Especially when you're an associate dentist, you have to start out with foundational principles. Dental school is amazing. It's taught us a lot. However, it didn't teach us everything.
Stop wasting time.
Some of our students are really frustrated because they're getting these incredibly bulky crowns back from their dental lab and they have to spend a lot of time adjusting the crown. A lot of time, 30, 40 minutes, and chair time's very valuable.
When I first started waxing up my cases in the Dawson Philosophy, I learned later that I had encountered a mistake where I had really steepened anterior guidances on the wax-ups and didn't really quite understand why I continued to do it. When I slowed down and I took a look, I realized that I wasn't taking into account that the articulator helps us. It gives a little fudge factor.
So, a tip to keep improving and growing your office is to focus on the new patient experience. Every month you should be having monthly meetings. I would recommend that at least quarterly you and your office staff actually go through your office as if you were a new patient.
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Inspiration for this article:
Recently we received the following comment on the blog article, "The Importance of Load Testing" by Dr. Leonard Hess.
I am a past attendee of the Pankey and Dawson curriculums ( long ago in the 1980's) and am flabbergasted that you still preach this anachronistic content which has long been disproven in the evidence based literature and debunked in dental education. I am a dental educator and long ago stopped teaching that every patient had to be in centric relation, that the TMJ bore the main load of occlusion and that anterior guidance and posterior interferences had a significant relationship to TMD. I see patients with harmful irreversible changes caused by excessive and unnecessary equilibration, and TMD patients grossly overtreated with unneeded prosthetics, orthodontics and orthognathic surgery. I am hoping that you will post this and respond. Although I have great respect for Dr. Dawson as a pioneer in dentistry the Dawson Academy needs to greatly modify its curriculum content to come into the 21st century. !
Harold F. Menchel DMD
You can find responses by both Dr. Hess and Dr. Dawson to Dr. Menchel's comments at the bottom of that article. Below is my response.
As dental educators, it is our duty to seek a total understanding of the foundational concepts and the associated clinical relevancy in order to teach our students and positively impact patients. Dr. Dawson’s very concept of complete dentistry, and what is taught by the Dawson Academy, is to identify any signs or symptoms that impede anatomic and functional harmony. It is our goal to provide the least invasive, most conservative treatment to help our patients achieve optimal health that is maintainably comfortable and beautiful. This we agree upon.
The “anachronistic content” you describe stems from an incomplete understanding of the anatomy and function of the masticatory system as well as the erroneous application of that misinformation. Much controversy and clinically skewed research stems from a lack of a common classification system for joint position, occlusion and temporomandibular disorder (TMD) diagnostic criteria. Sadly, such has perpetuated our profession and the opportunity to clarify is welcomed.
Today’s dentist must deliver high quality, beautiful dentistry. In dental continuing education, there are countless opportunities to learn the techniques to prepare the maxillary anterior teeth and deliver a decent result. However, I am utterly convinced that once a dentist learns and applies the techniques taught by The Dawson Academy, clinical results will become exceptional.
A complete dentist will deliver more than just a pretty smile; a complete dentist provides a stunning smile that is not only comfortable, but also maintainable long-term.
As general dentists, we methodically work through a patient’s problem list, taking patient specific wants and needs into consideration, to create a roadmap for optimum oral health. Together with the help of our patient and our team, we strive to create a masterpiece that, once completed, restores our patient back to health—physically and emotionally.
As dentists, we are always striving to better our clinical skills and our ability to deliver high quality care through hours of continuing dental education. Yet, for many of us, we do not spend enough time nurturing our team relationships. I am not speaking of only our staff, but also our lab technicians and referring specialists.
By Dr. Shannon Johnson
Obtaining an accurate bite record that will allow a precise mounting is crucial for treatment planning. Many products exist that are very accurate, yet they do not easily allow a precise mounting. Such is the case with many PVS bite records.
The Dawson Academy prefers the “blue (Denar*) wax” for several reasons.
Due to our recent blog on Signs of Occlusal Instability, we’ve received a great comment from one of our followers. The reader asked for a more detailed discussion on checking the fremitus, including the differences between operator's finger sensation or occlusal overload in the presence of bone resiliency and how it could vibrate the implant restoration. We’ve asked Dr. Johnson to elaborate this subject for our readers.
By Dr. Shannon Johnson
Let’s take a closer look at checking for fremitus. It is no doubt that checking for fremitus is a quick, easy, and low-cost way to evaluate a patient for signs of occlusal instability.
The operator’s finger should be placed very lightly on the tooth surface. The necessary pressure is quite similar to taking a patient’s pulse—if you press too hard, you miss it. Once there, focus your concentration on feeling any movement or vibration when the patient brings his/her teeth together and grinds around. The best way to learn is to check all patients. As we begin to feel teeth without fremitus, the ability to diagnose subtle movement and vibrations will improve. Different operators may possess different finger sensations, but hopefully with the above advice, the clinician will be able to develop this important skill!
By Dr. Shannon Johnson
As clinicians, the very purpose of our dental exam is to thoroughly evaluate each patient for any sign of instability that will lead to breakdown of the masticatory system. Not including macro-trauma, there are only two simple reasons for the system to break down:
1. Microorganisms (bacteria, viral, fungal)
2. Stress from microtrauma