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A dental cosmopolitan

An interview with Prof. Jean-François Roulet. A Swiss national, after stops in Bern and Zürich, Berlin and Liechtenstein, Jean-François Roulet now lives in Florida, where he holds a teaching post at the University of Florida in Gainesville. He has spoken at conventions across the world, in locations such as Australia, Russia, Japan and China. An internationally-networked researcher, with a string of publications to his name, he also co-founded the ZMP training scheme in Germany. He is also a chief editor, manager, and consultant. Above all, Prof. Jean-François Roulet is a dentist. D’life tracked down the cosmopolitan dentist in Berlin whilst on his way to a lecture tour across Asia, where he was planning to speak in Singapore, Manila, Sebu (the Philippines) Kuala Lumpur (Malaysia) Bangkok (Thailand) and Bali (Indonesia).

D’life: Long past your 65th birthday, don't you deserve retirement? Why are you still on the treadmill?

Because I enjoy it! In taking up the new challenge at Ivoclar Vivadent in 2002, I was convinced that I would be able to wield more influence in dentistry than as a professor at the Charité. The appointment to my current position in the » College of Dentistry at the University of Florida was not only a complete surprise, but came at just the right time. I was retired for a full five days. I'm very happy that it worked out this way. I feel that it is my duty to pass on my considerable experience as a scientist and a chief editor two young researchers.

What do you find so fascinating about Dentistry?

It represents the interface between medicine (biology) and the engineering sciences. Moreover, the majority of dental diseases have been subject to comprehensive investigation, we are now able to devote our energies to finding prevention. That is the greatest service which we could do for our patients.

Looking back, what are you most proud of?

Now that's a difficult question. If I'm honest, I'm proud of two things. Firstly I was able to overcome the resistance of my university colleagues - who for a number of reasons believed that it was not possible to provide individual dental prevention in Germany - and working together with a small active group of friends in Berlin, to start-up a course of training for prophylactic dental assistants. I am also very pleased, that two prognoses which I made in my inaugural lecture (held in Zürich in 1987 and titled "The future of dentistry") actually came true.

The word globalisation is on the tongue of every dentist. Is there such a thing as global dentistry, or global research into dentistry?

Yes and no. Dental researchers are all part of an international network, all have access to the same publications and regularly meet at international conventions. Nevertheless, in terms of research financing, there are a number of significant national differences which result in compartmentalised research.

In this sense, there is no global dentistry even though - as far as I can see - we should all be coming to the same conclusions. The fact is that dental practice is often dictated by the structure of each national healthcare system. If the system funds prosthodontics, then dentists will focus on prosthodontics. If on the other hand, the system funds prophylaxis, the national population will predominantly receive preventative care.

Despite the clear global trend to larger and joint practices, the German system is still dominated by individual practices. What is the trend in America?

America is also dominated by the traditional individual practice. Nevertheless, I think the number of group practices will increase, especially amongst specialists. In historical terms, patients in the USA pay for their own treatment. This deters many patients from going to their doctor or dentist. This system is also changing. The large number of insurance companies on the dental market generate a high cost pressure for the practices. This has encouraged the development of large-scale dentistry companies, which provide regional or supra-regional dental coverage. This means that dentists are increasingly working as employees of larger firms.

Where do you see the future of dental medicine - will biology and medicine exert a great influence? What does this mean for the future of dental practice?

Progress in molecular biology is giving us ever-greater insights into the processes at work in our body. This also provides undreamt of therapy options. The time is not yet ripe for all of this. Moreover, it is unclear whether the monumental costs associated with the approval of such products will make their production worthwhile.

Which role do digital technologies currently play in dental diagnostics, and which role will they play in the future?

Progressive dental technicians have long since swapped their wax knife for the computer mouse. CAD/CAM technologies already enable us to produce more precise and more reproducible restorations at lower costs. We are currently in a phase of transition. CAD/CAM does not represent the death of dental technology, but its springboard into the future. CAD/CAM restorations can be individualised manually, and already meet the highest aesthetic standards. Despite all the focus on aesthetics and the production of good-looking teeth, we mustn't forget that we are first and foremost dentists. Were we to restrict ourselves to the provision of restorative technologies we run the danger of being demoted to mere beauticians. We may well have come from this level, but I certainly don't want to go back there! Digital technology will also enable considerable progress in diagnostics; and not just in caries recognition and periodontological diagnoses. In the latter case, I anticipate excellent results in terms of long-term observation from the use of optical methods and computer technology. Moreover, we know that saliva contains a number of substances which act as indicators for general diseases. I am sure that the dentist of the future will play an important role in the incorporation and operation of the appropriate sensor technologies. Just imagine, we install a multi-sensor in your bridge, which monitors your general health and raises the alarm following an anaemia in your heart muscle. Not only will this save lives, but ensure that dentistry remains a medical discipline! This is the best possible outcome for our profession.

Many thanks for the interview.

Published by: rf/tk 04/16
Prof. Jean François Roulet interviewed by D‘life

Prof. Jean François Roulet interviewed by D‘life

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