The Dawson Academy Blog

Here's to the New Year: Resolutions to Improve Your Practice in 2009

As the turbulent times of 2008 now fade into a distant memory in our rear-view mirrors, it's time to look toward the promise that 2009 can bring to both our personal and professional lives. Although vows to stop smoking or lose weight are always terrific ideas, why not make a new promise to yourself this year? Use this opportunity to enter the new year with a renewed outlook for both you and your practice. By making—and sticking to—the following New Year's resolutions, you can help get your dental practice in tip-top condition. Here's how:

First, set goals for yourself. Consider where you are professionally and set a goal for where you'd like to be next year. Would you like to see more patients? Would you like to work only four days a week? Are your objectives realistic? Keep an open mind and document your goals, being sure to refer to them often to check your progress. Whether you hope to work less, work more, or ask for more referrals, you'll never get there if you don't know where you are going.

Second, master a new skill. Most successful dentists are quick to tell you the areas in which they could use a refresher course—a fact that dentists striving to be successful should keep in mind. It's a fact that we aren't bestowed with a mastery of dentistry simply by graduating from dental school. True mastery takes time and practice—and The Dawson Academy can help with both. By signing up for any of our 2009 courses, you will be well on your way to mastering dentistry and changing your future. In addition, you may want to subscribe to our newsletters, blogs, and You Tube page for even more new information about dentistry. The Dawson Academy strives to keep you "in the know" when it comes to the dental community.

Third, delegate, delegate, delegate. Although it's only natural to want to take ownership of everything in the office with your name on the door, you must also remember that you can only do so much. Therefore, remember that your number one goal is to provide your patients with quality dentistry; the rest is just details. Focus on getting tasks that carry minimal reward delegated to your staff. For example, do you manage your office's financial books? Perhaps an accountant may be better suited for the job, freeing you up for more time treatment planning. Look for ways to delegate and your practice will reap the benefits.

Next, assess your practice. Are you satisfied with the direction of your practice? Are you satisfied with the camaraderie of your staff? Are you satisfied with the career paths set forth for both you and your employees? If you need to make some tough decisions, remember to separate the business side of things from the personal side of things as you examine your team and office dynamics. After all, the most important rule of business is to separate yourself completely from the business before making any long-term decisions.

Finally, focus on your patients. Although it can be relatively easy to forget about your patients' satisfaction when your elbow deep in fillings, crowns, and paperwork, take the new year as a renewed opportunity to remember the very people who keep your business in business: your patients. Service is the cornerstone of any dental practice, so, unless your willing to lose a few patients, don't forget that fact as you renew your vows for 2009.

Increasing the Predictability of Anterior Restorations

Leonard A. Hess, DDS
Associate Faculty Member
The Dawson Academy


Every clinician is on a constant journey.  We all must continuously learn and hone our craft.  Every year thousands of dentists trust the Dawson Academy to help them on their path.  One topic that interests many restorative dentists is anterior indirect restorations, and how to do them better. 

Improving a smile is one of the fastest ways to make a person happy, as their life is often changed for the better.  But a pretty smile must also function properly.  Changing the anterior teeth with disregard to function can lead to broken restorations, uncomfortable speech, and muscular disharmony.  Here are a few commonly overlooked ingredients to “cooking up” a beautiful and functional smile.

Incisal Edge Position:  The incisal edges must be placed in the proper position vertically and horizontally.  The teeth must be long enough esthetically, but must also work with the patients anterior guidance and envelope of function.

Photographs:  The Dawson Academy consistently teaches the necessity of a complete set of diagnostic photographs.  Photos are needed for treatment planning, patient education, lab communication, and documentation.  Their importance cannot be overstated. 

Preparation Design:  One often neglected step in case planning is the creation of reduction stents.  The lab must have adequate reduction for esthetics and material requirements.  Remember, if the lab needs 0.6mm of reduction and you only gave them 0.4mm that is a 33% error!

Laboratory Communication:  Predictability comes from giving the proper information to the lab.  It isn’t their job to decide all the variables involved in anterior reconstruction.  And the lab certainly shouldn’t be put into the position of guessing length and incisal edge position.   

Predictable results come from a consistent approach.  As a practicing clinician I always find myself reviewing the Dawson Academy fundamentals that help me succeed.  

Enhancing the Gingival Frame With Periodontal Surgery

by Albert B. Konikoff, DDS

The creation of an esthetic smile is a collaborative process, which at a minimum involves the patient and restorative dentist. Often, however, the participation of other specialists is necessary to fulfill the patient’s expectations. This article explores the periodontist’s role in creating an optimal gingival frame: surgical crown lengthening and a modified subepithelial tissue graft to shorten the clinical crown are the treatments presented. These procedures are part of the periodontal plastic surgical armamentarium as these techniques rise to the highest levels of sophistication.

This article will discuss the two periodontal plastic surgical procedures most commonly used to alter the gingival frame: cosmetic crown lengthening to increase the length of the clinical crown, and gingival augmentation to reduce the clinical crown length. To be predictable, these procedures need to have a sound biologic basis and a reproducible clinical protocol, and be performed in a healthy periodontal environment.

Download Article: Enhancing the Gingival Frame

Why Porcelain Breaks- Ten Factors to Consider in the Restorative Process

by John C. Cranham, DDS

We have all experienced it. It could have been a single posterior ceramic restoration or a smile design case involving multiple anterior units. The case goes to place with ease, the shade is perfect, only minor adjustment was required at delivery, and the patient leaves the office thrilled with the result. Then, the dreaded phone call: An unhappy patient called to report a broken restoration. At best, the patient returns to the practice to have the problem fixed, creating unproductive time for the patient, dental practice, and dental laboratory. At worst, the patient loses confidence with the dental team, wants his or her money back, and leaves the practice. Either way, good will is lost, and referrals are not likely.

When a patient’s dentition breaks down, one of the signs of instability that is becoming more common in dentistry is the fracture of porcelain. This article discusses the Top 10 reasons to consider when fracture occurs.

Download Article: Why Porcelain Breaks

Digital Photography: The First Step in the Record-Gathering Process

by Shannon Pace Schmidt, DA

Digital photography allows clinicians to put the theory that “a picture is worth a thousand words” into practice. Before the dentist can plan a treatment, the patient must first go through an extensive record-gathering visit. Assembling patient information and understanding any signs of instability are important.

This article will help dental assistants learn the value of photographs in the record-gathering visit.

Download Digital Photography Guidelines

Treatment Planning for Predictability

by Glenn DuPont, DDS

The goal of any dental professional is to help people achieve dental health and well-being in a comfortable environment. Treatment planning is only one facet of dental service, and it begins with a philosophy of what is best and most conservative for the patient. This philosophy is the core of complete dentistry. Complete dentistry requires good communication with patients to blend what each patient desires with what each patient needs for total masticatory system health.

Download Article: Treatment Planning for Predictability

Restoring the Worn Dentition Before It Becomes Worse

by Andrew C. Cobb, DDS

Occlusal disease is the most common destructive dental disorder, leading to a myriad of potentially worsening problems.The solutions to these problems only become more complicated as the destructive nature of occlusal disease progresses. For the dental practitioner, this poses a diagnostic and treatment planning challenge. If our treatment goal is to correct all of the functional problems of our patients, satisfy their esthetic concerns, and do so with the least amount of dentistry, then knowing when and how to treat is of utmost importance. Early intervention can prevent the worsening of preventable problems and allow for more conservative treatment. The comprehensive examination and identification of signs of instability is paramount to this process. The following case illustrates this dilemma.

Download Restoring Worn Dentition

A Clinician’s Guide to Occlusal Splint Therapy

by DeWitt C. Wilkerson, DMD

Occlusal splint therapy has been used for many years for the diagnosis and treatment of various disorders of the masticatory system. Many designs are described in both the literature and educational lectures. The purpose of this article is to clarify the reader’s understanding of the basic splint designs and identify which factors are important in deciding how to use these effectively in daily practice. An overview of the examination and differential diagnosis is described to lead to a decision regarding the appropriate role of splint therapy for each problem. After reading this article, clinicians should be better equipped to successfully implement splint therapy into their armamentarium of treatment options in managing masticatory system disorders.

Download Article: Guide to Occlusal Splint Therapy

LEARNING OBJECTIVES After reading this article, the reader should be able to: have an awareness of the basic types and designs of occlusal splints. appreciate the appropriate use of the splint described. understand the common problems that can be treated with occlusal splint therapy. describe how to systematically evaluate and diagnose masticatory system problems.

Create your own practice stimulus package

With a down economy everyone is feeling the effects, including my practice. And while not losing patients, some people weren’t able to come in as regularly, leaving room for more patients. We thought about advertising, but that would be paying strangers to send us strangers and our thought was that we would rather have friends and family of the patients we already were familiar with.

So we started with our own patients and thought about giving them something to show our appreciation for their years of loyalty. In selecting the gift, we chose something we knew they would like to have, but probably wouldn't 'splurge on'. With that criteria in mind, I chose to give each patient their own home bleaching kit, rather than giving them away to encourage new patients (in my experience, freebies tend to bring in nothing but new 'bargain hunters'). In return, we gave out several business cards with each bleaching kit and asked our loyal patients to “stimulate us” by referring their friends and family.

We shared the whole story during every visit to put it in our patients’ minds so they might remember it and talk about us more.  We also explained to them that we couldn’t ‘wax a dirty car.’  We had to do an exam and cleaning (at our regular fees). Plus, any decay or defective restoration would be very sensitive so it had to be restored first.

I hired a patient who has an art degree and experience in working with plaster to come in and learn how to make bleaching trays.  We bought the bleach in bulk from Henry Schein and estimated the total cost including labor to be less than 35 dollars per unit.

Because our patients had to come back in for an impression, we spent more time (which we had) with our loyal clients and they had something to brag about to their friends and family when their teeth got whiter. As a result of our ‘stimulus package’, our numbers are back to normal levels after being down by 23%. The best part is that our stimulus package brought in a host of new patients who were in need of all kinds of restorative work that we were able to address.

Even with the down economy, I am still independent of insurance, doing complete exams and charging a fair fee for the services I provide. I am proud to say that my practice and our ‘stimulus package’ are doing wonders in the area of providing complete care dentistry for our patients. The results are speaking for themselves.

Replacement of a Single Missing Tooth With an Implant-Supported Patient-Specific Restoration

by Victor A. Martel, DMD

Treatment of a single hopeless tooth is a routine challenge in dentistry. Causes for this condition commonly include traumatic injury, advanced caries and/or periodontal disease, and failed endodontic procedures. When adequate bone exists at a hopeless tooth site, the current standard of care is surgical extraction of the tooth, followed by placement of a dental implant and eventual restoration with a single crown. This article reviews the evolution of this treatment modality and its alternatives. A case report describing restoration of a hopeless maxillary first molar site using state-of-the-art techniques for preserving both hard and soft tissue is also presented.

Download Article: Single Tooth Patient Specific Implants

Treating the Edentulous Patient with Dental Implant Therapy: A Review of Treatment Considerations

by Karen S. McAndrew, DMD, MS

Currently, the percentage of completely edentulous patients is declining 10% each decade; however, this is more than offset by the growth of the aging baby boomer population. In reality, an increase in the numbers of completely edentulous cases is being observed. By 2020, an estimated 37.9 million patients will present with one or both fully edentulous arches. According to the National Institute of Health, most of these patients visit their dentist every 14 years, a schedule not conducive to proper maintenance for ensuring properly fitting and functional prostheses.

This article provides an overview of the various restorative options for both the maxilla and mandible, and describes the various dental materials and their benefits that support these restorative options. Approach and treatment is much different for restoration of the maxilla and mandible. Selection of materials and prosthesis design is contingent on many factors. Clinically, assessment of the edentulous ridge anatomy, intra- and interarch spaces, smile line, and need for lip support will aid in determining the optimal prosthetic choice. The opposing dentition, parafunction, and biomechanical loading of the dental implant prostheses also must be considered.

Download Article: Treating the Edentulous Patient