So facebows are essential and a key point in dental treatment. We want to capture the facebow records for two very important reasons. By relating the maxillary arch to the condyles, we get a couple of very key pieces of information.
Treatment planning is absolutely key to what we do. We take care of our patients with treatment planning, and the better that we can treatment plan for that patient, the better the outcome, the happier the patient, the happier we are.
So when you're trying to decide if your patients have an internal derangement or an occlusal muscle problem, how do we go about doing that?
First part is the screening questions you ask before you start to testing.
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.