Interview: Prof. Barry Sessle on the impact of neuroscience on dentistry

Prof. Sessle, do dental clinicians normally have an adequate understanding of how neuroscience pertains to dentistry, or do you see this as an area in need of continuing development?
With the explosion of new knowledge about the brain and neural processes over the past three to four decades, I think dentists generally have developed an improved understanding about neuroscience in relation to dentistry. But the level of understanding is variable, depending considerably, I think, on how much emphasis has been placed on this area in their dental education, in the continuing dental education courses that they have taken, and in the dentistry-related literature that they have read.

It has been my experience that many dentists and dental specialists do not grasp sufficiently the extent to which neural mechanisms underlie the functions and dysfunctions manifested in the mouth, face and jaws. As we note in our review article and its related podcast, these functions include dental pain, taste, chewing, biting, dental occlusal relationships, swallowing and salivation, all of which, incidentally, are unique to this part of the body. And disorders can occur in each of these areas, so some understanding of neuroscience is important for their proper diagnosis and appropriate management. And, of course, the dentist relies on his or her own neural processes and brain-based functions such as cognition, memory, speaking and hand–eye coordination to be able to diagnose and carry out dental and related management procedures. So, there is a need for educational programmes to raise awareness in dentistry of the importance of neuroscience in many facets of dental practice.

Has this relationship been changed dramatically by advances in technology?
Technological advances have a bearing on the relationship between neuroscience and dental practice. One example over the past hundred years has been the introduction of new or improved medicaments and local anaesthetics for application to dental or other oral tissues to prevent nociceptive signals in orofacial nerve fibres arising or being conducted into the brain. This has had a remarkable impact on improving the patient experience of restorative and surgical procedures in dentistry and has given rise to so-called painless dentistry.

Related to this are the pharmacological improvements in analgesic drugs as well as in drugs used to reduce anxiety and stress, and the introduction of high-speed dental drills that have markedly reduced the time for cavity preparation or other dental restorative procedures. These advances have benefited the dentist as well as the patient. Another example is the improvement in imaging techniques that have enhanced diagnosis of disorders arising in the orofacial tissue or of brain disorders that affect orofacial functions.

What do you see as the future of the relationship between neuroscience and dentistry?
There has been expanded research interest in the field of neuroscience in recent decades and further technological advances are expected in the coming decades in fields relevant to neuroscience and to dental science and practice—for example, in artificial intelligence, genetics and molecular biology. Consequently, the future promises many more research studies providing new insights into the processes underlying these functions and related disorders. As a result, many of these additional insights will have clinical applications in improving diagnostic and treatment approaches in dentistry.

Editorial note: Sessle’s article, titled “The evolution of neuroscience as a research field relevant to dentistry”, was published in the December 2019 issue of the Journal of Dental Research.

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