There Are Multiple Paths to Happiness

January 3, 2022 Barry F. Polansky, DMD

Seventeen is young to decide what you want to do with the rest of your life. Deciding you want to become a dentist means that you are making a huge decision before you are aware of all the knowledge you will have to attain and the multiple skills and micro-skills in which you will need to become proficient.

It was a long time ago when I made that decision. I can’t even remember how I made it. I remember I was under pressure to decide from my parents and their friends. I remember telling others I thought dentistry was a good career because I had spent so much time in dental offices growing up.

That’s because I had malformed supernumeraries blocking the eruption of my centrals when I was seven years old. The dentist who suggested the supernumeraries should be removed, proceeded to remove the two good centrals by accident. This was followed by surgery to remove the supernumeraries and alas no centrals. This was traumatic to me at the time, but early in life, I learned to adapt to a dental prosthesis, having that replaced as I grew, and so on.

I wish now someone had set me down when I was in high school and given me real-world career advice like I did for my kids as they were growing up. Hoping they could avoid some of the mistakes I made, I would begin those conversations with Stephen Covey’s habit #2: Begin with the end in mind. And I would disqualify money as an end. Because money only buys people what they really want. I’d get my kids to think about what they really wanted to spend their lives doing.

Warren Buffet says he wanted to make money so he could be independent. In his biography, The Snowball, Buffet wrote, “It could make me independent. Then, I could do what I want to do with my life. And the biggest thing I wanted to do was work for myself. I didn’t want other people directing me. The idea of doing what I wanted to do every day was important to me.”

There’s truth in that for me. Independence is a universal thought that drives many of us, yet we are unique in our own lives…in how we ultimately determine and design our game plan to live independently.

If we had understood what we wanted to do for the rest of our lives when we were seventeen, then we could have better designed our careers to meet our adult desires. But that isn’t realistic, is it? It sometimes takes decades to a lifetime to understand ourselves.

Adam Grant in his book Think Again questions the unreasonable question kids are asked, “What do you want to be when you grow up?” In his book, he uses his cousin Ryan as an example of someone who chose to go into medicine because that’s a profession parents applaud. Once Ryan made his decision, he spent years staying on track.

Once you start, there is no turning back…financial debt…sunk costs…physical, mental, and emotional. We hit a certain milestone like owning our own dental practice and we tell ourselves we will be happy… that we will have all the things we want. But positive psychologists confirm that this is a poor prescription for happiness.

Positive psychologists say the road to happiness includes mastery, autonomy, positive relations, engaging work, and accomplishments. It’s a never-ending road. But each person takes their own road. There are many roads of mastery, freedom, positive relations, engaging work, and accomplishments.

Don’t get me wrong. I am not saying dentistry was a bad career choice for me. It is a great profession. The message of this blog is twofold. One, at the start of my predoctoral and doctoral education, at the start of my career in dental practice, and even midway through that career, I didn’t understand the complexity of what was before me–including getting to know myself well. And two, everyone needs to find their own happiness.

If you are reading this, you likely chose a career in dentistry. On your road of your own design, I believe you will find happiness in the continual act of mastering more, working with autonomy, fostering positive relations, and setting out to achieve new accomplishments. Money will be just a way to fund the things that really matter to you, and for many of you that will be making a profound difference in the health and lives of your patients. And when you segue, as I did, away from hands-on dentistry after practicing for four decades, you will find that new ways to use your people skills keep emerging. Your road to happiness continues.

Related Course

E4: Posterior Reconstruction and Completing the Comprehensive Treatment Sequence

DATE: February 27 2025 @ 8:00 am - March 3 2025 @ 2:30 pm

Location: The Pankey Institute

CE HOURS: 44

Dentist Tuition: $ 7400

Single Occupancy with Ensuite Private Bath (per night): $ 345

THIS COURSE IS SOLD OUT The purpose of this course is to help you develop mastery with complex cases involving advanced restorative procedures, precise sequencing and interdisciplinary coordination. Building on…

Learn More>

About Author

User Image
Barry F. Polansky, DMD

Dr. Polansky has delivered comprehensive cosmetic dentistry, restorative dentistry, and implant dentistry for more than 35 years. He was born in the Bronx, New York in January 1948. The doctor graduated from Queens College in 1969 and received his DMD degree in 1973 from the University of Pennsylvania School of Dental Medicine. Following graduation, Dr. Polansky spent two years in the US Army Dental Corps, stationed at Fort. Dix, New Jersey. In 1975, Dr. Polansky entered private practice in Medford Lakes. Three years later, he built his second practice in the town in which he now lives, Cherry Hill. Dr. Polansky wrote his first article for Dental Economics in 1995 – it was the cover article. Since that time Dr. Polansky has earned a reputation as one of dentistry's best authors and dental philosophers. He has written for many industry publications, including Dental Economics, Dentistry Today, Dental Practice and Finance, and Independent Dentistry (a UK publication).

FIND A PANKEY DENTIST OR TECHNICIAN

I AM A
I AM INTERESTED IN

VIEW COURSE CALENDAR

An Abridged Biography of L.D. Pankey

April 12, 2021 Deborah Bush, MA

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.

Related Course

E1: Aesthetic & Functional Treatment Planning at the Chicago Midwinter Dental Meeting

DATE: February 20 2025 @ 7:00 am - February 22 2025 @ 8:00 pm

Location: Chicago Midwinter Meeting

CE HOURS:

Transform your experience of practicing dentistry, increase predictability, profitability and fulfillment. The Essentials Series is the Key, and Aesthetic and Functional Treatment Planning is where your journey begins.  Following a system of…

Learn More>

About Author

User Image
Deborah Bush, MA

Deb Bush is a freelance writer specializing in dentistry and a subject matter expert on the behavioral and technological changes occurring in dentistry. Before becoming a dental-focused freelance writer and analyst, she served as the Communications Manager for The Pankey Institute, the Communications Director and a grant writer for the national Preeclampsia Foundation, and the Content Manager for Patient Prism. She has co-authored and ghost-written books for dental authorities, and she currently writes for multiple dental brands which keeps her thumb on the pulse of trends in the industry.

FIND A PANKEY DENTIST OR TECHNICIAN

I AM A
I AM INTERESTED IN

VIEW COURSE CALENDAR

How Long Does a Crown Last?

February 22, 2021 Lee Ann Brady DMD

How long does a dental crown last? The answer is, “It depends.” In this blog, I will review how I manage answering this question for my own peace of mind and to reduce disappointment for my patients.

All of us can think about crowns that are currently in our patients’ mouths that have been in four decades or more…crowns that are doing fine. Sometimes, we look at a bite wing of one of these restored teeth and see space enough “to drive a truck” between the margin and the natural tooth structure. Yet, the crowned tooth is fine with no caries.

We also can think about crowns in our patients’ mouths that needed to be or now need to be replaced within five years or under…perhaps, even within two years. Some of these crowns were carefully and beautifully done.

We have a habit of thinking: The better our skill is, the greater is the longevity of the crown. We need to get away from this generalization because there are numerous factors that impact longevity.

Yes, the dentist’s skill is a factor as are the amount of time and energy we put into making it exquisite, the quality of the laboratory, and the materials. But the other part of the equation is that we put dentistry into the mouths of human beings, and human beings come with risk factors. The most common reason we replace a crown or filling is recurring caries. We see some patients who have new carious lesions every time we see them in the dental chair. They are at high risk. At the other end of the spectrum, we have patients who have not had a carious lesion in multiple decades. The functional risk of the patient is the second primary risk factor. We have patients who can break any type of crown, and we have other patients who have no evidence of functional risk.

What do I say to my patients? I tell them dentistry does not last forever, and there are challenges in predicting the lifespan of their restorations. I do not say, “When your crown fails at some point in the future, it will need dental treatment again.” Instead, I say, “We’re going to treat this tooth with a crown. At some time in the future, it will need treatment again.” Then I say, “The most common reason why a crown needs to be replaced is dental decay around and under the crown, and what we know about you is that you tend to get cavities [or not get cavities]. The second most common reason we replace crowns is that they break. The materials cannot withstand the forces. And what we know about you is that you are tougher on your teeth [or not as tough on your teeth] compared to many other people. “

This type of conversation makes most dentists nervous. They fear the patient will not want to do the crown if the patient knows they will eventually need to retreat the tooth. That has not been my experience. The reality that cars do not run forever does not stop us from buying a new car. The knowledge that your roof will last 10 to 14 years does not stop us from replacing the roof. The reality that the tooth will need retreatment in the future does not stop us from having it treated now.

Setting realistic expectations results in less patient frustration, sadness, and disappointment. It also lessens conflict between the dentist and patients. I want my patients to understand the reality that dentistry does not last forever. It all has a lifespan, just like a car or washing machine. Any tooth we treat will need to be treated again. I also want them to know their risk factors for decay or breakage relative to other patients. Is it high? Is it low? Is it somewhere in between? We can then have a conversation about what they can do and what we can do together to minimize those risk factors.

Related Course

Pankey Scholar 15A

DATE: January 16 2025 @ 6:00 pm - January 18 2025 @ 3:00 pm

Location: The Pankey Institute

CE HOURS: 0

Dentist Tuition: $ 3495

Single Occupancy with Ensuite Private Bath (per night): $ 345

“A Pankey Scholar is one who has demonstrated a commitment to apply the principles, practices and philosophy they learned through their journey at The Pankey Institute.”   At its core,…

Learn More>

About Author

User Image
Lee Ann Brady DMD

Dr. Lee Ann Brady is passionate about dentistry, her family and making a difference. She is a general dentist and owns a practice in Glendale, AZ limited to restorative dentistry. Lee’s passion for dental education began as a CE junkie herself, pursuing lots of advanced continuing education focused on Restorative and Occlusion. In 2005, she became a full time resident faculty member for The Pankey Institute, and was promoted to Clinical Director in 2006. Lee joined Spear Education as Executive VP of Education in the fall of 2008 to teach and coordinate the educational curriculum. In June of 2011, she left Spear Education, founded leeannbrady.com and joined the dental practice she now owns as an associate. Today, she teaches at dental meetings and study clubs both nationally and internationally, continues to write for dental journals and her website, sits on the editorial board of the Journal of Cosmetic Dentistry, Inside Dentistry and DentalTown Magazines and is the Director of Education for The Pankey Institute.

FIND A PANKEY DENTIST OR TECHNICIAN

I AM A
I AM INTERESTED IN

VIEW COURSE CALENDAR

LuxaCrown in Clinical Practice

March 9, 2020 Lee Ann Brady DMD

LuxaCrown is a new material that was released by DMG America last year. LuxaCrown is a dual cure composite material that comes in a convenient chair-side cartridge. Because it has the physical properties of composite, it is much stronger and longer lasting than bisacryl provisional material. The manufacturer says it can last in the oral environment up to five years, maybe longer. It is stainresistant and color stable, so you can leave it in the mouth for long periods without concern that the color will change. I though it would be helpful to share the situations in which I now use LuxaCrown instead of a bisacryl material for provisionals. 

Multi-Unit Restorations 

In my own practice, I don’t use LuxaCrown for single crown preps where the provisional will be in the mouth for a couple of weeks, perhaps a month, or a little more. But, the strength of LuxaCrown and the color stability of this new composite material make it what I consider to be an incredible new clinical tool in my practice to provisionalize multiple units where there is pontic space. With LuxaCrown, I no longer need to reinforce the pontic with Ribbond or orthodontic wire. I don’t have to do anything to make sure we don’t get fracture at the connectors, because the material is strong enough and durable enough it to hold up, even long term.  

Anterior Veneers 

The other situation in which I use LuxaCrown routinely is with my shrink wrapped provisionals for anterior veneers. The strength of the material makes it more durable in a partial coverage anterior setting. And the color stability is appealing because the veneer may be in provisional for two months or three months, depending on how long it takes us to get patient approved provisionals for shape and contour that the patient really loves. Not having to worry about the color changing over time has been a huge bonus.  

Anterior Onlays 

Another situation in which I am using LuxaCrown is for partial coverage onlays in the posterior. So often we experience bisacryl onlay provisionals popping off the teeth, but LuxaCrown provisionals stay where you put them.    

Phased Dentistry 

And, I use LuxaCrown whenever I am phasing dentistry…when I am doing what I call “interim restorations” and the provisional restorations will be in the mouth multiple months before the patient receives ceramic restorations. Perhaps, the patient will be in provisionals six to 24 months while they go through orthodontics and we do final restorations in quadrants or even sextants of the mouth. Patients don’t mind having LuxaCrown in their mouths for long periods, because in addition to its stability, it polishes pristinely smooth and is glossy.   

Related Course

Today’s Top Clinical Tips: 2024

DATE: October 8 2024 @ 1:00 pm - October 8 2024 @ 4:00 pm

Location: Online

CE HOURS: 4

Today’s Top Clinical Tips: 2024 Dentistry is changing at a rapid pace. Being successful and efficient is about staying on top of the newest trends and clinical tips. In this…

Learn More>

About Author

User Image
Lee Ann Brady DMD

Dr. Lee Ann Brady is passionate about dentistry, her family and making a difference. She is a general dentist and owns a practice in Glendale, AZ limited to restorative dentistry. Lee’s passion for dental education began as a CE junkie herself, pursuing lots of advanced continuing education focused on Restorative and Occlusion. In 2005, she became a full time resident faculty member for The Pankey Institute, and was promoted to Clinical Director in 2006. Lee joined Spear Education as Executive VP of Education in the fall of 2008 to teach and coordinate the educational curriculum. In June of 2011, she left Spear Education, founded leeannbrady.com and joined the dental practice she now owns as an associate. Today, she teaches at dental meetings and study clubs both nationally and internationally, continues to write for dental journals and her website, sits on the editorial board of the Journal of Cosmetic Dentistry, Inside Dentistry and DentalTown Magazines and is the Director of Education for The Pankey Institute.

FIND A PANKEY DENTIST OR TECHNICIAN

I AM A
I AM INTERESTED IN

VIEW COURSE CALENDAR

Never Forget

January 14, 2020 Paul Henny DDS

When the art and science of dentistry are reduced down to primarily being about production and code mining, its spiritual dimension is easily lost. Spend a few minutes on some dental social media sites, and you will quickly see this truth in black and white. 

Dr. L.D. Pankey warned us about this problem.

The key to becoming a truly successful professional isn’t just about mastering the technical skills and endlessly chasing after the siren songs of our materialistic culture. Such narrow pursuits are ultimately hollow and do not represent enough to carry us through life as a fully developed person. And they do not represent enough to carry us through life’s inevitable tragedies and periods of significant suffering.  

Creating a habit of connecting with our patients in deeply meaningful ways, helps us to form the emotional antibodies we will need to carry us through the inevitable not-so-good times, the times when all the money and material possessions in the world can’t solve our problem. These are the times when only love, support, and reciprocated empathy can start the process of healing our wounds. 

Never forget this central truth.

Chasing after the next new and shiny object may not be the best solution for our challenging situation today. The best solution may very well be sitting right in front of us in the form of a deeply caring patient.
 

Related Course

The Pankey Assistant’s Experience

DATE: July 11 2024 @ 8:00 am - July 13 2024 @ 3:00 pm

Location: The Pankey Institute

CE HOURS: 17

Regular Tuition: $ 1950

night with private bath: $ 290

This “can’t miss” course will empower Dental Assistants to bring their skills to excellence! During this dynamic hands-on course, led by Pankey clinical team member, Sandra Caicedo, participants will learn…

Learn More>

About Author

User Image
Paul Henny DDS

Dr. Paul Henny maintains an esthetically-focused restorative practice in Roanoke, Virginia. Additionally, he has been a national speaker in dentistry, a visiting faculty member of the Pankey Institute, and visiting lecturer at the Jefferson College or Health Sciences. Dr. Henny has been a member of the Roanoke Valley Dental Society, The Academy of General Dentistry, The American College of Oral Implantology, The American Academy of Cosmetic Dentistry, and is a Fellow of the International Congress of Oral Implantology. He is Past President and co-founder of the Robert F. Barkley Dental Study Club.

FIND A PANKEY DENTIST OR TECHNICIAN

I AM A
I AM INTERESTED IN

VIEW COURSE CALENDAR

Selling Dentistry

September 9, 2019 Deborah Bush, MA

Janet Hagerman’s book, Selling Dentistry – Ethically, Elegantly, Effectively, presents a provocative and compelling analysis of how sales opportunities are missed by the entire dental team. Filled with practical solutions for how to feel good about your treatment recommendations and build your practice at the same time, Janet’s book focuses not only on how to be effective in your sales communications but also how to be elegant in your approach.

Selling Dentistry – Ethically, Elegantly, Effectively was born from a need, a cry for help from dental teams says the author and dental practice coach Janet Hagerman. Dental teams kept asking her how to stop dentistry from walking out of their doors and how to reverse the trend, so more patients would say yes to dental treatment.

In her book, Hagerman uses real-life examples and stories that come from her years of experience helping dental teams succeed.

According to Hagerman, dentists want to know how to sell dentistry. Their teams want to know how to sell dentistry. They want to move beyond an aversion to the “S” word to embracing the “E’s” of selling. Selling does not need to be controversial, says Hagerman, it’s about better serving patients and building trustful relationships, so patients accept the care they really need.

It comes down to surpassing external marketing and focusing on internal conversations with patients.

Related Course

E3: Restorative Integration of Form & Function

DATE: October 5 2025 @ 8:00 am - October 9 2025 @ 2:30 pm

Location: The Pankey Institute

CE HOURS: 41

Dentist Tuition: $ 7400

Single Occupancy with Ensuite Private Bath (per night): $ 345

Understanding that “form follows function” is critical for knowing how to blend what looks good with what predictably functions well. E3 is the phase of your Essentials journey in which…

Learn More>

About Author

User Image
Deborah Bush, MA

Deb Bush is a freelance writer specializing in dentistry and a subject matter expert on the behavioral and technological changes occurring in dentistry. Before becoming a dental-focused freelance writer and analyst, she served as the Communications Manager for The Pankey Institute, the Communications Director and a grant writer for the national Preeclampsia Foundation, and the Content Manager for Patient Prism. She has co-authored and ghost-written books for dental authorities, and she currently writes for multiple dental brands which keeps her thumb on the pulse of trends in the industry.

FIND A PANKEY DENTIST OR TECHNICIAN

I AM A
I AM INTERESTED IN

VIEW COURSE CALENDAR

Empathizing…an Act of Caring

July 22, 2019 Paul Henny DDS

It seems that “empathy” has become one of the most popular buzzwords in dentistry, and in spite of the popularity of its use, few people understand what it is and why it is so important.
Confusion may be rooted in dictionary definitions such as “the ability to understand and share the feelings of another.”

Can we really understand and share the feelings of another?

Avrom King used to say, “There is no such thing as a second-hand feeling.” It’s impossible for us to fully understand the feelings of another person. In truth, the best we can do is contemplate intellectually what a person MIGHT be feeling and then project our feelings upon our thinking.

Our feelings, and our patients’ feelings are unique to us and them. They cannot be fully explained or understood by others. Yet, they are valid because what we feel is our reality.
Our brains function based on mental models or “thought constructions.” These thought constructions may be fairly accurate, total fabrication, or something in-between. But in all cases, they are still our reality. And the only way for us to square the inaccuracy of our thought constructions with reality is to test them against what we perceive to be reality.

Perceptions are open to review. They change.

And, there is another problem. Our perception of reality is a thought construction as well. In other words, our brains function by testing our thought constructions against our thought constructions, and then we call the most successful ones “beliefs.”

Because a belief is still a thought construction, it is always up for review with regard to accuracy, unless of course, we don’t want to do that. And in that case, we choose to become dogmatic instead of continuously being open to refining our version of reality.

So, why is understanding this important?  Because beliefs, dogma, and empathy all fully infuse the relationship we have with ourselves as well as our patients.

What we think they think influences how we think.

Let me say that again. What we think they think influences how we think. So, if we come into a new relationship with beliefs about ourselves and other people which are rigid and dogmatic, then it is very unlikely that we will find the whole truth, and most certainly, we will never even come close to understanding our patient’s perspective. Yet, our patient’s perspective is the complete source of their motivation to act or change their perspective.

Empathy is an attempt to understand another’s thoughts and feelings.

Giving others quality attention signals we are interested in understanding what they think and feel. It signals that their thoughts and feelings are important to us. Empathizing is an act of caring about another person. When we give others this kind and quality of attention, it allows them to feel safe and accepted. And in that space, they are more likely to re-assess their beliefs about dentistry, dentists, and what dentistry might be able to do for them. Consequently empathy, non-judgmental acceptance, and behaving in a transparent authentic fashion is the pathway towards facilitating change in others. This is what Carl Rogers called “congruence.”

When patients feel supported and risk committing to change, we call it trust.

Change in attitudes, beliefs, and perspectives is what causes patients to commit to significant change, which at the end of the day is a risk…a risk taken because they feel like the people around them will support and care for them along their journey toward new understandings, perspectives, and experiences. And when that happens, we call it “trust,” which is at the foundation of every enduring and meaningful relationship.

Related Course

Direct Composite: Predictable, Easy and Beautiful

DATE: October 25 2024 @ 8:00 am - October 26 2024 @ 4:00 pm

Location: The Pankey Institute

CE HOURS: 14

Regular Tuition: $ 2195

Single Occupancy with Ensuite Private Bath (per night): $ 290

Achieving Predictable and Stunning Anterior Results Direct composite is something we do every day in our practices. Yet, they can sometimes be frustrating when we don’t get a tight contact…

Learn More>

About Author

User Image
Paul Henny DDS

Dr. Paul Henny maintains an esthetically-focused restorative practice in Roanoke, Virginia. Additionally, he has been a national speaker in dentistry, a visiting faculty member of the Pankey Institute, and visiting lecturer at the Jefferson College or Health Sciences. Dr. Henny has been a member of the Roanoke Valley Dental Society, The Academy of General Dentistry, The American College of Oral Implantology, The American Academy of Cosmetic Dentistry, and is a Fellow of the International Congress of Oral Implantology. He is Past President and co-founder of the Robert F. Barkley Dental Study Club.

FIND A PANKEY DENTIST OR TECHNICIAN

I AM A
I AM INTERESTED IN

VIEW COURSE CALENDAR

Planning Where The Pink Should Be

July 8, 2019 Lee Ann Brady DMD

When we identify patients, whose dental esthetics has been negatively impacted by altered passive eruption, our treatment plans are apt to include altering the gingival esthetics. One of the things we are tasked with is determining where we want the tissue to be.

We start by determining if the incisal edge is correctly positioned in the face.

For example, by looking at a lips at rest photograph and a full face image for my patient with altered passive eruption, we can see that the patient’s incisal edges are correctly positioned. If they were not properly positioned, we would next plan the position for the incisal edges.

Tooth proportion becomes the next building block in the planning puzzle. We know that beautiful anterior teeth are usually between 70-80% width to length ratio. This variability allows us to accommodate other clinical considerations, as well as patient preference. As a starting point, I begin with 75% and then look at the other parameters.

If the patient has excessive gingival display, and one of the hoped for outcomes is to minimize the amount of gingiva, we can alter the drawing to increase the length and then evaluate the esthetic result.  On the other hand, if there is excessive sulcus depth, we can place the proposed gingival margin within the confines of the sulcus and assess the esthetic result.

 

Patient Involvement

I create template drawings, like the one below, in Keynote on my Mac computer, but drawings also can be done in PowerPoint. I then sit down with my patient, insert a retracted teeth apart patient photo behind the drawing, and together we move the lines until the patient is happy with where the pink will be.

 

Once we have the final proposal, the next step is to determine the possible treatment options to gain the intended result. The information can easily be transferred to a wax-up or used to create a snap on trial smile.

How to Create and Use Templates

In Keynote or PowerPoint, take a retracted teeth apart photo of a beautiful, near perfect smile. Put it into the presentation software. Blow the image up to 200%. Using the free form drawing tool, trace the outline of the upper six anteriors. Take the photo out and save the presentation as a named template.key or template.ppt file.

When you want to do proposal drawings with your patient, open up the template, insert the patient’s photo and save the file with the patient’s name. You can copy and paste the tooth outlines onto any of the patient’s photos to propose gingival changes. If you pre-draw and save outline templates for various tooth sizes (ratios), you can quickly show options to your patient.

Related Course

E1: Aesthetic & Functional Treatment Planning

DATE: June 20 2024 @ 8:00 am - June 23 2024 @ 2:30 pm

Location: The Pankey Institute

CE HOURS: 39

Dentist Tuition: $ 6500

Single Occupancy Room with Ensuite Bath (Per Night): $ 290

Transform your experience of practicing dentistry, increase predictability, profitability and fulfillment. The Essentials Series is the Key, and Aesthetic and Functional Treatment Planning is where your journey begins.  Following a system of…

Learn More>

About Author

User Image
Lee Ann Brady DMD

Dr. Lee Ann Brady is passionate about dentistry, her family and making a difference. She is a general dentist and owns a practice in Glendale, AZ limited to restorative dentistry. Lee’s passion for dental education began as a CE junkie herself, pursuing lots of advanced continuing education focused on Restorative and Occlusion. In 2005, she became a full time resident faculty member for The Pankey Institute, and was promoted to Clinical Director in 2006. Lee joined Spear Education as Executive VP of Education in the fall of 2008 to teach and coordinate the educational curriculum. In June of 2011, she left Spear Education, founded leeannbrady.com and joined the dental practice she now owns as an associate. Today, she teaches at dental meetings and study clubs both nationally and internationally, continues to write for dental journals and her website, sits on the editorial board of the Journal of Cosmetic Dentistry, Inside Dentistry and DentalTown Magazines and is the Director of Education for The Pankey Institute.

FIND A PANKEY DENTIST OR TECHNICIAN

I AM A
I AM INTERESTED IN

VIEW COURSE CALENDAR

Are You Communicating Brand Preferences to Your Team?

June 24, 2019 Lee Ann Brady DMD
There may be times when you see an unfamiliar brand of material on the tray before you. If you do notice, it’s likely because the brand of this particular material has come to matter to you.

You know the brand you prefer is predictably reliable, and you have worked with it a lot.

A while back, I went to take a Centric Relation bite record for a patient so we could fabricate an occlusal appliance. After I dried the upper teeth and reached for the bite registration silicone, I realized it was an unfamiliar material in the gun. While trying to complete the procedure, I rotated the gun to read the label. Sure enough, it was bite registration silicone, but not a brand I had used before.

After the procedure was completed and the patient dismissed, I found a few minutes to talk to my assistant that handles ordering. She has been very effective in managing supplies and an incredible team member. I started with a simple question that I hoped would not sound accusatory. “That was a new bite registration material I haven’t used before.” She was pleased to say the brand was less expensive and they were having a special, so it was even less expensive than usual.

Now many of you might think all bite registration silicone is created equally, and I learned my assistant thought so as well. Her cost-saving thought process works well for many for the things we use in the office where I don’t have a brand preference, such as 2 x 2 gauze. However, I do have a strong brand preference for bite registration silicone. They are not all the same hardness, and they do not all have the same set time or moisture tolerance. This was not the staff member’s fault because I had never communicated this to her.

This has prompted me to take a moment, sit with my staff and go through the materials we order and identify any other places where my preferences are very brand specific. While doing this, I explain why I have each preference.

From time to time, I try new materials and brands of materials, adopt some and reject others. My preferences change. Therefore, I offer this little story to remind myself and to suggest to others that we periodically review with our teams the brands we like, the ones we don’t like, and the ones we would like to try.

Related Course

E2: Occlusal Appliances & Equilibration

DATE: April 26 2024 @ 8:00 am - April 30 2024 @ 2:30 pm

Location: The Pankey Institute

CE HOURS: 43.5

Cost: $ 7202

night with private bath: $ 290

This Course Is Sold Out! What if you had one tool that increased comprehensive case acceptance, managed patients with moderate to high functional risk, verified centric relation and treated signs…

Learn More>

About Author

User Image
Lee Ann Brady DMD

Dr. Lee Ann Brady is passionate about dentistry, her family and making a difference. She is a general dentist and owns a practice in Glendale, AZ limited to restorative dentistry. Lee’s passion for dental education began as a CE junkie herself, pursuing lots of advanced continuing education focused on Restorative and Occlusion. In 2005, she became a full time resident faculty member for The Pankey Institute, and was promoted to Clinical Director in 2006. Lee joined Spear Education as Executive VP of Education in the fall of 2008 to teach and coordinate the educational curriculum. In June of 2011, she left Spear Education, founded leeannbrady.com and joined the dental practice she now owns as an associate. Today, she teaches at dental meetings and study clubs both nationally and internationally, continues to write for dental journals and her website, sits on the editorial board of the Journal of Cosmetic Dentistry, Inside Dentistry and DentalTown Magazines and is the Director of Education for The Pankey Institute.

FIND A PANKEY DENTIST OR TECHNICIAN

I AM A
I AM INTERESTED IN

VIEW COURSE CALENDAR

Creating Dental Anatomy in Composite with Disposable Tips

June 17, 2019 Lee Ann Brady DMD

One of my goals with composite restorations is to do as much of the forming and shaping prior to picking up a curing light as I can.

The material is easy to sculpt before it is cured, and access to the surface of the tooth is easier with hand instruments. Once I have placed all the composite and have a dense fill, I remove as much of the excess sitting above the final occlusal surface as I can. With this step accomplished, I turn my attention to creating the occlusal anatomy.

My OptraSculpt handle and disposable tips from Ivoclar Vivadent are perfect for this. The various tip shapes allow me to create incline planes, occlusal grooves and the curve of the marginal ridges into the occlusal embrasures. This process often removes and shapes the composite. My assistant holds a two by two that has been moistened with rubbing alcohol to remove the excess off the end of the instrument. I can place a different shape on each end of the instrument, or I can interchange them as I need them.

Using a series of disposable tips enables me to work without the composite sticking. This has reduced the necessity for meticulous management of expensive instruments which frequently need replacement. And, I resist the desire to use dentin adhesive or an unfilled resin on the instrument to reduce sticking.

Related Course

Mastering Treatment Planning

DATE: October 2 2025 @ 8:00 am - October 4 2025 @ 1:30 pm

Location: The Pankey Institute

CE HOURS:

Tuition: $ 4795

Single Occupancy with Ensuite Private Bath (per night): $ 345

 MASTERING TREATMENT PLANNING Course Description In our discussions with participants in both the Essentials and Mastery level courses, we continue to hear the desire to help establish better systems for…

Learn More>

About Author

User Image
Lee Ann Brady DMD

Dr. Lee Ann Brady is passionate about dentistry, her family and making a difference. She is a general dentist and owns a practice in Glendale, AZ limited to restorative dentistry. Lee’s passion for dental education began as a CE junkie herself, pursuing lots of advanced continuing education focused on Restorative and Occlusion. In 2005, she became a full time resident faculty member for The Pankey Institute, and was promoted to Clinical Director in 2006. Lee joined Spear Education as Executive VP of Education in the fall of 2008 to teach and coordinate the educational curriculum. In June of 2011, she left Spear Education, founded leeannbrady.com and joined the dental practice she now owns as an associate. Today, she teaches at dental meetings and study clubs both nationally and internationally, continues to write for dental journals and her website, sits on the editorial board of the Journal of Cosmetic Dentistry, Inside Dentistry and DentalTown Magazines and is the Director of Education for The Pankey Institute.

FIND A PANKEY DENTIST OR TECHNICIAN

I AM A
I AM INTERESTED IN

VIEW COURSE CALENDAR