By Lee Ann Brady, DMD 

Balancing Benefits and Risks in Restorative Dentistry 

As restorative dentists, our commitment to providing high-quality, lasting care is unwavering. Ideally, we’d offer our patients restorative solutions that last a lifetime without needing repair or replacement. However, in reality, no restoration is permanent, so balancing the benefits and potential risks is essential in choosing the right solutions for each patient. 

What Makes Resin-Bonded Bridges Unique? 

Among restorative options, resin-bonded bridges may not be the first to come to mind, yet they serve as a unique solution for specific cases. Resin-bonded bridges are known for their conservative approach—they don’t require extensive alteration of the surrounding teeth and can often be placed without surgical intervention. For young patients, in particular, this minimally invasive option has a range of benefits. 

Preserving Alveolar Ridge Development in Young Patients 

One of the reasons resin-bonded bridges are favorable for younger patients is their flexibility in preserving the natural development of the alveolar ridge. By delaying more permanent options, such as implants, patients can avoid the potential complications related to ridge development and aesthetics that could arise years later. These bridges also offer an unobtrusive alternative, especially for patients who need a solution but may not be ready for an implant due to age or other factors. 

Setting Realistic Expectations with Patients 

Recommending a resin-bonded bridge requires a balanced approach to patient communication. These bridges are more likely to become loose over time, demanding a higher level of care and caution from patients. They must be aware of dietary limitations, avoiding hard or sticky foods that could disrupt the bond. Educating patients on the longevity and maintenance requirements of resin-bonded bridges helps set realistic expectations while ensuring they understand the care involved. 

A Conservative Yet Valuable Solution 

Despite their potential for detachment, resin-bonded bridges remain a valuable choice when the clinical situation calls for it. They offer patients a pathway to maintain oral functionality and aesthetics without the invasiveness of traditional restorative methods. Especially in younger individuals or those with adjacent unrestored teeth, this solution balances the need for stability with the importance of conserving natural tooth structure. 

Up Next in Part 2 

Part 2 of this series will discuss how resin-bonded bridges compare with other restorative options, such as traditional fixed bridges and implants. By understanding these options more fully, we can better guide our patients toward the solution that best fits their unique needs and preferences. 

By Gary M. DeWood, DDS, MS 

Whether you’re presenting research findings at a conference or sharing case studies with colleagues, your job is to craft and practice a presentation that informs, engages, and inspires. 

Key Strategies 

• Know Your Audience and Tailor Your Message: Understanding your audience is fundamental to effective communication. Consider their level of expertise, interests, and expectations. Tailor content and delivery style accordingly. For instance, when presenting to fellow dentists, you can delve deeper into technical details and use industry-specific terminology. Dentists like dental jargon. 

• Organize Your Presentation for Clarity: A well-structured presentation is easy to follow and more impactful. Consider using a clear outline that includes an introduction, body, and conclusion. Tell them what you’re going to tell them, tell them, and tell them what you told them. The introduction will briefly outline the main points of your presentation, while the body dives into the details. The conclusion will summarize the key takeaways and reinforce the message. 

• Leverage Visual Aids Effectively: Visual aids can enhance your presentation and help your audience retain information. Use high-quality images, diagrams, charts, and videos to illustrate your points, being careful to avoid overwhelming your audience with too much visual clutter. Keep your slides clean and easy to take in, allowing your visuals to speak for themselves. 

• Practice Makes Perfect: Rehearsal is essential for delivering a confident and engaging presentation. Practice your presentation aloud several times, paying attention to your pacing, tone, and body language. Consider recording yourself to identify areas for improvement, both audio and video. The more familiar you are with the content, the more comfortable and confident you will be when delivering that presentation. 

• Engage Your Audience: A successful presentation is not a one-way street. Encourage audience participation by posing questions, inviting discussions when appropriate, and including interactive elements. This not only keeps your audience engaged but also provides you with valuable feedback and insights. 

• Transparency: At the beginning of your presentation, disclose any financial relationships or conflicts of interest that may be relevant to your topic. This includes any payments, grants, or consulting fees received from companies that manufacture or sell products or services related to your presentation. 

Incorporate Dental Case Images Effectively 

• Choose high-quality images: Ensure images are clear, well-lit, and relevant to your topic. 

• Cite Sources: If you’ve used information or images from other sources, clearly cite them in your presentation. This demonstrates respect for intellectual property and enhances the credibility of your work. 

• Acknowledge Collaborators: If you’ve collaborated with colleagues or mentors on the research or case, acknowledge their contributions. This fosters a collaborative environment and recognizes the efforts of others. 

• Use images selectively: Avoid overwhelming your audience with too many images. 

• Provide context: Explain the relevance of each image and its connection to your narrative. 

• Tell a story: Use images to create a compelling narrative and engage your audience. 

• Maintain consistency: Use a consistent theme, typography, and color scheme throughout your slideshow. 

• Consider animation: Use subtle animations to highlight key points or transitions but avoid excessive use.  Audiences are distracted from the message when a lot of stuff is happening on your slides. 

• Practice and seek feedback: Rehearse your presentation and ask for input from colleagues or mentors. 

Consider Alternatives to Traditional Presentations 

While presentations are a powerful tool for communication, they may not always be the most effective approach. Sometimes, a more informal conversation or a collaborative workshop can be more engaging and productive. Consider the goals of your communication and choose the format that best suits your needs and the needs of each audience. 

Following these guidelines will help you create dental presentations that are informative, engaging, and impactful. Remember, the goal is not just to deliver information, but to inspire thought, discussion, and to foster a deeper consideration and understanding of your topic.  It’s also possible to have a lot of fun being the “expert.” (That’s anyone from out of town who brings slides.) 

By Paul Henny, DDS

Bob Barkley’s “learning ladder” concept, akin to Peter Senge’s “ladder of inference,” emphasizes understanding where individuals stand regarding their knowledge, beliefs, and motivations. When patients or dental professionals are “stuck” on this ladder, they tend to rely on outdated or incorrect mental maps, often described as deductive thinking.  

Inductive Thinking Is Double Loop Learning 

Progressing on the learning ladder requires engagement of inductive thinking or double-loop learning, which involves challenging existing mental models and the subsequent development of new and innovative solutions.

How I Facilitate Inductive Learning 

Here’s an example of how I facilitate inductive thinking which leads to more double-loop learning, the patient moving up the learning ladder, and ultimately better decision-making.  

I purchased my practice in 1994 from a retiring dentist, who was competent and capable relative to the state board defined standard of care. He had achieved MAGD status and served in several professional leadership positions. He also had a very confident and caring demeanor, and his patients loved him and believed in his leadership skills. However, he wasn’t comprehensive in his practice philosophy, and subsequently did not spend a lot of time investigating root causes.  

The result was that he was tooth-centered and focused on solving or stabilizing current problems, one at a time. His failure to plan for the future dental health of his patients led to many chronic, slightly-below-the-radar problems that were never diagnosed.  

For instance, many patients had progressive destruction of their anterior guidance, loss of vertical dimension due to accelerated posterior attrition, and then were fracturing posterior teeth. They had significant occlusal disorders that were causing occlusal disease and the self-destruction of their dentition. 

The challenge: How could I get these patients to better understand why their posterior teeth, restorations, or even the roots of their teeth were fracturing when the apparent problem was in the back of their mouth, and the unknown driver of their problem(s) was in the front of the mouth?  

The solution: We made study models and took occlusal records. and photographs. We then scheduled each patient for an appointment with me that was specifically intended to allow them the opportunity to learn more about their situation, understand why destructive trends were happening, and allow them the opportunity to choose whether or not they wanted to continue in that direction or alternatively engage in a comprehensive restorative process that would render out optimal form, function, and esthetics.  

This type of process creates the opportunity for more double-loop learning, and therefore better decision-making and long-term stability and health in my patient base. 

By Charlie Ward, DDS,

You’ve done your digital planning, printed your models, and created a mockup. That’s great! But before you start prepping those teeth, we need to make sure that mockup is spot on. Why? Because a precise mockup ensures that our preparations create enough space for the restorative material. 

Here’s where the magic happens: digital calipers. Yep, those little measuring tools are our secret weapon. We measure the distal-most tooth on each side and one in the middle. Then, we compare those measurements to the ones we took from the model. If they’re within a tenth of a millimeter, we’re good to go! 

A quick tip: If you’re right-handed like me, be mindful of applying even pressure when seating the matrices. You don’t want to push harder on one side than the other. 

The next step is the prep stage. When working with veneer patients, we must be very intentional while removing tooth structure from our mockup so that we can create adequate room for restorative material. On Restorative Nation, Veneers Tips and Tricks Prep With Intention – Restorative Nation, I demonstrate various burs. It’s through a thorough understanding and careful selection of burs that we can guarantee an accurate preparation. 

By David R. Rice, DDS 

Overcoming Initial Challenges 

Dr. Emily had always dreamed of owning her own dental practice. However, the path to achieving this goal was not without its challenges. After years of working as an associate dentist, she decided to purchase a practice from a retiring dentist in her community. 

Securing funding was one of the biggest hurdles she faced. She had to navigate the complex world of loans and financing, working with banks and lenders to secure the necessary capital. Once she had the funding in place, she faced the daunting task of transitioning the practice smoothly. 

Pleasing the existing patients was another priority. She knew that many of them had been loyal to the practice for years and were concerned about the changes that would come with a new owner. Dr. Emily worked hard to reassure patients and maintain continuity of care. She met with each patient personally, listened to their concerns, and assured them that she was committed to providing the same high-quality care they had come to expect. 

Working with the legacy team also presented its challenges. Some team members were resistant to change and unsure about the new direction of the practice. Dr. Emily recognized the importance of building trust and creating a positive work environment. She took the time to get to know each team member individually, understand their concerns, and address their needs. 

Building a Supportive Team Culture 

As Dr. Emily settled into her new practice, she quickly realized that building a strong and supportive team was not as easy as she had anticipated. Her initial team consisted of a few experienced dental assistants and a hygienist, but they seemed to be struggling to work together cohesively. There were frequent disagreements, low morale, and a lack of motivation. Dr. Emily knew that she needed to take action to address these issues and create a positive and productive work environment. 

She started by taking the time to get to know each team member individually. She learned about their strengths, weaknesses, and career goals. This helped her understand their unique perspectives and identify potential areas for growth. 

Dr. Emily also implemented several strategies to foster teamwork and improve communication. She held regular team meetings to discuss challenges, share ideas, and celebrate successes. She encouraged open and honest communication and created a safe space for team members to express their thoughts and concerns without fear of judgment. 

Addressing Conflict and Building Trust 

One of the biggest challenges Dr. Emily faced was managing conflict. She learned that it was important to address disagreements promptly and respectfully. She would often facilitate constructive conversations between team members, helping them to find common ground and resolve their differences. 

Building trust was also essential for creating a positive and supportive team environment. Dr. Emily demonstrated her commitment to her team by being transparent, honest, and supportive. She showed that she valued their contributions and was invested in their success. 

The Rewards of a Strong Team 

As Dr. Emily continued to invest time and effort into building a strong team, she began to see positive changes. Morale improved, productivity increased, and the overall atmosphere in the office became more positive. The team members started to work together more effectively and support one another. 

Dr. Emily realized that building a strong team was an ongoing process. It required constant effort, patience, and a commitment to creating a positive work environment. However, the rewards were well worth it. A strong and supportive team could help her achieve her practice goals, provide exceptional patient care, and create a fulfilling career. 

By Paul A. Henny, DDS 

As a dental professional, you’ve dedicated countless hours to honing your skills and knowledge. Yet, beneath the polished exterior, many dentists grapple with a hidden enemy: shame. This destructive emotion, often rooted in self-doubt and negative self-perception, can significantly impact your professional and personal life. 

I’ve personally experienced the debilitating effects of shame in my dental career. After graduating dental school, I felt a sense of inadequacy and confusion about my place in the profession. The transition from a structured academic environment to the demands of private practice was overwhelming. I struggled to connect with patients, build a successful practice, and find my footing in the dental world. 

Shame, as John Bradshaw describes it, is the “painful exposure of the believed failure of self to the self.” It’s a deep-seated belief that you’re not good enough or worthy of success. This toxic shame can manifest in various ways, including self-doubt, perfectionism, and difficulty forming healthy relationships. 

Overcoming shame is a challenging but rewarding journey. It requires self-awareness, self-compassion, and a willingness to confront your inner critic. Here are some strategies that have helped me and other dentists: 

• Challenge Negative Thoughts: Recognize and challenge negative thoughts and beliefs about yourself. Replace them with positive affirmations and self-compassionate statements. 

• Practice Mindfulness: Mindfulness techniques, such as meditation and deep breathing, can help you become more present and aware of your thoughts and emotions. 

• Seek Support: Connect with other dentists or mental health professionals who can provide understanding, support, and guidance. 

• Engage in Self-Care: Prioritize self-care activities that nourish your mind, body, and soul. This might include exercise, hobbies, spending time in nature, or seeking therapy. 

• Set Realistic Goals: Break down your goals into smaller, achievable steps. Celebrate your successes, no matter how small. 

Remember, you are not alone in this journey. Embrace the strength of the Pankey community and its collective insights and stories. Many dentists have faced similar challenges and have emerged stronger and more resilient.