Double-Loop Learning in Dental Practice Part 2: The Learning Ladder 

November 9, 2024 Paul Henny DDS

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 When patients or dental professionals are “stuck” on this ladder, they tend to rely on outdated or incorrect mental maps, often described as deductive thinking 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. 

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Creating Financial Freedom

DATE: March 6 2025 @ 8:00 am - March 8 2025 @ 2:00 pm

Location: The Pankey Institute

CE HOURS: 16

Dentist Tuition: $ 2795

Single Occupancy with Ensuite Private Bath (per night): $ 345

Achieving Financial Freedom is Within Your Reach!   Would you like to have less fear, confusion and/or frustration around any aspect of working with money in your life, work, or when…

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Paul Henny DDS

Dr. Paul Henny maintains an esthetically-focused restorative practice in Roanoke, Virginia. Additionally, he has been a national speaker in dentistry, a visiting faculty member of the Pankey Institute, and visiting lecturer at the Jefferson College or Health Sciences. Dr. Henny has been a member of the Roanoke Valley Dental Society, The Academy of General Dentistry, The American College of Oral Implantology, The American Academy of Cosmetic Dentistry, and is a Fellow of the International Congress of Oral Implantology. He is Past President and co-founder of the Robert F. Barkley Dental Study Club.

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Advice for Young Dentists Part 3: Be Open to Change 

August 18, 2024 John Cranham, DDS

By John C. Cranham, DDS 

Pete Dawson and I talked about this often. No matter how many years in practice, dentists never have everything figured out. The things that you are doing now are not going to be right forever.  

My advice to young dentists is to be open to new processes and new materials even if you have a predictable way of doing things now. Learning and adapting makes dentistry incredibly fun. Even in my 60’s I am always learning something new—like the digital 3D world of dentistry. I haven’t been this excited about dentistry ever. 

Starting out as a new dentist wasn’t easy for me. I wanted to be known for something in my community. I wanted to be known as the dentist who solved problems that other dentists couldn’t. The first thing I needed was courage to put myself out there and do whatever I needed to do.  

The second thing I needed was training, mentoring, and experience. I went to The Pankey Institute and Dawson Academy. I took all their courses. I took a veneer class with Bill Dickerson back in the day. I listened to Ross Nash and Larry Rosenbaum. At the turn of the millennium, I was trying to take the traditional occlusal information and blend it with the hottest cosmetic information at the time. (Those concepts were diametrically opposed back then. It was blasphemy to put them together.) I prevailed and became better at solving functional problems and improving aesthetics at the same time. Today, dentists do this all the time. 

I and all my colleagues coming up over the last 30 years have had to be open to change. We’ve had to try new things and work at mastering them. I don’t think I am doing anything today in the same way I was trained in dental school.  

My message in this blog is that it’s important to evolve as a dentist to stay enthusiastic about what you do and to provide the best care you can. It’s common for maturing dentists to let go of certain procedures and focus on what they enjoy most and develop specific expertise in niche services. It’s also common for other maturing dentists to continue enjoying general dentistry half of their time and focusing on complex cases the other half.  

Enjoy the relationships you build and take pride in improving your restorative work as you need to redo it. Patients are wowed by what you can do now and how you do it compared to how you did it years ago. They love learning about the advances in dentistry that benefit them.  

The relational part of practice will always be rewarding. Being able to choose what you do and who you do it with will always be wonderful. Passion for what you do is fueled by learning, so keep setting goals to learn something new and be open to that learning changing you. 

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DATE: March 6 2025 @ 8:00 am - March 8 2025 @ 2:00 pm

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Single Occupancy with Ensuite Private Bath (per night): $ 345

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John Cranham, DDS

Dr. John Cranham practices in Chesapeake, Virginia focusing on esthetic dentistry, implant dentistry, occlusal reconstruction, TMJ/Facial Pain and solving complex problems with an interdisciplinary focus. He practices with his daughter Kaitlyn, who finished dental school in 2020. He is an honors graduate of The Medical College of Virginia in 1988. He served the school as a part time clinical instructor from 1991-1998 earning the student given part time faculty of the year twice during his stint at the university. After studying form the greats in occlusion (Pete Dawson & The Pankey Institute) and Cosmetic Dentistry (Nash, Dickerson, Hornbrook, Rosental, Spear, Kois) during the 1990’s, Dr. Cranham created a lecture in 1997 called The Cosmetic Occlusal Connection. This one day lecture kept him very busy presenting his workflows on these seemingly diametrically opposed ideas. In 2001 he created Cranham Dental Seminars which provided, both lecture, and intensive hands on opportunities to learn. In 2004 he began lecturing at the The Dawson Academy with his mentor Pete Dawson, which led to the merging of Cranham Dental Seminars with The Dawson Academy in 2007. He became a 1/3 partner and its acting Clinical Director and that held that position until September of 2020. His responsibilities included the standardization of the content & faculty within The Academy, teaching the Lecture Classes all over the world, overseeing the core curriculum, as well as constantly evolving the curriculum to stay up to pace with the ever evolving world of Dentistry. During his 25 years as an educator, he became one of the most sought after speakers in dentistry. To date he has presented over 1650 full days of continuing education all over the world. Today he has partnered with Lee Culp CDT, and their focus is on integrating sound occlusal, esthetic, and sound restorative principles into efficient digital workflows, and ultimately coaching doctors on how to integrate them into their practices. He does this under the new umbrella Cranham Culp Digital Dental. Dr. Cranham has published numerous articles on restorative dentistry and in 2018 released a book The Complete Dentist he co-authored with Pete Dawson. In 2011 He along with Dr. Drew Cobb created The Dawson Diagnostic Wizard treatment planning software that today it is known as the Smile Wizard. Additionally, He has served as a key opinion leader and on advisory boards with numerous dental companies. In 2020 he published a book entitled “The Cornell Effect-A Families Journey Toward Happiness, Fulfillment and Peace”. It is an up from the ashes story about his adopted son, who overcame incredible odds, and ultimately inspired the entire family to be better. In November of 2021 it climbed to #5 on the Amazon best seller list in its category. Of all the things he has done, he believes getting this story down on paper is having the greatest impact.

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Advice for Young Dentists Part 1: Be Thoughtful 

August 8, 2024 John Cranham, DDS

By John C. Cranham, DDS 

Every hour you invest in your practice is an hour invested in your future, so invest time in thinking about how you are spending your time. 

I am often asked if I have advice for young dentists starting out in practice. As I reflect on my own experience in practice and on conversations with other dentists in private practice, several thoughts emerge.  

There will be times when you are working in a chaotic, undisciplined environment because you are trying to care for as many people as you can fit into your day. You will become physically and emotionally tired. At some point, you will recognize that you can’t go on that way. You will need to create more disciplined systems for you and your team. You will need to develop your team members, so they can do more and save you time. You will need to hold yourself and them accountable.  

A young dentist must understand that when you run around and do many procedures, you could be confusing activity with productivity. When you’re working on highly thought-out treatment plans, you’re sitting down, you’re doing more well-organized dentistry on fewer patients. You’re also usually executing the dentistry better, which means fewer remakes.  

How do you position yourself to have the luxury of working on those types of cases? The advanced CE at Pankey and other top programs will move you along, but you need to be patient with yourself…and your patients. You will be bringing them along with you through the opportunities you have to educate them about their oral health, where it is headed, and what can be done. Don’t assume you will achieve your goals fast. Eventually, you will become known as the go-to dentist to solve problems and the cases will flow.  

Know your patients. Be thoughtful about moving them along. Enjoy them as you do. 

I’ve written about this before…for the first few years I felt my colleagues were surpassing me. They were doing more advanced cases and utilizing what they were learning at Pankey and Dawson. I had purchased a tiny practice filled with patients who valued dentistry when they were in pain. I aspired to do more than fill cavities. Sometimes I thought I would have to give up on my dream. But I kept talking with my patients, building relationships, raising their awareness, and eventually they began accepting treatment. I had to stay hopeful and employ the behaviors I was being mentored to employ before I could employ my advanced clinical skills.  

I learned a lot about people, not just dentistry, in my early years. I look back upon the experience with fondness now. 

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DATE: May 14 2026 @ 8:00 am - May 17 2026 @ 2:30 pm

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CE HOURS: 39

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Single Occupancy with Ensuite Private Bath (Per Night): $ 355

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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John Cranham, DDS

Dr. John Cranham practices in Chesapeake, Virginia focusing on esthetic dentistry, implant dentistry, occlusal reconstruction, TMJ/Facial Pain and solving complex problems with an interdisciplinary focus. He practices with his daughter Kaitlyn, who finished dental school in 2020. He is an honors graduate of The Medical College of Virginia in 1988. He served the school as a part time clinical instructor from 1991-1998 earning the student given part time faculty of the year twice during his stint at the university. After studying form the greats in occlusion (Pete Dawson & The Pankey Institute) and Cosmetic Dentistry (Nash, Dickerson, Hornbrook, Rosental, Spear, Kois) during the 1990’s, Dr. Cranham created a lecture in 1997 called The Cosmetic Occlusal Connection. This one day lecture kept him very busy presenting his workflows on these seemingly diametrically opposed ideas. In 2001 he created Cranham Dental Seminars which provided, both lecture, and intensive hands on opportunities to learn. In 2004 he began lecturing at the The Dawson Academy with his mentor Pete Dawson, which led to the merging of Cranham Dental Seminars with The Dawson Academy in 2007. He became a 1/3 partner and its acting Clinical Director and that held that position until September of 2020. His responsibilities included the standardization of the content & faculty within The Academy, teaching the Lecture Classes all over the world, overseeing the core curriculum, as well as constantly evolving the curriculum to stay up to pace with the ever evolving world of Dentistry. During his 25 years as an educator, he became one of the most sought after speakers in dentistry. To date he has presented over 1650 full days of continuing education all over the world. Today he has partnered with Lee Culp CDT, and their focus is on integrating sound occlusal, esthetic, and sound restorative principles into efficient digital workflows, and ultimately coaching doctors on how to integrate them into their practices. He does this under the new umbrella Cranham Culp Digital Dental. Dr. Cranham has published numerous articles on restorative dentistry and in 2018 released a book The Complete Dentist he co-authored with Pete Dawson. In 2011 He along with Dr. Drew Cobb created The Dawson Diagnostic Wizard treatment planning software that today it is known as the Smile Wizard. Additionally, He has served as a key opinion leader and on advisory boards with numerous dental companies. In 2020 he published a book entitled “The Cornell Effect-A Families Journey Toward Happiness, Fulfillment and Peace”. It is an up from the ashes story about his adopted son, who overcame incredible odds, and ultimately inspired the entire family to be better. In November of 2021 it climbed to #5 on the Amazon best seller list in its category. Of all the things he has done, he believes getting this story down on paper is having the greatest impact.

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The Power of BHAGs (Part 2)

July 22, 2024 John Cranham, DDS

By John C. Cranham, DDS 

Even today, after decades into family life, dental practice, and continuing dental education, I sit down every January to outline my BHAGs (Big Hairy Audacious Goals) for the year. I block out the first Monday after Christmas to do this, but for the previous month, I’ve been thinking about what new goals will excite me most. I commonly do this type of thinking while I am exercising and driving.  

It’s during these alone times that I can intentionally mull over the things I could do next. I pay close attention to which possibilities excite me most. Oftentimes, these are goals that I feel will benefit others. 

Successful people have the ability to create daily behaviors that direct themselves towards their goals and take them forward on steppingstones. One of the simplest, yet powerful things I witnessed Dr. Pete Dawson do is how he started each day. He would go to his desk and spend 15 to 20 minutes writing six things on a 3×5 card. These weren’t a To Do list. These were six things that would direct him toward his next BHAG. He would place the card in his breast pocket. He did this day in and day out. 

Two weeks before he passed, Pete came to my lake house on oxygen. When he arrived, I had to help him out of the car and into the house on his walker. I looked at his shirt pocket, and there it was, the 3×5 card.  

We don’t have to use 3×5 cards to make notes for ourselves. We can use our phones. But it is powerful to reflect daily on steps that will take us in the direction we want to go and record those steps to lock them in our memory.  

In dentistry, we need to carve out habitual time to think about our goals and steppingstones. We need to carve out time to take the identified steps. The point is to have a system in place where you are thinking about it every day, because there is so much coming at us all day long that we are at risk of drowning in the noise.  

When we get caught up in the mundane, life is less interesting and less fulfilling. At least that has been my experience. When you sense you are becoming bored, you might just need to identify the next big goal that excites you. The challenge of getting there will bring you back to full life. 

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Description:  As dentists, our training with patients in school was all about becoming adept at the skills necessary to provide predictably successful dental procedures for them.  We examined them for…

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John Cranham, DDS

Dr. John Cranham practices in Chesapeake, Virginia focusing on esthetic dentistry, implant dentistry, occlusal reconstruction, TMJ/Facial Pain and solving complex problems with an interdisciplinary focus. He practices with his daughter Kaitlyn, who finished dental school in 2020. He is an honors graduate of The Medical College of Virginia in 1988. He served the school as a part time clinical instructor from 1991-1998 earning the student given part time faculty of the year twice during his stint at the university. After studying form the greats in occlusion (Pete Dawson & The Pankey Institute) and Cosmetic Dentistry (Nash, Dickerson, Hornbrook, Rosental, Spear, Kois) during the 1990’s, Dr. Cranham created a lecture in 1997 called The Cosmetic Occlusal Connection. This one day lecture kept him very busy presenting his workflows on these seemingly diametrically opposed ideas. In 2001 he created Cranham Dental Seminars which provided, both lecture, and intensive hands on opportunities to learn. In 2004 he began lecturing at the The Dawson Academy with his mentor Pete Dawson, which led to the merging of Cranham Dental Seminars with The Dawson Academy in 2007. He became a 1/3 partner and its acting Clinical Director and that held that position until September of 2020. His responsibilities included the standardization of the content & faculty within The Academy, teaching the Lecture Classes all over the world, overseeing the core curriculum, as well as constantly evolving the curriculum to stay up to pace with the ever evolving world of Dentistry. During his 25 years as an educator, he became one of the most sought after speakers in dentistry. To date he has presented over 1650 full days of continuing education all over the world. Today he has partnered with Lee Culp CDT, and their focus is on integrating sound occlusal, esthetic, and sound restorative principles into efficient digital workflows, and ultimately coaching doctors on how to integrate them into their practices. He does this under the new umbrella Cranham Culp Digital Dental. Dr. Cranham has published numerous articles on restorative dentistry and in 2018 released a book The Complete Dentist he co-authored with Pete Dawson. In 2011 He along with Dr. Drew Cobb created The Dawson Diagnostic Wizard treatment planning software that today it is known as the Smile Wizard. Additionally, He has served as a key opinion leader and on advisory boards with numerous dental companies. In 2020 he published a book entitled “The Cornell Effect-A Families Journey Toward Happiness, Fulfillment and Peace”. It is an up from the ashes story about his adopted son, who overcame incredible odds, and ultimately inspired the entire family to be better. In November of 2021 it climbed to #5 on the Amazon best seller list in its category. Of all the things he has done, he believes getting this story down on paper is having the greatest impact.

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The Value of Consultants, Coaches, and Mentors in Dental Practice 

April 5, 2024 Gary DeWood, DDS

Gary M. DeWood, DDS, MS 

As an associate dentist, you may be fortunate to learn from the instruction and observation of a senior dentist, but over your career, you will gain innumerable benefits from outside consultants, coaches, and mentors. 

One of my mentors, Dr. Richard A. Green, told me that one of the keys to my success would be to surround myself with a Board of Directors. He was correct. My board is composed of people who are willing and able to see my vision and hold me accountable for going to it. Some are consultants, some are coaches, and some are mentors. Sometimes they are all three in one person but no one person has all the answers. 

Consultants, coaches, and mentors help us in different ways. 

In dental practice, I often hear the words mentor, coach, and consultant used interchangeably to describe the activities of someone assisting the doctor with the management of his or her practice. I believe that these functions, while not mutually exclusive of the same individual, are different in their roles with regard to all three of you. 

What do I mean by that? “You #1” is the entrepreneur and leader of the business you have established. “You #2” is the manager of that business. “You #3” is the dentist working in the business. Each you possesses a different level of training, understanding, and ability. Each you benefits differently from consulting, coaching, and mentoring. 

Early in practice my partner and I hired consultants to see what escaped us and to give us solutions.  

Consulting is all about being an outsider looking in. The adage that consultants are individuals who are paid a lot of money to tell you what you already knew but couldn’t see, does not diminish their effectiveness or necessity, particularly in offering solutions.  

I met Jim Pride while I was still in dental school. In the early years of our relationship, following the acquisition of our practice, Laura, our Pride consultant, consulted us by telling us what to do. I was directed to employ systems that were developed by Jim Pride and his team while working with many Pride Institute clients. I did as we were “consulted” because I had no reference for individualizing the systems, something that changed as we found the parts and pieces that delivered and left behind parts that did not resonate for us.  

As my partner (who happened to be my wife) and I changed, our expectations changed, and our needs changed, we continued to need that outsider looking in to see for us that which we could not see. We did not, however, need or want to be offered solutions. The best consultants understand that their ultimate goal is to empower and develop their clients’ skills and abilities so that they can eventually operate independently. 

When we no longer needed a consultant, we needed a coach. 

Unlike consulting, where solutions with precise instructions are offered, coaching offered us a process out of which our vision for our practice developed. Dental practice coaches ask questions rather than give answers. They are observers. They take us inside ourselves and assist in our development as leaders. They draw out what is already within and empower us to act on it. 

What, then, is a mentor? 

For me, mentors are individuals who have traveled the path we seek to follow. They may fill the role as a consultant and/or a coach depending on our needs and their comfort with the things that are challenging us at any given time, but frequently their primary role is that of an example. The Pankey Institute community abounds in them. 

I have observed that dentists who develop a relationship with a mentor are able to move more quickly and clearly toward their preferred future. It is precisely for this reason that one of the goals of participation in a study club is to build groups with a broad range of experience and experiences. It is the third YOU, the practicing dentist, who gets the most from being mentored 

Dentistry is a tough job. It’s demanding and stressful to perform highly technical, intricate procedures continuously on a daily basis. Our mentors show us that we can do it because they did. Often there is peer-to-peer collaboration in “surfacing up” the mindset, approaches, and solutions that will work best for us. Always there is encouragement. 

Sometimes mentors listen. Sometimes they challenge. Always they support. Their map is not always the map we choose to follow, but their example–as individuals who continue to see their vision and map their future accordingly–inspires us to do the same. 

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DATE: October 29 2026 @ 8:00 am - October 31 2026 @ 12:00 pm

Location: The Pankey Institute

CE HOURS: 19

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Dental photography is an indispensable tool for a high level practice. We will review camera set-up and what settings to use for each photo. All photos from diagnostic series, portraits,…

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Learning the Essentials 

January 27, 2023 North Shetter DDS

In his recent book Subtract–The Untapped Science of Less, University of Virginia professor of design Dr. Leidy Klotz points out many instances where we allow ourselves to be overwhelmed with information and complexity. He argues and demonstrates that subtracting the extraneous often leads to greater clarity and efficiency.

Reading Klotz’s book, brought to my mind the Pankey Institute’s Essentials continuum that begins with Essentials 1 (E1). Dentists arrive at E1 overloaded with information taught in their dental schools and other CE programs. All that information may have some value but the role of the Essentials courses is to subtract the extraneous and focus on what is essential.

We arrive at E1 thinking everything is important, and we discover that there are essential elements of dentistry that are key to effectively working with patients, performing a complete exam, diagnosis, and technically excellent, predictable care. From these key elements, we can build practice systems that are clear and efficient.

What Is Essential?

We aren’t born with complete wisdom like Athena born from the forehead of Zeus. We learn wisdom (what is essential) faster by being in the company of others who have traveled the same road, asking, “What is essential? What do I NEED to know?”

The Pankey Essentials continuum exposes dentists to the clinical, behavioral, and financial aspects of practice. And goes beyond exposure to exercises and exploration. The courses invite dentists to understand themselves, their patients, and their work exceptionally well. The courses invite dentists to focus on and develop essential skills.

Our profession has undergone a technological explosion over the past few years. Some of this is wonderful. But how much of what we invest in are we fully utilizing? What is the best technology to invest in? What is the best way to implement it? The Institute’s faculty help us cut through the clutter and determine what works best…what we can implement with our teams and patients that will improve our dentistry and the patient experience. But first, the Essentials courses peel away the layers of hype and technology to help us grasp the core skills we must attain.

The core skills are behavioral as well as technical. And because the behavioral aspects of dentistry are not discussed to great extent in dental school curriculums, one of the roles of the Essentials continuum is to fill in this gap. In the Essentials courses, we learn the importance and skills of behavioral science. We learn how to most effectively lead and affectively influence. We dig deeper into understanding ourselves and our patients…our emotions, our motives. We discuss the behavioral concepts that were taught by Dr. L. D. Pankey because they remain valid today. These concepts are straightforward and help us develop lifelong patient relationships and personal skills.

The business aspects of dental practice are overwhelming. Dental schools do not have time to teach business essentials. In the Essentials, dentists learn essential financial skills such as how to understand their financial statements. If we are not making a profit in our practice we can’t stay in business.

Self-Examination

When I first attended an Essentials course (then called C-1), I worried that I might not know enough. I discovered that I knew a great deal but I had not clearly defined what was essential. I learned I needed to be more assertive about asking myself why questions. For example, I found myself asking:

  • Why am I doing this? Does this step add value to the final result?
  • Why is my final result not stress free and predictable? What step did I miss?
  • Why am I “telling” my patients rather than “asking” for their input and values?

An Intentional, Essential Community of Support

The Essentials faculty and my fellow students helped me understand that getting rid of what is not needed is not simple. Determining what is essential and building my practice systems around the essentials takes time, thought, and effort but was made easier for me because I had the help and constant encouragement of the Pankey faculty and community in shaping my approach to dentistry and my career.

My friend and colleague Dr. Richard A. Green has always said, “Intentionally becoming both more affective and more effective is essential to excellent patient care.” So often we intend to do something but don’t have the encouragement we need to remain intentional. As my friend and colleague Dr. Barry Polansky says, “We humans tend to slip, slide away. It is by developing habits intentionally and self-checking our assumptions that we stay alert to the possibilities of how we can become more.”

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Single Occupancy with Ensuite Private Bath (per night): $ 355

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North Shetter DDS

Dr Shetter attended the University of Detroit Mercy where he received his Doctor of Dental Surgery degree in 1972. He then entered the U. S. Army and provided dental care at Ft Bragg, NC for the 82nd Airborne and Special Forces. In late 1975 he and his wife Jan moved to Menominee, MI and began private practice. He now is the senior doctor in a three doctor small group practice. Dr. Shetter has studied extensively at the Pankey Institute, been co-director of a Seattle Study Club branch in Green Bay WI where he has been a mentor to several dental offices. He has been a speaker for the Seattle Study Club. He has postgraduate training in orthodontics, implant restorative procedures, sedation and sleep disordered breathing. His practice is focused on fee for service, outcomes based dentistry. Marina Cove Consulting LLC is his effort to help other dentists discover emotional and economic success and deliver the highest standard of care they are capable of.

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A Reflection On Personal Growth in Learning

December 1, 2021 Richard Green DDS MBA

A Reflection: Although most of our early educational classrooms have not often fostered it, an essential participatory experiential exercise can help ground our discoveries and anchor our adult learning, in which we can be “known through” an experience with self and others, more than knowing anything by our own thought. An authentic encounter with a teacher/mentor can foster, in time, our discovery toward a feeling of true knowing, in our heads, our hearts, our hands, and our bodies, as well. This understanding, authentically discovered, can emerge, in unique ways with each individual, and becomes an opportunity for True-Self seeing. It is quite unlike the intellectual “knowing” most of us have been taught to rely on. This experiential kind of “seeing,” can take away much of our anxiety concerning figuring it all out fully for ourselves or requiring ourselves to be “right” about our formulations beforehand. At this point, a teachers’/mentors’ facilitation can become more like a verb than a noun, more a process than a conclusion, more an experience than a dogma, more a personal relationship than an idea.

Life then becomes more like a verb than a noun…We were not put on this earth to describe life, rather we are invited to actively live it,,,! In time, there often can be someone dancing with us (maybe sitting on our shoulder), and we are not afraid of making mistakes. We learn through experience, mistakes, doubt, while allowing a reviewing process to become an intentional part of our experiential learning. It is often best, if we are not told first… Rather, we can be invited to discover it for ourselves! Hmmm…Isn’t that interesting?

“The true wonder of learning is discovering for ourselves!” Carl Rogers, PhD

Through our own experience we can discover while having many encounter’s in which family, patients, team members, friends, and colleagues become our teacher’s / mentor’s. Even when we are doubtful, we can look in the mirror, at our authentic self and say, “Yes” – knowing full well, there is much more to be experienced and it is bound to add layers to our understanding and learning on the job! What ever the “Job” may be or become! Learning becomes a “Two-Way Street” and our teachers and mentors can become participants, team members, patients, spouses, parents, grandparents, adult children, children, and grandchildren, in all age groups. Success then, is a moving target… Not a fixed destination; instead, it can be a becoming!…Isn’t that wonderful…!

Related Course

E3: Restorative Integration of Form & Function

DATE: April 12 2026 @ 8:00 am - April 16 2026 @ 2:30 pm

Location: The Pankey Institute

CE HOURS: 41

Dentist Tuition: $ 7500

Single Occupancy with Ensuite Private Bath (per night): $ 355

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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Richard Green DDS MBA

Rich Green, D.D.S., M.B.A. is the founder and Director Emeritus of The Pankey Institute Business Systems Development program. He retired from The Pankey Institute in 2004. He has created Evergreen Consulting Group, Inc. www.evergreenconsultinggroup.com, to continue his work encouraging and assisting dentists in making the personal choices that will shape their practices according to their personal vision of success to achieve their preferred future in dentistry. Rich Green received his dental degree from Northwestern University in 1966. He was a early colleague and student of Bob Barkley in Illinois. He had frequent contact with Bob Barkley because of his interest in the behavioral aspects of dentistry. Rich Green has been associated with The Pankey Institute since its inception, first as a student, then as a Visiting Faculty member beginning in 1974, and finally joining the Institute full time in 1994. While maintaining his practice in Hinsdale, IL, Rich Green became involved in the management aspects of dentistry and, in 1981, joined Selection Research Corporation (an affiliate of The Gallup Organization) as an associate. This relationship and his interest in management led to his graduation in 1992 with a Masters in Business Administration from the Keller Graduate School in Chicago.

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Three Profitable Tips to Simplify Dental Billing for Obstructive Sleep Apnea

May 10, 2021 Mark Murphy DDS

When I speak with dentists who have dipped their toe in the waters of treating obstructive sleep apnea (OSA) in their practice, the number one reason they say they quit doing it or are not doing more is …

“I couldn’t get paid!”

You may be committed to helping patients achieve better health through treatment of OSA, but it’s challenging to make it financially possible. Here are three tips that will make dental billing for obstructive sleep apnea more consistent and predictable:

Use Practice Management Software to Simplify Dental Insurance

Understanding how to succeed in the complicated system of medical billing is a game-changer.

We have all figured out how to streamline our approach to making sense of dental insurance, but the rules are different for Dental Sleep Medicine (DSM). You should use a segment-specific software platform (DS3, NiermanDentalWriter, or other) for your SOAP notes and communication with physicians and payers.

These platforms ensure that you include the right notes, tests, patient status, and history to get paid. DSM and medical reimbursement are under the jurisdiction of rigid documentation of processes, protocols, and standard practices. Choosing the most effective DSM practice management software is the first step to payment because it will not let you forget to harness critical information.

Make It Easy for Patients to Say Yes to Treatment

My second piece of advice is the most difficult to implement because it requires a change in behavior. Talk less about co-payments, deductibles, and the patient’s responsibility than you may be used to in dentistry when dealing with obstructive sleep apnea.

As an example, consider this: When you visit your doctor and they suggest an x-ray, draw blood, or order a specific test, do you usually say, “How much will that cost?” No, you don’t. We know that tests and medical treatment recommended by our physician are necessary and not usually optional to achieve optimal health.

Plus, we know that their treatments will be covered by our medical insurance (after the deductible and with certain co-payments). As dentists, we are expected to have significant upfront financial discussions about how much the patient will have to pay out of pocket because of the different nature of dental insurance.

Unfortunately, this same approach when applied to a sleep apnea appointment may backfire. Treatment of sleep disorders can be life-changing, so it’s beneficial to the patient if you focus less on dollars and more on care outcomes.

When we get detailed about the financial arrangement, upfront copayments, and deductible discussion, patients think we are still treating them as a dentist, not as a medical care provider. Make it easy for patients to say yes by leaving out the money talk. Many will have good coverage and can make the treatment a possibility.

Outsource the Details to a Competent Billing Company

Hire a billing company to do the dirty work. Third-party billing companies (Four Pillar, Nierman, Pristine, Dedicated Sleep, GoGo, Brady) typically charge a small per claim fee around $50 and 8-12% of the paid amount. This fee is worth every penny.

I have seen far too many revolutions from the administrative teams in dental practices when they were forced to try to figure out the weird, ever-changing rules of insurance reimbursement.

Billing companies are experts. Plus, the cost as a percentage of sales works for medical practices, so why shouldn’t it for dentistry?

Treating patients for OSA with Oral Appliance Therapy (OAT) is easier clinically and technically than making bite splints in centric relation. And yet the minefield is littered with the remains of dental teams who tried to do the billing themselves.

If you only did one case per month, subscribed to a cloud software solution, paid a billing company their fair share, and risked not talking so much about money, you would still help patients get healthier, feel very fulfilled, and make more money than you are now.

That success can breed more success. You just might add $100,000 to your annual revenue! Curious how you can start incorporating treatment of sleep apnea into your practice workflow?

I’ll be holding a live, three-hour virtual course, “Treating Sleep Apnea In Your Practice With Oral Appliance Therapy,” on Friday, May 21st, 2021. Registration for my course is easy at Pankey Online.

Join me from 2 pm to 5 pm EST to learn more about the medical background of sleep conditions, marketing sleep appliance therapy, and more in-depth techniques I implement to transform medical billing.

Can’t wait to see you there!

Sign up for free at Pankey Online to access complementary and paid CE-granting webinars spanning hot dental topics like sleep apnea treatment, equilibration, and indirect bonded anterior restorations. 50+ cutting-edge courses at your fingertips …

Related Course

E1: Aesthetic & Functional Treatment Planning

DATE: July 17 2025 @ 8:00 am - July 20 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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About Author

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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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2 Transformative Tips to Leverage Phased Therapy for Single Tooth Dentistry

April 23, 2021 Kevin Muench DMD, MAGD

One of the greatest challenges of dentistry is developing a conceptual framework for how to approach complex cases. We leave dental school bright-eyed but unfamiliar with the personal and professional tools that help us get to know patient needs and provide optimal care over a lifetime.

Phased therapy is a skill that takes time to develop but creates the mental space to build relationships and techniques simultaneously. How do you follow through on a treatment plan over the course of many years, phasing out the process to improve the patient’s experience, your experience, and their ability to afford it?

Single tooth dentistry may seem simpler than a full mouth reconstruction, but it still poses its own set of challenges. You’ll be able to gain skills without requiring patients to commit to a heavy financial burden, but you’ll still need to manage esthetics and deal with unforeseen issues with occlusion.
A dental career is one marked by introspection that necessarily leads to improved patient care as you gain greater self-knowledge alongside technical skills. Here are 2 tips you can use to develop your love of both simple and complex cases, your long-term relationships with patients, and your passion for dentistry:

1. Approach Learning as a Layered Process

It’s easy to get hung up on technical prowess and let your communication skills or personal development suffer. The mountain of knowledge that exists in dentistry is formidable, especially the way it is presented early on in our dental educations.

But you don’t have to build Rome in a day. Start with single tooth dentistry so that you have time to learn the technical and behavior skills along the way that will build your confidence to tackle bigger cases.
Longevity in a career as physically and emotionally demanding as dentistry requires that we approach learning as a layered process. Each case deepens our understanding of how to evaluate and succeed at the next one. Along the way, we can find joy in each incremental improvement.

2. Build Trust Through Patience and Demonstrable Success

Nothing works without the patient’s trust and acceptance. They will be more likely to say yes to a simpler restorative case. What you’ll find is that as they get to know you and you get to know them, their willingness to engage in future dentistry will improve.

With patience, you’ll put in the work to improve their health and esthetics. The fruits of your labor will naturally result in greater trust.

Later this year, I’ll be hosting my course “Think Global, Work Local,” at Pankey Online. During this course, I’ll dive deeper into the concepts I’ve brought up here.


I’ll be covering three cases that stood out in my career, including the details on preparations, impressions, fee presentation, treatment planning, restorative care, and case results.

I can’t wait to see you there for this opportunity to dive into a Pankey-infused approach to learning over a lifetime!

Related Course

Mastering Aesthetic Restorative Dentistry

DATE: November 20 2025 @ 8:00 am - November 23 2025 @ 12:00 pm

Location: The Pankey Institute

CE HOURS: 32

Dentist Tuition: $ 6300

Single Occupancy with Ensuite Private Bath (per night): $ 345

THIS COURSE IS SOLD OUT! Aesthetic dentistry is where artistic form meets functional restorative dentistry. Where patients, clinicians, specialists and laboratory technicians communicate with each other in an effective way…

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Kevin Muench DMD, MAGD

Dr. Muench started his private practice in February, 1988. Graduated from Boston College in 1980 with a B.S. Degree in Biology. In 1987, he graduated from New Jersey Dental School with honors and was elected into the Dental Honors Society, OKU. He received the Quintessence Operative Dentistry Award and the Dentsply Fixed Prosthodontics Award. In 1993, he received a Fellowship in the Academy of General Dentistry and in 2002 received a Masters in the Academy. He has completed greater than 1500 hours of continuing education since Dental School. He is an alumnus, visiting faculty, and an Advisory Board member of one of the most significant continuing education groups, The Pankey Institute. Kevin resides in his family home in Maplewood where he was born and raised. Kevin and his wife Eileen have three boys; Colin, Tommy, and Michael. They strongly believe that participation in community efforts are what make the difference in Maplewood NJ.

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Bring on the New Year! It’s all about Growth.

January 4, 2021 Paul Henny DDS

If I were to select one word most strongly associated with a successful relationship-based, health-centered practice, it would be the word growth.

What kinds of growth? The kinds I am thinking of are growth in knowledge and growth in sophistication of attitudes toward people and dentistry. As I meditate on this, I am enlarging my hope for and commitment to fostering personal growth … interpersonal growth … care team growth … patient growth … and, of course, practice growth. I welcome you to come along with me as I breathe fresh energy into leaving 2020 behind and growing in 2021.

Notice I didn’t mention a single word about teeth or techniques. I didn’t mention a word about technology, or what you must physically own to achieve growth. And that’s because growth isn’t a material thing; it’s a spiritual thing.

Growth can be promoted, or it can be impaired by the way we think, and consequently the things that we do and say day-in and day-out. And what we do repeatedly is driven by what we believe … what we believe about ourselves … what we believe about others … and what we believe about the purpose of dentistry.

What is your purpose in dentistry?

Each of us have a purpose that is driven by our philosophy … our world view … our perspective of things … and therefore what it all means to us. This changes as we grow in knowledge and sophistication of attitudes.

Avrom King said that it all boils down to these three questions:

  1. Who am I?
  2. Why am I here?
  3. What is it that I am trying to achieve?

All three of them are philosophical questions, and all three lead us to answers which directly influence almost everything else. If we do not understand who we are on a values and beliefs level—what Mac McDonald likes to refer to as “the deep structures of ourselves,” we cannot predictably lead ourselves in any desired direction. And as a result, we cannot predictably lead others in a desired direction either.

Growing with Purpose

Growing with purpose requires Hope and Agency. If we do not hope for something of greater meaning to ourselves and we think we have truly little personal agency, we flounder.

In a world where we believe we have minimal personal value, everything around us starts to look scarce, and everything around us starts to look scary, so we’re tempted to take short cuts. We’re tempted to just grab what we can get for ourselves as quickly as possible. After all, who knows what tomorrow will bring? If we “stay on shore” with feelings of disempowerment and a little too much wine and whining, we ultimately achieve very little with our lives.

If we “stay on shore,” we will attract others who similarly think and behave. Like attracts like. Avrom King liked to call this “King’s Law.”

We tend to create our practice in the exact image of what we believe about ourselves, and consequently, that could be some version of heaven or hell. All of this happens because we choose to grow or to not grow.

Growth requires hope, courage, attitude, energy, and action, i.e., self-determination and self-control. Talk is cheap, so what will you do to master these? Surround yourself with a vision of your preferred self … your preferred career … your preferred dental practice. Acting on that vision leads to a next step and a next. In doing this, you will attract “likes,” and this positive reinforcement will help keep you on the road of your personally purposeful life. How much growth is happening in your practice today?

Can you see the green shoots of enthusiasm and creative change all around you, evidence of constant renewal? Or do you see an ossified structure struggling to maintain the status quo? Are you surrounded by people who are down, frustrated, and thinking that they have no other choice but to keep plodding on as they are?

Who are you?

Why are you here?

What is it that you are trying to achieve?

Philosophy Matters.

And that’s why L.D. Pankey, Bob Barkley, and other of our dental heroes constantly talked about it.

Related Course

E1: Aesthetic & Functional Treatment Planning

DATE: July 9 2026 @ 8:00 am - July 12 2026 @ 2:30 pm

Location: The Pankey Institute

CE HOURS: 39

Dentist Tuition: $ 6900

Single Occupancy with Ensuite Private Bath (Per Night): $ 355

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…

Learn More>

About Author

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Paul Henny DDS

Dr. Paul Henny maintains an esthetically-focused restorative practice in Roanoke, Virginia. Additionally, he has been a national speaker in dentistry, a visiting faculty member of the Pankey Institute, and visiting lecturer at the Jefferson College or Health Sciences. Dr. Henny has been a member of the Roanoke Valley Dental Society, The Academy of General Dentistry, The American College of Oral Implantology, The American Academy of Cosmetic Dentistry, and is a Fellow of the International Congress of Oral Implantology. He is Past President and co-founder of the Robert F. Barkley Dental Study Club.

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