by Laura Wittenauer DDS
I hear many dentists ask, “Where do I start and how do I get my team members to buy into the process?” In my experience as an Assistant Faculty member at the Comprehensive Exam and Records course, here’s what I have found to be five important concepts to help answer this question.
Concept One. DIAGNOSTIC PHOTOS
I am amazed at the grateful look on dentists faces when we review the Dawson Academy Photography Series, which covers the step-by-step process of digital photography for creating diagnostic patient records. Hand in hand with this is the proficiency in the use of mirrors, retractors and patient positioning because it allows you to achieve excellence in your diagnostic photos. The best part of this process of digital photography is empowering your assistants to become involved in taking the photos themselves.
Concept 2. TMJ AND OCCLUSAL EXAMINATION
We say it all the time, and it should be our tagline, but because it isn’t I’ll repeat it...Complete Dentistry begins with a Complete Exam! The cornerstone of all patient diagnosis is performing TMJ and occlusal examinations. I have noticed that hands-on exercises in muscle palpation, recording of range of motion, joint evaluation, bimanual manipulation, load testing, and joint vibration analysis are invaluable when it comes to examining your patients. The hands-on exercises covered in class point out the value of this information gathered and how it can positively affect your treatment plan. One of the most common pieces of feedback we hear from dentists attending our course is that ‘they never knew what bimanual manipulation really felt like until they performed it under the supervision of someone who practices it’. Then the clouds parted, and the seas calmed....
Concept 3. IMPRESSIONS
Although all dentists know how to take impressions, not all dentists know the best materials and techniques to use. It is essential to review what the best materials and techniques are to obtain highly accurate impressions. Good impressions are no accident, they are perfected with practice. Make sure your staff understand the ‘hows’ and ‘whys’ of your apparent obsessive compulsive behaviors when it comes to making impressions. A bad impression can be a huge misstep on the road to treatment, and one that will cost you!
Concept 4. FACEBOW TRANSFER AND CR BITE RECORD
As Dr. Dawson has always said, “Practicing in centric relation is the key to practicing Complete Dentistry”. It is essential for you to be proficient in bimanual manipulation, and your staff must have the facebow transfer and centric relation bite record processes down cold. Once again, any misstep in this process will greatly affect your treatment planning and diagnosis. Remember the old adage ‘garbage in is garbage out’.
Concept 5. MOUNTING DIAGNOSTIC CASTS
Mounting your casts is where the ‘rubber hits the road’ with all your records and examinations. Through all the previous steps, the dentist is able to obtain highly accurate, beautiful diagnostic casts. These diagnostic casts, when used with the patient’s clinical evaluation, full series of radiographs, and the Dawson Academy Photography Series are what allow you to develop the best possible treatment plan. Ask yourself this question: if your casts aren’t great, how great is your treatment going be? Or more importantly, what is your tolerance level for frustration and costly redos, because you will be testing the limits.
Convert your staff into your team
There is no ‘i’ in team because you can’t do it alone! When students leave and return to their practices, training their staff with these skills will make a true team. Everyone has a role, and all the parts require a contribution from every player. Complete Dentistry is all about having a Complete Team, and nobody ever won the big game by playing every position. Your practice is no different!
Where do you begin?
Concept One. DIAGNOSTIC PHOTOS
I am amazed at the grateful look on dentists faces when we review the Dawson Academy Photography Series, which covers the step-by-step process of digital photography for creating diagnostic patient records. Hand in hand with this is the proficiency in the use of mirrors, retractors and patient positioning because it allows you to achieve excellence in your diagnostic photos. The best part of this process of digital photography is empowering your assistants to become involved in taking the photos themselves.
Concept 2. TMJ AND OCCLUSAL EXAMINATION
We say it all the time, and it should be our tagline, but because it isn’t I’ll repeat it...Complete Dentistry begins with a Complete Exam! The cornerstone of all patient diagnosis is performing TMJ and occlusal examinations. I have noticed that hands-on exercises in muscle palpation, recording of range of motion, joint evaluation, bimanual manipulation, load testing, and joint vibration analysis are invaluable when it comes to examining your patients. The hands-on exercises covered in class point out the value of this information gathered and how it can positively affect your treatment plan. One of the most common pieces of feedback we hear from dentists attending our course is that ‘they never knew what bimanual manipulation really felt like until they performed it under the supervision of someone who practices it’. Then the clouds parted, and the seas calmed....
Concept 3. IMPRESSIONS
Although all dentists know how to take impressions, not all dentists know the best materials and techniques to use. It is essential to review what the best materials and techniques are to obtain highly accurate impressions. Good impressions are no accident, they are perfected with practice. Make sure your staff understand the ‘hows’ and ‘whys’ of your apparent obsessive compulsive behaviors when it comes to making impressions. A bad impression can be a huge misstep on the road to treatment, and one that will cost you!
Concept 4. FACEBOW TRANSFER AND CR BITE RECORD
As Dr. Dawson has always said, “Practicing in centric relation is the key to practicing Complete Dentistry”. It is essential for you to be proficient in bimanual manipulation, and your staff must have the facebow transfer and centric relation bite record processes down cold. Once again, any misstep in this process will greatly affect your treatment planning and diagnosis. Remember the old adage ‘garbage in is garbage out’.
Concept 5. MOUNTING DIAGNOSTIC CASTS
Mounting your casts is where the ‘rubber hits the road’ with all your records and examinations. Through all the previous steps, the dentist is able to obtain highly accurate, beautiful diagnostic casts. These diagnostic casts, when used with the patient’s clinical evaluation, full series of radiographs, and the Dawson Academy Photography Series are what allow you to develop the best possible treatment plan. Ask yourself this question: if your casts aren’t great, how great is your treatment going be? Or more importantly, what is your tolerance level for frustration and costly redos, because you will be testing the limits.
Convert your staff into your team
There is no ‘i’ in team because you can’t do it alone! When students leave and return to their practices, training their staff with these skills will make a true team. Everyone has a role, and all the parts require a contribution from every player. Complete Dentistry is all about having a Complete Team, and nobody ever won the big game by playing every position. Your practice is no different!
Where do you begin?
The Comprehensive Examination and Records course teaches the foundation for developing the concepts and skills listed above, and ‘The Hygienists Role in Complete Care Dentistry’ will summarize treatment planning concepts, and show your team members how to assist you in every aspect of your patient diagnosis.
Do you recommend any particular articulator/facebow system?
Posted by: francis kassir | September 22, 2010 at 02:10 PM
We like the Denar Mark 320 articulator by Whip Mix and the Denar facebow system that works with it.
Posted by: Joan Forrest | October 07, 2010 at 01:30 PM
No i don't. All semi ajustables thaat I know will work if used properly. the denar the dawson Center recommends is excellent but I use Hannaus, whipmix, dentatus and yes the Denar. They all have their plus and minuses.
Posted by: peter bradley | October 21, 2010 at 10:34 AM