The good, the bad, and the stunning!

The good: It's mid-December and final exams are officially over here in Cambridge (for me at least ... as the rest of you - hang in there!). Also, I've been accepted to a couple of awesome dental schools! :) If you know me well, we probably already celebrated HARD together! That being said, it's still too early for me to decide whether I want to stay in the area or head back to Californiaaa.

The bad: It's mid-December and it is COLD! Boston's schizophrenic weather never ceases to amaze, me neither do the New England winters. Hmm maybe I should go back to the West Coast for dental school ...

The STUNNING: I've finished my first paper on teeth!

I learned a whole lot from my research ... it turns out that there is considerable (relative) dental morphological variation among human populations. Carabelli's cusp, for example, is one of the most well-known distinguishing morphological traits, and is most commonly found in people of European descent. Dental morphological variation has been researched before, but my specific focus was on racial admixture and the phenotype of specific traits

Things like tooth studs and grillz don't count ... at least not for this project.

I'll post the abstract soon - and stay warm!

E

Research and Interviews!

Heya folks,

Here are some pictogram updates of one of my teeth research projects! Not a short amount of time was spent mounting and sawing this suspected mandibular first molar for your (or my professor's) viewing pleasure. This was actually a really awesome side-project and was done for more than one reason! A detailed procedure will follow...

In the meantime, this month sees travel to LA, Philly, and short trips around Boston for my first batch of dental school interviews! Wish me luck :)

Cheers,

E

(click to enlarge!)

A timely capture

Complete visualization of prisms and the like!

New Teeth Research Project

Today marks the day that I began my first dental-related research project! Although I concentrate in Molecular and Cellular Biology (MCB), I am currently working in the Dental Hard Tissue Lab in the Human Evolutionary Biology (HEB) department with Dr. Tanya Smith.

Live imaging

To hone my skills before jumping into my yet-to-be-determined project, my preliminary goal is to identify a tooth sample that was extracted by a dentist. There are two roots, one mesial and one distal, with the mesial one larger and more strongly grooved. Interestingly, there also appear to be 6 cusps with a maintained talonid basin, in addition to a suspected carious lesion which is perhaps why the tooth was extracted in the first place. Yet my best guess so far is that this is a lower first molar (M1) which is typically rare to extract unless there is a specific orthodontic/occlusal reason to do so. Further, the end of the roots suggest that the lower M1 is in fact from a juvenile. The typical dentist might have filled the carious lesion - aka cavity - but in this case the tooth was extracted ... interesting! An aggressive dentist indeed!

Suspected lower M1 from a juvenile

Today I also made a mold of the tooth, took some key measurements (mesial-distal and buccal-lingual), and also took some cool photographs (see below)! Research details will continue as I work on my technique. Next step will be a Micro-CT scanner to completely visualize the tooth!

Suspected carious lesion, likely reason for extraction

Live imaging focusing on the carious lesion

Stay tuned!

E

Why are teeth Cool? 10 Reasons

As credited to Dr. Tanya Smith at Harvard, here are 10 cool and interesting reasons to study teeth and dental anthropology!

In other news, I'm taking her amazingly awesome course HEB 1421: Teeth -- check it out folks!

Me holding a tooth sample! Who knew roots were so much larger than the crown?

10) Abundance -- In many cases we have more fossilized teeth than living specimens. And in some cases of extinct species, all we have are their teeth!

9) Variation -- From variation in metric and non-metric data we can reconstruct phylogenies.

8) Development --As early as 10 weeks of fetal age, there are already signs of teeth buds! Further, the first (permanent) molars already appear 2-3 weeks before birth. Amazing!

Teeth morphology -- A small collection of Homo sapien teeth

7) Record-Keeping -- Using the 'birth certificate' embedded within our first molars and other cues we can determine approximate age at death with striking precision.

6) Forensics -- Aka forensic odontology aka everything you see on CSI, NCIS, and all those addicting, romanticized crime dramas. But seriously, you can reconstruct criminal events, identify remains, and even examine bite marks.

5) Aging -- Did you know that not everyone grows wisdom teeth, or grows all four of them? 3rd molar eruption is highly variable. Tooth wear in aged populations and calcification in juveniles can help determine age.

4) Stress & Disease -- Teratoma formation ... don't really want to elaborate

Our textbook -- does NOT compare to the online readings

3) Dietary Evidence -- Tooth chemistry, isotopic chemistry, micro and macroscopic wear. Also, more light and fun stuff like discoloration (er not quite fun) from coffee (very fun) and betelnuts (fun for some)!

2) Enamel Thickness -- Did you know that women have relatively more enamel, whereas men have relatively more dentine? Also, hominins have evolved to have really thick enamel.

1) Genetics -- Many dental traits and characteristics are indeed heritable. Shovel-shaped teeth, anyone?

And that's it folks! Come back soon for more!

E

19th Century Dental Instruments

So as I was going through my camera after visiting the Linnean Society in London, I completely forgot of the hundreds of gems (literal and non-literal) on display at the Hunterian Museum of the Royal College of Surgeons that I had documented. Now I present to you ... some of the most expensive and beautifully fashioned dental instruments ever created!

Set of dental instruments made of steel, mother of pearl and ivory
in a leatherette case (19th century).

Some particular items of note, however, were the great number of outdated dental instruments that are no longer used today. For instance, I came across the dental key, also known as the toothkey. Designed with the door key in mind, the dental key could be inserted horizontally into the mouth where a claw of sorts could be fitted over the tooth. Next, as you can imagine a key turning, the dental key could be turned to loosen tooth. Many cases in England have documented the fracturing of the tooth, fracturing of adjacent teeth, and fracturing of the jaw as a result of using the dental key. However, with the purpose of extracting teeth as a means of treating dental infections before the advent of antibiotics, the toothkey provided the best extraction technology of its time. The dental key, with continuously modified and improved designs, was used predominantly from the 18th through 19th centuries until the development and introduction of forceps.

Left: Vertical dental forceps made of steel
probably for removing small molars and pre molars (19th century).
Right: Modified form of a dental key made of ivory and steel,
probably used for removing molars (late 18th or early 19th century).

Below are photos of these quite exquisite 19th century dental instruments that were commonly used in England. Many are made of ivory and mother of pearl, which today would be rather expensive and - don't forget - illegal (oh the ivory!). Perhaps it was the British tradition, or perhaps it was just the norm in the 19th century to use such fine materials in constructing dental instruments of the Western world. Just take a look below -- don't these ornate instruments remind you of the gold and platinum dentures that were created specifically for Winston Churchill?

Dental instruments for filling and excavating teeth (19th century).

Set of instruments made of steel, silver, and mother of pearl
used for removing tartar from teeth (19th century).

Ivory, platinum, gold, mother of pearl ... mother of expenses!! Perhaps this is where the 'million dollar smile' originated. A great idea for my next idioms post!

E

Winston Churchill's Dentures

As I continue my mini-expeditions and my studies abroad in England, I've come across a number of hidden gems in the nation where it seems to rain everyday, relentlessly, despite my being from California ...

Just yesterday on the program sponsored trip to the Hunterian Museum of the Royal College of Surgeons of England (don't you wish HMS had a museum?) I came across a few eye er mouth-catching exhibits. Naturally, the Royal College of Surgeons had to be in possession of the dentures of Winston Churchill, the man who led Great Britain during WWII. Even more naturally, the great man's dentures had to be one of the most stunning set of dentures I've ever laid eyes upon (pics below).

Interestingly, it's important to note that Churchill had either a stutter or a lisp, and that his dentures were fashioned to help overcome his impediment, not to mention help with mastication and self-esteem. That's proof to you folks who think that dentistry is mainly for the aesthetics! Perhaps King George VI too could have invested in a set a la The King's Speech. Just imagine watching a movie called The King's Dentures ... 

Anyways, here's what the description reads at the Royal College of Surgeons:

"Partial upper denture, with gold base, platinum clasps and mineral teeth, made for and worn by Sir Winston Churchill, c. 1941

Dentures like these are normally made to fit as closely as possible to the palate of the wearer. Churchill's denture  was different. To compensate for his natural lisp his was designed to leave a gap between the plate and the roof of his mouth, thereby enabling him to maintain his distinctive speaking style. Churchill's dentures were designed by his dentist, Wilfred Fish and made by Fish's dental technician, Derek Cudlipp."

And here are the pics folks! (click to enlarge)

Absolutely stunning! Now who wouldn't want a gold and platinum-laced mouth?

E

British Beginnings

Phew! It's been quite an exhausting day as I just finished my first day of work at the Natural History Museum in London!

To update you guys, after spending a full month and a half back home in sunny Los Angeles, I'm now across the pond (the Atlantic that is, not Pacific) where I'll be working in London for a bit before studying abroad at Queen's College at Oxford University! Very exciting! Also very expensive!!

Anyways, I'm sure that you've heard of the stereotype of British teeth as compared to American teeth. Apparently they're worse. Apparently, that may or may not be correct. I've only spent two full days here so far, and when people do smile (albeit rarely) their teeth seem perfectly normal to me! Time will certainly tell, and I'll be sure to create a post in the future after I've detailed a sufficient number of observations about the Brits and their ways. :)

Pics from the museum! (click to enlarge)

Natural History Museum -- London

Outside

Inside

Charles Darwin

Some good-looking guy

E

7/15 Update! Here's a link to the blog here at the Natural History Museum about my work as an intern!

http://wallaceletters.info/content/more-about-harvard-interns

Basically, there are 7 of us Harvardians doing some cheap but prestigious labor ... it's a pretty fun group (find my twitterlicious Twitter for the real deal) and now you can learn more about what I'm doing with regards to evolutionary biology!

E

DONE with the DATs !

For those of you who know me well or have been following my delicious blogging from wherever around the world you may be, today I took my DATs!

The DAT, also known as the Dental Admissions Test, is required for entrance to United States dental schools. There are a total of six sections on the DATs that appear in the order of Biology, General Chemistry, Organic Chemistry, Perceptual Ability, Critical Reading, and Quantitative Reasoning. And to think that you're done with standardized tests after high school :p - sorry, try again folks!

Anyways, the experience was quite nerve-wracking to say the least. I was fingerprinted at least six times at the Prometric Test Center where a whole slew of these American standardized tests are administered, and had a camera happily recording my frantic scribbling on the scratch-boards, my attempts to keep the earplugs that they give you inside my ears, and of course my sacred pre-test rituals.

Above all, the MOST amazing/interesting/frightening thing about the DATs - unlike the MCATs - is that your scores are instantaneous. That's right folks. The scores are INSTANTANEOUS! For better or for worse, you'll find out your numeric scores as well as your scored percentiles a mere few moments after you click the final submit. Crazy right? The fact that the scoring comes out ASAP and that you leave the test center with an official print-out of your scores further contributes to the anxiety that comes with months of preparation for a five-hour test. It's quite the experience. It's not meant for the faint of heart, or for those who are prone to anxiety attacks.

For those of you who want to know how I did ... that's NOT important (well, the scores are important, but that's besides the point :p )! Although I felt that I could have done better on one of the sections (which ironically I aced on all of my practice tests beforehand), I am plenty happy with my performance.

Now I can officially begin my dental school applications, and also go out for a round of drinks !!

Best of luck to all of you who still need to take your DATs, MCATs, GREs, SATs, or whatever test it may be. And trust me on this - study hard and don't lose focus! Set high goals - this is your future we're talking about!

Eric

Wisdom Teeth

Stress and anxiety are in the air as we enter spring semester exam period over here in Cambridge, Massachusetts ... BUT it was even worse for a close friend of mine, whose wisdom teeth were causing her a ton of pain and distracting her from studying for exams!

After 2 full days of enduring pain in the back of her gums (our group of friends was fairly certain that her wisdom teeth were the sources of her discomfort), she got her x-rays taken at Mass General Hospital, and here are the results! Isn't this a stunning image? (click to enlarge)

Impacted wisdom teeth

The following day, she got three of her wisdom teeth removed. Take a closer look at the x-ray -- you can probably guess which tooth was NOT removed. If you guessed the one on the upper right-hand side of the image, you're right! As you can see, this tooth appears to be coming at an angle and at a different position than the other three teeth.

The x-ray shown here is called a Panoramic Film, which was taken extra-orally. This is in contrast to the typical Periapical and Bitewing x-rays that are normally taken annually or once every two years. In a Panoramic film, the film is placed outside of the mouth on the opposite of the head from the X-ray source. The result is an extra-oral radiographic view, as shown above.

Anyways, I'll be sure to add an update if and when my friend's final wisdom tooth is removed!

Back to exam-studying ...

Eric

Human Evolutionary Biology 1421: Teeth

As mentioned previously, at the 2011 Boston Pre-Dental Conference hosted by Harvard's very own Pre-Dental Society (which was a tremendous success by the way, see my previous post!), there were a number of fantastic speakers and presenters. One of whom, Dr. Tanya Smith, Assistant Professor in the Department of Human Evolutionary Biology, gave a truly fascinating presentation not only on her research on dental development and 3D fossil tooth structure, but also on her course to be offered next Fall semester!

Her course is aptly named Human Evolutionary Biology 1421: Teeth. Although the course name may sound ridiculously boring and sleep-inducing to some of you (my friend Judith says this sounds potentially worse than Plant Biology), to the few of us enlightened folk out there - isn't this really exciting? Seriously though ...

Anyways, the last time the course was offered, which was in Fall of 2009, the class received near perfect ratings (4.8 out of 5 on the Harvard Q Guide). Plus, the research seminar-type class is capped at 6 students, and you spearhead your own independent research project. That's right, SIX students! I guess there is life after those humongous general chemistry and organic chemistry lectures.

Here's the course description from the website:

"Teeth are one of the best preserved and most commonly-recovered elements in fossil assemblages. This seminar will focus on ways in which dental remains may inform studies of primate growth and development, ecology, and social structure. Students will read and discuss current scientific literature, engage in histological studies in the Dental Hard Tissue Laboratory, and conduct pilot research projects."

So that probably sent the rest of you packing. BUT to me and a couple of my friends this is amazing!

Another friend says that there might as well be a course titled Human Evolutionary Biology 4321: Eyeballs for people interested in optometry school. What's next, an English department? Ahhh let's pretend she didn't say that ...

See you at shopping week!

This hygiene is acceptable ... if you've been dead for a few centuries.

Eric

Sink your teeth into something (idioms #4)

Sink your teeth into usually precedes a noun, which may or may not be something edible.

Typically, to sink your teeth into something is to really muster your powers and/or energy either to understand something or to get a good grip mentally, emotionally, and perhaps even physically of something. Similar idioms include digging deep as in digging deep for the solution.

i.e. She finally sank her teeth into the crux of the problem and was able to find a resolution that satisfied both parties.

On the other hand, to sink your teeth into something may also imply having a rather voracious appetite, and consequently the quick and plunging sinking of your teeth into whatever food hits the spot.

i.e. My sister sank her teeth into the brussel sprouts (weird), while my brother sank his teeth into durian fruit (weirder).

Durians. Spiky, eh?

Hedgehogs. Cute, right?

Dur-hog or Hedge-ian, otherwise known as a Durian-Hedgehog hybrid. (weirdest)

Eric

The Shark Dentist

I stumbled across this gem and thought I'd share.

The Shark Dentist, digital illustrations by Rich Werner.

See the complete set of illustrations here

Eric

Kim Clijsters won the Aussie Open ... with the help of a Dentist!

For those of you who don't follow tennis, earlier today Kim Clijsters of Belgium won the 2011 Australian Open women's singles title, her fourth Grand Slam title. She defeated Li Na of China 3-6, 6-3, 6-3 to win her first Grand Slam in the land down under, and will be looking to retire within the next year after having come out of a previous retirement back in 2007. Interesting. And exciting! But you may have already gathered that from the thousands of articles about her hard-fought win today.

But what you probably didn't hear ... was that Clijsters had chipped her tooth when she landed at the airport before the tournament even began! Some say - and by 'some' I mean myself - that it's possible she wouldn't have won the Aussie Open had a dentist not come to her aid in this oral emergency! In fact, she may have had to withdraw from the tournament completely due to the excruciating pain ... (just kidding here)!

So it turns out most chipped tooth situations aren't that painful. But it IS important to see a dentist as soon as you can after you realize your tooth has been chipped. Depending on the severity of the situation, you may need a filling or even a crown. Besides potential pain, increased sensitivity to cold and heat, and perhaps a small hole in your smile, an obvious reason to visit a dentist immediately is so your gums or tongue don't suffer any damage from a sharp, jagged-edged tooth. This is not unlike a shark, but sharks probably don't think about these issues.

Anyways, here's the quote from her press conference after her win:

"Q: What happened to your teeth at the airport?


Kim Clijsters: To my tooth? Yeah, it chipped off. That's what happened. I was eating a rice cracker, actually, nothing hard. Just a nice, soft rice cracker. I thought there was like a piece of rice that wasn't cooked well or something, and I just spat it out. I felt my tooth not being there completely, so I was like, Oh boy."

Oh boy indeed! Who knew that an innocent rice cracker could win a battle of strength against your tooth?

"I went to a dentist here in Melbourne and he fixed me up really quickly ... He just said that me if you get to the final ... so I promised him 'OK, for sure, I'll do that.' So, thank you."

That's very sportsmanship-like of you Kim - congrats on the win!

But anyways, case in point, dentists are more important than you might think! Although a chipped tooth is probably one of the best worst things that could happen to you from a sports injury or any injury whatsoever, more damage could have easily been done. If Kim was a high school tennis player with braces and suffered a 35 meters/second (or 80 mph) tennis ball to the face, the situation would have been much different. An oral surgeon may have been involved!

Oh, and here's my favorite bit from Kim:

"Q. Are you going to name the mystery dentist?

Clijsters: I actually don’t remember his name. He was somewhere near Chapel Street."

:)

Kim's pearly whites

What was the dentist's name??

Eric

Why do you fear the Dentist?

Are you afraid of the dark? Are you afraid of the dentist? The former may have been a favorite TV show of yours from childhood (Nickelodeon, anyone?), but unfortunately the latter is a negative no-brainer to many. We all know of some friends or family members who really despise their visits to the the dentist and will do anything in their power to make these bi-annual visits as brief as possible.

Since writing my post last week on the new device that eliminates the sound of a dental drill, I've been doing a lot of thinking on why some people have such an extreme fear of the dentist. Let's just call this dental phobia. And as I've been continuing my shadowing and work at my awesome dentist's office this month, although I haven't encountered any patients who seem to have any apparent dental phobia, I do notice some general trends including hand-clasping, eye-closing, legs-crossing, and (just once) chair gripping - even during general cleanings! These behaviors are usually secondary to some of the things you might expect a patient with dental phobia to exhibit.

A fear of dental visits may pose a major issue in achieving and maintaining good oral health. Often, it just takes one negative experience, usually from childhood, for an individual to develop a dental phobia that may last a lifetime. If you had to have seven baby teeth pulled out when you were in the second grade because of the cavities that formed due to your bad childhood brushing habits (and because of all those Hershey's, Reese's Pieces, and Kit Kat bars you gulfed down in one sitting that day after Halloween), it makes sense that your dental phobia likely has its roots in the unpleasant and painful dental experience that ensued. A few numbing shots to your gum and a fountain of your own tears probably didn't help your newly developed phobia either.

But for adults, a number of other factors besides the physical often explains a dental phobia.

The sky-high costs of certain procedures (especially if you don't have insurance or if your carrier doesn't fully cover certain procedures), the disruption of your normal work day, the need for control (especially of a part of your body where you otherwise have 100% control of what goes in and out), and even antiseptic odors can contribute to such anxieties. Self-consciousness and general anxieties may also be possible factors contributing to this fear, in addition to a combination of higher order social and psychological factors.

As you can imagine, a modern-day dentist also assumes the role of a psychologist in ensuring that patients have a pleasant experience while receiving the utmost oral care. Interestingly, some dental schools like UCLA and UCSF dental actually require that all applicants take an introductory psychology course.

Ultimately, while a comfy chair and your favorite TV show playing on the screen may help you temporarily forget about your dental phobia, the most important step in overcoming your fear of the dentist's office begins with good communication between you and your oral care professional.

Never be afraid to ask questions before, during (procedure-permitting), and after a procedure!

For those of you who are more cosmetically-inclined, just imagine how great your teeth will look when all's said and done!

Eric

Pre-Dental Society Updates

Great news: the website for the pre-dental society is almost finished - it will be up and running soon!

As a brief preview, here is the bio I will be putting up on the website. I've always been asked a lot why a career in dentistry and not say, medicine (or finance, consulting). The answer and story that comes with it is long, but I'll be sure to share it all with you sometime in the future. I promise!

But for now, here's the bio:

Eric Chen
Class of 2012 | Molecular and Cellular Biology

My belief in the commitment to the best self and the common good saw tremendous alignment with my passion for dentistry. The creation of a patient's best self through oral health and confidence, and the commitment to the greater community from a public health perspective - these are my visions in dentistry. Outside of the classroom I serve as President and former concertmaster of the Mozart Society Orchestra, and volunteer heavily with the Harvard College Red Cross. I'm an avid swimmer and water polo player, I love the beach, and I also write a blog on all things teeth!


And no the last line was NOT a shameless plug for my blog ... otherwise I would have included a link! :)

In other news, we're currently in the midst of organizing our 2011 Boston Pre-Dental Conference, to be held on campus in Cambridge! Details coming soon!

Eric

Afraid of the dentist? This active noise control invention will help!

One common reason why people are afraid of the dentist is because of the sound of ... the drill!

I'm sure many of you have experienced the dental drill before - typically it's used to carve out the decayed tooth material before your dentist puts in the filling. Because the sound of the drill usually comes immediately before some amount of acute pain (dentists like to call this pain pressure), many people unfortunately associate the drilling sound with anxiety, a sense of fear (seriously!), and a mouth that was numbed an hour too late.

In reality though, the sound of the drill should be linked to happiness! Your cavities will disappear, and the value of your mouth will increase tremendously with the new addition of expensive (and shiny) metals.

Anyways, a group of researchers at King's College London Dental Institute led by professor Brian Millar have developed something called the digital signal processor chip.

How it works is simple: you attach this small device to your headphones, and - similar to those Bose Noise Canceling headphones - the sound of all that dreaded drilling inside your mouth suddenly disappears!

The trick here is that this device selectively filters incoming sounds. So although your ears will miss out on all that deep drilling, you can still hear the dentist warning that you will continue to feel that "pressure."

Details: this "digital signal processor" chilp analyzes the incoming sound from the dental drill via small microphones placed near the drill and then produces an antiphase sound wave that cancels out the undesirable noise. Further, "adaptive filtering" technology is used so that the sound of the drill, and only the drill, is removed even if the drill's sound wave amplitude and frequency change during your time on the chair.

Yet somehow, you still hear your dentist: "You might feel some pressure ..."

Photo creds to Sony.

Imagine you are the woman in the pink. Imagine the the chair is in a slightly (er .. considerably) more reclined position. And now imagine the sounds of THIS ... eliminated!

Pure bliss!

Now how do we bring this to market?

Eric

And we're back!

Hey all,

Sorry for not keeping up with my posts recently!

December was really hectic with exams, final papers, a concert (which went REALLY well), and ... SNOW back in Massachusetts! But now that I've been back home in LA for a bit (and will still be for another two weeks before school starts again), I promise I'll get back to blogging!

On the bright side, I've been doing some work at the dentist's over winter break, and will be going in again for a full day this Saturday, from 8-6 !!

Can't wait to share! :)

Eric