By Mary Osborne, RDH  

Think for a moment: Is there a change you think you could make in your life that would contribute positively to your health? Is there anything you could be doing—or not doing—that could improve your overall health and wellbeing? Most of us can think of something we could do, or do more consistently, to improve our health. Next, ask yourself if the reason you have not made the change you need to make is because you do not have enough information. Our clinical training taught us that if we give people the right information they will change their behaviors. It’s easy to get disappointed in ourselves and our patients when that turns out to not always be true.   

Reflecting on our own past and current health challenges is a way to remind ourselves that health is a journey, not just a set of strategies. What makes perfect sense to us now, may not have been relevant 20 years ago. Often we have heard the relevant information before but were slow to act on it. We may have conflicting priorities, such as time, or money. We may have had fears or doubts. When we can look at our own journey with understanding and compassion we are better able to see our patients that way.   

I remember a patient who came to us with a lot of dentistry that needed to be done. As we talked with her about recommendations for treatment, her eyes welled up with tears. “It’s nothing,” she said when I asked her what the tears were about. Eventually she shared with us that she and her family had been saving up to build a deck on their house. Doing the dentistry she knew she needed would mean they could not build the deck. There was a time when I might have thought, “What’s more important, a deck or your dental health?!?” But I was moved by her struggle. I can’t judge what a deck may mean to her and her family, but I can relate to her sadness in letting go of something they had been saving toward.   

As you advise patients, it’s helpful to share that are you on a path to better health yourself, and that it is not always easy. In this way we can step outside of the role of “expert” and come to our conversations as fellow travelers. And when we do come as fellow travelers, we bring our empathy, our humanity, and we allow ourselves to feel compassion. We are likeable.  

One of my favorite books is Dr. Rachel Naomi Remen’s Kitchen Table Wisdom: Stories That Heal. She quotes the psychologist Carl Rogers, who said:  

Before every session, I take a moment to remember my humanity. There is no experience that this man has that I cannot share with him, no fear that I cannot understand, no suffering that I cannot care about, because I too am human. No matter how deep his wound, he does not need to be ashamed in front of me. I too am vulnerable. And because of this, I am enough. Whatever his story, he no longer needs to be alone with it. This is what will allow his healing to begin.  

Because we are on a journey of becoming healthier just like everyone else, we can sit side by side with a patient. We can say, “I get it. It’s not always easy.” We can allow ourselves to feel compassion—that urge to genuinely help someone, and gently invite them to understand they are no longer  

By Mary Osborne, RDH 

There was a time when I thought “partnering in health” was just about getting people to take better care of their teeth. 

Many years ago, I had a patient who was excellent with her home care, but she showed up periodically with an acute periodontal infection. We asked about stress and her overall health, but she was not aware of any issues. We would treat the infection and she would be fine for a sometime. We knew she worked for National Public Radio, and one day we made the connection that her infections showed up concurrent with NPR’s fund-raising drives. That shared realization allowed us to help her see that her stress was affecting her dental health and her overall health. She was open to conversations about lifestyle changes that would help her be healthier. My relationship with her influenced my thinking and my ability to connect with my patients from a perspective of Whole-health Dentistry. I came to understand that I had been missing opportunities to influence the way people think and feel about health. I knew that I wanted my patients to see me as “a partner in health.” 

Unfortunately, most of our patients come to us with the perspective that we are fixers of teeth, not partners in health. 

In the culture today people are bombarded with information about what is healthy. From friends and families, social and news media, and a wide variety of health care practitioners, everybody expresses opinions on how they are supposed to take care of themselves. Why, then, are we surprised when our patients don’t know whom to trust? Why are we surprised when they shrug their shoulders or appear confused? It’s not always a case of conflicting facts but a case of various perspectives that people don’t know how to navigate. 

Think about where you place your trust. How do you decide whom to trust about decisions—whether it’s about your health, or about your finances, or about how you raise your children? When I ask myself that question, two criteria surface. They need to know their subject and to know me. I want that person to know what it is they’re talking about. I want them to be well informed. I also want someone who knows me, who understands my values. I want that person to have a sense of who I am and what is important to me. 

As we get to know our patients over the years, most of them come to see us as trusted advisors when it comes to their dental health—but fewer see us as trusted advisors when it comes to their general health. If we jump too quickly to making recommendations about their overall health, we are more likely to meet resistance. If we want to cross the bridge into influencing our patients’ overall health and wellbeing, I believe we need an invitation to cross that bridge.   

The Missing Piece in our quest to influence the overall health of our patients is the failure to invite patients to share their perspectives on health. Beginning a conversation with a new patient with the question, “What can you tell me about your health in general?” is an invitation for them to talk about their experience of their health, not just details. Instead of “reviewing” health histories, what if we “explore” health histories? As we connect and get to know each other we can learn to listen beyond information to hear attitudes, beliefs, fears, biases, concerns, barriers, etc. As you understand their perspectives on health issues that come up in conversation, it’s easy to ask if they would like your perspective on that issue. These conversations often lead to more questions and answers that invite more and more invitations from our patients to be their partner in health. 

Kelley Brummett, DMD 

Recently, I completed growth conferences with everyone on my team. The beauty of a growth conference is that it’s all about growth. It’s all about effort. It’s all about meeting each other and becoming more aligned with the mission of the practice. If I have something I want to share with a team member that’s a concern or something new I would like them to achieve such as mastery of a new skill, I think about how I’m going to communicate it. And as I do growth conferences with the individuals on my dental team, I am cognizant that they are likely to want to receive feedback differently as individuals.  

I’ve discovered that if I ask my employee upfront how they like to receive feedback, they pause to think before responding. I wait patiently for their response because I know the response will save both of us time and energy. For example, there are some team members who want the short and skinny of it—“Give it to me straight now.” They don’t want you to hold back. There are some team members who need to be gently warmed up before they can hear the message and require thorough explanations of why. 

I’ve discovered it helps to frequently ask the “how do you like feedback” question of my team to get their buy-in of my feedback. The beauty of “feedback” is that even criticism can be framed in a positive way as the next identified step in working towards a goal.  

Those of us in dentistry know that sometimes we move fast, but there are times that we need to sit back, think through what somebody gave us information about, and then come back and have a conversation. Mary Osborne has guided us to have conversations with patients that allow us to slow down and learn more about them so they can think, hear themselves speak, and learn about themselves. I’ve decided the feedback question is also a good question to ask patients. “How do you like to receive information? Would you like to know all the details or for me to summarize?” 

I’ve learned from Mary and experiences with patients that “staying in questions” helps them grow. Staying in questions also helps team members grow. Staying in questions helps us providers grow. So, feedback—how do you give it? How do you like to receive it? How do you handle it? I encourage you to think about this. 

By Michael (Mike) Rogers, DDS

Close to my office there is a small strip center that includes a realty group and a small church. At one end, there is no sign to show what it is, but it has a drive-through window. Every day there is a significant line of cars going up to that window. Cars line up waiting their turn, and the line is so long the cars snake through the parking lot, out into the street, with hazard lights flashing. 

I have a friend who loves to create stories about what is going on in strangers’ lives. Why is someone driving so fast? What meal are they going to create with food in a shopping cart? Why are two people arguing?  

Fantasized from some level of observation, my friend has captured what this drive-through is all about. He believes that because the drive-through is adjacent to a church, you can pull up to the window and are given a donut along with a prayer. It’s a small ministry for people to have a better day. That’s not a bad narrative but no real basis for the story. I say that as the line of cars grows longer, the prayers gain power. I get a warm feeling of their impact on others. 

I find we make up stories in my office as well. We make them up about why someone didn’t show up for an appointment, why someone didn’t move forward in care that has been advised, or why someone won’t pay a balance. Our tales are based on some level of observation, but they are tales none the less. 

I try to remember to look at these moments in three ways. 

• What do I know? 
• What do I think I know? 
• What do I want to know? 

We practice this in our office. I encourage my team to not live in “what I think I know.” This state of mind too often leads to creating stories that reflect a judgement. If I hear a team member begin to create a narrative based on a circumstance with the phrase “I think…,” I try to politely make them aware of what they are doing. They most certainly recognize when I do it and politely let me know. I just grin to hide my disappointment in myself. Maybe someday, I’ll say, “thank you.” 

In relationship-based practices, we have such marvelous opportunities to help people be healthier. Asking questions about what we’d like to know and sometimes creating self-discovery for the patient as well. We often get repeated moments to connect and learn with each other. The need to make up stories is dissolved when we get to hear their story. Sometimes that story is fun, other times hard. We get to walk along that story with them. What a gift to live a life in that connection! 

Recently, a member of the realty group on one end of the strip center came in to see me. I couldn’t resist asking what the line of cars is about. It turns out it is an Ignition Interlock site for people that have had a recent DUI. You go up to the window for your installation time of the small handheld breathalyzer to prevent your car from starting after drinking alcohol. 

I haven’t shared that with my friend. I like his story better. 

Gary M. DeWood, DDS, MS 

Many dentists believe that provisional restorations don’t really matter. After all, they are not really a stand-in for the final restoration. I would respectfully disagree. I am a proponent of creating functional, durable, and highly esthetic provisional restorations, every time. They have the potential to impact your dental practice a lot more than you might think. Whether you print them, form them, or free-hand them, a GREAT temporary is a great billboard for your practice. 

1. Make the provisional as Esthetic as the final restoration.

I contend that the more your provisionals look like what you are hoping for when you seat the final restorations, the more people will talk about them, AND you. 

I was able to build a referral restorative practice by creating provisionals that made patients want to come to my practice and specialists want to send people. For much of our career, almost the entire team of the oral surgery office we worked with, and many of the team members from the other specialty practices we worked with, were our patients in Pemberville, Ohio. 

Front teeth or back teeth, when you make them look like teeth, people will like it and they will show and tell other people. “This is just the temporary?!” was not an uncommon question or exclamation from our patients.  

2. A GREAT guide makes a GREAT provisional restoration.

Your wax-up** cast/model serves as your vision, as your preparation guide fabrication device, and as your provisional former. When the preparation is appropriately reduced for the material selected, the temporary can mimic the restoration. 

** The wax-up might be created with wax then duplicated with impression material and stone to create a cast, or it might be scanned to be duplicated with resin and printed or milled to create a model. 

3. 3. Use that provisional to highlight the talents of your team members.

You might LOVE to make those provisionals, but if your assistant is equally excited when it comes to recreating nature for the patient to appreciate, then it could be an opportunity for patients to see that your assistant does much more than set-up, clean up, and hand you an instrument. My dental partner, Cheryl, (who is also my wife) and I actively sought out things that could help our patients experience our team as much more than our helpers. 

As we all know, dental assistants are an integral and vital part of what the practice is and are a powerful force in how and why patients ask for dentistry. Assistants who fabricate provisionals have an opportunity to be seen differently, and we were always looking for ways to create partnership with them in our treatment. 

4. 4. Take pictures of them.

Photographs of the temporary will make it easier for the lab to design the outcome. They will be able to see what you are thinking, able to visualize what you want, AND maybe even more importantly, see what you do not want. With anterior provisionals, I have frequently noted to my ceramist, “Please put the incisal edge in exactly this position vertically and horizontally in the face, then use your artistry to create the tooth that belongs in the face you see in the photographs of the patient before, prepared, and temporized.” 

There were many times when the technician was able to see and create effects that I might have not recognized as being “just the thing that would make these teeth extraordinary.” And don’t forget to show the patient the photograph. 

5. 5. Love the material you make the temporary with.

The better the provisional material is at holding tooth position and functional contact, the less adjustment we’re going to have, so using a high-quality material is important. There are a lot of them out there. I like bis-acryl materials that polymerize with a hard surface, have little or no oxygen inhibited layer, and can be polished easily. The polish is more about feeling smooth than about the shine. Ask you patients how their provisional tooth “feels” when you are done, so they sing your praises. 

6. 6. Use high-quality core material.

When you use a good core material the prep will be smoother, making it easier to fabricate nice provisionals. Ideal prep form goes a long way toward better provisionals. 

7. ASK your patient to tell people.

As noted above, when you can elicit an emotional response about the awesomeness of your provisional, ask the patient to tell other people, “….and this is just the TEMPORARY!” 

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. 

Paul H. Henny, DDS 

Trust is commonly thought of as a firm belief in the reliability, truthfulness, and capability of another. But trust is about vulnerability . 

The more a person trusts, the more they are willing to allow themselves to be potentially hurt. They make a risks-benefit analysis, and when they feel they are ready, they decide to throw the dice.  

Conversely, when a person isn’t willing to trust, they have strategically chosen to minimize their vulnerability.  

Think about the times when you were personally unwilling to let someone into your life—when you were feeling too vulnerable. 

It’s easy for us to project our values without sensitivity to others’ often hidden concerns. When a patient says no to x-rays, to allowing us to proceed with a proper restoration, or other appropriate procedures, they don’t trust us enough right now. And when that occurs, it’s easy for us to instinctively respond by projecting our values onto the situation.  

A better strategy is to empathetically explore why a person responded to the situation the way they did—try to understand the situation from their perspective, and then focus on finding common ground in shared goals and values. Hopefully, with the right questions and empathy, we can build a bridge of trust and help our patients cross over to a place of more information on which to make the appropriate decisions for themselves. 

“No” often means “not yet,” as in “You haven’t convinced me yet that I should allow myself to be that vulnerable around you.” 

Co-Discovery requires a leap of faith on our part—a belief that most people will eventually do the right things for themselves. If we are unable to trust our patients on that level, then we’re going to struggle emotionally, demonstrate frustration, and to some extent inadvertently manipulate patients into doing what we want them to, a behavior that drives emotionally sensitive patients away. 

We need to trust our patients will make the leap as well. We need to willingly take the time and energy to continue in and trust the Co-Discovery process during which the patient starts to believe that we are the best resource to help resolve their problems and achieve their goals. When we allow our patients the time to make decisions based on what they think is in their best interest, they usually make healthy choices and appreciate the services we provide. This is how we succeed in helping them (and us) have a healthier, happier life. 

For an in-depth look at Co-Discovery and multiple essays on patient-centered dentistry, you are invited to read my recently published book: CoDiscovery: Exploring the Legacy of Robert F. Barkley, DDS, available at The Pankey Institute and on Amazon. 

Gary M. DeWood, DDS, MS 

Adults have a wealth of experience to draw on and they like to do so as part of their learning. Adults are not used to taking direction in education; they choose what they want to learn. When my friend (in Part 1 of this series) lost his active interest in seeking out dental education, he had made a choice to learn other things he hoped to know.  

One of my heroes, Doctor Parker Mahan, told me once that one of the harshest lessons of mortality for him was the realization that he could never live long enough to learn everything he wanted to know. 

Adults need to create specific opportunities to self-reflect and internalize what they are learning in order to integrate it with what they already know. Adults have preconceived notions about education, learning style, and subject matter that interfere with their learning. Adults are often afraid to fail so they frequently guard their learning process by telling themselves why what they are hearing is wrong. 

Where children are sponges when it comes to learning, as adults our brains adapt to experiences and interactions that occur “on purpose.” We acknowledge a reason to remember that experience…to have that new knowledge. 

Here’s an example. 

Our eldest child, Patricia, entered a world in which those charged with her immediate care had barely learned to care for themselves–a world to which she adapted very quickly. In no time she had taken control of the lives of two sentient beings who proudly professed their independence and right to make decisions about their own lives but nonetheless jumped through the hoops of her creation as soon as they were offered. 

After the grandmothers had departed and Cheryl and I were now totally responsible for this baby FOR REAL, her training of us began in earnest. Turns out Cheryl and I CAN be taught, proven by our immediate response to Patricia’s guidance in managing her universe. A visit by Uncle Toby and Aunt Patsy presented us with an opportunity to learn from another source. 

Following a hearty meal, a very sleepy baby was laid in her crib for some sleep. Almost immediately upon our return to the living room Patricia realized she was no longer being held, and realized she was no longer where the “party” was happening. Being WITH the party is very high on Patricia’s list. When she “called out” in response to that situation, two very well-trained parents immediately stood to head for the emergency that was happening for the helpless baby. Uncle Toby looked at us as we simultaneously rose and said, “What are you thinking?” 

That might sound like a question, but it was really a statement that meant “stop.” So, when Uncle Toby asked his “question,” Cheryl and I stopped as we were instructed. Uncle Toby then asked, “What are you teaching that baby if you go in there and pick her up every time she cries?” 

As brand-new, first-time parents, this thought was alien to us. Being so well trained, we thought our only mission in life was to keep the baby from crying. With some angst in our stomachs that tightened each time Patricia’s wailing reached a new crescendo, we sat in the living room and pretended to ignore what we were hearing.  

Suffice it to say that when our second child Dale came along, he learned, and reasonably quickly, that we were not necessarily coming every time he rang the bell.  

Every day, we hear and see a lot of information that never makes the transition to “learning” because it does not produce change.
Change can only occur for adults when we enter into an agreement with ourselves that there is something we want to learn in what is being said or shown to us. We ACT on it. 

The truth is EVERY interaction we have with any other person or situation is a potential learning experience if we reflect upon it and internalize its meaning for us and act on it. It’s impossible not to learn. We do it all the time. Lifelong learning is thus a forgone conclusion.  

One of the greatest joys in dental practice is creating learning moments for patients by providing intentional opportunities for them to experience their oral health and interact with us in a way that provokes their curiosity, internal reflection, and acknowledgement of needs. Just as we are lifelong learners, we can trust that they are lifelong learners, too. 

Gary M. DeWood, DDS, MS 

Learning begins from our first moment of awareness as our eyes open and we have a response to something external to us that is brand new. That experience and all the ones that follow until the moment awareness leaves us to shape our reactions to and our actions in the world. 

Experiential Learning 

The brain is a dynamic and ever-changing organ, constantly adapting to new experiences and knowledge. 

When our youngest daughter Katie was a child, I was cooking dinner one night–my turn–and Katie was sitting at the island where the stove was. I turned around to get something from the cupboard and heard a loud inhale followed by a whimper. Upon turning quickly, I saw her move her hand rapidly behind her back. No more sounds came forth, but I saw a tear and I asked her what was wrong. She said in a wavering voice, “Nothing,” and then looking at the stove burners, “Mom told me those were HOT and never to touch them.”  

I gently took her hand from behind her and saw the blisters rapidly forming on her fingers. She started crying and said to me, “Please don’t tell mom.” I’m certain she never felt the need to verify the information her mother had given her again. THAT is learning. 

All of us have experiences like that every day. Some are memorable and become part of us, embedded in a manner as yet not fully understood inside our brains for almost instant access. Some “learning” seems to fade quickly or never even get recorded. I “touched” a lot of biochemistry information over the years without burning much of anything into my brain. Maybe I should have been touching the stove at the same time. Learning is not simply having an experience of something and then being able to view the recording later.  

The Definition of Learning 

In nearly all of the definitions I have located in my research I see that CHANGE and PROCESS are prominent parts of learning. For example: 

• A change in disposition or capability that persists over time and is not simply ascribable to processes of natural growth. 
• Relatively permanent change in a person’s knowledge or behavior due to experience. 
• A transformative process of taking in information that, when internalized and mixed with what we’ve experienced previously, changes what we know and what we do. 

Choice & Focus 

My personal experiences have shown me that a big part of lifelong learning is what you believe about it and how you embrace it. It’s driven by some measure of choice and focus. 

Cheryl and I have sought out new ideas in dentistry wherever they took us. One of my friends in dental school, a wonderful man whom Cheryl and I still hold close, took a different path. Sometime around the 10th anniversary of our graduation we were visiting, and he told us that he had been able to get all the continuing education he needed without traveling.  

I discovered that his feelings around need and learning as it pertained to dentistry meant satisfying the requirements to stay current with licensure. He is NOT a bad dentist, but like many of the dentists I have come to know in the last 48 years, a hunger for dental learning changed once school was finished.  

A Drive for Learning 

I am reminded of one of the most original and influential thinkers on the creativity process, Robert Fritz, who believed you can create your life in the same way an artist develops a work of art. He said, “If you limit yourself only to what seems possible or reasonable, you disconnect yourself from what you truly want and all that is left is a compromise.” 

As a philosopher and scientist-physician, Dr. L. D. Pankey intentionally observed processes and their results (change) with the goal of becoming better at helping others. The embodiment of compassion, he was highly curious and actively sought ways to alleviate the sufferings and misfortunes of patients and colleagues. He traveled long distances to learn from others’ experiences. He inspired others to know themselves, their patients, and their work on a continuous road of mastery. As a lifelong “leisure” learner, he was interested in a wide range of subjects outside of dentistry as well. Through reflection, he often discovered he could apply this outside learning to his work. 

Laura Harkin, DMD, MAGD 

Let’s delve deeper into the preclinical interview! 

It’s helpful to understand a patient’s perception of their overall health and oral health, as well as what type of restorative dentistry they’re hoping to have and why they feel the way they currently do.  

Sometimes, an integral family member has influenced the timing of care. For instance, you may hear, “My grandchildren are making fun of my teeth” or “My wife asked me to get my teeth fixed.” From this response, I know that I will need to be sure my patient personally desires treatment before rendering it. I’m also anxious to understand what type of restorative dentistry a patient is considering. For example, are they open to removable prosthetics, fixed crown and bridgework, or implantology? 

Recently a new patient came to my office with an emergency. Tooth #5 presented with the buccal wall broken to the gumline and a moderate-sized, retained, amalgam filling. He immediately said, “I do not want bridgework.” I listened quietly until he elaborated by saying, “When I had this front tooth replaced by my other dentist, I had to take it in and out, and I just found that so irritating.”  

I finally understood that he was referring to a flipper but calling it bridgework. So, it’s important to listen and ask questions when someone seems close-minded about having a certain modality of treatment. Delve deeper into the conversation because it may simply be confusion surrounding dental terminology. 

For the grandparents who ask for a better smile, I’d like to understand their thoughts on the scope of treatment and their expectations. Are they looking for a white, straight, Hollywood smile or a more natural appearance with a little bit of play in the lateral incisors? Are they mainly concerned about stains, gaps, or a missing tooth? Are there other problems they’re aware of such as tooth sensitivity, inflamed gums, or the need for a crown? This input is very important as we continue conversation with co-discovery throughout the clinical exam, diagnostic records, and treatment planning phase. 

Learn to count on your chairside for pertinent information. 

I’m fortunate to always have my assistant, Cindy, beside me for preclinical conversations, comprehensive examinations, and restorative procedures. Sometimes, Cindy interprets a patient’s statement or component of conversation differently than me. She may hear a message that I missed or read body language of which I wasn’t aware. Sometimes, auxiliary conversations between patient and assistant take place after I’ve left the room to complete a hygiene check.  

At the end of the day or in the morning huddle, we always take time to discuss interactions with our patients. Together as a team, we’re more efficient at acquiring accurate information so that we may approach the road to health most effectively for each individual. 

Determine if trust is present. 

As I’m getting to know a patient and before I choose to begin restorative treatment, I seek to understand if trust is present in our doctor/patient relationship. New patients often share past dental experiences, and, unfortunately, some have lost trust in dentistry itself. This may be warranted due to improper care, but it may also be due to a lack of understanding or unclarified expectations regarding a given procedure or material choice.  

It’s not unusual, particularly when a patient is considering a large scope of treatment, to serve as a second or third opinion. Building trust and waiting to be asked for our skills are key necessities before moving forward in irreversible therapy.  

The comprehensive examination, periodontal therapy, splint therapy, and gathering of records are all appointments during which opportunities exist to get to know our patients. True trust often takes time to establish, but the reward reaped is frequently one of empathy, friendship, and the ability to do our best work.