out before each appointment and returned at the end to central sterilization, and students no longer buy gold.

Telephones and technology

Television monitors and chalkboards are now a thing of the past. (Photo courtesy VCU School of Dentistry)
Television monitors and chalkboards are now a thing of the past. (Photo courtesy VCU School of Dentistry)

To set up appointments with patients, students once stood in long lines to use a school-provided phone. All calls — local or long distance — went through the landline phones, which weren’t plentiful. Today, cellphones have eliminated the waiting.

The powerful microscopes of the 21st century will likely be replaced by even more powerful and patient-friendly technology, but in the ‘80s, there were no such tools. Simulation labs had no mannequin heads on which to practice and dental materials were vastly different.

Thanks to 3D printing and computer assisted design and manufacturing technology, students benefit from time savings and an improved patient experience.

Dental students prepare for clinical experiences. Simulations help build student confidence and skills. (Photo courtesy VCU School of Dentistry)
Dental students prepare for clinical experiences. Simulations help build student confidence and skills. (Photo courtesy VCU School of Dentistry)

“We’re teaching students to practice in the future, not in the past,” said Sompop Bencharit, D.D.S., Ph.D., associate professor and director of digital dentistry at VCU School of Dentistry. “Imagine a patient with trauma or a tumor that requires removing a part of the jaw. A resident can practice on a 3D model to determine precisely where to put a bone graft. The more we understand technology, the better we’ll be as clinicians.”

Increased diversity and year-round patient care

The VCU School of Dentistry dates to 1893 when the University College of Medicine opened with a dental department as one of its divisions. Since then, Virginia’s only dental school has evolved into one of only 10 in the country within a comprehensive academic medical center. In late 2017, VCU’s dental hygiene program was integrated into the Department of General Practice offering dental and hygiene students more opportunities to experience real-world practice settings.

Collaborative, interdisciplinary learning is on the rise at VCU and the two-part board certification process is evolving into one. Today, the dental school operates more like a health care facility where clinics offer year-round patient care.

Future dental hygienists learn to use a diode laser to reduce bacteria prior to scaling and root planing procedures. (Photo courtesy VCU School of Dentistry)
Future dental hygienists learn to use a diode laser to reduce bacteria prior to scaling and root planing procedures. (Photo courtesy VCU School of Dentistry)

“In recent years, the implementation of interdisciplinary education has changed oral health education,” said VCU School of Dentistry alumna Susan L. Reid-Carr, a past president of the Virginia Dental Hygienists’ Association and recipient of the 2018 Dr. Franci Stavropoulos Outstanding Dental Hygiene Alumnus Award. “The idea that oral health is part of total health has a real-world meaning when you’re working with nursing, pharmacy, allied health and health administration students. As the scope of practice changes for dental hygiene, so must the education. Students now learn to give anesthesia, administer nitrous oxide, and use nonsurgical lasers in periodontal treatment. These things were just a dream in 1983.”

Reid-Carr is particularly proud of the diversity found at the dental school of today.

“There were no male students in my class and no one from another culture,” she said. “A couple of years ago, at a local welcome luncheon of the Virginia Dental Hygienists’ Association, I took a photo of the entering classes of 2017 and 2018. I was so proud of my alma mater. The image shows how much more diverse those classes were than my all-white, female class of ’83.”