Stopping the invasion


Dr Jeanette MacLean is looking forward to addressing Irish dentists at the IDA Conference and spreading her message about the benefits of minimally invasive treatment in children.

Jeanette is an advocate for minimally invasive dentistry and is the owner of Affiliated Children’s Dental Specialists in Glendale, Arizona, in the United States. She is a Diplomate of the American Board of Pediatric Dentistry and a Fellow of the American Academy of Pediatric Dentistry. She believes non-invasive treatment has many advantages when treating children, not least of which is helping young people avoid dental fear and develop a good relationship with their dentist: “To put it simply, minimally invasive treatments are particularly beneficial to paediatric patients because they can often reduce, delay or altogether eliminate the need for local anaesthetic and surgical tooth preparation (i.e., shots and drilling).

The dental treatment is better tolerated by the child and less likely to induce a fear of the dentist, but rather help them build a positive relationship with their oral healthcare provider. It also helps reduce, delay, and/or eliminate the need for sedation, which can help reduce cost and risk, while increasing access to care”.Personal experience with one of her own children also influenced her work around minimally invasive techniques: “My daughter had to have surgery under general anaesthesia at just nine months old. This dramatically impacted the way I empathised with parents regarding the use of sedation to treat their children’s tooth decay. I also experienced a medical emergency with a special needs child who was undergoing IV sedation in my office. He recovered; however, it made me question what I was doing and how I could do things differently and better for my patients and their families. This began my journey to minimally invasive dentistry and adopting treatment techniques such as silver diamine fluoride, SMART (silver modified atraumatic restorative treatment), the Hall technique, and resin infiltration”.

It made me question what I was doing and how I could do things better for my patients and their families.

These techniques were not part of Jeanette’s formal dental education, which primarily focused on the surgical management of caries, but they have helped her address a number of issues which are important to her, she says: “Shifting to more non-surgical interventions has enabled me to reduce my use of sedation, increase access to care (by increasing the volume of patients I am able to see), reduce the cost of the care, and improve the efficacy of care”.

IDA Annual Conference
Jeanette is one of the speakers at this year’s digital IDA Annual Conference, Online World: In-person dentist. Her presentation will run on Saturday April 17. She will be speaking on icon resin infiltration and the etch bleach seal technique.She gives an overview of her presentation: “Unsightly congenital enamel defects and acquired white spot lesions can be troublesome for many patients. Historically, these blemishes have been treated with invasive and costly resin bondings and veneers. Dealing with enamel defects can prove particularly troublesome for young patients, which when left untreated, often become a source of embarrassment for the patient. Or worse, some lesions may progress to cavitations, particularly post-orthodontic white spot lesions. This course will review two simple and painless options to manage enamel defects. Icon resin infiltration and etch bleach seal can improve or even completely reverse the appearance of congenital enamel defects and white spot lesions, while preserving tooth structure and repairing the patient’s natural enamel”.
While the pandemic has been a worrisome time for the public and for dentists, one advantage that Jeanette sees is that online conferencing allows people to attend and speak at conferences all over the world: “During 2020 when all dental conferences were either cancelled or shifted to a virtual platform, I was able to deliver information on these topics to a much broader audience. The webinars I provided reached over 30,000 viewers from a global audience, which was quite remarkable to me. Many of the webinars had record-breaking attendance, record numbers of attendees viewing the content live, as well as views of on-demand content. It is not unusual for me to receive calls and emails from dental professionals from all over the world on a daily basis. It can feel overwhelming at times, but it is also rewarding to feel like I’m making a positive impact on the dental profession. My happiest moments are when dentists tell me that I changed the way they practise”.

Oral health and Covid-19
Covid-19 has of course affected Jeanette’s day-to-day dentistry and she had to close her practice for two months in 2020. She explains that lockdowns are having an impact on oral health in a way that perhaps many have not thought about: “We reopened at the end of May 2020. We are seeing a reduced volume of patients and increasing the time between patients. We continue to have a high demand for appointments and families eager to come into the office. We are noticing an increase in poor hygiene, poor diet, and more tooth decay, as families quarantine and work and learn from home, with easy access to the pantry and less regimented routines of sleep, bedtime, oral hygiene, etc.”
Of course, oral health problems did not just suddenly appear with the onset of Covid. Jeanette believes in affordable access to dental care for all. She is also concerned about the easy availability of high-sugar foods, which is an issue both in Ireland and the US. She wants to raise awareness of diet (high sugar and processed food consumption) and its impact on oral health: “In the US, in particular, there is an obesity epidemic and many constantly snack and sip all day, destroying their teeth. There’s a Starbucks or convenience store on practically every corner, with easy access to high sugar and highly processed foods”.

Jeanette MacLean

The party planner

Jeanette is married and a mother of two. She hopes to visit Ireland one day, as both she and her husband have Irish ancestry. She likes to spend her spare time with family and friends, and says if she wasn’t a dentist, she would be a party planner: “I go over the top for birthdays and holidays and love to decorate! Halloween is my all-time favourite. My house gets decorated inside and out, we make elaborate costumes, and host a huge pumpkin carving party”.

Colm Quinn
Journalist with Think Media