Ask One More Question

One of the ways I have learned to Stay in the Question is to practice asking one more question before I give information. Learning to ask one more question has helped me to be more effective in several ways

1. The practice of asking one more question helps us save time.

My experience is that we spend a lot of time giving patients information they may not want or need. We can waste our time and theirs by giving information they have not asked for.

There was a time when if a patient asked me if x-rays were “really” necessary, I would go on at great length about the value of the radiographs, what we could see on them, and what we might miss if we didn’t take them. But I learned to respond, “It sounds like you might have some concerns about having x-rays,” and ask, “What is your concern?” By asking one more question, I was able to answer the patient’s question or concern very precisely and quickly.

2. Staying in the questions helps us understand what the patient wants from us.

Patients don’t always know how to communicate with us to get their needs met. They ask what they know how to ask. Sometimes their question is “Will my insurance cover that?” Sometimes their question is “How long will it last?” or “Will it hurt?”

Asking a follow up question to any question or concern they express allows us to better understand their needs and expectations. If a patient asks, “Will it hurt?” I could reassure them I will be as gentle as possible. Alternatively, I could say, “It sounds like you are concerned about the pain of this procedure. Have you had a painful dental experience in the past?” Responding to a specific fear will always be more powerful than a general reassurance.

3. Asking one more question allows us to give information clearly, to give information that is useful to them.

After seeing patients over years, it is easy to fall into giving the same information repeatedly. We all have our scripts we fall back on that describe a particular disease or procedure. Having a ready-made script may seem efficient but in the long run it can cause us to miss opportunities to be more effective with our patients. We can spend a lot of time giving them reasons why we think they should have treatment instead of providing more precise information relevant to their needs and their wants.

Aristotle said, “The fool persuades me with his reasons. The wise man persuades me with my own.” We don’t need to guess how to persuade our patients. I’ve learned that, when I stay in the question, patients tell me exactly what they need from me to be able to make decisions.

4. Asking one more question creates an opportunity to build trust.

There was a time when I thought having all the answers for my patients would make me seem competent and gain their trust. I’ve come to understand that I will never have all the answers and that, in dentistry, it is just as important for patients to trust our motives as it is for them to trust our competence. When we take their questions and concerns seriously, follow up with genuine curiosity, and listen deeply to their responses, they are more likely to feel our care and concern. They are more likely to trust that what we want is what is best for them.

More dental leaders are blogging on the subject of leading dental patients to improved health by learning what is important to them. Often, the next words we read are “We need to meet patients where they are.” What exactly does that mean???

To me, this doesn’t mean we meet expectations of low cost, faster care, with immediate results. This doesn’t mean we make promises that all their dental needs are met for the next six to twelve months. It doesn’t me the therapy we provide will solve an incipient or chronic problem for life. It doesn’t mean their insurance coverage dictates the value of the care we deliver. It doesn’t mean we are going to open our office after hours or on the weekend because that’s what someone wants. It doesn’t mean we guarantee a crown or veneers will last and never need to be replaced.

To me, this means understanding the individual patient, not patients (plural) as a population with trending, new expectations in 2022. It means focusing on the things each person thinks are important and relevant to their lives…where their priorities lie. Then, we can attempt to strategically tie what they value to their dental health to help them make a connection to a preferred future self. Most people, it seems, are unable to make these connections on their own.

Two Big Questions We Ask Ourselves

What do our oral health findings–ideally uncovered during a co-discovery exam, mean to a particular person? If our findings don’t have meaning to the patient, how can we possibly motivate the patient to take action? All of us struggle with these types of questions because we can’t force our values, our philosophy of oral health on others.

We can, however, create opportunities to reveal a pre-existing, unrealized value of health the patient has. If we find the patient is not health-centered, we can triage that person appropriately so we spend most of our time with patients who are health-centered.

“Revealing” Unrecognized Value Takes Time

Early in my career, I thought I could educate my patients to see the value of oral health the way I saw it. I found I was often knocking my head against the wall. Some people just didn’t value it. They wanted help when they were in pain, but preventing dental deterioration wasn’t something they felt needed immediate action. Moving forward with treatment was not on their personal agenda.

Gradually, as I read Bob Barkley, L.D. Pankey, Nate Kohn, Jr., and others, I realized they had gone through a discovery process of their own. The first task was to get to know the patient and understand the patient’s value for health and the patient’s oral health objectives. It was also to try to discover if their oral health circumstances were important to them so I could help them envision their preferred health future. But that takes time—time with each patient.

If your practice is primarily insurance dependent, you are underpaid most of the time. How do you compensate for this problem? You find ways to work faster. You find ways to see more people in a day. You delegate more. You look for a way to cut your lab technician’s salary out of your life. You buy in bulk and wake up in the middle of the night wondering why you got into dentistry in the first place.

It doesn’t have to be that way!

Many years ago, when I began spending time with new patients to learn if they are health-centered, I was able to better manage my time with them. If they valued health…if I could connect them with their dental needs on a deeper level, then spending even more time with them was well worth it.

Those who value health are the patients we can easily help understand why we take our comprehensive approach to restoring and maintaining optimal oral health.

You can be more productive per hour than you can imagine, IF you take the time to connect with patients on a deeper level and you strategically find ways to spend most of your time with people who care about their health in the first place.

L.D. Pankey wisely said, “People change, but not very much.” And that’s a critically important life lesson, one that took me years to accept because I thought my philosophy would psychologically trump theirs, and I would therefore win the day. I was wrong – very wrong.

The Pankey Institute is the world’s oldest, most prestigious learning center for advanced dentistry. Our Traverse City, Michigan dental practice has been involved with The Pankey Institute for the last 27 years. You will often hear or read that the purpose of the Institute is to narrow the gap between what is known and what is practiced. And the unique thing about this nonprofit organization is that the faculty promote and facilitate learning around the behavioral aspects of dental care as well as the technical aspects.

The technical things we do in dentistry are transactional. Those are the clinical procedures we perform every day. But the behavioral training we receive at The Pankey Institute is truly transformational. It transforms how we approach patient care, placing focus on building relationships of trust based on genuine concern for what is in the patient’s best interest. It transforms how we thoughtfully and collaboratively lead our patients to improving their oral health. It teaches and encourages us to provide the highest standard of clinical excellence so our patients can achieve optimal oral health, comfort, and beautiful smiles.

During our years of association with The Pankey Institute, we have learned how to predictably manage and treat complex dental cases, and how to help patients who, at first, are anxious and lack trust. We’ve learned how to understand where individual patients are coming from and work from that basis to open their minds to what is possible for them and help them access fine care.

The greatest benefit of returning to the Institute for continuing education has been the total immersion that we experience at the Institute as we learn from, interact with, and are mentored and encouraged by like-minded individuals. We’re learning from some of the best dentists in the world. They’re flat-out experts in what they do. They flat-out care about their profession and want to help other dentists become the best they can be. They also want to help the dental professionals on our care teams, whether they are clinical or administrative, become more effective in their roles.

The year 1994 was the first time I attended a course at the Institute in Key Biscayne, Florida. And now I have progressed through the Pankey continuum of courses to where I am part of the visiting faculty to help teach and mentor other dentists. And, I am now the Coordinator of the Pankey Scholar Program, which is the pinnacle of the Pankey Learning Experience.

Since 1994, our dental practice in Traverse City, Michigan, has grown to be the largest “Pankey practice” in the world, and we’re proud of that because of what it means for our patients. We have a common culture here–among our five dentists and all team members, and a vision of patient-centered, comprehensive care that is easily articulated. It positively impacts our work, our lives, and our patients’ lives. It has enabled us to provide a consistently wonderful patient experience.

The Pankey Institute is the voice, the home, and the hope of private care dentistry. The Pankey Institute experience and its supportive community of learners has helped our practice thrive as a private practice that offers expertise in restorative and cosmetic dentistry, including full-mouth reconstruction, implant dentistry, and IV sedation. At Traverse Dental Associates, we are facing today’s business challenges well, we are proud to provide the finest care, and we are strongly committed to private practice.

If you are new to the Institute and I have not met you yet, please let me know. You are the life blood of our profession and may one day be a standard-bearer, if not a missionary for The Pankey Institute, the Pankey community, and everything it represents. I look forward to meeting you.

I think all dentists would agree that mutually beneficial and enjoyable relationships with patients are key to a dental practice’s long-term success. But what does that “relationship” look like in a health-centered practice?

To some, a good relationship represents two people who get along and perhaps enjoy being in each other’s company. But I would argue this is not enough to build a successful health-centered dental practice. Getting along and even enjoying the presence of another person alone doesn’t go deep enough. It only addresses good rapport, and good rapport is only the starting point of a truly helping relationship. We need more to help patients achieve optimal oral health.

The More We Need

We need shared values, shared understanding, and shared goals. And to a large degree, we also need a shared vision of a preferred future so that all the goals are oriented in a specific mutually agreed upon direction. That vision must largely originate from the patient because it is their water to carry, and not ours. We can facilitate the development of the patient’s vision, but we cannot realize it for them.

This type of relationship is often called “patient-centered” or “client-centered.” And it is only possible through mutual trust — and a lot of it at that. We must have enough trust present within the relationship to allow for open and transparent communication to occur. This type of communication is much deeper.

The Deeper Communication We Need

Communication that is deeper includes discussions around:

• concerns,
• personal challenges,
• barriers,
• fear,
• short-term agendas, and
• longer-term goals.

When a patient trusts us, they are essentially allowing themselves to be vulnerable to our actions, which could, if something went wrong, harm them physically, emotionally, and/or financially.

A first sign of trust is the willingness to have these types of discussions.

Some patients will trust us quickly because we have big capital letters after our name, but this de facto trust is becoming rare. We must EARN our patient’s trust through the quality of the relationships we build, our attitude, our philosophy, and our actions that lead to deep communication and development of shared understanding and goals.

I would argue that meaningful conversations around important issues are what distinguishes a “health-centered” or “patient-centered” dental practice from one that is an attractive and pleasant place where dental services are provided in exchange for money. A key metric to monitor in each patient record is whether the deeper discussions are taking place. A key objective is to schedule time to gently have those discussions.

I had a great reminder recently while I was working with a patient that listening to patients’ intuitions and beliefs about their own dental health and care can be valuable. I’ve had this experience with many of my patients. Sometimes that value is clinical, and sometimes it is in increased patient understanding and relationship development.

I treat a lot of patients who have chronic TMD…oral facial pain…occlusal muscle disorders. You have them, too, in your dental practice. We try to help them understand that there is no “treatment,” but we have management strategies. Even when patients know this, it is frustrating for them when they have flare ups.

My patient had been comfortable and symptom free for the better part of a year, which was a long period for her. Recently, though, she had started waking up with headaches and muscle tension in her masseters and temporalis. She came in to talk about “What now?” And the answer to “What now?” is always “What has worked in the past?” We walked back on our options.

She wondered, “Can you add some material to my appliance? I always feel better at a slightly open vertical.”

The question didn’t surprise me. She’s been a dental patient for a lot of years and knows the meaning of “open vertical.” My first gut reaction was to dismiss her suggestion because it ran counter to what I know about the science and my clinical experience with other patients. I honestly didn’t want to change her appliance. But I intentionally put a pause on that resistance and sought clarification from her about what she has experienced.

Over the years, it has amazed me how knowledgeable patients are about their own dental health. They are receiving physiological data that so often they don’t know how to describe. Assessing the validity of what patients describe can be a challenge, but I’ve learned the value of acknowledging the information and asking the patient to tell me more. I ask, “Why do you think that? What have you experienced in the past that has led you to that belief?” Often, I can access the data and understand the validity of the information to help the patient.

When I don’t have a really good idea of what to do next and the TMD patient has an intuitive idea, I’ve come to respect their intuition and do what they suggest. Many, many times I have no evidence to explain why it works but their intuition works. And when it doesn’t work, it’s still okay because the patient has been validated. We’ve demonstrated we’re in a partnership in their care, and we move on to try something else.

I’ve learned to stop and recognize there must be something behind intuitions patients share. Seeking to learn more about their intuitions has led to trying new types of care and always deeper relationships with patients.

We had another interesting week at the dental office when a patient (I’ll call Ron) came in. Ron has been a patient of mine for over 20 years and is nearing 80. Whenever I saw him, we would have interesting conversations about what he was doing and thinking about doing next. He was the kind of person I love to be around, always positive with a “can-do” attitude.

This time was different. I hadn’t seen Ron in over three years, because he suffered a heart attack which led to some other complications. He came in using a cane.

When it was time for my hygiene check, Julie came to me and said, “I don’t know what’s going on with Ron, but he was really hard for me to work with today. I tried to get as much accomplished as I could. I’m sorry.”

Ron was previously very health-centered but now he was behaving like he wasn’t. Do values change in that short a period? No, but a person’s priorities might, particularly when they have developed a distorted perspective due to some traumatic events.

When I entered the room, Ron’s attitude perked up. He was positive and respectful — he was honoring our long history of mutual respect. He updated me on what happened and how he was doing. Not only were his physical disabilities frustrating, but he had rarely left the house for over a year.

Following my exam, we discussed an area of decay and several cracked teeth — all restorable with crowns. He responded that he was old and wasn’t sure how much longer he would be around. He asked, “Is there an inexpensive way to fix this? I don’t want to spend a lot of money on my mouth.”

Dentists hear this every day, but in this case, I knew the REAL Ron. I knew it was his depression speaking to me. I told him it would make sense for us to develop a Phase 1 plan, meaning, “Let’s remove the decay and get everything stabilized like they would do for you in the ER if you had an emergency, and then we can talk later about restoring things back to the way they need to be — strong and secure.”

“I don’t think I want any restoration work,” he replied.

Then, I said, “Ron, I know how much you love to eat fine food, and it would be tragic if, in your last decade, you were limited to eating only soft food or you had to fumble around with a partial denture that catches food around it all the time. Like I said, let’s focus on Phase 1 and then talk about restoration later. We have time on our side.”

“Ok,” he said, “I can go along with that.” He needed to feel like he was in control.

I finished by using words that would resonate with him, “You know Ron, despite these things that need to be addressed, you have great bone around your teeth and a great smile, so there are good reasons to restore things and finish out strongly. If you were an old, uninspiring ‘84 Oldsmobile, I’d say there is no point in restoring things, but you’re like a 1956 Corvette barn find that’s still in good condition. You’re worth it. Let’s save the conversation about restoration for another day when you are feeling better. I’m so glad that you came in, I miss talking to you.”

Ron’s eyes lit up. He smiled and said, “Yea, maybe you’re right. I can’t move like a Corvette any longer, but I understand what you are saying. I really appreciate it.”

New Patients / Patients of Record

Often a dentist or team member can believe: A new patient or patient of record wants to be efficiently informed on two or three things:

• What do you want me to know about my dental health?
• What and how do you want me to do “it”?
• What is this going to cost? Or isn’t dental insurance going to pay for this?

A Story of Dr. R. A. Green from the Past to the Present:

A retired physician of seventy-five years of age was enjoying teaching at The University of Chicago Medical School. At the time of this conversation, I was attending Northwestern University Dental School and working part-time as a Doorman at The Hotel Pearson. The Hotel Pearson was a residence hotel; the physician was a resident of the hotel. The hotel was located where the Ritz Carleton presently stands on Pearson Street, one block East of Michigan Avenue; the time frame was the early 1960’s. That evening, as the retired physician walked out for some fresh air, he engaged me in a conversation, which he had done on previous occasions. I remember asking him about, what he was teaching?

His reply has stuck with me all these years. He said, “I am trying to encourage the young Interns and Residents to slow down and listen.” Slow down and listen, I replied with a question lingering in my voice. He said, “Yes, if I can help them begin to create opportunities for a patient to experience “deep listening” and then stay “present” with and for a patient, the Intern/Resident will notice, in time, a patient will diagnose their own ailment (at least offer enough important information to be able to develop a very accurate differential diagnosis); a wonderful place to start, a beginning!”

He went on to say, “If I can encourage the Intern/Resident to continue to listen deeply, a patient can reveal how they want to be treated. And, if the Intern/Resident can listen just a little longer, a patient can initiate a conversation about how they want to pay for the services to be rendered. Deep Listening accomplishes a greater understanding of the patient, which leads to a better diagnosis, and can lead to a more successful practice model than running from room to room, thinking you only have three – five minutes to do all of the above, while not accomplishing any of the above. I am really trying to encourage them to slow down and listen!”

Now, almost sixty years later, I am sitting and reflecting on my lifetime in dentistry and work with patients, team, and dentists; I too have been involved with teaching and coaching, myself and others, for over sixty years. While I strive to have conversations concerning many different aspects of dentistry, which surface while being present, with and for others, the bottom-line in a relationship-based life and practice are very similar to that of the retired physicians’ message, nearly sixty years ago.

My response is also altered and influenced, due to an early encounter’s with Dr. L. D. Pankey, soon after I had met him in 1968. In a conversation, he had asked me to tell him about my office and the flow of a day in my office. His response to my description of my usual day was, “Why don’t you Slow Down and become more Affective, you are Efficient Enough!” A similar message, and it had a heightened impact upon further reflection: “I have heard this before and it sounds very familiar!”

What is it you do intentionally, on a regular basis, to slow down and become more Affective (Affective Domain), for you too are Efficient Enough?

Hmmm… Isn’t that interesting!

According to a recent survey released by the John Templeton Foundation, people are less likely to feel or express gratitude at work than any other place. And their feeling of appreciation toward their current jobs, ranked dead last on their list of things they are most grateful for.

Oddly, this outcome isn’t because people don’t crave receiving gratitude at work. Ninety-three percent of those surveyed agreed that their bosses are more likely to succeed if they expressed gratitude more often, and only 18 percent thought that expressing gratitude made their bosses “weak,” or hurt the organization. Additionally, the majority surveyed reported that hearing “thank you” from others at work made them feel better about themselves and more motivated.

So, What Gives?

Why is something which is so obviously appreciated and helpful so frequently withheld? Why do Americans actively suppress gratitude at work, even to the point of robbing themselves of happiness and all its benefits?

The answer lies within the nature of our “reptilian” brain which lies buried underneath or logical neocortex. Our brainstem, midbrain, and limbic system are constantly surveying the environment to determine if we are safe as well as where we are within our tribe social status-wise, as well as how our tribe ranks relative to other tribes.

As a result, we are slow to give support and appreciation to others because it might change the organization of our social structure in such a way that we might personally lose out. Another way of saying this is that we are all built on a neurobiological level to be inherently selfish.

Overcoming Our Silence

The role of gratitude in dental practice should be a positive, intentional one that makes every single care team member feel values. When they feel good about themselves and their contributions, performance will rise. To this end, we must consciously work at overcoming our tendency to remain silent and ignore other people’s contributions and exceptional performances. And how can we do this?

1. Make gratitude part of your practice culture from the top down. One of the biggest takeaways from research on workplace gratitude is that your care team needs to hear “thank you” from the doctor regularly. This is because it’s up to the people with the most social, political, and financial power to clearly, consistently, and authentically thank, in both public and private settings, those who have helped their status. In other words, we need to lift everyone else around us. Rising tides should lift all boats.
2. Gratitude should also be built into your performance reviews and staff meetings, where time can be allocated for each person to say “thanks” to others on the team for being thoughtful and pitching-in at critical moments.
3. Thank those who seem to never get thanked. Thanking those who do important, but easy-to-take-for-granted work is key. Your office cleaning crew, your UPS delivery person, the mailman, your accountant… You get the picture. These simple gestures improve morale and increase trust, and therefore increase performance.
4. Aim for quality thankfulness, not quantity. Forcing your team to be grateful to one another won’t work if they’re harboring resentment and other unresolved issues which remain untouched. Hence, forcing gratefulness as a strategy is not “cultural,” its superficial and doesn’t work. Instead, it can feed upon the power imbalances which undermine gratitude in the first place, and therefore make expressions of gratitude feel inauthentic.

The key is to create times and spaces that foster the voluntary, spontaneous expression of gratitude such as morning huddles and regular team development meetings.

Many of you are already doing these things, but are you doing them frequently enough and with the right intentions?

What would you like to build your relationships upon in your practice? With all the attention that is paid to dental insurance, it sometimes seems as though that becomes the foundation of our relationships with patients. When this is the basis of our relationship, the moment the plan changes, the patient may be looking for another dental office. Do we want to have our relationship based on such a fragile platform?

When I think about what we could have at the foundation and how we could make this happen, several things come to mind.

Compassion as the Basis

Basing a relationship on compassion can begin with the very first phone call. When a new patient calls, compassion can be expressed by something as simple as, “What prompted you to call us today? I hope you are not experiencing any discomfort.” Right out the gate, you are putting out there that you care about their comfort.

For a new or an existing patient, you might to say something like, “I’d like to make sure we schedule enough time to do this very thoroughly…very gently, and that we provide you with the best possible service so you are as comfortable as you can be.”

When you talk with patients about conditions you are seeing in their mouths, you can express concern as simply as saying, “I see a crack in this tooth, and I am concerned that, as it gets larger, you may experience some pain. Have you experienced any pain there?”

Mutual Trust as the Basis

On the very first call, you can begin to base your relationship on mutual trust and respect. You might do this by saying something like, “I’d like to schedule enough time for you to get to know us and for us to get to know you. When we learn what is important to you, we can help you make choices that are in your best interest. We’ll want to know what your previous experiences have been in dentistry because we want to provide you with the best possible experience in this practice.”

During Hygiene appointments, you might say something like this, “As I look in your mouth, it appears to me that over the years, you’ve gone to the dentist regularly and done everything you could to take care of yourself. You’ve chosen to have treatment when it was recommended. I believe that if you have the right information and you have some support in working through the process, we can help you make good choices for yourself in the future.”

If the patient is not in pain, you might say something like, “You’re in a really good position right now. We’ve got time to study the information we’ve gathered and to learn about your preferences. The doctor will want to go over all the information we’ve gathered today and spend time thinking about your oral health circumstances and options. If you decide later to have treatment, you will be fully informed about your options so you can make the decision that is right for you.”

Shared Values as the Basis

When we discover shared values in conversation, there is a powerful connection between us and the patient. If a patient mentions a filling has lasted for decades, you might say something like, “It seems to me that you like to have your dentistry last as long as possible?” And if the patient says yes, you might say, “Excellent, we’ll take that into consideration when we think about options for you.” Give them opportunities for discovering together with you what is most important to them.

The foundation you intentionally build on compassion, mutual trust, and shared values will enable you to expand conversations you have with patients about insurance and the cost of care. You will be able to assure them you will do whatever you can to make the dentistry they value affordable for them.

In 1999, I participated in the writing of a 500-word bio of Dr. Lindsey Dewey Pankey, Sr. for his posthumous induction in the Pierre Fauchard Academy International Hall of Fame. Although he was born over a century ago, his legacy has impacted many thousands of dentists and millions of patients.

Sharing this abridged bio with you 20 years later means that the asterisked number of dental professionals instructed by The Pankey Institute has greatly grown. Nevertheless, I offer this to you in its original words to make his abridged biography more widely known.

From the Pierre Fauchard Academy International Hall of Fame of Dentistry, 1999

Dr. L.D. Pankey, Sr. Was born on July 31, 1901. He received his Doctorate in Dental Surgery degree from the College of Dentistry at the University of Louisville, practiced in New Castle, Kentucky for one year, then relocated to Coral Gables, Florida, where he practiced dentistry until 1969. In 1932, he became a member of the Florida State Board of Dental Examiners and served 12 years, including his term as secretary and chairman. Concurrently, he was a member of the American Association of Dental Examiners, serving as Vice President in 1942 and President in 1943.

Throughout his professional career, Dr. Pankey was an essayist, lecturer, and student.

Having made presentations before countless local, state, national and international dental groups, he was best known for his seminars on “A Philosophy of the Practice of Dentistry.” In 1956, his Philosophy lectures were organized into three-day seminars. Subsequently, a curriculum was developed whereby practicing dentists would attend a series of once-a-year classes over a three-year period. In these classes, Dr. Pankey helped dentists find fulfillment through building relationships with patients about the benefits of optimal dental care. He helped his colleagues seek a balanced life. And he inspired them to do their personal best for every patient.

Dr. Pankey also developed a procedure for occlusal rehabilitation. In collaboration with Drs. Arvin W. Mann of Ft. Lauderdale, Florida, and Clyde H. Schuyler of New York city, he developed a teaching manual. In 1959, they began giving seminars, attracting dentists from throughout the United States and many other nations. Their occlusal rehabilitation procedures became known as the Pankey-Mann-Schuyler Technique (PMS). He was acknowledged by the dental profession for this work by being elected President of the American Prosthodontic Society.

Over 7,000 dentists attended the occlusal rehabilitation and philosophy classes taught by Dr. Pankey. The dentists who attended these classes formed the nucleus of support for establishing The L. D. Pankey Foundation, Inc., and creating “The L. D. Pankey Institute.” The Pankey Institute was the first advanced dental education organization of its kind in the world. It opened the doors to its first class in Miami, Florida in 1972. The curriculum was organized into what has become known as “The Continuum,” a series of one-week classes taken at a pace that is convenient and pertinent to the growth of the participant.

Well beyond simply honoring its namesake and continuing his teaching, The L. D. Pankey Dental Foundation, established a higher mission for dentistry “to bridge the gap between what is known and what is practiced.” Since 1972, The Pankey Institute has instructed over 17,000* dental professionals from many nations of the world, affecting the dental outcomes and well-being of millions of patients. Dr. L.D. Pankey, Sr. was deeply committed to the Institute’s success, participated in its development, and lectured at the Institute up until the time of his death in March of 1989.

Dentistry, our beloved profession, is better because of the man we recommend for induction. The Academy is privileged and honored to induct Dr. Lindsey Dewey Pankey, Sr., into the PFA International Hall of Fame of Dentistry.