One of my favorite bumper stickers is “Who rescued who?” I have a difficult time believing in pure altruism by the biologic definition that it is done at your own expense, as in my life I always receive as much or more then I give.

The Value of Giving Back

My experience time after time is that I’m always better for attempting to improve the well-being of another. Nine years ago, we hosted our first Pankey Dental Access Days with the guidance of Dr. Keith Phillips, from whom I have learned much about the beauty of giving back.

Keith took a small and mighty crew from North Carolina (with a 10 chair mobile clinic) to Evanston each year. We consistently provided comprehensive care over a two-day period of over $100,000. The tears of a patient who’d been given a flipper where he hadn’t had a tooth in 10 years (so that he could go confidently to an interview) changed me forever.

In 2010, I met an MD who had traveled with Doctors Without Borders to Haiti after the devastating earthquake that killed 230,000 people. He showed me a photograph of a 5-year-old Haitian boy with a big smile on his face and a sticker on his cheek.

At the time, my boys were 7, 5, and under 1. He asked if I knew why the boy had such a big smile on his face. I didn’t and he told me that it was his first sticker. When I brought that story home to my boys, they countered with, “He has other toys though, right?” When I informed them that it was his first anything, I knew I needed to experience Haiti with them.

Last January, I took my 12 year-old son on the trip of a lifetime. Braden and I joined a group of 18 medical professionals to help care for a tent community of Haitians displaced by the earthquake. On his first call back home to his mom, he recounted, “Mom, the kids here are so happy—and they don’t have anything!” My heart warmed and I felt my mission for him was already accomplished.

Our original plan was for him to work at a nearby orphanage and play with the kids, but the distance proved too dangerous for our trip director. Braden stepped up and assisted me amazingly for someone whose only previous work experience in my office was to pick out toys for the treasure chest.

On about the third patient, I asked, “I guess you’re OK with blood, huh?” “No problem, dad!” was his response. There is no way I could have treated the number of patients I did without his help.

There is no doubt in my mind that I would not have been able to experience such a trip without my Pankey experience. Having the financial freedom to give back and an expectation of quid pro quo has allowed me to answer the “Who rescued who?” bumper sticker question with a smile.

How do you give back? Please leave your thoughts in the comments! 

This is part 2 in a series where Dr. Mike Crete describes an conservative esthetic case where he combined Invisalign and veneers.  Part one looks at helping the patient become aware of the possibilities. Read on for the conclusion.

A Smile Dialogue

… All of this conversation took place in about 5 minutes at the end of the patient’s initial hygiene examination. I then invited him to return for a ‘complimentary smile analysis’ appointment where I would take a series of digital photos and then sit down with him and talk about what we could do to improve his smile.   

I find I can build trust and credibility with a new patient by offering to see them for this complimentary appointment. It only takes about 20 minutes and I typically ‘convert’ the patient to a records appointment (comprehensive exam, X-rays, and mounted study models).

The records appointment was scheduled. More co-discovery revealed how significant Drew’s self-esteem was impacted by his smile and his ‘baby face and baby teeth.’ The records appointment was followed by a diagnostic wax up (or a “3D Design” as I like to call it when talking to patients).

Then a consultation was done to review treatment options. This was a formal case presentation using Powerpoint, photos, and mounted models. Drew’s mother sat in on the consultation appointment.

By having accurately mounted study models on a semi-adjustable articulator, I was able to determine I could give Drew an ideal occlusion AND a pleasing smile. This would involve some minor tooth movement using Invisalign for 6 months and then restoring his upper and lower anterior teeth with conservative porcelain veneers. His posterior teeth were equilibrated during the restorative process. Also, an upper bite guard was fabricated for nighttime wear and added protection of the restorations.  

Drew graduated from college approximately 18 months after I first met him. He completed an internship during his final semester and then was hired by the Fortune 500 company immediately following graduation. He recently got married and said to me, “After I had my teeth done everything in my life started to fall into place. I graduated, got a great job, and met the love of my life. Thanks, doc.”  

Changing a smile and changing a life. It’s being able to impact the lives of others in this way that makes it so rewarding to practice dentistry!  

Dr. Crete discusses an anterior esthetic case from the initial conversation to finished treatment plan for a patient who lacked smile confidence.

Patient Profile

Drew became a new patient at my practice as a 20-year-old junior in college. His reasoning was: “Just to get my teeth cleaned.” During his initial hygiene appointment, he mentioned the “spot” on his front tooth (#9 – small pit filled with composite 10 years prior).  

He asked: “Can you put some new bond on there and make it match better? Even when my dentist did it the first time, it was always obvious.”

I heard his question as a window to ask further questions and find out a little bit more about him. At Pankey, we call this, ‘knowing your patient.’ It can start with an introduction to a new patient during a hygiene examination.  

Asking the Right Questions for Case Acceptance

I began by asking, “Do you know why you had the bonding done?” and “Did you have a cavity?”  

His answer was, “No, I have been playing hockey since I was really little. I was not always good about wearing my mouth guard and I chipped my teeth a lot.”   

Further questioning revealed he was referring to the enhanced mamelons and pitted enamel areas of his anterior teeth as “chips.”

His parents had elected not to have the chips repaired because they were told it was cosmetic treatment and their insurance would likely not pay anything.  

The Value of Open Dialogue

I then asked a few more open-ended questions like, “Is there anything about your smile you would change?”  

His answer: “Well, I always feel like I have little teeth and it makes me look like a little kid. I wanted braces when I was in junior high but my dentist told me I had a good bite and braces wouldn’t fix all the spaces I have.”  

Further dialogue with Drew revealed a significant concern he had about graduating from business school in a year and having to go through interviews looking like a little kid. He said, ”I worry no one will want to hire me because I look so young.”

To be continued…