iTOP Founder - Mudr Jiří Sedelmayer
MUDR JIŘÍ SEDELMAYER – Prevention Hero, Teacher, Mentor and Artist
In 1986, Mudr Jiří Sedelmayer graduated in Dental Medicine from the University of Hamburg, Germany, and spent the next 25 years as a clinical teacher and researcher at the UKE Hamburg (Department of Conservative dentistry and Periodontology, University Medical Centre Hamburg-Eppendorf).
Dr Sedelmayer taught students restorative therapy, endodontics, periodontology and individual prophylaxis. Students appreciated how simple and clear he could explain complicated dental procedures. They would often stay after classes to listen to his lectures and to work with him on their patients.
Colleagues and students admired his practical and artistic skills, as well as his teaching methods. It came as no surprise that after graduating, many of them would invite Dr Sedelmayer to lecture in numerous events for dentists organised by the local dental chamber. Thanks to his talent in drawing, he made colourful and detailed illustrations for his lectures, often copied by attendees.
Jiří’s focus and passion for prevention came during daily work with countless patients that came knocking on the door of the University clinic. Many patients that came had pain or swelling – no matter their age, sex, or socio-economic background – with the pathology caused by dental plaque, as a consequence of an insufficient or inadequate tooth brushing routine. He questioned his own work and the profession itself and thought about how to improve the oral health of his patients once and for all. Also, his students were a huge motivation for him – many of them had perfect results in difficult clinical subjects but they still were victims of caries and gum bleeding themselves.
Dr Sedelmayer conducted small empirical research and asked his own students to prepare and show him the Bass Technique in the upcoming class. The result was shocking but somewhat expected – ten different techniques were presented, as each dental student described something different to each other. Remembering that class, Dr Sedelmayer said: “Of course we couldn’t ask Dr Bass about which technique is the right one because he was already dead”. He went deeper into the research just to conclude that unlike other areas of dentistry, prevention doesn’t have clearly defined principles and criteria on which proper biofilm management is based. For him, this was a sign. He decided to develop a unique teaching method, based on clear criteria and empirical data.
Dr Sedelmayer developed a programme to teach his students optimal oral hygiene techniques – a programme that would take its final form in 2006, when it became iTOP. The difference between iTOP and other programmes was the so-called Touch 2 Teach component – all the techniques were practiced hands-on, in the mouth, like in any other area of dentistry. He taught the students new approaches to prevention education and then engaged them in interesting practical examinations. Students would have to teach their colleagues optimal oral hygiene techniques and then the “patient” would demonstrate what they had learned. If the technique was correctly demonstrated, the student who taught their colleague would pass the exam. One of Dr Sedelmayer core beliefs was that you cannot learn a great brushing technique from a book.
(Practical exam of dental students in prophylaxis, UKE Hamburg, left student as patient, in the centre student on exam, right Dr Sedelmayer, 1990`s)
Dr Sedelmayer was not just committed to the development of optimal oral health techniques. He also understood the need for effective oral care devices. After diagnosing his own student, an 18-year-old (Monika) with interproximal caries – who reported to have regularly used both floss and a toothbrush – he started his research. He became more interested in devices to take care of interdental spaces and this is where he started his research with interdental brushes, especially their usage on people with closed interdental spaces. This led Dr Sedelmayer to develop the first generation of CPS Prime (interdental brushes for closed interdental spaces) brushes, the Interdental Access Probe and a bleeding index that was a modification of the Eastman index – instead of a toothpick, one would use an interdental brush to initiate interdental bleeding.[i] Later, Dr D. Hofer (Department of Preventive Dentistry, Cariology, and Periodontology, University of Zurich, Switzerland) introduced this index within the literature[ii].
During his time at university, Dr Sedelmayer included 600 students in practical research about their own BIOB (brushing on interdental bleeding) index. Upon first measuring, 85% of bleeding spaces overall were found after the first week of regular usage of interdental brushes. This result reduced to 42%, then to 19% the second week. After the third week, the BIOB index was only 3%. These results showed that the bleeding reduced after regular usage of calibrated interdental brushes. His students and followers confirmed the thesis in their own research.[iii]
(Dr Sedelmayer illustration on necessity of an interdental brush, 1999)
Dr Sedelmayer did not stop there. The need for practical tools to achieve perfect biofilm removal was still there. Observing some oral health habits in different cultures motivated him to develop the single brush and solo technique, which is described today in Color Atlas of Dental Medicine: Periodontology by Rateitschak [iv].
"Among other things, areas that scarcely need cleaning such as prominent tooth surfaces and gingiva, are often injured. Notorious plaque retentive areas – which are above all interdental spaces, the gingival sulcus and oral-distal tooth surfaces – are regularly cleaned by only a few number of patients.”– Dr Jiri Sedelmayer, Color Atlas of Dental Medicine: Periodontology by Rateitschak 2000'
He dedicated a good part of his professional career to promoting oral health through developing effective, non-traumatic and acceptable oral hygiene techniques and tools – the pillars of his individually-trained, oral prophylaxis programme. It was through his passionate and relentless work that, in collaboration with Curaden, he co-developed a new generation of oral hygiene tools that meet high iTOP criteria.
One side of the puzzle was to test oral hygiene techniques and identify the most effective ones. The other side of the puzzle was determining how to transfer the knowledge and skills to patients. That is how Touch to Teach – hand-ons training in oral prophylaxis – was established. Touch to Teach has a literal meaning: touch and guide the patient’s hand to teach them the right technique.
He advocated in dental communities the importance of the educational and coaching role of dental professionals towards patients. He believed that “lifelong teeth preservation without unnecessary damage is realistic under the supervision of a highly qualified specialist who knows and is able to exercise effective, non-traumatic techniques and devices”.
Dr Sedelmayer became known not only in Hamburg, but also in his own motherland. He was invited regularly to the Czech Republic to teach in dental congresses and lead practical courses. On 28th October 1995, Curaden CEO, Ueli Breitschmid, attended a lecture by Jiří in Prague at his invitation. More than 400 people followed the lecture breathlessly, laughed often and applauded feverishly in the end. In this single moment, Ueli said that he came to understand that he was dealing with a special person and decided for himself that, “This man can change the world - and I want to go this way with him”.