It was August of 1995 when I first walked through the doors of The Pankey Institute.

At that time, I had only one year of experience under my belt as a licensed hygienist, and I believed I had won the “dental lottery” by having spent the past six months working for a Pankey Institute trained dentist. Dr. Steve Ratcliff was passionate about the Institute and his philosophy of care that was inspired by what he was learning there. He proudly shared everything possible with me about how he wanted our practice to develop.

It was a hands-on perio course at the Institute where I eagerly learned about non-traditional use of Gracey currettes, utilization of ultrasonics, and the current science of periodontal disease and its management with Dr. Sam Low. I remember being so nervous and so excited. There were hygienists from all over the country with similar desires, challenges, and dreams, and together we formed a sweet community of our own, learning and growing together with an even better understanding of what was possible as a dental hygienist.

It’s difficult to believe that 25 years have flown by, and it’s so cool that here I am about to lead the 2020 version of that very same program. Appreciating the magnitude and beauty of Quid Pro Quo, I’m honored to now be teaching with Dr. Sam Low to support hygienists toward their full scope of practice.

Our program will focus on two key components of the hygiene chair:

1. What it means to be a Restorative Partner in your practice by deepening the art of co-discovery and patient engagement.

2. Understanding current science around the diagnosis and management of periodontal disease, including hands-on utilization of power instruments, air polishing, and adjunctive therapies.

There are many pieces and parts to my enthusiasm about this program, The Pankey Hygienist.

What brings me the most joy is knowing that I get to share “my version” of Dr. L.D. Pankey’s philosophy with the doctors and hygienists in attendance. The Institute was certainly a game-changer for our practice and our patients 25 years ago. It continues to be a life-changing experience for me each and every time I get to be within this community, whether it is at the Institute, at an offsite event, or visiting other dental practices inspired by their own time with the Institute. I’m not just grateful. I’m “over the moon” grateful for this life.

Sleep issues and sleep apnea is a very serious concern today for our patients’ health. I have been giving patients an Epworth sleepiness self-assessment for several years. It is a great way to find out if patients should pursue their sleep with a physician and inquire about having a sleep study.

Another incredible indicator of apnea is if someone else hears you stop breathing. Of course, there are challenges with this approach. First, there has to be someone near you when you sleep to hear what is happening. Second, someone has to be awake in order to listen and watch while you are sleeping. Third, someone has to interpret what is happening. I recommend the SnoreLab app that records and evaluates the sounds made while sleeping. It can even show you graphs of what was happening. Not only is this a great self-learning tool, but the recordings can be taken to the doctor as part of the information to determine if a sleep study is indicated. The product is available on the web and through the App Store.

Several of my patients have used the SnoreLab app and had follow-up studies in a sleep lab. Within my Glendale, AZ practice, I have a Dental Sleep Medicine practice and treat patients with sleep apnea appliances.

To serve patients to the best of their ability, I recommend general dentists learn how to competently develop a Sleep Dental Medicine niche within their practice. I can honestly and wholeheartedly say that The Pankey Institute’s 5-day immersion Dental Sleep Medicine course is one of the best programs in the nation. It is uniquely designed to give dentists the experience of being a sleep apnea patient themselves.

When it comes to diabetes, let your patients know about the impact oral inflammation can have on their health. Explain what you can do to help them and what they can do to help themselves. Clarify what they can do to take control so that they can live happier, longer lives.

Give your patients optimal assistance.

Include questions in your health interview about whether the patient has been diagnosed with diabetes, has been counseled about being at risk (prediabetic), and/or has a family history of diabetes. If your patient affirmatively answers to any of these questions, inquire about what they know about the link between gum inflammation and systemic diseases, such as diabetes.

Gently, explain why you are concerned.

Even if it is slight, gum inflammation is harmful when chronic. Let them know that among other health problems, persistent inflammation exacerbates diabetes and development of diabetes. It would help to tell them a story about an anonymous dental patient whose blood sugar decreased over a matter of six months and improved again within a year due to the elimination of gum inflammation.

Invite your patients to begin a new oral health regimen.

Let them know that you will partner with them to track their compliance, evaluation, and improvement. Inspire them with a story about another anonymous patient whose oral health and diabetes was improved by starting a healthier regimen.  They too can experience the healing power of making healthy choices and developing healthy habits throughout their life.

Your patients will start to report to their physicians, family, and friends about the conversations you have had with them. They will all be able to see the efforts you are making to control inflammation in their mouths, and the evidence of improved health. You might begin to see referrals from these patients and their doctors start to follow.

Dental graduates frequently say they chose dentistry because they liked science and working with their hands. Many thought medicine was their path, but in medicine, they saw the lack of control and time away from family. Dental graduates also say they were attracted to dentistry due to the monetary return they could get for their efforts.

When practicing, profitability can be elusive. You can feel like your child’s hamster trying to outrun your overhead. You can feel like dentistry is #1 in your life and there really is no other life for you, but you are frustrated because your dream was to be farther along in your debt reduction and wealth growing. You are putting in the hours but not receiving the return.

Many things and decisions can get in the way of profits.

We want to convey positivity here, not rehash the problems. You can have a profitable practice. A larger net return can be yours.

Let’s have a frank discussion about you, the leader, THE one who wants very much to win in the game of profitability. The keys to profitability involve YOU–your attitude, your team’s attitude which comes from you, and systems you need in place to be more efficient.

YOU are the key to opening the profitability gate. What is your current attitude about life, your success, and your situation? This is a challenge as you are slightly prejudiced. Do you have a family member or a really good friend who can assess your attitude (your positivity about yourself)? Years of negativity can be a challenge.

How do you feel about the future?

Here are some questions to help assess your present attitude about yourself:

• What are your goals five years from now?
• What are you looking forward to?
• What do you want most out of life?
• What do you like best about yourself?
• What do you feel motivates you?
• Do you have any personal power in your life?

At Blatchford Solutions, when we work with dentists and teams, we ask them to assess various life choices, such as the place they choose to live, and the friends, marriage partners, courses and schools they choose, even cars, vacations, restaurants and more. We all have a Comfort Zone for each of these areas and when pushed out of your comfort zone, you reply, “I would never go there, do that, try that, spend time on that”, and more. Our comfort zones have a floor and a ceiling.

You need to know if your “Deserve Level” allows you to be profitable. You can sabotage your success if you feel you deserve less. You can modify your Comfort Zone (Deserve Level) with a clear vision, strong determination and possibly some outside help.

What is profitability to you?

Put some numbers down; spell it out for yourself at this time. Is a net of $500K unreasonable for you? Do you deserve to have 60% overhead on $1.2M collection? Is a net of $750K unreasonable for you? Is a net of $1M something you deserve? Do you deserve to be debt-free? What would change in your life if you were debt-free?

Your Deserve Level also affects the quality of team members with whom you choose to work, the building and area in which you choose to practice, the continuing education courses you take, and so many non-dental activities, too. Our goal is to help you realize you can be as profitable as you feel you deserve. Dentistry is not just about your clinical excellence. It can also be about your excellence in the business of profitability.

It has been a life-long observation of mine that leaders who are well-loved, who people are drawn to, who friends just want to hang out with, have a comic side to them. A quick wit and the ability to tell a funny story are traits people enjoy.

This was certainly true of Dr. L. D. Pankey, as I found out the first and only time I ever met him.

It was July of 1988 and I was making my first ever visit the renowned Pankey Institute for Continuum Level 1 taught by Drs. Irwin Becker and Donald “Ozzie” Asbjornson. To say the week for me was monumental is, quite frankly, an understatement. It would be like saying smartphones have had an influence on our culture. You see, I knew I had a passion for dentistry, but before that week at C1, I had no idea what to do with it.

And the perfect ending to the week was a visit to our class by the legend himself, Dr. L. D. Pankey. He was well up into his 80’s and had been “under the weather” for the last month, or so. But he was extremely excited that there were some international students in the class – four actually: two from the U.K., one from Denmark, and one from Alabama. So, on the last day, which was Friday morning, Dr. Pankey had asked to be brought up to the Institute for a surprise visit to the class.

Executive Director, Chris Sager, was speaking to the class in Mann Hall when Dr. Pankey stepped into the back of the room and took a seat. Chris immediately stopped what he had been saying and announced, “We’ve had a special visitor just come into the room.”

All eyes turned to the back of the room where we saw a humble, elderly man wearing a white starched shirt, necktie, and freshly pressed suit. Honestly, it didn’t immediately dawn on me who he was.

Then Chris asked from the front of the room, “Dr. Pankey, how do you feel?”

Without missing a beat, Dr. Pankey responded, “Oh…mostly with my fingers.”

The whole room laughed. The witty retort was funny, but even funnier was the fact that Dr. Pankey had played Chris Sager as the straight man. What a moment. What a gift. By the following March, L. D. Pankey would no longer be with us. But we had the privilege in that one glimpse of seeing the cleverness of the man who had charmed so many.

After we all finished laughing. On that Friday morning so many years ago, Chris invited Dr. Pankey to come upfront and speak to the class. He welcomed us and expressed his pleasure that we were there. Then he picked up a marker to begin writing on the whiteboard. After a pause, he put the cap back on the marker and placed it in the tray. He looked at us and with his voice a little shaky said, “There’s so much I want to tell you. Just read my book – it’s all in the book.”

Most of us in the Pankey family today never got to meet Dr. L. D. Pankey. But you can still “meet” him in the pages of A Philosophy of Dental Practice, the book on which he and Dr. Bill Davis collaborated. If he could speak to us today, I believe he would tell us a little joke and say, “Just read my book – it’s all in the book.”

A patient’s feeling of comfort and trust is increased when you demonstrate you appreciate your team.

Showing appreciation to your team in front of patients demonstrates you respect the people who support you in serving patients. This only raises their opinion of your quality of care.

• When patients witness you calmly moving through moments of stress with instructions to your team delivered in a calm tone, a smile, and thanks, it speaks volumes to patients who are eager to have confidence in their care.
• When you spend time informing team members well and empowering them with knowledge of “the why” of your diagnoses and treatment plans, they naturally and appropriately prepare patients for your case presentation, answer questions, and encourage patients to move forward. Expressed gratitude for this support is a positive affirmation that creates growing team confidence, competence and job satisfaction. And this fosters a happy work environment and employee retention. Patients are highly attuned to team happiness and are relaxed among your loyal team members they have come to know. Again, this increases trust.
• A team’s feeling of appreciation will be undermined, and individuals easily become stressed when they are chronically overworked or asked to perform tasks they are not well prepared to do. Be alert to lead them through stress with assurances and demonstration that you care enough to take measures that will restore work balance and comfort.

There are multiple situational stresses that occur every day in your practice that produce the flow of stress hormones, 112 of them to be exact. And when there are stress hormones building up in the bloodstream, the physiological and psychological consequences are noticeable to patients. Fortunately, PankeyGram readers and participants in Pankey Institute courses and study clubs receive a constant flow of fine examples of colleagues showing appreciation for their teams. Showing gratitude doesn’t always have to be done in a big way or at great expense. A positive spoken affirmation in any given moment is going to release some oxytocin. And that’s what we want!

When I was a young dental student, the voice of “right from wrong” came from my instructors. Their voices annoyed me, and I didn’t think that the dental school approach could ever work in the real world. When I got out of residency I began to learn “real world” dentistry from employers and insurance companies. They became my voice of right from wrong. I concluded that cutting corners was the way most dentists practiced—no face bows, no articulators, models or comprehensive examinations.

I found that I had a knack for selling dentistry. I was blessed with patients who allowed me to perform some rather complex dentistry…without articulators, face bows or comprehensive examinations. I became a master at making excuses for my dentistry:

• “You’ll get used to your bite…”
• “The temporaries really can’t approximate what the final will look like….”
• “Your jaw pain is stress. You need to relax…”

I was lucky! Most of my dentistry worked, but it was never predictable. Dentistry became stressful and honestly downright scary sometimes. So, I studied at the Pankey Institute. I heard voices of honorable people. What was right and good and decent for my patients…and me…and my family! I thought that I can’t do this type of Dentistry; it’s like dental school! No one practices like this.

Then, a Voice Appeared

One day I was fabricating a provisional and left an open margin. “So what?” I thought. I became aware, however, of a very faint voice that said, “Do the right thing; close the margin.” Hmm, close the margin. “Why should I?” I thought. “The new crown will be here in two weeks. What’s the big deal?” Again, I heard a whisper, “Close the margin.”

Annoyed, I explained to the patient that I wanted to work more on the temporary in order to make it fit better. The voice stopped whispering. The patient said, “Thank you for caring and being so thorough.”

The voice, once a sheepish whisper, began to speak in clear tones:

• “Carve the restoration the best that you can.”
• “Let specialist perform the procedures that they do best.”
• “Restore that patient only when you really know that person both clinically and behaviorally.”
• “Treating a patient is not about you; it’s about them, always.”

I was really starting to feel that I was going insane until one morning a poem came to me. I titled it “The Voice.”

THE VOICE

Who was this voice that I couldn’t see? It pushed and prodded and bothered me.

The voice was strong and judgement free, and I began to like its philosophy.

As time went on its words rang true, and I began to see the good I could do.

The voice which spoke of doing things right, began to be my guiding light.

I began to live with genuine care, with genuine love, a genuine air.

Who is this voice that I can’t see, that stirs my soul and bothers me?

This voice lives in me deep and strong.

It guides my path. It sings my songs.

It is so much a part of me

Who is this stranger I can’t see?

One day the voice said loud and clear:

“I’m always with you. I’m always near.”

I asked the voice to give its name,

to show its face, to stop playing games.

The voice just laughed. It said with glee.

It’s always been you, yourself, you see!

To the many participants who come to The Pankey Institute to study, I hope that you all let your best inner voice become your guiding light throughout your journey. That voice, that wonderful voice will never let you down!

I’d like to tell you about my neighbor up here on Bent Mountain. His name is Mike Stockton. He personally designed the house we live in. He drew every line of it and then supervised, as well as participated in its construction. Mike had no formal training in architecture or construction. He just loved it and then studied it long enough to master it. His history is that of an artist.

We are all born with certain gifts and talents.

The key is to discover them, develop them, find ways to connect them with others in a fashion that they will be valued, and then to share them. Of course, applies to dentistry as well. We will only be willing to invest the time, energy, and attention necessary to master something if it brings us joy and satisfaction. That’s the pay-off—the ability to step back and say to ourselves, “That was pretty good, but next time I think I’ll try this instead and see if I can make it even better!”

But that’s not enough to be successful. To be a masterful and successful dentist, you also must be able to connect and inspire others to become better versions of themselves. And that, of course, includes team members and patients alike.

What else do you need?

You need to be able to promote yourself. You must be willing and able to share what you know and can do with others in a way that they feel it will be helpful. And there’s a word for that. It’s called “marketing.” Marketing is not a dirty word if it’s done from your heart and you deliver on your promises. No, let me correct that. You over-deliver on your promises.

When you go into that private coffee shop and they take a moment to create a heart in the froth of your latte, that’s marketing too. That’s caring enough about what you do to take the extra steps that demonstrate you sincerely care about what you are doing and how other’s feel about it.

So, now we have five key things:

1. Gifts and Talents

2. Mastery

3. Inspiration

4. Communicating What You Can Do to Help Others

5. Extra Steps that Show You Care

How others perceive how well you do these five things, will determine your financial future, because people will give you their money in exchange for your gifts, talents, skills, and caring when they perceive that you do the above five things exceptionally well and they benefit significantly as a result.

Passionately practice these things, and you will have a bright future ahead!

The search for temporary cements has been a long one over the last decade as my practice has moved away from porcelain fused to metal full coverage as the “go to” indirect restoration. The difference in mechanical retention, aesthetics and final placement protocols places different demands on our temporary cements. There are quite a number of criteria we want out of a temporary cement, and finding it all in one product was the challenge.

• Great Retention
• Easy to Remove
• Easy to Clean the Prep
• Eugenol Free
• Easy to Clean Excess During Cementation
• Esthetic/Translucent
• No Sensitivity
• Doesn’t grow black Scuz

Having played with many of the temporary cements on the market there are many that meet most of the criteria, but I hadn’t gotten everything I wanted until I started to use TempoCem ID from DMG America.

Why I am so pleased with TempoCem ID:

• It is a resin-based temporary cement that actually changes from slightly opaque to translucent when you move through the curing process.
• The initial opacity that remains — even at the gel phase, makes cleaning away the excess very easy.
• Once all the excess has been cleaned off, a final cure takes you to fantastic retention and a beautifully esthetic cement.
• The chemistry allows you to place the final restoration without worry of incompatibility with adhesive or traditional cement systems.

Whether for full or partial coverage TempoCem ID has become the temporary cement of preference in my office.

Fifteen years after graduating from dental school I was searching for answers.

I barely knew what questions to ask because there was no guidebook to learning how to practice dentistry and live the life I imagined. I read every book including Juggling for Dummies. Then I stumbled across The Pankey Institute, and I knew my search was over. Back then the program consisted of five continuums. At C1, I was lucky enough to meet Dr. William Davis, the co-author of the then recently published book A Philosophy of the Practice of Dentistry, with Dr. L.D. Pankey.

At the end of classes one day, I stayed behind to talk with “Bill” about philosophy.

I always had an interest in philosophy, but Bill discussed how Dr. Pankey applied philosophy to a dental practice. We spoke into the evening and through the week. I told him that this philosophy sounded a lot like a garden variety of personal development. It was loaded with quotes from Napoleon Hill and Dale Carnegie, yet I felt there was more to it; after all, Pankey had studied “real” Aristotelian philosophy at Northwestern University.

I was never satisfied with the explanation of the philosophy consisting of the graphical “Pankey Crosses.”

From that week on I took my studies deeper. My search for answers continued, but now I was on a path. I realized that if I was going to apply philosophy to my practice it required behavioral changes. The Pankey Philosophy was more than a moral philosophy which is projected and leads to judgements about the way others do dentistry. I realized that this philosophy was a personal and practical philosophy which was designed to direct my own behavior.

The examination process became very important to me, because by continually perfecting it, I could focus on my behavior and the changes it made. Those personal changes lead to more success and more enjoyment. Slowly I began to appreciate dentistry. I focused on the “apply your knowledge” arm of Dr. Pankey’s Cross of Dentistry. Then, while taking courses in positive psychology, I realized that in order to make real changes I would have to focus on my “character strengths and virtues.”

“Dr. Pankey and the Greek philosophers used the word virtues.”

Dr. Pankey and the Greek philosophers used the word virtues. I never truly knew what that meant. Somewhere I read that a virtue is a habit of the mind that is consistent with nature and reason. It can be argued that when L.D. Pankey spoke about care, skill, and judgement, he was speaking about virtues. Not surprisingly the positive psychologists have written about character strengths and virtues.

They have defined twenty-four separate strengths divided into six virtues: wisdom/knowledge, courage, humanity, justice, temperance, and transcendence.

By studying these strengths and virtues and working them into my daily habits, a funny thing happened. Not only did I become a better dentist, but I became a better leader for the first time in my practice. Leadership was the answer I was searching for, and character was the answer to leadership. It has been a long and worthwhile journey that may have ended differently without understanding Dr. Pankey’s philosophy was a personal and practical philosophy that had real meaning for my life.