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08.07.2016

Dental medicine in Rio de Janeiro – day-to-day dental surgery routine in the city of beauty

An interview with dentist Dr Carlos Eduardo Sabrosa. Nowhere is beauty as important as in the international capital of cosmetic surgery, Rio de Janeiro. With the bulk of social life taking place outdoors, a perfect body is a pre-requisite. The inhabitants of the city of Rio show off their bodies the whole year round – whether on the four kilometres of sandy beach at the Copacabana or during the annual carnival. Rio is now also seen as the world no. 1 centre for cosmetic dentistry. Dentist Dr Carlos Eduardo Sabrosa founded his practice in Rio de Janeiro together with his sister. D'life paid him a visit to discuss the day-to-day routine in his surgery in the second-largest city in Brazil.

D’life: The people of Rio de Janeiro, who call themselves "Cariocas", have a reputation for placing considerable importance on beauty. How does this affect your work?

We Brazilians have always set great store by beauty and our appearance. A range of new technologies and materials means that we are now able to realise our dreams in the area of dentistry, and as such, aesthetic dentistry is gaining increasing social importance. The rise of minimally-intensive dentistry means that we are now able to improve the appearance of teeth whilst maintaining dental function and health at the same time.

What are the principal ideals of dental beauty in Brazil in general and Rio de Janeiro in particular?

Beauty is in the eye of the beholder. I still believe that our principal focus should remain on improving oral health. We should be cautious in the face of ever-new beauty trends. I am convinced that less is often more. The main thing I am pleased about is the excellent instruments we now have at our disposal, which helps us to improve the diagnosis and treatment of our patients.

You divided your training between Brazil and the USA. Why did you decide to open your practice in Rio and not Boston? Do you perceive any significant differences between the treatment approach in the USA and Brazil?

After finishing my studies at the state university of Rio de Janeiro, I went to Boston to continue my training, enrolling on one of the best courses in biomaterials and prosthetics. Taking a Master's degree and then a PhD, I taught at the » Boston University School of Dental Medicine for two years. I had always planned to return to Brazil to open my own practice together with my sister. I also took up a teaching post at my old university. Today, I also work as a tutor for restorative dentistry, teach undergraduates and perform laboratory tests and research work. In our practice, I am primarily responsible for oral restoration and implantology. Our practice is able to cover all dental specialisms, thereby enabling us to provide comprehensive, multi-disciplinary dental treatment. Thankfully, the benefits of globalisation mean that we can provide Brazilians with the same treatments that are available in the USA or Europe. Although Brazilian regulations, taxes and import controls sometimes make it difficult to purchase the latest machines and technologies, we usually catch up after a short time.

Your practice work focuses on oral restoration and implantology, something you also teach at the State University of Rio de Janeiro School of Dentistry. You have also won two awards in this area from the American College of Prosthodontists. How did you become so passionate about dental prosthetics?

I first developed an interest in this area during my undergraduate studies. I first decided to specialise in this area once I realised that it would enable me to reconstruct damaged teeth and replace missing teeth. Prosthetics is a unique area of dental medicine; improving the function and appearance of teeth can have an impact on a patient's general well-being. I am fascinated both by the impact that rehabilitation can have on people's lives and the range of technologies that is applied within this process. For example, the methodologies available with CAD/CAM technology in prosthetics and implantology are spectacular. Passion for a subject makes everything possible.

On average, how many patients do you treat in your private practice per day? What does your typical patient look like? Do you also treat international patients?

On a normal day, I treat patients from 8 in the morning to 7 in the evening. Of course, I have to be in the practice before this and I have to stay on a bit later to organise the day-to-day workings of the practice. I usually treat between four and seven patients a day, as we try to minimise the number of visits that a patient needs to make until the treatment is finished. This can vary - when operating, I might only see two patients in a single day. As I said, since we cover all dental specialisms within our practice, I usually only treat patients requiring prosthetics or implants. Our patients are of all ages and, I am glad to say, come from many different countries all around the world. Many come to us on the recommendation of friends abroad, whose patients live in Brazil for business reasons.

Are there dental disease patterns that are particularly common or are found more often in Brazil than in the USA? What role does prophylaxis play in Brazil?

We still treat a lot of caries and periodontitis cases. Luckily, people are much more aware today of the importance of oral health. This explains the why many patients visit us for a checkup more often than for treatment. For me, this used to be the greatest difference between treatment in the USA and in Brazil. Today, people pay considerable attention to their oral hygiene and usually come to us twice a year for a check-up.

How does the Brazilian healthcare system work? Are there any unique ways in which dental services are billed and paid for?

Unfortunately, the public health system in Brazil does not provide much in the way of treatment. One of my dreams is to help ordinary people to access low-cost but high-quality dental healthcare. That is one of the clinical projects that we run at the university. I hope that we will one day be able to develop a practical option with which we can produce low-cost crowns from a range of materials that can be carried by implants. » VistaScan Mini has enabled us to document the survival rate of these restorations over a long period.

Over the last twelve months, you have been using two VistaScan Mini systems from Dürr Dental. Did you have any previous experience with sensor technology? If so, which advantages do you see in comparison to X-ray diagnosis with image plates? Why did you decide to opt for this system?

It took a long time for me to change to a digital system. I began with a digital sensor that was connected to my PC. Unfortunately, this solution did not offer the versatility I was looking for, so my sister suggested that we try one of the range of image plate systems – she thought that the Dürr Dental system had the best reputation in this area. We decided to purchase two units. We tested the first unit in our private practice; I deploy the second in my clinical projects at the university. A range of factors influenced this purchase: the simple application, the good communication it allows with patients, the precision offered by this solution and the data storage it enables.

This immediately improved our internal practice communication, as we were able to add comments to our findings and send them to each other. Maintenance of the equipment is extremely simple, which accelerates processes for our assistants.

The number of patients we treat in the university means that the VistaScan Mini brought considerable improvements to our data archiving practices. However, to my mind, the greatest impact was experienced in the precision of the measurements we obtained and the comparisons during the post-examinations. Standardisation of procedures enabled us to make comparisons of patients at various stages in the treatment process. In all, we are very pleased with our purchase; I am convinced that there was no better alternative.

Disinfection is a central issue in every practice. Has your practice implemented any special measures in terms of procurement and handling of disinfectants?

The Dürr Dental system has simplified our disinfection procedures for X-ray procedures. The light protection covers are very user-friendly, and it is very easy to disinfect the equipment. These innovations in our practice have enabled us to speed up procedures considerably.

Digitalisation is a global trend in the dental branch. Which of your other processes in the practice have already been digitalised? Which other digital technologies do you use?

We have long used CAD/CAM systems to make our restorations. Today, we use an intra-oral scanner to make our crowns and permanent implants. We also document all cases with a digital camera. This not only records the starting situation and the final outcome, but also records all of the procedures that are carried out along the way in order to achieve success.

This year the Olympic Games will be held in Rio de Janeiro. What impact do the preparations for this event have on everyday life in Rio?

We have long become accustomed to the large number of international visitors who come to Rio every year to celebrate the spectacular event that is the carnival. Unfortunately, or perhaps fortunately, the Olympic and Paralympic games are different. Athletes and visitors will be staying in various parts of the city for a longer period of time. Different areas of the city will host the various disciplines; the entire city is currently under construction. I hope that we put on a great show and that the games leave behind a lasting and positive legacy.

Coming back to yourself. Do you take regular time for your hobbies? How do you relax after a long day's work?

Rio de Janeiro is also known as the "marvellous city". And that it is. It offers some unique landscapes, and I am very lucky to be able to live in one of the more beautiful areas of this great city. I live in Leblon, only a block away from the beach and a block away from my practice. Here, it is all about quality of life. As a result, I am able to practise my favourite sports every morning, whether going to the beach in the mornings to surf or riding up the mountains on my mountain bike before starting the day's work. I also go swimming to keep fit and relaxed. At the weekend, I often go windsurfing in Leblon or Barra da Tijuca, 20 minutes west of Leblon. A lot depends on how the wind is behaving on that day. It's just spectacular.

Many thanks for the interview.

Published by: ml/rf
Dental medicine in Rio de Janeiro - day-to-day dental surgery routine in the city of beauty