Why did you choose stomatology?
Because I had liked it since I was very young. As a boy I had to go often to the dentist because I had a rather delicate mouth. I would also go alone because my mother would say that she didn’t want to sit in the waiting room for two hours, as was generally the case at that time.
The dentist and the nurse were very kind. They’d say to me: “Did you come by yourself? My what a big boy!” I was never frightened.
Where did you study?
I started studying for my degree in medicine in Salamanca, where I completed my pre-clinical studies from 1st to 3rd year. Then they started teaching clinical studies in San Sebastian, so I took 4th to 6th year at the Residencia, which is now known as the San Sebastian University Hospital.
And to become a dentist, I specialised in Stomatology in Toulouse, France, given that I’d spoken French since I was very young.
In Toulouse the speciality went deeper into Surgery and Orthodontics, both of which I also found very important for complete buccal treatment at my surgery.
Did you always want to be a doctor?
Yes, from the age of 14, precisely when I went to Toulouse to perfect the language. There I attended French classes at an academy where private classes were also given to 1st year medical students, which was a selective subject in France for making it into 2nd year.
Fate would have it that, one day there was no classroom free for me. While I was waiting, they put me into another classroom for half an hour where they were teaching doctors-to-be. I really enjoyed it and, with my interest in doctor’s surgeries, I decided to study Medicine.
How do you remember your first year of working as a dentist?
With great pleasure. I worked long hours, because in the morning I would attend to patients at a day centre, seeing 30 patients in 2½ hours and in the afternoon I would work in my private surgery until 10 o’clock at night. I also worked on Saturdays, morning and afternoon.
A lot more people needed fillings than they do today since they didn’t look after their mouths as well. Most of them would only come to the surgery when they were in pain or had something bothering them.
Given that there were no dental implants, patients were often fitted with removable dentures. Aesthetics, while always important, wasn’t considered to be a priority like it is now.
Today, luckily, dental aesthetics are equally important to the masticatory function.
Not only that, but prevention plays an enormously important part in the everyday work of a dental clinic, given that the population is much more aware of the need for good health.
Has the doctor-patient relationship changed much since you started your career?
Not really. There was a change when my generation started working, when we were told that we were closer to the patients than the majority of dentists of the earlier periods. As a result, doctors also started to enjoy a more agreeable relationship with their patients.
Today, when people are more aware of health issues, it’s easier to explain the different treatments, with the result that patients are more likely to follow the guidelines and instructions we give them.
How did you get into implantology?
It happened naturally; as the technique progressed, I started using it. It is great to be able to replace removable dentures with fixed teeth, and the satisfaction for both myself and my patients is enormous.
I started fitting teeth onto implants 24 years ago.
At first I would send my patients to a trusted tooth surgeon, who would carry out the implant surgery and then fit the false teeth to said implants. Shortly afterwards, when implants started to experience improved attachment to the bone, and given that I had good surgical training from my time in Toulouse, I started to do the implant surgery myself. That way I could control the whole project from start to finish.
And into orthodontics?
I learned orthodontics, the removable kind, in Toulouse, and fixed orthodontics in Monaco. The technique was rather complicated and slow to apply.
The straight arch technique simplified and improved the treatment and, having studied and practiced several cases with Dr McGann, from Santa Monica (California), orthodontics became part of the treatment offered to adults and children at my surgery.
In your speciality, on what would you insist from the point of view of prevention?
While it may seem elementary and obvious, but I would say brushing both your teeth and your gums. We must brush our teeth 3 times a day. Also, the technique and hygiene products must be adapted to each patient depending on their age, mouth type and pathology, etc.
The other pillar of prevention is a yearly dental check-up.
Where is the future of this speciality heading?
Towards improved masticatory function and aesthetics. The materials we use are increasingly more biologically compatible with our bodies and in aesthetics we try to ensure that the passing of time takes as little toll as possible on the teeth.
In the future, if someone is unlucky enough to lose a tooth, we will implant a dental germ or embryo, which will grow as it does in children and adolescents.
How has surgery changed?
Surgery is less traumatic than it was years ago. Implants have enormously improved and we can fit short or narrow implants which adhere very well to the bone.
This means that we do not have to regenerate the bone by taking it from other parts of the body, as we did until recently.
Aesthetics too are taken strongly into account, ensuring that the gum around the tooth looks good after implant surgery or any other kind of curative surgery.
On preparing operations with a scanner and 3D image, immediately we make an incision we know what we are going to find, meaning that we can take as little action as possible to fix the problem, and in exactly the right place. This means that post-operatory discomfort is minimum and very bearable.
What professional projects do you have for the future?
To continue making progress and learning new techniques in the fields of both implant surgery and orthodontics, including periodontics and general dentistry.
The new 3D technologies for diagnosing and planning cases, and their associated surgery and prosthetics make ours an interesting and exciting profession.
Finally, if you hadn’t been a dentist, what would you have liked to be?
Well, instead of moving forward, I would change directions and head back into the past: I would like to be an archaeologist.