Fixing the Failed Restoration: Treatment Planning

July 30, 2018 Lee Ann Brady DMD

Replacing a failed restoration starts with a careful examination of the patient’s needs, desires, and current oral health. My patient in this case presented with a six unit anterior bridge, decay, and many esthetic issues. After an esthetic evaluation and comprehensive exam, it was time to move on to treatment planning.

Failed Restoration: Treatment Plan

To treatment plan this case, I relied on an advanced facially-generated treatment planning system for communicating with the rest of the team. Communication is essential to a reliable outcome.

First, a diagnostic work-up was generated. Then, the interdisciplinary team together developed a final treatment plan and sequence, with the incisal edge position of the upper right central as reference.

We chose orthodontic extrusion of the upper teeth to handle proclination in the anterior and the gingival discrepancy. Additionally, we treatment panned the maxillary right canine for over-extrusion by 2 mm. This was done to achieve adequate restorative ferrule through crown lengthening, not to mention re-treatment endodontic therapy with post and core.

We talked about implant therapy, but ultimately it was not a workable solution. Root proximity on the upper right and the gingival tissues meant it wasn’t ideal as a first option. For the final treatment, we decided on placing a six unit anterior bridge. I then discussed the outcome with the patient and she decided conservative therapy for the posterior esthetics of direct composite veneers was best. This enabled us to create consistent contour and shade.

Next up was the lab, which made a pre-orthodontic wax-up based on periodontal surgery and planned tooth movement. I gave them the proper information by using PowerPoint and digital photography with the proposed tooth positions. After this, the post and core endodontic re-treatment was done for the upper right canine.

To be continued…

What’s your approach to treatment planning? 

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The Pankey Administrative Team: Inspiring Front Office Excellence

DATE: February 6 2025 @ 8:00 am - February 7 2025 @ 2:00 pm

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The Pankey Administrative Team: Inspiring front office excellence Front office systems for a Pankey-trained dentist hold very specific differences compared to a  typical dental office.  Learning how to differentiate your…

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Lee Ann Brady DMD

Dr. Lee Ann Brady is passionate about dentistry, her family and making a difference. She is a general dentist and owns a practice in Glendale, AZ limited to restorative dentistry. Lee’s passion for dental education began as a CE junkie herself, pursuing lots of advanced continuing education focused on Restorative and Occlusion. In 2005, she became a full time resident faculty member for The Pankey Institute, and was promoted to Clinical Director in 2006. Lee joined Spear Education as Executive VP of Education in the fall of 2008 to teach and coordinate the educational curriculum. In June of 2011, she left Spear Education, founded leeannbrady.com and joined the dental practice she now owns as an associate. Today, she teaches at dental meetings and study clubs both nationally and internationally, continues to write for dental journals and her website, sits on the editorial board of the Journal of Cosmetic Dentistry, Inside Dentistry and DentalTown Magazines and is the Director of Education for The Pankey Institute.

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Fixing the Failed Restoration: Exam & Evaluation

July 29, 2018 Lee Ann Brady DMD

A comprehensive exam is the first step in a long line of decisions that can end in case success or failure. For this case, my patient presented with a litany of problems and dental concerns.

Failed Restoration: Patient History

When I first encountered the patient, she had a six unit anterior bridge with temporary cement. She came to my practice because she was unhappy with how her dental work looked and was interested in a permanent restoration that would truly suit her goals.

She had a checkered dental history beginning with orthodontic treatment for a diastema between the maxillary centrals and a left maxillary lateral that fractured down to the root and had to be removed. After a FPD was placed for the tooth removal, her diastema reopened and the right maxillary was also lost to fracture.

That wasn’t even it for the patient’s woes. She was given a bridge that made her very unhappy and also had to have endodontic therapy on the upper right canine. Despite multiple placements, the restoration was never to her liking.

Esthetically, the patient wanted to remedy her uneven gingival margin, the length of the upper right canine, the relative size of laterals and centrals, and the color match. The latter was difficult to remedy because of tetracycline staining from her childhood. Finally, she was also displeased with the thick feeling of the bridge.

All of this together painted a picture of a patient in need of serious help.

Failed Restoration: Evaluation & Exam

My esthetic evaluation confirmed many of her concerns. I completed it intraorally and with diagnostic photographs. The patient presented with tooth proportion asymmetries, inadequate tooth display at rest on one central, an uneven incisal plane, and gingival discrepancies.

Her comprehensive exam revealed normal TMD joints, but also showed posterior wear. She had muscle pain and headaches yet no muscle tenderness. I put her on six weeks of appliance therapy, which led to the discovery that she had a habit of ‘power wiggling.’ I was then able to obtain an accurate centric relation bite record.

I removed the anterior bridge for radiography of the abutments. It became clear that her maxillary right canine had a lot of decay and inadequate ferrule.

To be continued…

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E1: Aesthetic & Functional Treatment Planning

DATE: August 21 2025 @ 8:00 am - August 24 2025 @ 2:30 pm

Location: The Pankey Institute

CE HOURS: 39

Dentist Tuition: $ 6800

Single Occupancy with Ensuite Private Bath (Per Night): $ 345

Transform your experience of practicing dentistry, increase predictability, profitability and fulfillment. The Essentials Series is the Key, and Aesthetic and Functional Treatment Planning is where your journey begins.  Following a system of…

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Lee Ann Brady DMD

Dr. Lee Ann Brady is passionate about dentistry, her family and making a difference. She is a general dentist and owns a practice in Glendale, AZ limited to restorative dentistry. Lee’s passion for dental education began as a CE junkie herself, pursuing lots of advanced continuing education focused on Restorative and Occlusion. In 2005, she became a full time resident faculty member for The Pankey Institute, and was promoted to Clinical Director in 2006. Lee joined Spear Education as Executive VP of Education in the fall of 2008 to teach and coordinate the educational curriculum. In June of 2011, she left Spear Education, founded leeannbrady.com and joined the dental practice she now owns as an associate. Today, she teaches at dental meetings and study clubs both nationally and internationally, continues to write for dental journals and her website, sits on the editorial board of the Journal of Cosmetic Dentistry, Inside Dentistry and DentalTown Magazines and is the Director of Education for The Pankey Institute.

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Let Patients Try a Smile

July 27, 2018 Pankey Gram

Like with any big purchase or expensive commitment, it’s not surprising patients would want to try on a new smile before going all in. You wouldn’t expect someone to purchase a sports car without first riding it around the dealership, would you?

Think of your cosmetic treatment as a high-end experience and your patients will too. Even the most hesitant spenders will be much more interested in moving forward if they’ve gotten a taste of how beautiful their smile really can be. This is where the ‘trial smile’ comes in.

Cosmetic Case Acceptance: Let Patients Try Their Smile

There’s no need to feel daunted by the process of creating a trial smile. Patients want to find a dentist who will offer them the kind of care they feel they deserve and who are willing to give them exactly what they want. You’d be surprised how hard it can be to find someone who will listen to a patient’s expectations instead of delivering what they personally feel is best.

With esthetics, the patient should have the primary say. Invite your patients who have given indications of wanting cosmetic treatments to communicate their preferences in a very tangible manner. All you have to do is first conduct a co-discovery appointment complete with high-quality digital images and an occlusal exam as well. Then, temporarily put composite on their unprepared teeth.

With this strong foundation already in place, your patient can see the potential outcome of smile design. When you pitch a trial smile to them, you can even call it a ‘demo.’ If the patient loves what they see, it’s no problem to move on to a diagnostic wax-up using a model of their demo smile.

What case acceptance techniques do you find most effective? We’d love to know your thoughts in the comments section below!

Photo courtesy of Matt Roberts CDT, CMR Laboratory.

The Aesthetics Course taught by Matt Roberts, CDT, Dr. Frankie Shull, Dr. Susan Hollar, Dr. JA Reynolds and Mr. Michael Roberts is just the place to learn to use digital technology to help patients want an aesthetic makeover.

 

 

 

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E1: Aesthetic & Functional Treatment Planning at the Chicago Midwinter Dental Meeting

DATE: February 20 2025 @ 7:00 am - February 22 2025 @ 8:00 pm

Location: Chicago Midwinter Meeting

CE HOURS:

Transform your experience of practicing dentistry, increase predictability, profitability and fulfillment. The Essentials Series is the Key, and Aesthetic and Functional Treatment Planning is where your journey begins.  Following a system of…

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Developing a Shared Path of Learning

July 25, 2018 Denison E. Byrne, DDS, MAGD

The phrase, “You can do this!” when offered by a trusted friend at the ideal time can help us put thoughts into actions around our learning. 

My partner Nancy and I always aggressively pursued dental continuing education for many reasons. We were racking up hours, techniques, ideas, travel, and expenses way beyond the norm.

As we went along, I started to notice a disjointedness to my learning. While I was in charge of my path, I missed discussing the journey with others.

Learning How to Learn With Likeminded People

One afternoon, while sitting in a study club meeting with two of my mentors, Rich Green and Jay Anderson, we were discussing our schedule and next meeting. Jay looked at me, winked, and said, “You can do this!” He meant that he thought I could organize a similar study group.

That was an interesting thought. The idea of gathering people in my network and developing a shared path of learning was attractive to me. Here were my next steps: 

  • I spent some time clarifying in my mind exactly what I was looking for.
  • I had coffee, lunch, or a drink with about a dozen of my peers to see what they were interested in and whether our goals meshed.
  • I gathered interested people together to “meet and greet” and develop a shared vision, direction, responsibilities, and tentative schedules.
  • I lined up facilitators and we were off.

The benefit to me was a local community of likeminded peers bolstered by the significant input they gave about the program. I learned more not only about dentistry but also about working with small groups. There was plenty of downtime with many of my dental heroes.

Of course, there are always nitty gritty aspects of creating a new study club. But those of us on the Pankey Learning Group team stand ready to help you with the process because, “You can do it too!”

How do you make sure your CE learning is deep rather than surface? 

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DATE: January 9 2025 @ 1:00 pm - January 11 2024 @ 8:00 pm

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Denison E. Byrne, DDS, MAGD

Dr. “Denny” Byrne graduated from the University of Maryland Dental School and has been in restorative practice in Baltimore for 40 years. He is a member of the Pankey Faculty and Co-Director of Pankey Learning Groups. In addition to being the husband of a dentist, father of a dentist, and grandfather, he is keenly interested in facilitating small group learning, golfing and sailing. He enjoys cooking and is a fan of C.S. Lewis.

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Trust in the First 10 Seconds

July 23, 2018 Bill Gregg DDS

Do you want to develop an emotionally engaged, relationship-based practice where people choose you over the insurance-driven option? It is not going to be your technical knowledge that does this. It is in how you touch people’s hearts.

Trust or the lack of it can be built within seconds. How can we best emotionally engage people? Immediately as you greet a person, focus on them – each and every time. Give the S-O-F-T-E-N approach a try:

How to Develop Trust in Only 10 Seconds

Smile: A welcoming greeting in any language.

Open up: Open body language – relaxed, welcoming, arms open, palms up.

Forward body lean: Again, welcoming, not aggressive. A slight forward lean can demonstrate attention, interest, engagement.

Touch: Lightly when and where appropriate. Studies indicate people feel a warmth of endorphins with a light human touch. A gentle handshake with the left hand also touching lightly can work. A light touch on the shoulder or arm is effective too.

Eye contact: This is the most important thing you can do to gain immediate connection. Immediately look the person in their right eye. Not to stare. Especially while you are speaking to the person. Recent studies indicate eye contact has dropped to the 30-60% range in today’s digital smartphone era. That’s a huge drop into disengagement. It drops even more when one is speaking.

We are losing human connection to the soul, yet 60-70% eye contact is ideal. Practice glancing into their right eye consistently. Yes it feels awkward at first and yes it takes conscious intent. Why the right eye you ask? Mostly so you don’t stare at the bridge of the nose and look cross-eyed, but also the right eye engages a person’s creative, intuitive parts of the right brain more quickly.

Nod: A slight affirmative nod as the person is speaking is a strong indicator to continue. Studies indicate a person even accepts criticism and correction better if one nods slightly while presenting bad news. A nod tends to indicate support, not just agreement.  

Interestingly, the reverse is also true. A shake of the head while giving supportive news can create a sense of skepticism. Yes, I can look like a bobblehead at times. Emotionally engaged attention is becoming a lost art. But it is the greatest way to touch a person’s heart.

In dentistry we have a huge advantage. We have multiple interactions every day with good folks who trust us enough to do scary things in one of the most intimate parts of the body. We can grow that trust to emotional engagement one person at a time.

What is the result of an army of emotionally engaged dental missionaries? Lots of loving people who say: “You have to go see my dentist. They’re the best in the world!” Whose world? Theirs.

How can you achieve an emotionally engaged, relationship-based practice where people choose you over the insurance-driven route? Practice, practice, practice – on people, not just their teeth. Start with your family! And love the practice.

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Bill Gregg DDS

I attended South Hills High School in Covina, Denison University in Granville, Ohio and the University of Redlands in Redlands, California prior to dental school at UCLA. My post-graduate education has included an intensive residency at UCLA Hospital, completion of a graduate program at The L.D. Pankey Institute for Advanced Dental Education ; acceptance for Fellowship in the Academy of General Dentistry (FAGD); and in 2006 I earned the prestegious Pankey Scholar. Continuing education has always been essential in the preparation to be the best professional I am capable of becoming and to my ongoing commitment to excellence in dental care and personal leadership. I am a member of several dental associations and study groups and am involved in over 100 hours of continuing education each year. The journey to become one of the best dentists in the world often starts at the Pankey Institute. I am thrilled that I am at a point in my professional life that I can give back. I am honored that I can be a mentor to others beginning on their path. As such, I have discovered a new passion; teaching. I am currently on faculty at The L.D. Pankey Institute for Advanced Dental Education devoting 2-3 weeks each year to teaching post-graduate dental programs. In other presentations my focus is on Leadership and includes lifestyle, balance and motivation as much as dentistry.

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Conscious Change Drives Results

July 20, 2018 Mark Murphy DDS

Our behavior directly influences the results we see in our life and career. In the dental practice, recognizing the need for conscious change and following through requires true self-discipline.

We all know what we need to do to improve our situation, whether that be in working on patient care or engaging in more education. The hard part is that even once we’ve gotten the information we need, we still have to implement change consistently.

Conscious Change & Practice Success

Discipline goes counter to human nature. In the practice, we know we should always be on top of things like scheduling a patient’s next hygiene appointment or asking the patients we trust most for referrals. These are the behaviors that require diligence and more attention than we may have on any given day.

It’s not easy to change. It’s not easy to commit to using intraoral cameras more often or anything else you have as a goal. The difficulty lies not in an individual failing, but in the structure of our brain.

Conscious change is a fight against our natural inclinations. It requires holding ourselves accountable to the behavior changes we want to implement.

Self-Doubt and Commitment

We also have to face the self-doubt that comes with change and handling any hiccups that occur. It’s painful to make mistakes, but even more painful to stay mired in old, stale behaviors.

One thing that helps is transparency and being held accountable by an external source. Project management software already does this well. It keeps track of our successes and failings for us.

We should be using this tool to identify our weaknesses and thereby improve our results. Once we notice what behaviors aren’t driving success, we can replace them or find avenues toward heightened performance.

How do you support behavior change in yourself? Let us know your thoughts!

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Mark Murphy DDS

Mark is the Lead Faculty for Clinical Education at ProSomnus Sleep Technologies, Principal of Funktional Consulting, serves on the Guest Faculty at the University of Detroit Mercy School of Dentistry and is a Regular Presenter on Business Development, Practice Management and Leadership at The Pankey Institute. He has served on the Boards of Directors of The Pankey Institute, National Association of Dental Laboratories, the Identalloy Council, the Foundation for Dental Laboratory Technology, St. Vincent DePaul's Dental Center and the Dental Advisor. He lectures internationally on Leadership, Practice Management, Communication, Case Acceptance, Planning, Occlusion, Sleep and TMD. He has a knack for presenting pertinent information in an entertaining manner. mtmurphydds@gmail.com

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The Dentist’s Leadership Role

July 18, 2018 Mary Osborne RDH

Leadership shouldn’t be a happy accident or something you fall into simply by virtue of becoming a dentist. It should be an acknowledged responsibility that you treat with genuine seriousness.

Of course, your instincts shouldn’t necessarily be ignored, but can they always be trusted? As the dentist, you are by default a leader. In reality, you should understand your role in shaping your practice’s vision as well as fostering growth for the entire team.

The hardest part about navigating the nebulous realm of leadership is clarifying and meeting the duties ascribed to your role. For dentists, you are actually fulfilling four different roles, all of which are important for general morale and success.

4 Roles of the Dental Leader

Follow the leader has real meaning in a professional space. One of your primary roles is that of the vision initiator. You have to be bold, verbal, and engaged in your vision to help your team attain the same values. You need to be fully present, especially when your practice is new or developing. The future depends on how you see it.

You will also become the educator in your practice, if you haven’t already. You must guide patients and team members toward your expectations for care. They can’t identify with your vision if you don’t yourself have the skills to state it clearly.

Your third role is that of the vision facilitator. At some point, your team and practice will be fully imbued with the tangible effects of your vision. You have to make the effort to prevent that vision from stalling through team building and careful hiring.

Finally, you must embrace your role as a mentor. This may be more challenging if you have a very strong personality, as it can make people embrace your vision even if they don’t appreciate the philosophy. What you want is a sort of vision immortality, so that even if you leave the practice, your vision and leadership live on.

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TMD patients present with a wide range of concerns and symptoms from tension headaches and muscle challenges to significant joint inflammation and breakdown. Accurate thorough diagnosis is the first step…

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Mary Osborne RDH

Mary is known internationally as a writer and speaker on patient care and communication. Her writing has been acclaimed in respected print and online publications. She is widely known at dental meetings in the U.S., Canada, and Europe as a knowledgeable and dynamic speaker. Her passion for dentistry inspires individuals and groups to bring the best of themselves to their work, and to fully embrace the difference they make in the lives of those they serve.

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Treatment Planning Tips

July 16, 2018 Pankey Gram

Treatment planning is simultaneously tricky and thrilling because it’s the step right before diving into the case. Before the appointment, you should discuss the patient’s readiness to hear about comprehensive treatment with your dental team. They are usually in touch with the patient’s emotions around moving forward.

Another thing to do beforehand is to lock in any financial considerations. If phased treatment is planned, you should be able to respond to any changes that come up.

For the appointment, the most important thing is to review important details from the earlier clinical examination with the patient. They’re bound to have forgotten the majority of what you told them previously.

Critical Treatment Planning Information

This information includes identifying healthy areas, areas of concern, and consequences of not moving forward with treatment. You’ll want to draw their attention to healthy TM joints and bone support on both x-rays and diagnostic models. This measure comforts the patient before diving into concerns.

Move tactfully onto the problem areas, such as active disease, occlusal issues, or periodontal disease. Then cover consequences of delayed or cancelled treatment. Patients who are on the fence will be motivated by fearing loss of their oral health. Confirm that they understand their problem and open it up for questions. Don’t linger too long here though.

Next, present the best treatment plan for the patient without confusing them about other options. You can ensure a much smoother process going forward if you develop credibility by using a diagnostic model wax-up and helping them visualize the positive effects of treatment.

Once the patient fully understands their situation, go through the steps of your plan including timing, phases, specialists, and more. You can then clarify priorities and objectives while involving the patient in the decision-making process. They need to feel control over the problem and the solution.

After investing all of this effort into helping the patient emotionally commit to treatment, get verbal commitment to your treatment plan. A patient who trusts you is a patient who will choose treatment. Coercing them is the exact opposite of what you want.

Thank them for their trust, discuss the fee, and agree on the cost before handing them off to the financial coordinator.

And that’s that!

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DATE: July 25 2025 @ 8:00 am - July 29 2025 @ 2:30 pm

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Understanding that “form follows function” is critical for knowing how to blend what looks good with what predictably functions well. E3 is the phase of your Essentials journey in which…

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On Providing a Fix vs an Experience: Part 3

July 13, 2018 Will Kelly DMD

There are three words on my business card that may seem obscure to patients at first. These words, which come to have important meaning later on in their relationship with my dental practice, are: Comprehensive, Restorative, and Esthetic.

Promising and Delivering a Luxury Patient Experience

Comprehensive

We look at the patient as a whole. We observe and diagnose globally. We intend to partner with our patients in a thorough individualized manner. The best dentistry does not happen when we just look at a tooth with a problem. In fact, it isn’t much better when a dentist has a look at ‘teeth’ plural.

Comprehensive dentistry considers the whole system and the individual. How are the muscles and joints that affect and are affected by the teeth and their use considered? How are the structures that support the teeth?

What are the factors unique to a patient’s habits, routines, and systemic health that relate to ideal dental health? What are a patient’s individual goals, desires, and expectations? Will the dentist take everything they can gather about the causes of problems and consider them in the solutions?

The list goes on. This is a highly intentional paradigm of patient care.

Restorative

The focus on restorative dentistry is just as it sounds. In our practice, we want to restore patients to an ideal state of health and function. We put tremendous effort toward continuing education, technology, and our approach to care beyond the average dental setting to achieve this ability.

Esthetic

Esthetic dentistry speaks to taking great care in the art and science of making dentistry beautiful. Yes, it is a nose thumbing at the overused term “Cosmetic Dentistry.”

We believe all good dental restoration is more beautiful if provided in the context of health and function. At the end of the day, we want to create smiles our patients can be proud of because they are beautiful, healthy, and durable.

We all have things we value enough to invest in. We all make choices that take effort because we want the result, just like my car that I enjoy and is reliable. I invite patients to consider that experience with their teeth through the approach of ‘Comprehensive, Esthetic, Restorative’ dentistry.

What do you do in your dental practice to make dental care a valued experience for patients?

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DATE: September 5 2024 @ 8:00 am - September 7 2024 @ 2:00 pm

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Although implant dentistry is considered one of the most predictable treatments we offer, guaranteeing optimal anterior implant esthetics is tricky and often feels challenging to create predictably. This program will…

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Will Kelly DMD

Dr. Will Kelly attended the North Carolina State University School of Design and received a BA in Communications. He went on to spend two additional years in post baccalaureate studies in Medical Sciences at both UNC Chapel Hill and Virginia Commonwealth University. Dr. Kelly graduated from the top ranked UNC School of Dentistry in 2004. His good hands and clinical abilities led to his being chosen as a teaching assistant to underclassmen in operative dentistry. In addition to clinical time in the dental school, Dr. Kelly had valuable experiences working in both the Durham VA Hospital and for the Indian Health Service in Wyoming. As a child, Dr. Kelly had the opportunity to assist his father on several dental mission trips in Haiti. After completing dental school, Dr. Kelly joined his father in private practice and served on the dental staff at Gaston Family Health Services, where he maintained a position on the board of directors. At this time Dr. Kelly also began his studies in advanced dentistry at the prestigious Pankey Institute in Miami, a continuing journey of learning that has shaped his philosophy and knowledge of the complexities of high-level dentistry. Today Dr. Kelly devotes over 100 hours a year studying with colleagues and mentors who are regarded as "Masters of Dentistry".

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On Providing a Fix vs an Experience: Part 2

July 11, 2018 Will Kelly DMD

When a car breaks down, the way we choose to have it repaired says a lot about how much we value our vehicle. A similar phenomenon occurs with dental care. 

In part 2 of this series about how we see a fix versus a valued service-based relationship, Dr. Kelly dives back into an experience that made him reflect on the dental profession. Keep reading for the rest of his story:

A Car Service Analogy: Obligation, Expense, or Experience

Coincidently, many days I use the analogy of cars to taking care of teeth with my patients. We wear away the surfaces of our teeth similarly to how tires age. We pay for maintenance and parts with an equal financial obligation and expense.

When we have to start over and restore our vehicle (or get a new one), sometimes it costs the same as major treatment we could have done for our teeth. Sometimes the auto investment is inconvenient and urgent. Often, if we choose, it is predictable and pleases us. We find ways to pay for it.

Individuals always seem to find ways to pay for the things they value. We choose our own experiences whether we know it or not. I invite my patients to consider experiencing dental care in my practice similarly to the good experience I have had with reliable and well-maintained cars.

The business card for my practice has three tag words on it: Restorative, Comprehensive, and Esthetic. I’ve been told that the meaning of these descriptors is too obscure for new patients to understand. Why not be like the dentist down the street and just say “Cosmetic” or “Family Dentistry”?

I believe every opportunity I have to help patients experience each of these focused goals for our patient care enriches the dentistry I can provide them. So many in our patient family have learned through these experiences exactly what these words mean.

To be continued …

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Will Kelly DMD

Dr. Will Kelly attended the North Carolina State University School of Design and received a BA in Communications. He went on to spend two additional years in post baccalaureate studies in Medical Sciences at both UNC Chapel Hill and Virginia Commonwealth University. Dr. Kelly graduated from the top ranked UNC School of Dentistry in 2004. His good hands and clinical abilities led to his being chosen as a teaching assistant to underclassmen in operative dentistry. In addition to clinical time in the dental school, Dr. Kelly had valuable experiences working in both the Durham VA Hospital and for the Indian Health Service in Wyoming. As a child, Dr. Kelly had the opportunity to assist his father on several dental mission trips in Haiti. After completing dental school, Dr. Kelly joined his father in private practice and served on the dental staff at Gaston Family Health Services, where he maintained a position on the board of directors. At this time Dr. Kelly also began his studies in advanced dentistry at the prestigious Pankey Institute in Miami, a continuing journey of learning that has shaped his philosophy and knowledge of the complexities of high-level dentistry. Today Dr. Kelly devotes over 100 hours a year studying with colleagues and mentors who are regarded as "Masters of Dentistry".

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