Working as a dentist in a rural practice in Ōpōtiki, Shayden Bell (Tainui, Ngāti Awa, Ngāti Maniapoto, Tūhoe) treated a lot of patients who had to choose between a root canal or extraction. Cost meant the choice was often extraction.
“I saw so many deep holes in teeth and so many situations where I had to decide if I should start a root canal or extract the tooth and what the patient could afford.”
Driven by the need to better help his community, Shayden decided to pursue a Doctor of Clinical Dentistry.
He is one of two Māori tauira to graduate with Doctor of Clinical Dentistry. Dr Shayden Bell crosses the graduation stage tomorrow as a newly minted specialist in endodontics, the dental specialty concerned with the study and treatment of tooth pulp and tissues.
Endodontics was not a field he would have chosen as a young graduate dentist, he says.
“Root canals were never my favourite procedure as a generalist, which is the most common treatment that endodontists prescribe.
“The more I did them, the more I realised that it's one of those things where if you follow the steps properly, and you're careful about it, nine times out of ten things are going to be okay.”
But Shayden never did like second guessing himself even for that one time out of ten, he says.
“Increasing your knowledge changes how you manage things and how you practice.
“There’s always going to be cases when you question yourself because you want the best for your patients, but specialist knowledge helps with that little bit more confidence.”
It also helped that he worked in a practice where the owner was passionate about conservation over extraction.
“Losing a tooth is a massive burden on a patient and we were encouraged to look at options to save a tooth if we could.”
Studying endodontics gave him insight into alternative treatments to extractions and root canals, Shayden says.
“I learned about pulpotomies, which is when the dentist only takes out the inflamed tooth pulp as opposed to a root canal where you take out infected tooth pulp all the way down to the nerve endings.
“Had I known this during my practice in Ōpōtiki, it would have changed my approach to so many treatments.”
Treatments like pulpotomy can also potentially help reduce oral healthcare inequities, especially for Māori who are disproportionately disadvantaged when it comes to oral care, he says.
“Root canals can be quite a tedious and expensive process for patients, leaving extraction as the quick fix. A pulpotomy is much faster and cheaper and so can incentivise low socio-economic patients to seek treatment.”
These treatment options also feature in Shayden’s thesis, which looked at the creation of guidelines for deep caries or deep tooth decay.
“Currently there are no New Zealand guidelines for the management of deep caries. There is no consistency in the approach and dentists usually have their personal preference on how they are going to treat a patient.
“Implementing guidelines that are evidence-based and offer more biologically conservative and financially viable treatment options presents an opportunity to reduce inequities in the Aotearoa oral healthcare system.”
After graduation, he’s looking to get his “feet on the ground”.
“Going back into practice after taking a break to study feels like you’re starting off fresh in some ways.
“I’m headed out to work with a practice in Hamilton, to establish my specialist practice.
“That said, once I’ve settled down, I would love to go back to a rural practice for a few days every now and then to offer specialist treatment.”
As a Māori clinician, Shayden is looking forward to giving back to his community.
“I grew up in Whakatane and working there and in Ōpōtiki was special.
“You’re from the same iwi, from the same town, with similar experiences growing up. It's quite cool being able to connect on that level while making a positive difference.”
Associate Professor Lara Friedlander, who taught Shayden as an undergraduate and was his thesis supervisor, is “incredibly proud” of her student.
“Success is not just about personal achievement but about the impact we make on others.
“Shayden’s dedication to study, resilience, and passion for reducing oral health inequities have not only elevated him to be a leader in our profession but he has also touched communities.
“Shayden reminds us all of the power of using our gifts and opportunities to inspire change and uplift those around us."
~ Kōrero by Sandra French, Adviser Internal Communications