We have multiple options when we want to capture bite records for diagnostic models that will be mounted in a seated condylar position. Our approach will depend on specific patients and their needs. This will ensure we can get more accuracy on a more consistent basis. In the end, we’ll have less frustration when we modify our methods to the unique situation.

Here is a great go-to guide for bite records in a variety of circumstances:

3 Tips for Bite Records

1. Patients who need to release muscles or who tighten their muscles as a response to procedures.

In this case, we use bite registration silicone with a leaf gauge or a lucia jig. The leaf gauge allows is to set the vertical dimension to only allow 1mm of thickness of silicone between the posterior teeth. A lucia jig bite record is taken at a more open vertical dimension, but this is the perfect distance for a universal appliance.

Patients with positive muscle findings are most commonly deprogramed through appliance therapy at night, and then true centric relation bite records are taken at the end. Deprogramming can be accomplished with a temporary anterior discluder called a QuickSplint or a more permanent appliance in multiple different designs.

The main challenges with silicone bites include trimming and mounting for an accurate representation and dealing with patients who posture forward.

2. Patients who have relaxed musculature and no findings on a joint & muscle exam.

This situation calls for capturing records with a wax platform. This is a very popular technique at Pankey and produces quite an accurate record result as it is taken at the smallest increase of vertical dimension. Plus, it’s easy to mount while maintaining that high accuracy. As a second choice a leaf gauge with silicone can be used making sure that the fewest number of leaves possible are used just to gain adequate thickness of the silicone.

3. Patients at the end of deprogramming or appliance therapy.

Here again a wax platform record is very advantageous. Wax platforms are made from Schuyler wax. This wax comes in sheets that resemble baseplate, but are a deep red.

For this, you’ll want to tell the patient to take their appliance out to brush and eat breakfast the morning of the appointment. Then they should wear it to the office and then you can take it out to capture the bite record.

For the wax platform: Heat the sheet at the midpoint, cut it in half, then heat each half at the midline, folding to double thickness. Finally, cut the sides for a trapezoid shape. The occlusal stops are placed at the canine and second molar positions and made out of Delar wax. The record is captured using bimanual guidance or can be done with a leaf gauge.

What indicators make you decide to change your technical approach? We’d love to hear from you in the comments! 

Cost vs. Benefit of Building an Online Presence

Blogs are all the rage for company websites and an increasing number of dental practices are using them. You may have already dipped your toe in by starting one or wondered if it’s worth it.

The answer is: Sort of.

What’s a Blog and Why Do I Need It?

A blog is simply a short or long amount of written information added regularly to a specific page on a website (this is getting pretty meta, isn’t it?). It’s a place where people write public thoughts, opinions, etc. Usually, it’s more casual than most other website copy. In the dental practice world, you might use it to explain common questions patients have in more detail, relate patient success stories, or talk about your practice values/events.

Saying you need a blog though is like saying you need a new paint job in the office. Unless the place looks like a barnyard shack and paint is peeling down entire walls, it’s hard to determine exactly how much of an effect the improvement is having.

Understanding the Pros and Cons of a Dental Practice Blog

Blogs – in marketing a business – are used mainly to improve Google ranking. A higher Google ranking for keywords related to your practice like, ‘[insert state/city] dentist,’ means you’re one of the first links a potential patient sees. They aren’t likely to look past the first page.

Your initial instinct might be to post randomly generated nonsense using ideal keywords. Unfortunately, Google is too smart to let people game the system that easily (not to mention it looks crazy next to the rest of your gorgeous website and people will actually try to read it).

Blog content has to be readable and it has to be mostly real/unique. Effective blog posts are Frankenstein monsters of actual relevant content and arbitrary computer info that helps Google do its thing (i.e. keywords interspersed a maximum and minimum % throughout, meta descriptions, titles of a certain length and structure, headings, overall blog length, and so on). There are WordPress plugins that will help you manage the latter.

Here’s the clincher. Your ranking won’t be boosted to any useful degree by posting an ideal blog once a month or once a year. For the system to work, you have to post regularly. The exact amount of times a week or month is unclear, but at least once a week is preferred.

If you don’t have the resources, time, or desire to make decent content and post it often (or have someone else do it), there isn’t much point to doing it occasionally. It’s going to be off-putting to potential and current patients browsing your website if the latest post on your blog is many months to multiple years old. It looks unprofessional and makes it seem like your practice went off the radar for a long period of time.

Basically, if you can’t hire someone for the amount of time it takes to completely paint the wall and/or don’t have the ability to finish it yourself …. well, why even start in the first place?

What has your experience been of incorporating a blog into your practice website? We’d love to hear from you in the comments!

Denial in dentistry is often more subtle than how it appears in other medical professions. Because the denial doesn’t stem from a life-threatening situation, it isn’t as apparent to us or to our patients.

How we respond in a situation where patients react illogically to our recommendations can make all the difference in our effectiveness at helping them. Ultimately, trying to force feed convincing information leads nowhere. It simply encourages our own doubt in ourselves or leads to inaccurately judging a patient’s level of motivation.

There is an alternative to backing off and laying the discussion aside. This alternative depends on an understanding of the process of denial and enables us to enter into that process with our patients.

What is Denial and How Does it Affect Our Patient Care?

Many of us have experienced denial wrenchingly in our personal relationships or less severely with difficulties like having too much stress or high cholesterol. By definition, we don’t see our behavior or feelings in these moments as denial.

Remembering this will help you relate to your patients with a greater degree of empathy. Also, don’t forget that denial is normal. It can’t be avoided or overcome, so it’s much more helpful to approach it empathetically.

One of the most common ways I see denial showing up in dentistry is when patients avoid treatment we have recommended. The fact that these treatments don’t usually involve anything life threatening doesn’t mean they aren’t a significant loss for the patient. What seems like an insignificant diagnosis to us (bite problems or decay) can feel like a loss of a measure of health to them.

There is much to be said on this topic, but the most important thing to do first and foremost is to think of your role as one that is not just informative. The patient is in denial not because they doubt the validity of your assessment. They simply don’t believe the implications are true for them.

Patience is the true means for helping patients through denial. They will come to recognize what they can’t see clearly after guided conversation and appropriate questioning.

How do you recognize denial in your dental practice? We’d love to hear from you in the comments! 

Having dental work done when you’re a dentist is a strange experience. It can be enlightening, frustrating, relaxing, or a combination of all three.

The phenomenon of dentists treating dentists is one fraught with more than a few commonalities…

4 Things That Happen When Dentists Get Dental Work

1. We Empathize More With Patients

When we’re the one in the chair, we experience dental work from the opposite perspective. We’re bound to think things like, ‘Geez, this grinding really does shake my head.’ What seems like no big deal as a dentist seems much more dramatic as a patient.

2. We Notice the Overlooked Details

Lying back gives us the chance to see the operatory from a whole new angle. We notice all the water spots on the light cover from the disinfrectant and the quality of the safety glasses. We’re sure to have these details checked in our own office as soon as we get return from the appointment.

3. We Get Super Controlling or Super Relaxed

For many dentists it is hard to just be the patient; we understand every little thing that is happening, but can’t keep track of the details when we are being worked on. With nothing else to do, our minds race as we review the procedure, how we do it, and how it is being done right now. We’ll wonder, ‘did they let the etch sit for exactly 25 seconds?’ or ‘did they scrub with the dentin adhesive for 15 seconds twice?’ We can’t help but hold our chosen clinician’s hand throughout the prep, despite vetting and trusting them beforehand.

Other dentists take the opposite approach. You don’t even want to think about what’s going on. For once, you don’t have to make the critical decisions.

4. We Experience Some Miscommunication Issues

Many of us squeeze our dental work in at lunch or other free time during the work day. We end up having to go back and talk to our patients numb. Often times, this creates the best conversations, as patient realize dentists have dentistry too!

What would you add to this list? We’d love to hear from you in the comments!

Making better business decisions for your dental practice comes down to four key goals: (1) doing more dentistry patients need, (2) helping patients have healthier mouths, (3) making more money and (4) stressing less.

Improving your success in any one of these areas will affect the others, which is why you should think of these various elements comprehensively rather than separately.

How to Do More Dentistry

If you feel that you’re not making enough or treating enough patients, the problem likely isn’t economic downturn. The truth is, if you have a strong system in place, external economic factors shouldn’t have a huge effect on how many patients return for basic treatments such as hygiene.

One of the most common issues practices face is the efficacy of their systems. You may be seeing plenty of patients but without a clear system for setting new appointments, you may not have a full schedule.

Retention is all about measurements. What this means is that when you track or record data, you’re more likely to pay attention to it. A great way to increase the number of hygiene appointments you have is to track how many your are scheduling and how many patients are showing up for.

Simply by measuring this information, you will be more likely to ensure appointments are made. The same goes for your staff who actually carry out scheduling and encourage patients to return. This will also help you better understand what appointment scheduling methods you should offer. Different people like to be reminded differently. Some prefer an email, some prefer a text, some prefer the date and time written on a piece of paper, and some prefer a call.

The lesson of retention illustrates a thought process that can be applied to all areas of your business. Essentially, remember that one size does not fit all and simply paying more attention can improve your success.

What do you think is the hardest part of running a dental practice? 

We value Pankey logo items not because of the physical object itself, but because of what they represent. Our clothing, accessories, and lifestyle ‘Pankey’ gear allow us to show off our pride for what it means to be a Pankey dentist.  Of all the “swag” and logo items over the years, there is one that means more to our alumni then any other.

In this post, four alumni tell us what their Pankey cross pins mean to them.

‘Pankey Bling’ Perspectives on the Cross Pin

Dr. Michael J. Crete

“I must say, my favorite Pankey bling is my pin! I have worn it with pride since I first received it from Bill Davis, my C1 lead faculty member and the author of The Pankey Philosophy book. I have had fellow Pankey alumni who I have never met come up to me at meetings, in airports, etc. We always have an immediate bond. I have also had strangers ask me what the pin is for. It always gives me a chance to tell my professional and Pankey story.”

Dr. Christine Shigaki

“I love my Pankey Cross pin! My Pankey mentor Mike Higashi gave it to me after I took C1.”

Dr. Michelle M. Lee

“For me, the Pankey pin symbolizes my commitment to dental excellence, being part of the Pankey family, embarking on my own journey in life and practice, and creating a better life for myself and better dentistry for my patients. It makes me feel like I am part of a supportive community of givers. It’s also a practice and life philosophy that you can carry with you throughout your entire professional and personal career. Pankey has changed my life and not a day goes by that I don’t think of the Pankey Institute and how much it has impacted me!”

Dr. Richard Hunt

“I see my two favorite Pankey bling in my dresser drawer every day. Like most men, I have a variety of lapel pins that represent an emotional attachment to the professional organizations, institutions, and charitable causes that I have been associated with. While proud of every one, my Pankey cross is at the top of my list. I wear it often and am amazed at the number of conversations it engenders about the Institute and what a wonderful influence it has been on so many lives. My other favorite “bling” is a wooden round ‘TUIT’ that was a gift from my C5 instructor, Dr. David Hildebrand. It reminds me of a special person and the gift of his message at an impactful time in my life.”

What Pankey bling do you hold dear? We’d love to hear from you in the comments! 

New to the Key? Interested in expanding your culinary oeuvre? If you’re attending a Pankey course, you should add Cuban to your list of must-try Key Biscayne cuisine. 

Luckily, just across the street from the Pankey Institute is a small (but recently renovated & expanded) walk-up restaurant called ‘Oasis Cafe.’ Ordering at this local’s favorite can seem intimidating at first to those unfamiliar with Cuban cuisine, but it is actually a great experience.

The cafe is such a local institution it doesn’t have a sign, so we created a map to help you find it!

The food isn’t fancy, but it is real cuban food! You probably can’t go wrong with any selection, so it’s worthwhile to simply see what’s cooking today or ask for recommendations from the Oasis staff.

On the other hand, you could try out some of our favorites:

Pankey Favorites – Cuban Food at The Oasis Cafe

1. The Cuban Sandwich

This sandwich is not like other sandwiches. You either love it or your hate it. Cuban sandwiches are legendary for their salty-savory expansion on the traditional ‘ham and cheese.’ Trust us, they are on a whole new level.

Cuban sandwiches are filled with three different types of meat: ham, roasted pork, and salami. Pickles, mustard, and Swiss cheese add depth to the flavor profile. Everything is then squeezed between flaky, soft Cuban bread (a delight in its own right).

2. Cafe Con Leche or a Cortadito

Coffee with milk? It sounds simple, but a true cafe con leche from a Cuban establishment is a very specific type of drink made with strong cuban espresso. Despite not actually being food or ‘cuisine,’ cafe con leche is an essential part of a Cuban-inspired meal. If you like your coffee stronger, ask for a Cortadito.  Think of it as a smaller, more intense cappuccino. Get it the way the locals like it: “con azucar” (with sugar).

3. Empanadas

Empanadas are a savory pastry usually made with beef. They are universally adored for their reasonably doughy, deliciously fried exterior and flavorful insides. You won’t be able to stop at just one, we promise. They are filling, moist, and perfect for an on-the-go lunch.

4. Guava & Cheese Pastelitos

Think of fruity cheesecake filling in a warm, flaky, fresh-baked pastry. Its a delicious, authentic cuban pastry with a unique, islands flavor.  There are other flavors and even savory versions with meat, but we recommend you just ask for a “Guava & Cheese”.

5. Sweet Fried Plantains

“Maduros” as they are called are a delicious treat, often included with a meal as a side dish. Plaintains look like large bananas, but have a different flavor and texture.  Even if you don’t like bananas, you may like Maduros, which are fried (but not breaded). The sugars in the fruit are caramelized, and many like them slightly burnt.

How important is a satisfying local food scene to you when taking CE? We’d love to hear your thoughts in the comments! 

Between the mid 1950s and early 1960s, four significant innovations converged to permanently change the dental profession worldwide. All four innovations had dentists behind them that were connected to the the Pankey Institute years later. Modern dentistry evolved from their forward thinking.

One of these innovations was ‘sit-down’ dentistry. My father Dr. John Anderson played a large part in designing the chair that enabled dentists to sit while working with patients. Today, I tell his story.

A Pankey Dentist Shapes Modern Dentistry: The ‘Sit-Down’ Chair

Up until the late 50s, most if not all dentists worldwide were standing up doing dentistry with no dental assistants. The ‘work smarter, not harder’ theme of the time period ushered in the need for a type of dental chair that could accommodate more efficient and better care of the patient, as well as benefits to the doctor’s own ergonomic health.

The major dental manufacturers of the day, when approached with the concept of sit-down dentistry, flatly said “that would never work.”

At a dental convention, my father Dr. John Anderson approached a contour chair exhibit and met a salesman/owner named John Naughton. Sales were not good. My father asked Naughton if he would be willing to risk a new application of his contour chair for dentistry. Naughton basically responded, “What do I have to lose? I’m going broke.”

The long and short of this is that the first sit-down dental chair was placed in my father’s Chicago dental office. It was a full contour chair that had some significant restrictions. My father suggested a split-back design that is now used by every dental chair manufacturer in the world.

The first split-back chair was produced by Dental-Ez Corporation and called the ‘J-Chair.’ It is still being used throughout the US and world along with many other designs. John Naughton later sold Dental-Ez for eight million dollars.

My father’s creativity in modifying the dental chair forever changed how dentists practice dentistry.

What makes you proud to be a Pankey dentist? We’d love to hear from you in the comments! 

As dentists, we tend to see our regular patients far more often than other doctors. This means we have the opportunity to be the first point of detection for diseases like oral cancer.

The Updated Demographic of HPV and Oral Cancer

Oral cancer is on the rise. What does this mean for dentists? First and foremost, it means understanding how the demographic of oral cancer has changed. At one point, it was associated with lower socioeconomic groups, smokers and poor nutrition/oral hygiene.

These associations with oral cancer have changed dramatically. One of today’s largest at-risk group is young, educated non-smokers.

New research has lead to the discovery of many different types of oral cancer. The majority of oral cancer cases are associated with HPV. Thankfully, HPV related oral cancers are highly treatable with chemotherapy and radiation.

Nowadays, oral cancer is more survivable and treatment is less detrimental to quality of life.

Why Early Detection and Prevention Matters

Early detection and prevention are the areas where dentists can have the most significant impact.

Early detection is crucial to improving the chance of survival and how treatment proceeds. One way to facilitate early detection is to offer oral cancer screenings at the beginning of every hygiene visit and exam. The best exam combines visual and technological assessment.

If you detect or are suspicious of oral cancer, you must actively refer your patients. It’s better to be safe than sorry, so there’s no reason to be concerned if you refer them to an oral surgeon and they aren’t diagnosed with oral cancer. Simply be upfront with patients about the likelihood that everything will be fine.

Prevention is the most powerful tool in our arsenal. It is our responsibility, along with the pediatric medical community, to promote and discuss the HPV vaccine with parents of our younger patients. Encourage them to vaccinate both sons and daughters for the prevention of oral cancer.

What early detection measures do you implement in your patient exams? Please let us know your thoughts in the comments! 

Click Here For Paving The Way: Part One

Click Here For Paving The Way: Part Two

Being a woman in dentistry used to mean years of struggle. Now, the experience couldn’t be more different.

Dr. Glenda Owen graduated from dental school in the early 80s. In her last two blogs, she related the challenges she faced while receiving an education, as well as how percentages of women dentists and the model of a dental practice have changed. Below, she discusses success while managing a family and career.

Wife or Work: Struggles of an 80s Woman in Dentistry

Many of us, with a household and children to manage in addition to a career, chimed in on a dialogue that was already present in the 80s culture regarding “having/doing it all.” This was not a conversation among most male dentists.

Our older male colleagues often had a wife who managed the domestic and family affairs. But as more and more women entered the work force, we and our male counterparts experienced the strain of trying to manage office and home fronts and keep peace in the marriage.

One friend of mine, a pediatric dentist with three kids and a lawyer husband, mused in the 1980s, “There are lots of single moms out there; some of them just happen to be married.”

The bottom line is that we have learned success at home and at work require an equal partnership on the domestic front. Otherwise, burnout and frustration, along with stressed relationships, are bound to occur.

At Pankey, we have been ahead of the curve. Our core values, represented by the Cross of Life, have put balance and relationship at the forefront of our conversations. This is bound to impact the home life for all of us, men and women alike.

In our classes, I have been impressed with the young men who talk about managing kids and helping with domestic chores alongside their wives/partners who often have their own careers. Granted, this is a cultural phenomenon across all careers, but it is a pleasure to witness nonetheless.

As women dental students graduate and continue to increase their percentage among practitioners, I trust that a male professor could no longer get away with telling a woman that she is taking a position that could have been used by a man. It is simply irrelevant and archaic. And that is some of the best news yet.

How do you approach balance and relationship? We’d love to hear from you in the comments!