Milwaukee VA Medical Center
Dental residents find innovative ways to train
As schools across the country have shuttered due to the coronavirus, learning has continued for the three residents in the Milwaukee VA Medical Center’s prosthodontics program.
But their work has been anything but normal.
When the pandemic hit and drastic shifts started taking place throughout the hospital, the dental program wasn’t immune.
“Right now, we’re not treating patients,” said Dr. Jesse Smith, head of the program. “But these guys aren’t just sitting at home doing virtual, online learning.
“They still do that on a daily basis, but they’re also running a 3D print lab to provide PPE and finding solutions to other problems that can be fixed through 3D printing,”
The shift isn’t that dramatic because prosthodontics -- the restoration of broken-down teeth and replacement of missing teeth – is driven by technological innovations, especially 3D printing.
The residents saw their workspace move from the hospital’s eighth floor to the 3D printing technology housed in the Spinal Cord Injury Center, and they soon began acquiring a different set of skills.
“We’re way more versed in 3D printing than we were six month ago,” said Michael Wanserski, a second-year resident in the three-year program. “The big takeaway for me is we’re able to really troubleshoot our 3D prints.
“We’ve always kind of thought outside the box when it comes to dentistry, but now we’re bringing that skill set to … making masks and shields.”
Third-year resident Lam Le agreed.
“We’re designing and printing other stuff needed during the COVID-19 pandemic,” he said. “It’s opened our eyes to other possibilities.”
David Kachelmeyer, a staff prosthodontist, said the residents are getting a unique educational experience.
“These guys are really fortunate to be part of this institution where, during this crisis, they can continue their education,” he said. “Where most schools have shut down and continue their education virtually, these guys have been able to maintain their lab experience.”
Smith noted that the residents are now becoming hybrids – part prosthodontist, part engineer, part lab technician.
At the same time, they’re continuing their coursework and other requirements for the program, which Smith described as “intense.”
“They are easily doing 12-hour days and working 80 hours a week,” he said. “This is an extremely rigorous three-year program.”
This week, April 19 to 25, is National Prosthodontics Awareness Week, which is promoted by the American College of Prosthodontics as a way to showcase the dental specialty.
Smith said the prosthodontics program at the Milwaukee VA is one of 54 across the country, most of which are housed at educational institutions.
Prosthodontics is the “last line of defense for dental,” Smith said. “It’s not just the prosetheses; we treat the whole mouth as one piece.”
Smith described prosthodontists as the “quarterbacks” of a dental team that can include oral surgeons, periodontists, endodontists and orthodontists.
“We’re the driving force … dictating and devising treatment plans. … We need to make sure everything is pre-planned and goes off without a hitch,” he said.
Fellow staff prosthodontist Todd Pienkos said the work is challenging and rewarding.
“When you can take someone from having a train wreck in their mouth to having a beautiful smile, so they feel better physically, emotionally, aesthetically and functionally, it is extremely rewarding.”
The three residents agreed they were drawn to the specialty out of dental school due to its demanding and innovative nature.
“In dental school, I never felt like I got the whole picture,” Wanserski said. “The only way I got that was through dealing with prosthodontics. I thought this was the next step to getting that full training.”
First-year resident Dimitri Basilakos agreed.
“You can spend 10 to 15 years slowly getting the answers or spend three years being trained to approach problems in ways that you may never have learned practicing on your own,” he said.
Le said he was intrigued by the specialty because many other dental students shy away from it.
“Prosthodontics is something that a lot of new (dental school) grads struggle with, but I wanted to challenge myself. In dental school, it’s like the great unknown.
“A lot of students shy away from it because they’re afraid of it, but I’m just the opposite; I want to tackle it to be a better dentist.”
Smith said the students at the Milwaukee VA have a leg up on other programs thanks to the technology at their disposal and the backing of the country’s largest medical system that continues to push forward and innovate.
And for the residents, there is an added bonus of working with Veterans, even though they are not Veterans themselves.
“It’s an awesome experience (working with Veterans),” Le said. “I’ve been able to interact with World War II Vets, and that was awesome to hear their stories. It’s like living history. I can’t imagine doing anything else that’s more rewarding.”
And Le will be able to continue working with Veterans, as after his residency is done, he will be joining the staff in July.