Interview with Thomas Péchier, associate dentist

Thomas Peschier, you are a partner dentist at Smile and Care. How long have you been working at the Grand-Saconnex clinic?

I have been working in the Quartier des Nations for almost twenty years. Seven years ago, Isabelle Bek, my current business partner, was looking to boost the dental centre in Sonnex. I was then a clinic head at a dental center in the Quartier des Nations, and it was time for me to take on a new challenge. In Sonnex, we were a small team of seven people and in seven years, we developed the clinic well. Today, the team consists of seventeen people.

What are your specialities?

I don’t have a specialty; I’m a general practitioner. I enjoy doing a bit of everything, except for more complex surgeries, which my colleagues handle better than I do. I have always had a keen interest in optics, vision and magnification. You can only do well what you can see well. This motto is fundamental in our profession, both for diagnosis and for the therapeutic aspect. Not everything can be seen on an X-ray.

When I completed my thesis 25 years ago, I specifically focused on the usefulness of the microscope in surgical procedures, and working under a microscope has always been somewhat of a passion for me. I use it half the time – whether during consultations to clarify a diagnosis or to communicate with patients using photographs projected on a screen. These images are magnified 25 to 40 times and can highlight both a problem and the results of a treatment.

The microscope allows us to zoom in, but not to discover any problems inside the tooth?

Indeed, but it allows you to see what is through it, since enamel is a crystalline structure. It will highlight certain problems more clearly. We see our teeth all the time, but the microscope can reveal issues that are invisible to the naked eye, such as cracks.

Here, for example, we have the case of a patient who grinded his teeth a lot without realising it. When faced with this photograph, he realised all the weaknesses caused by the grinding of his teeth. From a distance, it was impossible to detect this problem. Today, this patient has understood the importance of wearing aligners, as his cracks are so significant.

The microscope enables an essential dialogue with the patient, both to explain the situation and the treatment plan. This visual evidence contributes to the patient’s understanding. It allows us to discover frailties that we would not have discovered without a microscope and to adapt the treatment plan.

Leica Picture

Example of a crack found under an old filling, which was causing pain to the patient. Cleaning and a composite were carried out.

Why did you choose this Leica microscope?

I wanted our dental clinic to have a very specialised microscope that was 100% functional. Attached to the wall to avoid instability, it has optics that provide me with very satisfactory light, allowing me to discover the tiniest details.This microscope represents a real investment for the clinic, which is not billed to the client. For Smile and Care, the priority is to offer us visual comfort, precision, performance and quality. This tool allows our practitioners to solve problems and adopt a change in practice.

What types of dental care is it used for?

It can be used in all dental disciplines, but it is especially valuable in dental surgery, particularly endodontics, as we cannot see up to 40x magnification with the naked eye. In concrete terms, with this tool, we can see right to the end of a canal, in depth. I use it a lot for treating tooth decay, mainly in the upper teeth, from cleaning the cavity to applying the composite. Prosthetics is another discipline for which we use the microscope. We also use it very frequently for root treatments.

Leica Picture

Leica Picture

Examples of tooth decay seen under the microscope

Root treatment as seen through the microscope

Leica Picture

How long have you been using it?

We have been using it since January 2022, and since then, our approach to work has changed radically. My working posture remains stable, which also helps to prevent back problems for practitioners. Only our hands move, and the precision of our treatments is greatly enhanced.

In a few words, what was your objective with this tool?

Above all, we wanted to equip ourselves with high-quality tools, which is the case for much of our equipment. Our ultimate goal, which we all share here, is to enhance the quality of our treatments.