Dr. LD Pankey was born and reared in Southern Illinois over five miles of countryside. His father had a grocery store and a farm, but he didn’t venture into the larger world until he was ten years old. When he was about 12, he fell in love with dentistry while climbing the steps to a dental office for the first time. He knew then it was what he wanted to do.

Dr. Pankey moved to Indiana halfway through high school to get an accredited high school education. Then he went to the University of Louisville and graduated at 22 in 1924. That was the beginning of his career.

His wife was a dentist’s daughter who he met at a board meeting. They married in 1933. He has three daughters and a son, who went on to be an orthodontist. But without a crucial move early in his career, everything might have been different for Dr. Pankey.

Courage in the Face of Complacency: Why Dr. Pankey Moved to Florida

Dr. Pankey’s first practice was in Newcastle, Kentucky. After graduating, his advisor in dental school told him to take on this practice in Kentucky from a dentist who was moving to Florida, as he knew Dr. Pankey was young, broke, and $3300 in debt (at the time, this seemed like a lot more money).

He suggested Dr. Pankey gain some maturity and security in a practice that was already built up before moving on to bigger and better things. Dr. Pankey had nine patients the first day and fourteen the second, a trend which continued for many months. He paid off his debt, was happy, and bought a new car.

At the time, he wrote a letter to his mother about how well he was doing. She responded saying she was glad for him, but that she hoped he wasn’t providing poor dental care. She had recently had dentures placed and hadn’t felt good since.

This formative interaction made him very unhappy because he was in fact practicing the kind of dentistry his mother had experienced. He also felt he had become too comfortable. In 1925, he left for Florida and promised to save teeth not remove them. This was the beginning of the development of his philosophy of practice and his journey of continuous learning, a concept he taught other dentists until the end of his life.

The rest is Pankey history!

The question of what makes something ‘aesthetic’ or pleasing to the eye is one that often plagues dentists. We are so concerned with our patients’ perceptions of beauty that it is always on our mind.

The sense of aesthetics is an innate quality that we all carry. This sensibility is intertwined with our own internal creativity and curiosity, as well as our desire to create. Many people conflate a particular affinity for aesthetics with a lesser ability in other more technical areas, but in reality these are not mutually exclusive.

As dentists, we balance the technical and the aesthetic every single day. It can be challenging to handle the needs of both these areas in concert.

A Pankey Take on Aesthetics

Dr. Pankey had a particularly eloquent way of describing aesthetics. He clearly had a great appreciation of the world. This is why he combined his appreciation for aesthetics with the needs of dentistry, which resulted in multiple insights about the complexities of aesthetic dentistry.

Dr. Pankey’s aim was to learn the ins and outs of dental aesthetics to maximize quality of patient care. He had a vision of organizing all of the information he had acquired and making it available to more dentists.

The S Curve

An important tenant of dental aesthetics is the ‘S’ shaped curve that visually stimulates a sense of beauty. This has to do with the way it moves the eye and creates a flowing movement. The curve is a common aesthetic aspect of teeth and tissue, especially in the tips of every papilla to the zenith point.

We see the S shape as a result of the emergence profile or the angle of the entrant line of each tooth. Contour also plays a role in this specific part of the smile’s appearance. All in all, it’s important to pay attention to this aesthetic nuance in your work.

What do you think is the most important consideration for aesthetics in dentistry? 

When a dental partnership fails, it’s natural to want to keep the truth quiet. The dissolution of relationships, especially business relationships, is often seen as shameful. In Part 1 of this series, I decided to openly discuss a partnership that ended. Here, I continue that story.

When Dental Partnerships Go Awry

After negotiation and mediation failed, our contract stated we would have our case settled by the American Arbitration Association. When the dust settled three-and-a-half years later and the final appeal ruling of the Arbitrator’s decision came down in my favor, it ended up on the front page of our local Daily Law Bulletin.  

I had multiple texts come in that morning from attorney friends and patients congratulating me on the victory. Even an arbitration victory can feel like a loss with the stomach lining and energy that it takes to go through the process.  

I know that some lessons will never be learned out of a book and need to be experienced, but please add this one phrase to your existing or upcoming contract: The loser of any appeal of binding arbitration shall pay the other party’s attorney fees. That alone would have prevented many years of stress, a whole lot of money spent on attorneys, and some gray hairs to boot.  

Creating a Partnership Charter

Recently, I was introduced to a book entitled ‘The Partnership Charter’ that has energized me around new possibilities for a partnership with my current associate. A partnership charter is a cooperative document meant to instill a spirit of collaboration into an agreement between parties.  

While not legally binding, it provides a framework for the partnership that is highly individualized and contains no boiler plate standard clauses. The process is the most important outcome and the document is secondary. It is meant to be reviewed and revised throughout the partnership, becoming a true living document that creates continued conversation over synergy and fairness.  

Though not every scenario can be planned for, I am confident that getting in and out of my next partnership will be spelled out much more clearly than my last. The charter will provide a process of collaboration that will guide us toward fairness for all concerned.