So over the years, with these snippets of philosophy and wisdom in mind, I have "picked a pocket or two" and tried to teach it as well. However, teaching a bunch of would-be pickpockets is sometimes very challenging, even though I would like to think that our motives are far more altruistic than those of Fagin in Oliver Twist! Technically, root planning/closed root debridement or "picking a pocket" is a difficult procedure to do well; because it is in most situations a "blind procedure". So when you depend on a favourable outcome dictated by tactile feedback (can you feel it?) as opposed to visual feedback (can you see it?), there is a very different learning curve. Dare I say some dentists never develop that tactile feel for subgingival calculus ever - a common situation, which has been described as "supervised neglect". However, healing will only occur if closed debridement is of a high standard and the root surface decontaminated, which in turn may obviate the need for open cleaning, which is surgery. In other words, surgery should be the last resort, not the first option. So therein lies another contradiction, how do you teach someone to do good surgery, if the objective of initial good closed debridement is not to have to do surgery at all?? Hence sometimes we have to "bend the rules" a little for the postgrads to teach them surgical techniques and skills, because it is still essential that they have to be able to do good surgery when the need arises; and they do arise from time to time. One of our nurses, who worked with a dentist from overseas, informed me that the dentist told her that Australian periodontics was very backward, because we only did root planing and did not do surgery. If that is the case, and we can still achieve comparable, or even better outcomes, then I will wear that "backwardness" as a badge of honour.
Thank you, ladies and gentleman, for your attendance, and for the honour of being the 2012 inductee in the Campbell-Wilson Roll of Honour. I bid you all a good night.
Clinical Assoc. Professor Albert Tan.
A/Prof Alistair Devlin (Dentistry, School of/Oral Health Centre of Western Australia (OHCWA)) (+61) 8 9346 7552.