Tuesday, September 30, 2014

What Do Dentists From Around the World Think About My Approach to How I Treat You?

I have been telling you that I post my work on International Dental Sites for the last 15 years or so. I thought that I would show you what one of my posts looks like and what other dentists from the United States and around the world say about my work. My work is currently posted on the Dental XP website and nothing has been edited.

Bread and Butter Dentistry

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Posted on 09.17.2014 11:12 PM By Gerald Benjamin In Composite Resin
Everyone likes to see complex cases but it is our everyday work that pays the bills and allows us to attract new day to day patients.
Three simple direct posterior resins that when placed under a rubber dam , placed and carved correctly result in beautiful, undetectable restorations. All cavosurface margins are beveled. The teeth are restored with Filtek Supreme Ultra using bulk fill technique and after carving, the resin is pulled over the bevel with a #2 sable brush. There is no exact margin to stain or leak. The resin is cured using bilateral transenamel illumination using 2 ultra strong Ultradent lights simultaneously.

The technique can be used on any size preparation and any number of missing walls. 
Occlusal caries maxillary right 2nd molar
LO caries maxillary right 1st molar and occlusal caries 2nd bicuspid

Three teeth ready to be restored
Final restorations mimicking natural tooth structure
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12 Comments

Beautiful work, attention to detailed anatomy is great

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Thank you Warren. Trust me this is NOT hard to do.

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Hey Gerald
"Trust me it's NOT hard " Trust ME it ain't
easy. The way you set up , prep the areas,
especially small ones speaks volumes
I may not be able to do that but I can see
and understand what is exceptional
I'm sure it took few years to master that
How many? 40?
Really Nice
Rocco

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I gave a hands on course (typodont) to graduating seniors at SUNY/Buffalo School of Dentistry 3 years ago. When given proper instruction along with the confidence in the material, the students were able to place and carve restorations equal to mine.

Again, dental schools are masters at teaching how to create and fix carburetors in a fuel injection world. Everything is challenging to a dental student and schools believe that placing amalgam is 'hard enough' for students. Nonsense! Teach them and they will learn.

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That's the way it should be done...great job, Gerald

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Thank you Dr. Goldstein. Your support of my work is very gratifying

Sadly, resin based dentistry will soon be the way of the past. Few care to learn this fabulous modality of treatment. The destruction of mass amounts of tooth structure for crowns and inlays has become the norm.

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Gerald very nice work.
I truly believe that what you show should be a goal on daily dentistry and the vision we all have to have for long term teeth survival.
Patient should undergo this type of approach as much as possible.
Thanks for sharing
Armando

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Gerald, I like the very much your job.
I do agree with Armando´s point of view.
Why this images are so unusual?
Thanks for sharing.
Jorge.

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Armando and Jorge;
Thank you for your comments.

We are losing sight of what our profession is about: allowing patients to keep their own teeth.

Unfortunately, our poor dental school education, our fabulous technology, our talent (or lack thereof) and how we are paid for our work all encourage the mass removal of enamel, the only part of the tooth for long term structural integrity of the tooth. The more tooth structure that we remove, the more we are paid.

In my practice, I tell my patients that what they pay me for is to walk out with every mm of healthy tooth structure...and I charge a significant amount for that.

As I recently told the Dean at the Dental School,
"You need to fire half of your faculty and double the pay." He told me that he could not do that and I told him that if I could, I would fire him. If we do not teach excellence, students will not know excellence.

For the past two decades I have proven that resin is a fabulous material to the scorn and dismay of my colleagues.

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Good work Dr.Gerald. Everybody will do direct resin restorations, but how many are taught by the dental schools to follow strict simple protocols like using dam, good bonding system and the way to cure resin!!!. Not expensive at all,but highly rewarding. Does not need much of a learning curve, like your full mouth rehabs,!!, Thanks for sharing this case.

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Gerald. Beautiful work! I totally agree with you about the importance early development of these skills at the Dental school level. My father practiced and tought Dentistry for 60 years and always emphasized the importance of developing quality skills early in ones education. He taught me(and my classmates)to spend the extra time to develop quality skills rather than teach "short cuts". In saying "the standard of care you develop now will follow you the rest of your life and you will find in time it takes the same amount of time and effort to be a good dentist as a bad one". I believe these words to be true and suspect you provide your exquisite quality of care to your patients on a daily basis without much extra effort. Great work. Best regards. Chuck.

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Your Father was a very wise man.

It is my belief, which means that there is a small possibility that I am wrong, that dental schools, controlled by the ADA which sets curriculum and requirements, is teaching yesterdays dentistry. This makes it virtually impossible for today's graduates to enter high level practices but also makes them ripe for clinic style (medicaid mills) or corporate style dentistry.

Why even teach mercury based dentistry?

Why don't our young colleagues learn more about occlusion considering all of the information that we have learned over the last two decades?

Why do our young colleagues have such a poor understanding of diagnosis and treatment planning?

Why does the faculty perpetuate the myth that resin, properly placed under a rubber dam to retain the most amount of natural tooth structure is an inferior material to porcelain? Why is the 'standard of excellence' determined by the number of crowns placed?

I make a very good living placing direct resin restorations without destroying tons of enamel.

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Sunday, September 28, 2014

Confirmation

I consulted with a 16 year old young lady and her Mother last week. The mother and father are my patients and they wanted me to treat their daughter  rather than the pedodontist (children's dentist.)
I had consulted with this young lady about 2 years ago and I realized that she was not able to breath through her nose. During the last five or so years, dentistry has realized that breathing difficulties  have an effect on the size of the mouth and the shape of the face in addition to being a quality of life issue. I don't remember why mom asked me to see her daughter a few years ago but I did strongly recommend that she see a pediatric ear nose and throat specialist to correct her difficulty in breathing threw her nose.

At the consult this week, my patient's mother volunteered that her daughter had her tonsils and adenoids removed as I had recommended and that the ENT specialist said to her, " You must go to a very good dentist because only the best dentists are knowledgeable about the connection between  breathing problems and oral complications."

I really try to do the very best that I can to take care of my patients even if it is only a recommendation to see a medical specialist.

Dollars earned: Zero
Reward: Great satisfaction in knowing that I made my patient's life better.
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Sunday, September 14, 2014

If You Don't Know, You Must Learn

This past weekend I attended a course in Charlotte,NC to study a 25 year old technology. Why study something that is a quarter of a century old? Easy! For the first 22 or so years the technology was impressive  but mediocre despite the incredible marketing effort by the company.

Another reason I avoided the technology was because I sincerely believe that my job is to save your teeth for your entire life and cutting down teeth is not my idea of saving teeth.

So what is this improved 25 year old technology and why should I learn about it NOW?

The technology allows dentists to restore parts of teeth or the entire tooth without placing all of that gook in your mouth to take an impression. And, it allows the fabrication of parts or all of the tooth in a single visit.  I had SIX crowns  placed in MY MOUTH this year and I know how unpleasant taking an impression can be for a patient.

It has been my goal for the past almost 40 years to avoid placing crowns in patients under the age of 50 because I strongly believe that crowns in young people probably means that the teeth under the crowns will not survive until old age.  Because the majority of my patients have very large direct posterior resins in their teeth, I may have run out of natural tooth structure to place another filling and a crown may be NECESSARY and I am looking down the road a few years to make sure treatment will be as comfortable as possible and functionally excellent.

Am I going to make the move to a technology that is now fabulous? I don't know yet as the cost is significant but it is my job to take care of you in the best way that I know how.

Because of YOU, I never stop learning.
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Saturday, September 6, 2014

So What Do Two of the Greatest Restorative Dentists Say About My Work?

Hi Benjamin,
This case represents the true meaning of artistic and sound conservative dentistry. Kudos to your perpetual drive for excellence!
Newton (Fahl)

And

Good job, Gerald,
I have advocated using composite restorations for over 27 years when I wrote my article on the reasons not to crown endodontic teeth whenever possible and to save the existing enamel. Still too many endodontists routinely recommend full crowns to "protect" the teeth when I feel so many times it weakens the tooth by stripping off all the enamel.

Newton Fahl and Ronald Goldstein are two of the greatest restorative dentists in the world...bar none. The fact that dentists at that level would even CARE to comment on MY work is, in itself, incredible. And the fact that each saw treatment on only ONE tooth and not a large case that is always impressive and  amazing.



Dr. Banchs performed root canal therapy for our patient and she was financially limited at this time in her life  but she understood the need to protect her tooth so I placed a direct bonded resin restoration for her rather than placing a crown or an onlay. Limited natural tooth structure was removed and the tooth is strong enough for many years without further treatment. This is the kind of dentistry that I do for YOU every day of the week and what I usually tell you at the end of the appointment is, "Most dentist would tell you that you need a crown on this tooth but I really do not think that it is necessary."

I am honored that two of the best dentists in the world (who are also two of my mentors) would comment so favorably on my work.

I am also honored that you have selected our office for your care. Putting your interests ahead of our (financial) interest is what we have always done.
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Thursday, September 4, 2014

It Is Starting Again

For most of my career, long time patients would tell me, "Please don't ever retire." And when you are a dentist in your 40s or 50s, it would sort of make me laugh. My response was usually, "Why would you even worry about that? Don't you have something really important in your life to worry about? Besides who said that I was retiring?"

Now in my final ten  years of practice, patients ARE becoming concerned about who will be their dentist a decade from now. Just this week three patients pleaded with me not to retire. My response now is: " I am not retiring so don't worry and in any case, we have been thinking about my successor so that I will be able to work with them for 3-4 years BEFORE they enter our practice and work WITH them for 5-6 years to help them develop into fine restorative dentists.

I then explain that in addition to having fabulous clinical skills, my successor must be highly ethical and devoted to our patients.

This is a very big hurdle for the dentist that will follow me but I am confident that you will be in great hands for the next 10 years and beyond.

Don't you have something REALLY important to worry about?
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