By Lee Ann Brady, DMD 

As a dentist, I’ve always been dedicated to providing the best possible care for my patients. But over the years, I realized that I needed to prioritize my own well-being as well. One area that had been taking a toll on my body was ergonomics. I’d noticed how some of my colleagues were using ergonomic loupes and seemed to be much more comfortable and less fatigued. 

At first, I was hesitant to invest in new equipment. I had a perfectly good set of loupes that I’d been using for years. But after experiencing increasing pain in my neck, shoulders, and back, I knew I had to make a change. I finally decided to take the plunge and purchase a pair of ergonomic loupes. There are multiple brands, but I happened to buy mine online from a company called LumaDent. I have their lights, and I happen to love their products and their customer service. 

The Learning Curve 

I’ll admit, there was a bit of a learning curve. It took some time to get used to the new positioning and magnification. But once I got the hang of it, I was amazed at the difference it made. I could sit up straighter, my neck and shoulders felt less strained, and I was able to see my work more clearly. 

The Benefits of Ergonomic Loupes 

• Reduced Physical Strain: Ergonomic loupes are designed to minimize neck, shoulder, and back strain by allowing you to maintain a more upright posture. 

• Improved Vision: These loupes offer better magnification and lighting, reducing eye fatigue and improving the accuracy of your work. 

• Enhanced Patient Care: When you’re comfortable and focused, you can provide higher-quality care to your patients. 

• Increased Career Longevity: By reducing the physical toll of dentistry, ergonomic loupes can help you maintain a long and fulfilling career. 

One of the biggest benefits I’ve noticed is that I’m able to focus on my patients for longer periods without feeling exhausted. When I’m comfortable and pain-free, I can provide better care and have more energy to connect with my patients. 

I believe that ergonomic loupes are a game-changer for dentists who want to protect their health and prolong their careers. If you’re struggling with pain or fatigue, I highly recommend giving them a try. It might just be the investment that helps you enjoy your practice for many more years to come. 

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. 

Lee Ann Brady, DMD 

The origin of a patient’s dental wear may be deceiving. Is it physiological or pathological? This minor difference could spell major consequences for the lifetime oral health of your patients. We care about understanding the differences and how to manage them for the benefit of our patients. 

What is the amount of normal tooth wear? 

To understand normal tooth wear, let’s compare the size of teeth at age 10 to their size at age 70. Based on extensive research, we’ve found that the average loss of tooth structure over this 60-year period is approximately: 

• 1.74 millimeters on posterior teeth (first molars) 

• 1.01 millimeters on upper anterior teeth (centrals and laterals) 

This equates to roughly 15-26 microns of wear per year, depending on the tooth type. 

It’s important to note that this includes all forms of wear, such as attrition, erosion, and abrasion. Even with this normal wear, most people should still have a layer of enamel on their teeth at age 70. In fact, you might expect to retain at least half of the original enamel thickness on your incisal edges and cusps. 

While a certain amount of tooth wear is a normal part of aging, it’s important to distinguish between physiologic wear and pathologic wear. Physiologic wear is a natural part of aging and includes abrasion, erosion, and attrition. It occurs at a predictable rate and typically does not result in significant tooth structure loss. If you notice excessive tooth wear beyond the expected range of 15-26 microns of wear per year, it may be a sign of an underlying issue that requires further evaluation. 

What is the patient-centered approach to discussing wear and understanding the cause of tooth wear? 

When discussing tooth wear with patients, it’s essential to approach the conversation with empathy and understanding. By using a patient-centered approach, you can foster open communication and encourage patients to take an active role in their oral health care. 

• Open-Ended Questions: Ask open-ended questions to encourage patients to share their observations and experiences. For example, you might say, “I’ve noticed some wear on your teeth. Have you noticed any changes in how your teeth feel or look?” 
• Avoid Assumptions: Don’t jump to conclusions about the cause of tooth wear. Instead, ask questions to gather more information and explore potential contributing factors. 
• Emphasize Collaboration: Emphasize that you’re working together to identify the cause of tooth wear and develop a treatment plan. This fosters a sense of partnership and encourages patient involvement. 
• Avoid Blame: Avoid blaming the patient for tooth wear. Instead, focus on identifying the underlying causes and developing strategies for prevention and treatment. 

What do I say to my patients? 

I always start from a place of curiosity. I might say, “When I examine your teeth, I notice some wear that seems more than what’s typical for your age. I’m curious if you’ve noticed any changes in how your teeth feel or look. Sometimes, unusual wear can be a sign of underlying issues like teeth grinding, acid reflux, or other factors.” 

Many times, patients will then say to me, “I don’t know. Do you think I grind my teeth?” or “I don’t know. I do have acid reflux.” If the patient says, “Gosh, I don’t know what that’s about,” the next piece of the puzzle is to take my curiosity and help them understand what we would do diagnostically to figure that out and potentially what we would do to manage that. 

If I think the wear is erosive, the conversation can turn to acid reflux or an acidic diet or abrasive toothpaste. If I think it’s erosive, the conversation leads to “seeing if we can learn what your teeth are doing when you sleep at night. If you’re grinding your teeth, that is something we can manage.” 

I never start with “I think you grind your teeth,” or “I think you have acid reflux,” no matter how confident I am that that is the case. I don’t approach it that way for a couple of reasons. I need to give the patient a chance to process that information and come to terms with the fact that something may be going on that they weren’t aware of beforehand. There’s an emotional impact from hearing that information, so we want to deliver it in a gentle way. And I want the patient to become aware of what may be happening on their own. I want to create a co-discovery process.  

The general message is “We can work together to figure out what might be causing this. By understanding the cause, we can work together to determine the best course of action to protect your teeth and prevent further wear.” 

by Lee Ann Brady 

Have you ever noticed a confused look on the face of an older dental patient when you tell them they have a cavity? Many people falsely assume that only small children develop cavities. When I let older adults know that they have one or more cavities, they say something like, “Wait, I thought only kids get cavities” or “I haven’t had a cavity in decades.”  

They honestly think we outgrow that, so I typically say to these patients, “I know you’re thinking that cavities are something that only kids get, and you’ve outgrown this. But that isn’t accurate. Yes, kids are often prone to getting cavities, but adults can get them for the same reasons.” 

Most of my older adults with cavities are doing a good job with their oral hygiene, so I will explain four things to them.  

1. As we age our saliva is no longer as protective. There are also lots of medications older adults take that diminish saliva production. But, even if our mouth does not feel dry, the saliva does not protect us against bacteria and plaque as well as when we were younger. 
2. As we age our taste buds change, and the foods that satisfy us the most are carbohydrates, so like children, older adults tend to eat more sugary foods. 
3. As we age, if we have gum recession, we have larger space between our teeth, and this tends to trap more food particles that feed bacteria.
    
4. After teeth are restored, normal function over time can introduce openings in the restoration, and bacteria can creep into those openings. 

After we talk about the various reasons that they and other older adults may get cavities, we talk about the fact that there are several preventive strategies and I suggest ones they might like to try.  

My patients enjoy our conversations because they know I really care about them, and I will happily spend time explaining why changes are occurring in their mouth. They appreciate hearing that their problem is not unusual and there are strategies to avoid cavities going forward. 

By Stephen K. Malone, DMD and Michael Costa, DDS, MHS 

We all know that the instrumentation options for dental hygiene services have come a long way since the first dental hygienist scaled teeth in 1906.   Early in the 20th century, the only technology a hygienist had was a set of sharp metal instruments and a spinning brush of gritty pumice. In the 1950s, ultrasonic technology was invented which helped disrupt calculus, but hygienists still had to follow up with scalers and polishers. Similarly, since the days of first scientific articles regarding oral micro-organisms in the 1870’s, our knowledge has increased exponentially regarding the role of oral biofilm not only in oral diseases, but whole-body health.   

In 2021 our office staff attended continuing education courses with legendary periodontist, Dr. Sam Low. Dr. Low introduced our practice to new technology that would help elevate our hygiene practice by improving biofilm removal, increasing patient ownership of personal oral hygiene practices, decreasing damage to root surfaces and restorations, and providing a gentler patient experience.   

The instrumentation is provided though a unit called a Prophylaxis Master – which is a combination of two different treatment modalities.  The hygienist first uses the Airflow unit to remove soft biofilm and young calculus.  The airflow handpiece delivers a combination of water, air and fine erythritol powder to lift and suction away the biofilm as well as stains.  Once the biofilm, young calculus and surface stains are removed, the hygienist moves to the integrated Piezo scaler to gently emulsify the remaining calculus. There are several different tips for both units to access deep pockets and implant surfaces safely. 

Scientific research has demonstrated this system is the gentlest and most efficient way to eliminate bacteria around cosmetic work and titanium implants, on enamel and root surfaces, and even on soft tissues. 

The GBT Protocol 

To get the most out of our investment, we implemented the “GBT” protocol, which is recommended by EMS, the company that manufactures the Prophylaxis Master. The 8-step GBT protocol is as follows:  

1. Assess the teeth, gingiva, periodontal tissues, and any implants and peri-implant tissues. 
2. Use disclosing solution to identify areas of biofilm accumulation. The color will also guide the hygienist to remove the biofilm with Airflow handpiece, after which calculus is easier to detect. 
3. Show the patient the colored biofilm to raise awareness. Spend time educating the patient and emphasizing the importance of prevention. 
4. Removal of biofilm, early calculus and stains with the Airflow. Airflow Plus powder is safe to use on teeth, root surfaces, gums, tongue, and palate. It can also be used to clean dental implants, restorations, orthodontic appliances, and clear aligners. 
5. Use Airflow Plus powder with the Perioflow® nozzle to remove biofilm in >4 to 9mm pockets, root furcations, and on implants. 
6. Remove the remaining calculus, using the minimally invasive EMS PIEZON® PS instrument supra and subgingivally in up to 10mm pockets and clean >10mm pockets with a mini curette. Use the EMS PIEZON® PI MAX instrument around implants up to 3mm subgingivally and on restorations. 
7. After checking to make sure all biofilm and calculus has been removed, diagnosing for caries, and applying fluoride for a fresh and smooth feeling. 
8. Schedule the patient’s recall visit based on risk assessment. 

What Our Patients Love About It  

• Patients trust the thoroughness of the therapy because they can see the disclosed biofilm before it is removed and its absence after it is removed.  

• The therapy is more comfortable than traditional methods. The water is warmed, and there is minimal root surface sensitivity compared to traditional hand and ultrasonic instrumentation.  

• This technology gently reaches into places where traditional instruments couldn’t remove stains and tartar.  

• The education patients receive from our hygienists highlights the value of the therapy.  

• We have found that this is a superior stain and calculus removing technology.  

• The erythritol powder that is mixed with warm water is pleasant tasting.  

 What Our Hygienists Love About It  

• Less hand instrumentation means less body fatigue.  

• There is superior stain removal and visual evidence that the biofilm is completely removed.  

• Patients don’t complain about sensitivity or “poking.”  

 What Doctors Love About It 

• Patients are happier.  

• Hygienists are happier.  

• It eliminates patient complaints about hygienists who are either “too aggressive” or “not aggressive enough” with instrumentation.  

• It prevents damage to cosmetic and implant restorations, as well as root and enamel surfaces.  

Note: We are not paid to promote EMS or Guided Biofilm Therapy. We honestly think this is the best way we can efficiently, comfortably, and thoroughly provide the comprehensive care our patients deserve—and we thought we should share our great experience 

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. 

By Paul A. Henny, DDS 

How are you doing in your quest for a “positive” life? 

Martin Seligman PhD spent most of his career at the University of Pennsylvania advancing the concept known today as “Positive Psychology.” He states that Positive Psychology is “the scientific study of what makes life most worth living.” Along the way, Martin identified five core elements highly associated with psychological well-being and happiness. He believes understanding these five elements helps us to create more fulfillment, happiness, and meaning in our life. 

In Part 2 of this two-part series, we’ll pick up where I left off with the third core element in Seligman’s model. 

R – Relationships 

Relationships and social connections are essential for the creation of meaningful lives. Human beings have been social animals since the earliest of times, hence we are hard-wired to bond and depend on each other. That worked particularly well when we functioned in small social units or “tribes.” The tribal unit allowed us to easily ascertain who was friend or foe. It also allowed us to know who to pay attention to, ignore, and with whom we should invest our time and energy. 

In our modern-day world, the historical notion of tribes has largely been broken and replaced by sub-sects of people who are clustered together around common interests, agendas, and values, brought together in new and different ways. Social media now connects people from around the world in ways we never could have imagined 20 years ago. So, this has created a situation where we don’t know our neighbors, but we do know intimate details about our friends in Australia, Tampa, and Kansas City. 

Since we are less tribal in the historical sense, we have lost our ability to easily trust those who are around us, as we can no longer assume they share our values and priorities. That is WHY the relationship-based practice model is so valuable today.  

The relationship-based practice model is a vehicle of connection that can be used to co-discover our similarities as well as areas of disagreement. Alignment of values, goals, perspectives, and efforts are key to successfully advancing health. Strong interpersonal relationships are the key to the door which opens up all of those possibilities. 

M – Meaning 

Some people work to live, while others live to work, with the latter meaning that a person has been successful at merging their life purpose with their daily work. And when work becomes meaningful on a deeply personal level, it evolves into becoming much more than just a “job.” 

With the ever-expanding discovery of connections between oral health and whole health, dentistry now stands at the forefront of a huge new opportunity – the opportunity to help others to grow, develop, and maintain whole health over their entire life  

A – Accomplishments 

Living a values-driven, purposeful life, integrated with how we practice, aligns ourselves with the achievement of deeply meaningful accomplishments on a daily basis. Helping others in deeply meaningful ways, and then being rewarded with appreciation and appropriate compensation, establishes a self-sustaining cycle, and a successful model for living.  

That’s why you will commonly see relationship-based dentists practicing into their 70’s. Their sense of purpose as they continue to accomplish meaningful work is what motivates them to return to the office and continue striving to help patients, coach younger dentists, and create an-ever-happier positive environment. 

An Easy Acronym to Remember: PERMA 

A great to start your day might be to remember what each letter of PERMA stands for: 

• Positive Emotion 

• Engagement 

• Relationships 

• Meaning 

• Accomplishments 

How will these five elements of Seligman’s model fit into your quest for a sense of wellness and happiness today? How will these fit into your quest to serve and help others? 

By Paul A. Henny, DDS 

Martin Seligman PhD spent most of his career at the University of Pennsylvania advancing the concept known today as “Positive Psychology.” He states that Positive Psychology is “the scientific study of what makes life most worth living.” Along the way, Martin identified five core elements highly associated with psychological well-being and happiness. He believes understanding these five elements helps us to create more fulfillment, happiness, and meaning in our life. 

One of our Pankey colleagues, Barry F. Polansky, DDS, spent a lot of time and energy studying Seligman’s work. In his last decade in practice, Polansky turned his attention to writing books to help new dentists find wellness and happiness in dentistry. Polansky’s 2017 book The Complete Dentist: Positive Leadership and Communication Skills for Success is an excellent guide to starting and running an effective and meaningful dental practice. 

In this two-part series, we’ll take a look at Seligman’s positive psychology model in relation to how we feel about our work in dentistry. 

Seligman’s Five Core Elements: 

P – Positive Emotion 

This represents a “glass-is-half-full” perspective toward life, commonly called an “abundance” perspective. This positive world view is critical because it has a heavy influence on how the brain functions. Our brain is a memory-driven cybernetic solution-seeking organ, with a primary purpose of creating and supporting a successful life. When our mind is in a positive orientation towards our environment, we are typically in a very observant and creative mode of living. In this mode, we constantly scan our environment for relevant bits of information and experiences that are potentially useful in the advancement of our desires.  

When our desires are positive and life-affirming, we are co-creating our experience: We see and experience to a large degree what we expect to see and feel. That is why having a clarified positive vision and purpose for our life and practice is essential for well-being. 

E – Engagement 

L.D. Pankey famously said, “Know Yourself.” What interests us most? What worries us most? In what circumstances are we most comfortable? Under what conditions are we most productive? What are our personal strengths? What are our habits? What are our triggers? What do we aspire to do? What about ourselves would we like to change? 

We all direct most our attention toward the things that interest us or we fear. And it is what we pay the most attention to, whether at work or elsewhere, that we develop the most while engagement with things of lesser importance wither away. It’s healthy to go into ever deeper relationship with the things we value. Clarifying what we believe we are good at and what we will enjoy is a key first step to successful practice development. 

Defining our values is essential so we know when to keep “first things first,” as Stephen Covey likes to say. 

Mac McDonald is a Visiting Faculty member at Pankey, his 2017 book Unchanging Points of Light: Finding Your Way in the Dark is an example of the positive power of values clarification. 

My discussion of Seligman’s five core elements will be continued in Part 2. 

By John C. Cranham, DDS  

Having BHAGs (Big Hairy Audacious Goals) has been important to me for my whole life, whether it was the Ironman triathalon, getting the opportunity to teach with Dr. Peter Dawson, finishing my book, or setting big goals for my practice. The biggest things in my life that were important to me from a professional standpoint started with an idea that got me excited but seemed impossible. 

A BHAG has a way of motivating you when you think there’s a sliver of chance that you might be able to do it. You set it as a goal and proactively discover steps to work towards it; then you get out of bed each day intent on moving forward.  

People are “wired” differently, but I do think extremely successful people do this. Pete Dawson was like this. He died four years ago, and I remember being with him at my lake house two weeks before he passed away. He talked about a BHAG he was working on–a new book, and he showed me the layout he had in mind for it.  

If you don’t have a BHAG (the next big goal that’s exciting to you), it’s easy to get caught up in the day-to-day routine. I can think of times in my life when dentistry became mundane. 

One of the most amazing times in my life was right after I was invited to teach with Pete Dawson. I was on the faculty before I was the clinical director. After I was teaching there, there was a six-month period when I was a little depressed. I didn’t understand the feeling. One night at dinner with Pete, I told him I was struggling. We talked about it for a few minutes, and then he said, “It sounds like you need a new goal.” 

That hit me like a ton of bricks. Once I have attained a goal, I need a new aspiration to chase.  

BHAGs are our reasons to get out of bed every morning and be fulfilled by our efforts. Even if we don’t quite complete everything we visualize, we still end up in a completely different place. And in my experience, it’s always a better one.