Read the interesting story behind the unique educational programme for dental professionals.
The idea of iTOP was born at the University of Hamburg in the early 1990s. Dr Jiří Sedelmayer, the father of iTOP, was unhappy about the state of oral health of his patients. Countless people came knocking on the door of the university clinic where he was practising – with pain or swelling – no matter their age, sex or socio-economic background. Their pathologies were 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.
How to teach students to brush correctly
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 create a unique teaching method, based on clear criteria and empirical data.
The courses he developed began at Hamburg University as a non-compulsory after-school activity. When Dr Sedelmayer retired and returned to his hometown of Prague, the then-rector of Charles University wanted Dr Sedelmayer to officially implement his concept. This resulted in a veritable cascade: Dr Sedelmayer’s own iTOP students went on to implement the concept in places around the world where they taught.
Hands-on training as the key element
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 Touch to Teach component – all the techniques were practised 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.
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.
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The man who can change the world
In 1995, Curaden CEO Ueli Breitschmid attended a lecture by Dr Sedelmayer 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.”
After their meeting in Prague, the topics of prophylaxis, dental hygiene and oral hygiene gained renewed importance for both protagonists. “Health begins in the mouth” – this claim became the guiding principle of the iTOP prevention programme developed by Dr Sedelmayer, with which Curaden has been training dental professionals in proper tooth brushing with the optimal instruments for decades, worldwide on all continents. The declared credo behind it: prevention instead of cure. The guiding principle: through a healthy mouth, a healthy person.
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 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 inter-dental 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.
Research that showed the importance of interdental care
Dr Sedelmayer included 600 students in practical research about their own BIOB – bleeding on interdental brushing – index (now adapted into the BOB score). Upon first measuring, 85 percent of bleeding spaces overall were found after the first week of regular usage of interdental brushes. This result reduced to 42 percent, then to 19 percent the second week. After the third week, the BIOB index was only 3 percent. 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.
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.
Jiří Sedelmayer (1946–2019) was a Czech dentist, university teacher and researcher. He studied and taught dentistry at the University of Hamburg. Sedelmayer was a founder of the Czech Preventive Society, New School of Individual Prophylaxis and the Individually Trained Prophylaxis (iTOP) programme. In his practice and research he focused on individual prophylaxis, filling therapy and endodontics. Jiří Sedelmayer and his wife Lucie trained thousands of dentists and hundreds of iTOP teachers from all around the world.
