Preparing dentistry students for the digital future

Often, different learning and working environments must adapt to the buildings they are assigned to, with the existing framework and floor plan defining how the facilities can be equipped and utilised. In some instances, however, the buildings themselves are being designed and constructed according to the specific requirements of an organisation. Such was the case in the city of Oulu in Northern Finland a few years ago.

Dentopolis, a modern hub for dental care, research and education, was designed and built according to the requirements and wishes of the local dental care and dental education providers. Inaugurated in 2017, the facilities combine the education and research facilities of the dentistry programme at the University of Oulu, the dental hygienist training of the Oulu University of Applied Sciences and the central dental care clinic of the Wellbeing Services County of North Ostrobothnia under one roof.

Planmeca and its local distributor in Finland, Plandent, was engaged in the project early on to help optimise the facilities for various dental workflows. According to Hilkka Pernu, DDS, Senior Lecturer in Periodontology, and Ritva Näpänkangas, DDS, PhD, Senior Lecturer in Prosthetic Dentistry and Stomatognathic Physiology, even the tiniest details were considered in the planning phase.

“Our hopes and wishes were listened to carefully and our requirements were taken into account in the layout planning. Not only were the limitations of the facilities considered but Planmeca was also able to point out different possibilities the building offers,” tells Ritva Näpänkangas, who is in charge of the degree programme in dentistry at the University of Oulu.

Simulation environment prepares students for patient encounters

Of the four universities offering dentistry education in Finland, Oulu is the northernmost. Students, however, are arriving to the university from all corners of Finland. Each year, 52 new students are accepted for the degree programme in dentistry.

At the University of Oulu, the students start their learning journey by studying together with medical students for the first two years. Dental and medical students share the same curriculum, which includes, for example, basic studies in biochemistry, anatomy, physiology, and microbiology. In addition, the pre-clinical studies for dentistry students also include some introductory courses into oral health and dental profession.

After the first two years, students delve deeper into dentistry. Although the focus of the curriculum now shifts to dental care, it also continues to explore the connection between general health disorders and dental issues. As the students enter their third year, they move on to the clinical phase and start gaining hands-on experience in the simulation environment. This is where Dentopolis comes into the picture.

“Our learning environment is very modern and designed according to our specific needs for dental education,” Ritva Näpänkangas tells.

The learning facilities consist of a simulation environment of the university and a Dental Training Clinic, which is run by Oral Health Care in the Wellbeing Services County of North Ostrobothnia. Both are equipped with Planmeca solutions, more specifically with Planmeca Compact™ i simulation units and Planmeca Compact™ i Touch dental units, respectively. The main benefit of using the equipment by one and the same manufacturer in both environments is quite obvious, but an important one, nonetheless.

“Performing dental procedures on a real patient for the first time after the simulation can be intimidating for some students, which is why we wanted to make the transition as smooth as possible. Using similar equipment in the phantom classroom and in the Dental Training Clinic allows our students to focus fully on the patient on their first patient encounter. In simulation, they learn how to use the dental unit, how to work in an ergonomic position, how to ensure proper infection control and how to use instruments and start a drill, for example. By the time they go to the Dental Training Clinic, they know all of this by heart already,” Ritva Näpänkangas explains.

According to Saara Kantola, DDS, PhD, who is in charge of the training clinic, the 80 Planmeca Compact i Touch dental units of the Dental Training Clinic are operated precisely the same way as the simulation units, which smoothens the transition to clinical work. Planmeca PlanID™ system allows students to login to their dental unit and access their personal settings with only a flash of the card, including their preferred treatment positions and instrument settings.

Capturing digital impressions no longer a curiosity

In dental education, the University of Oulu prides itself in taking advantage of the latest technology, teaching methods and a digital approach to dental treatments. In addition to utilising digital dental equipment, digital teaching materials and a digital student assessment system, digital treatment workflows form one focus area for the clinical training. Furthermore, each dental speciality is taught in the Dental Training Clinic by licensed specialists.

Today, digital impressions and digital workflows in restorative dentistry are part of the basic skills students learn at the University of Oulu. In addition to traditional methods for capturing impressions, the students learn how to use an intraoral scanner by Planmeca to capture a full arch scan and single restorations digitally. The students also learn the principles of computer-aided design and manufacturing of dental restorations.

Later, in the Dental Training Clinic, the students design and manufacture restorations in house, using for example a Planmeca PlanMill® 40 S chairside milling unit, producing inlays, onlays, crowns and short fixed dental prostheses (FDPs). In total, about 50% of the prosthetics works at the university are nowadays performed using CAD/CAM technologies and the rest are sent to partner laboratories. The curriculum also covers digital workflows in theory, for example in implantology and orthodontics.

“Digital dentistry was one focus area for us when we were planning our learning environment. As Planmeca specialises in streamlining the daily work at a dental practice with their digital solutions, they were a good match for us,” Näpänkangas says.

Ergonomics and infection control emphasised in equipment selection

Infection control and ergonomics also played an important role when the supplier for the simulation environment and Dental Training Clinic was chosen. A lot of effort was used to planning the facilities in a way that would support optimal ergonomics and adopting infection control practices. Plandent also equipped the facilities with the necessary sterilising stations.

“In simulation, we were able to customise ergonomics with Planmeca simulation units just the way we wanted, as it is possible to adjust the height and the distance of the phantom head from the table. A simulation unit that supports four-handed dentistry was exactly the solution we were looking for, since we have 30 simulation units and over 50 students in class. The phantom head can also be moved laterally, which allows left-handed users to learn working with a patient in an ergonomic position, too,” Näpänkangas tells.

“With regards to infection control, we wanted units that are easy to clean up – both on the inside and outside. Planmeca units ticked all of the boxes,” tells Pirjo Päkkilä, Dental Simulation Instructor at the University of Oulu.

Everyday ergonomics was also on the wish list in the search for suitable hand instruments. Dental students are using instruments by LM-Dental, a Planmeca Group subsidiary, not least because of the LM Dental Tracking System™, which tracks and monitors the use of instruments using RFID technology. With the system, the personnel can follow the circulation of hand instruments the students have been provided with and check when the instruments were autoclaved for the last time.

Utilising the latest technologies in an efficient way was not forgotten in furnishing the facilities, either. For example, AV systems were integrated into the fixed furniture of the simulation environment and endodontic microscopes were connected to the video system. These allow students to follow the lessons from a lecture room or with a remote connection. Thanks to the built-in ICT infrastructure, the lectures can also be recorded for future use.

When it comes to furniture, the turquoise surfaces of the tables in the simulation environment were also not chosen by accident. Plandent supplied all furniture, of which some pieces were even custom made for the University of Oulu, including the unique hexagon teacher’s table in the simulation environment. There are also different options of dental stools available – also by Planmeca – enabling students and personnel to change their working positions flexibly during the day.

Close collaboration in user training and aftercare

The students are, of course, novices when they enter the simulation environment for the first time. Some might have been working as dental assistants before applying for dental education, but most have no prior knowledge on the dental units. Therefore, the university staff created a detailed introduction video on the dental units together with Plandent.

Before students enter the phantom classroom, they are required to watch the video, which helps them prepare themselves for the next phase of their studies. Having watched the video, they train to repeat all of the steps on their own simulation unit according to the instructions. For example, the students train adjusting the position of the operating light, using the foot pedal, changing a bur head, or adjusting the settings of the unit.

“This is one example of our pedagogic approach. Our instructional materials are mostly digital, allowing students to view recorded lectures and tutorial videos at their convenience. With digital materials, students can easily revise what they have learnt for an examination or run through the workflows before they start working with patients. Usually, we have a Plandent representative join us the first time our students use the simulation environment, presenting different features and functions of the units. Our own staff can then bring up their own experiences from a user’s point of view,” Näpänkangas tells.

Ritva Näpänkangas in the simulation environment of Dentopolis.

Later, in the Dental Training Clinic, everything the students have previously learnt are gone through once more before they encounter a patient for the first time. Continuous learning is supported in various ways like this throughout the studies.

The introduction video is a great example of Planmeca’s and its distributors’ commitment to long-term partnerships with dental schools. In addition to user training, Planmeca also provides customised after sales services for its solutions. This also includes continuous system updates and the possibility for future upgrades thanks to the platform-based design of the products.

“In our experience, Planmeca has truly considered the needs of modern dental education in their product development and has proven eager to listen to our feedback as well. We can only describe the communication with Planmeca as open and respectful,” Näpänkangas concludes.

Copy: Mari Suominen
Images: Henri Luoma, Henri Luoma Photography