Simple, complex and heuristic


"Complicating it invariably leads to chain multiplication of unforeseen effects and unexpected consequences, followed by excuses about the "unexpected" aspect of the consequences, and further intervention to correct the secondary effects, which results in the explosive branching of a series of "unexpected" reactions, each one worse than the last." NNT 

Perhaps you have had an experience similar to the one just described. 

The problem is that it is difficult to understand (and to explain) that a simple procedure is in most cases much better in all respects than a complicated procedure. Partly because it goes against the mentality established in society that complexity, sophistication, modernity and or "technologically advanced" mean that a procedure with these characteristics is much better, which does not correspond to reality at all. 

Despite all the technology that is currently used in Dentistry, and widely advertised, materials, methodologies, weighing processes and work philosophies have changed little in the last 100 years. We use ceramics for crowns and veneers, just as Charles Land used in 1903. We use composite (plastic) in caries treatment (reconstruction), which replaced amalgam (black lead) 40 years ago. We've been using titanium in implants since 1965. Zirconia has replaced metal over the past 20 years. And little else happened that was truly disruptive in dentistry in the 21st century, despite wanting to sell the opposite idea.

In addition to the materials, the techniques also changed little over the last century. The best aesthetic works in ceramics (facets and crowns) are still done manually by a Dental Prosthesis Technician, with little use of technology, only with the help of a brush. In the clinic, the great change in the paradigm of rigor and quality of work occurred with the introduction of the use of magnification (magnifying glasses and microscope), whose discovery dates back to 708 BC. Despite all the machinery with a sophisticated technological aspect, clinical procedures are still - and will continue to be - manual work performed by a Dentist, using relatively old and time-tested materials. Which is a good sign. 

However, technology has helped in the positive evolution of the visual appearance, aesthetics and comfort of a dental clinic, which today is no longer an austere and chilling place. It also came to help, with CAD-CAM technology and 3D printing, in the design, engineering and production of more accurate prostheses (crowns, bridges, etc.), at a lower cost, as it partially eliminates the human factor from the equation, in time , cost and error. 

Last but not least, technology has also helped the clinician in planning surgeries and complex treatments, with the help of software now being able to carry out the study and preparation of a case that 10 years ago would have been unthinkable. 

But technology is just another tool, or instrument, at the service of the clinician. It does not replace the need for rigor, experience, knowledge and values.