When Nicholas Bello was a high school sophomore, he founded a science club whose 40 members built rockets. Their ships never left the ground, though—it was post-9/11 New York, and the students couldn’t get FAA clearance to launch their craft over their school on Long Island.
Still, none of the amateur rocket scientists took the disappointment too hard, says Bello, D13, M.S.14, the first student in Tufts’ combined D.M.D./M.S. in dental research degree program. “We had a blast building them anyway.”
Bello brings that same enthusiasm to his master’s project, for which he will modify a tool already used to make dentures and bridges to achieve even greater precision—and perhaps offer a way to expand access to care for patients living in remote or underserved areas.
The computer numerical-controlled (CNC) router is a shaping machine that is guided by data fed into its computer. Manufacturers use the milling machines to cut and trim wood, metal or plastic into precise, three-dimensional shapes. Bello’s father, a sculptor and woodworker, used one to carve letters into signs he made. “I always thought you could use it on people’s teeth,” he says.
Bello is trying to develop a CNC router that can be fitted onto a dental handpiece and used like any instrument in a patient’s mouth. With images from the mouth scanned into the computer, a dentist could prepare teeth for fillings or crowns with even greater exactitude. “You’d have tremendous control over the execution, so you’d deliver better care,” Bello predicts.
But maybe more important, the modified device could someday allow dentists to deliver more care to more patients in more places. Bello imagines a world where another trained provider—perhaps a medical professional or dental assistant—could prep and assist with the patient onsite while a dentist maneuvers the CNC router from afar.
“Currently, if you want to go to a world-class prosthodontist, you have to go to the prosthodontist,” Bello explains. “Say you’re on an oil rig, and there’s an accident. [With the router] you wouldn’t have to fly the dentist to you or you to the dentist. Or you could set one up in public health clinics. The router would allow one dentist to do several preparations at the same time.”
Is Bello’s idea far-fetched? “Today there’s a rover on Mars, so I don’t think so,” says Peter Arsenault, D94, associate professor and head of operative dentistry, who is Bello’s faculty advisor for the project. “This could be the future of dentistry. We could solve some access-to-care issues.”
Treating All Comers
And it is caring for patients—not the tools involved—that matters most to Bello. Having spent the summer treating patients in the Tufts clinics, Bello recalls one woman whose dentures fit so poorly that she couldn’t pronounce S sounds. After he made the needed adjustments by hand, “she went home very, very happy,” he says. “I get a lot of satisfaction from being able to make serious changes in people’s day-to-day lives like that.”
Bello knows what it’s like to go without oral health care. The son of two artists, he didn’t always have dental insurance. Bello was in high school when his family again had dental coverage after a decade without it. At his first dental visit in 10 years, he was surprised to learn he had no cavities—the tight family budget also meant no soda, sweets or junk food.
Despite his clean bill of health, Bello felt the injustice deeply: “Do we have the right not to treat someone’s need if that someone cannot pay? If you ask me, my answer is no.”
Bello spent most of his childhood on Long Island, attending an academically rigorous all-boys’ parochial school where he took advanced math and played the tuba. The Society of Mary, which runs the school, is now supporting Bello’s scientific endeavors by lending him use of a CNC router for his research. An Eagle Scout, he credits the time he spent in the woods hiking and camping with sparking his interest in science and biology.
Beyond his own insatiable curiosity, Bello says he loves to teach, a talent he honed leading Boy Scout excursions. Few people meet Bello without coming away with at least one new survival skill—how to build a shelter in the woods during a torrential downpour, for example. (“Look for branches about the size of your wrist that have a split. Put three of these together, and you get a tripod that holds itself together. Make two and run a pole between them; now you’ve got something resembling a lean-to.”)
Most mornings Bello tutors undergraduate students applying to dental school on subjects on the DAT, the dental school admissions exam. He teaches others in the same methodical way he thinks about complicated subjects—breaking them into palatable bites and grounding them in the real world. “I noticed a lot of people have trouble with math,” Bello says. “A lot of times textbooks give a proof and say ‘This is why it works,’ but they don’t provide anything that a student can relate to.”
That’s why he wants to produce a series of math texts filled with problems and their solutions worked out step-by-step. He’s also interested in writing a better test-prep book for the DAT. Eventually, he says he’d like to practice dentistry at a low-cost or free clinic and teach and conduct research at a dental school.
Until then, though, Bello is concentrating on finishing his final year of dental school as well as the seven core courses—including biostatistics, technical writing and evaluating scientific literature—that the master’s program requires.
Tufts launched the program in 2011, says Paul Stark, director of the division of advanced and graduate education at Tufts Dental School, to give undergraduate dental students the chance to earn a master’s degree without having to pay for another year in school.
“The quality of the research being done by dental students here has been really high,” says Stark. “It seemed unfair that they had been working on these very rigorous projects and not getting anything but a single publication out of it.” Stark hopes more students will consider the D.M.D./M.S. program.
“As dentistry becomes more evidence-based, the ability to perform and evaluate research becomes more valuable,” he says.
Those are certainly skills Bello will hone as he perfects his dental router. His master’s degree project could result in a patent, says Arsenault, his advisor, who worked as an engineer before becoming a dentist. “This could parlay into many things,” Arsenault adds. “You know what? Keep your eye on Nick Bello.”
This article first appeared in the Fall 2012 Tufts Dental Medicine magazine.
Jacqueline Mitchell can be reached at email@example.com.