The Pre-Clinical Interview – Part 1 

March 4, 2024 Laura Harkin

The Pre-Clinical Interview – Part 1 

Laura Harkin, DMD, MAGD 

I am a third-generation, restorative dentist in New Holland, Pennsylvania, which may be best known for its blue, New Holland tractors. I own my grandfather’s and father’s dental practice where I am the sole provider for approximately 1,000 patients. My dental team consists of two hygienists, two assistants, and two front office administrators. 

I graduated from dental school in 2008 after short careers both in the actuarial sciences and as a stay-at-home mom. In 2010, I purchased my practice and signed up for my first course at The Pankey Institute. Note, my father also studied at the Institute when it first opened its doors in the early 70’s. One of my greatest challenges, early in my career, was learning how to diagnose oral conditions, develop and present treatment plans, and execute that treatment via phases. I found it quite overwhelming to simultaneously manage multiple, complex cases. Now, I love sharing my experience and the approach I’ve found works best for me. 

Above all, I’ve learned that in the midst of daily pressures in dentistry, we need to maintain our own health and strength to properly treat our patients and lead our teams. Surrounding ourselves with knowledgeable, positive, and compassionate colleagues helps! 

Knowing ourselves is as important as knowing our patient. 

Dr. L. D. Pankey’s Cross of Dentistry supports the belief that knowing oneself is of equal importance to knowing a patient whom we choose to treat. This challenge forever evolves because no person remains unchanged with time. I frequently evaluate my strengths and weaknesses as a provider, team leader, and mentor. At the same time, I ask myself what aspects of patient care and business management I excel at and most love to do. I can then choose my specialist team accordingly and empower my office team to best support me. 

Together we ultimately provide a better product and higher level of care. 

To prepare specifically for the treatment planning process, my team helps me gather key information and clinical records from a patient for a comprehensive evaluation. After a thorough analysis, I carefully craft written documentation which will help educate my patient, my team, and the specialist team I’ve chosen. An added benefit is its ability to serve as legal documentation.  

I always ask a team member to join me during treatment plan presentations. They bring another set of ears and eyes so that we may better understand a patient’s motivating factors as well as the challenges they may face in receiving treatment. We encourage open and honest conversations and understand that treatment plans evolve to fit the needs of individuals. 

How do we get to know our patients? 

In addition to gathering a thorough health history and dental history, we are seeking to learn more about our patient’s chief complaint, perception of their current state of oral health, desires for treatment, and barriers to care. 

We listen intently for clues to identify a patient’s communication style. I’ve always heard that we have two ears and one mouth for a reason. I practiced with my father for two years and once, after observing me, he said, “Laura, you do far too much talking. You need to really listen to what your patients are sharing.”  

I’ve had to develop the skill of active listening. To stay in the question and become comfortable with silence takes practice. Some observations that I try to make in order to effectively communicate and build a relationship with a patient are as follows: 

  • Do they seem to enjoy conversing or are they responding with short answers in order to get through the interview quickly? 
  • Do they readily ask questions and express thoughts, or are they quiet and need to be invited and prompted to share? 
  • Are they amiable? 
  • Are they distrustful or fearful due to past dental experiences? 

We need to intentionally verbalize our empathy when we’re in conversation with a patient to help them recognize that they’re being both heard and understood. 

It is beneficial to understand a patient’s background. For example, what have they done in life? What do they love to do? Who is important in their life? Sharing in these conversations will help build a rapport, lead to improved doctor/patient communication, and can help to begin a trusting relationship. 

Does the patient have limitations such as the ability to drive to appointments, afford dentistry, or find time for treatment? Do they need to discuss their oral health condition and treatment options with a trusted family member before making a decision? 

Understanding these answers helps us to not only provide respectful and resourceful solutions but also limit inaccurate assumptions. This knowledge is especially helpful in my third-generation practice, where I have many elderly patients who are dealing with health issues, multiple medical appointments, and scheduled drivers. Their desire is to simply make a careful decision for an oral rehabilitation which fits their objectives and abilities. 

Do we hear the desire for treatment? When speaking with an existing patient, I can often recognize signs of interest to move forward with previously recommended treatment. At that point in time, I often ask, “Why now?” The answer helps me clarify their chief concern(s) so that we can move forward fittingly. 

In Part 2 of this series, we will explore additional techniques to clarify our patient’s desire for oral health and long-term, oral stability. 

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A History of the Pankey-Mann-Schuyler Method

February 19, 2024 Bill Davis

A History of the Pankey-Mann-Schuyler Method 

By Bill Davis 

During his three-month summer course at Northwestern University in 1931, L.D. Pankey was introduced to the principles of occlusion. This was a new term for him and many of his dentist colleagues. The students were assigned an article by Clyde Schuyler and published in the 1926 New York Dental Journal. Dr. Schuyler was a promenade prosthodontist from New York City. The article talked about the basic principles of occlusal function, its dysfunction (malocclusion), and the basic requirements for restoring occlusal harmony. 

1931: Dr. Clyde Schuyler Prompts Considerable Thinking 

At first, L.D. did not understand what Dr. Schuyler had written. He was not alone because most of his classmates had the same problem. L.D. eventually made personal contact with Dr. Schuyler and, after a series of conversations, understood Schuyler’s work.  

Schuyler told L.D., “Those in the field of dental reconstruction must have and cultivate the creative mind of the artist and the accuracy of the engineer.”  

That was easy for Schuyler to say, but he did not explain to L.D. how to approach and visualize a dental reconstruction. Before L.D. met Dr. Schuyler, he had restored posterior occlusion using a Munson articulator and a chew-in technique. The Schuyler article pointed out the importance of anterior teeth guidance. This made L.D. start thinking about approaching occlusion in a more logical step-by-step manner. 

1947: Dr. Arvin Mann Looks Up Dr. L.D. Pankey 

In 1947, Arvin W. Mann moved to Ft. Lauderdale from Birmingham, Alabama. Dr. Mann had graduated from Western Reserve and moved to Alabama to do nutritional research at the University of Alabama before he moved to Florida. L.D. also had an interest in nutrition. His first published article in the Florida State Dental Journal was related to the connection between carbohydrates and dental decay. 

While in Alabama, Arvin became interested in occlusal rehabilitation and the relationship between periodontal disease and restorative dentistry. A periodontal faculty member told Arvin, “When you get to Florida and want to do a restorative work where you won’t have to do all this grinding to correct occlusal restorations, look up Dr. L. D. Pankey in Coral Gables.” 

As soon as Arvin got to Florida, he went to Coral Gables to meet L.D. They became fast friends because they realized they had the same goal of helping their patients keep their teeth for their lifetime. Over the next ten years, they worked together to develop a predictable diagnostic and treatment method for restoring patients’ teeth to health, comfort, function, and esthetics that would fit into the Philosophy of doing their best to help patients keep their teeth. 

1947: Drs. Mann and Pankey Begin Collaborating on Cases 

Arvin began bringing a set of mounted diagnostic casts and an intraoral series of radiographs to L.D.’s office. Arvin and L.D. would review the case together and develop an optimum treatment plan. L.D. would then present the case to Arvin using Arvin as the patient. This was a way to demonstrate to Arvin how to use the Philosophy, get to know the patient, explain what needed to be done, and educate patients to accept the treatment plan.  

Arvin would practice the presentation on L.D. He would then return to his office and explain the treatment plan to his patient. When the dentistry was finished, Arvin would have another appointment to “resell” the case to the patient and make them a missionary for his practice. Within a short time, Arvin had a busy and successful practice. Arvin eventually helped four young dentists from outside his office like L.D. had helped him.  

Mann and Pankey Replace the Munson Articulator with the P-M Articulator 

They used L.D.’s Munson articulators when they started working together on their new restorative method. But soon, they found Munson articulators had limitations for their 3-dimensional approach, including a functionally generated path. Along with an engineer from the Ney Gold company, they designed their own — the P-M instrument and face-bow.  

Arvin became excited about their restorative technique and wanted to share this information with the profession at a Chicago Mid-Winter Dental Meeting. L.D. felt that it would be best to work with a small select group of dentists interested in occlusion and comprehensive restorative dentistry. By now, L.D. had been teaching the Philosophy for a few years.  

L.D. and Arvin selected eleven dentists from various geographical locations around the country who had taken the Philosophy course at least three times and were already using a conventional method to do restorative dentistry. They asked them to try the new P-M technique and articulator for a year. At the end of the year, the group got together in Dallas. The reports from the eleven dentists at the meeting were positive and gratifying. L.D. and Arvin then started the Occlusal Rehabilitation Seminars to teach other dentists the P-M technique and how to use their articulator and face bow.  

1959: The P-M Method Is Presented to the AARD 

In 1959, they presented the P-M therapeutic method to the American Academy of Restorative Dentistry at the Chicago Mid-Winter. They were then asked to write up two articles describing their new process showing the use of the P-M articulator for publication in the 1960 Journal of Prosthodontic Dentistry 

1960: The Occlusal Rehabilitation Seminars Begin 

Arvin and L.D. wrote the Pankey-Mann Manual for the Occlusal Rehabilitation Seminars and started teaching the restorative technique to other interested dentists. The seminar schedule was coordinated by L.D.’s long-time secretary, Rose Quick.  

One of the most significant difficulties in teaching the P-M technique was the inability of dentists to understand occlusion. At that time, no dental school in the United States taught occlusion. L.D. and Arvin realized it was essential to have Dr. Clyde Schuyler present his work on occlusion at their seminars. Also, they did not want Clyde to go to his grave without the profession appreciating his contribution to dentistry.  

L.D. asked Clyde if he would help them teach occlusion. Clyde was reluctant because he anticipated much opposition to this new method and articulator. Also, he didn’t want to upset his friends and colleagues who had authored books or conducted clinics with him about occlusion. 

Eventually, Clyde agreed, and from that point forward, the P-M technique became the Pankey-Mann-Schuyler Technique for Oral Rehabilitation. 

 

 

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William J. Davis DDS, MS is practicing dentist and a Professor at the University of Toledo in the College Of Medicine. He has been directing a hospital based General Practice Residency for past 40 years. Formal education at Marquette, Sloan Kettering Michigan, the Pankey Institute and Northwestern. In 1987 he co-authored a book with Dr. L.D. Pankey, “A Philosophy of the Practice of Dentistry”. Bill has been married to his wife, Pamela, for 50 years. They have three adult sons and four grandchildren. When not practicing dentistry he teaches flying.

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A Team Approach to Creating a Dental Practice Mission

June 30, 2023 Kelley Brummett DMD

A quick, easy way to create a mission statement for your dental practice involves your team. Last year, I called a team meeting to discuss what we want the practice to be like each day for ourselves and our patients. I wanted us to discuss what we could focus on.

We sat around the table in our break room. I asked the team members to take turns going around the table throwing out one word, two words, or a phrase that they felt described our practice. After a moment’s reflection, someone started the process. They had words. They had phrases. They developed whole sentences. And the beauty of this was that I didn’t have to say anything. I just sat there and listened.

If you are asking a team to be part of a mission, I think it is important that you allow them to create the mission. By the end of the meeting, we had a mission statement that we wanted to reflect on and revisit. A week later, we had a conversation about the statement. The team changed a couple of words, and then, Voila! We had our mission statement. It was a mission to which everyone had contributed.

Our next discussion was about how we wanted to be reminded of our mission and how we wanted to make patients aware of the mission. The team decided to put the mission statement on the break room wall, where we would see it daily, and to frame it for the reception area wall, where our patients could see it.

We also met to discuss our values. The team went around the table, listing our practice values. After collaboratively sorting the values, the team developed a list of our top values. This list also has been framed and displayed in the reception area.

We want to share our values and mission with our patients because they are like family. Our top priority is helping them understand their health, so they can make better decisions to improve their health.

Curious to know the wording we settled on? Our mission statement follows: “Devoted to impacting our patients’ lives by investing in their health while establishing relationships through our exceptional care in a safe and comfortable environment.”



In your dental practice, it’s important to create a restorative partnership with your assistants, hygienists & front office team. Make the handoff between your team seamless, build a stronger team & create lasting patient connections. Check out our three Pankey Team Courses that are coming up: Team Series.

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Kelley Brummett DMD

Dr. Kelley D. Brummett was born and raised in Missouri. She attended the University of Kansas on a full-ride scholarship in springboard diving and received honors for being the Big Eight Diving Champion on the 1 meter springboard in 1988 and in 1992. Dr. Kelley received her BA in communication at the University of Kansas and went on to receive her Bachelor of Science in Nursing. After practicing nursing, Dr Kelley Brummett went on to earn a degree in Dentistry at the Medical College of Georgia. She has continued her education at the Pankey Institute to further her love of learning and her pursuit to provide quality individual care. Dr. Brummett is a Clinical Instructor at Georgia Regents University and is a member of the American Academy of Cosmetic Dentistry. Dr. Brummett and her husband Darin have two children, Sarah and Sam. They have made Newnan their home for the past 9 years. In her free time, she enjoys traveling, reading and playing with her dogs. Dr. Brummett is an active member of the ADA, GDA, AGDA, and an alumni of the Pankey Institute.

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Tips for Being More Present with Patients 

May 29, 2023 Kelley Brummett DMD

Tip 1: Develop the Habit of Clearing Your Mind as Your Move from Patient to Patient

One of the hardest challenges in dentistry is moving from room to room and being able to refocus and give each patient your full and undivided attention. Here’s a little trick I do to increase my presence as I move between rooms and patients.

As I move down the hall between operatories, I habitually self-talk. I silently say to myself, “The patient I just left will be fine with my dental assistant.” I intentionally turn off thoughts about the patient I left, and as I cross the threshold of the next operatory, I am interested in only that next patient. It is not easy, and the more intentional I am at bringing it into my consciousness, I believe the better my focus can become.

Interruptions of this type occur throughout the day as I need to stop what I am doing with one patient to check in on the patient in the Hygiene room. Fortunately, I have a long enough hall between my operatory and the Hygiene room to “practice” my little self-control meditation.

Tip 2: Identify an Analogy that Is Understandable for the Present Patient

I know I am not the only dentist who has patients who are not moving forward with the treatment I have recommended. Recently when interacting with a patient who was not moving forward with occlusal therapy I got to watch his understanding shift about the recommendation I had made. The difference was in explaining it in a language he understood. I credit Dr. Rich Green for mentoring me through this understanding. I related it to a real-life experience he already had.

The patient had been in my practice for a little while. We had identified that he had some occlusal disease. He had wear on teeth, some clinical attachment loss, abfractions, teeth that ran into each other, awareness that he brought his teeth together, and at times muscle tension.

One day I asked him, “Can you help me understand why you are not moving forward with occlusal therapy?”

He said, “You know, I just don’t know if it is going to benefit me.”

I happened to look down at his feet and notice he had good running shoes on. I said, “Those are fancy running shoes. They’re pretty cool. Do you wear them because you like how they look or because of another reason?”

He replied, “Actually I wear them because they are very supportive. I often have back muscle tension, and I need to wear really good shoes.”

I said, “You know, the dental orthotic that I’ve been calling an occlusal appliance is no different than wearing really good running shoes. Wearing a dental orthotic is like putting inserts in your shoes to create balance, decrease fatigue in the muscles, and provide me with the opportunity to learn what’s going on at the tooth level, the muscle level, and the joint level. Wearing the dental orthotic is likely to help you understand why you are experiencing discomfort at times, what those patterns are, and when they occur. And it just might be therapeutic in relieving muscle tension you have been experiencing and protect your teeth while we discover what is going on.”

He nodded and said, “Okay, I get it. I understand now. When can we start?”

Tip 3: Ask a Well-Crafted Question

Asking well-crafted questions allows us to better know the patient and get more complete information. Asking powerful questions also makes patients more aware that some of what they are experiencing is not healthy…is not normal.

For example, I often notice patients are not reporting pain as we do risk assessments on their muscles and joints. So, I ask the patient to rate the level of pain at which they take pain medication when they have a headache. “On a scale of 1 to 10, when would you pick up the bottle of Advil and take a pill to treat the pain?”

There are people who will take Advil when pain is at a 1 or 2 and others who will only take it when pain is at a 12. I’ve learned that there are people who have low pain tolerance who will call whenever they have pain in a tooth and other people who tolerate higher pain for months because they think it is normal.

By asking patients to rate their pain tolerance level, they become self-aware of symptoms they might be experiencing that align with the signs you observe and are discussing. They become more aware of what is normal and abnormal. If they have the tendency to not move forward with treatment until they are in acute pain, they become more aware that delaying treatment is not in their best interest. They realize the discomfort they have been experiencing is abnormal and they do not have to…should not tolerate it.

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Kelley Brummett DMD

Dr. Kelley D. Brummett was born and raised in Missouri. She attended the University of Kansas on a full-ride scholarship in springboard diving and received honors for being the Big Eight Diving Champion on the 1 meter springboard in 1988 and in 1992. Dr. Kelley received her BA in communication at the University of Kansas and went on to receive her Bachelor of Science in Nursing. After practicing nursing, Dr Kelley Brummett went on to earn a degree in Dentistry at the Medical College of Georgia. She has continued her education at the Pankey Institute to further her love of learning and her pursuit to provide quality individual care. Dr. Brummett is a Clinical Instructor at Georgia Regents University and is a member of the American Academy of Cosmetic Dentistry. Dr. Brummett and her husband Darin have two children, Sarah and Sam. They have made Newnan their home for the past 9 years. In her free time, she enjoys traveling, reading and playing with her dogs. Dr. Brummett is an active member of the ADA, GDA, AGDA, and an alumni of the Pankey Institute.

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A Pankey Philosophy Overview 

March 20, 2023 Bill Davis

Philosophy has to do with the relationship between belief and action. In the end philosophy is what gives meaning and purpose to our lives. As dentists who are consciously aware of our own beliefs and what holds meaning to us, our daily work and our routine are not merely unrelated actions and episodes, but integral parts of our personal lives.

There is an important distinction to be made between having a philosophy and living a philosophy. “Having” a philosophy implies having an idea or set of ideas, but it doesn’t necessarily mean that those ideas are being acted on. Learning can best take place when we are “living” a philosophy—that is, living in a state of inquiry—based on our personal values, our knowledge of ourselves, and our individual goals.

Questions lead to answers.

According to Jim Dyce, a British dentist/philosopher and good friend of L.D. Pankey, “Philosophy can do no more than initiate questions.” When Dr. Pankey decided to devote his life to saving teeth, he was forced to ask himself a difficult question, “How can I help people keep all of their teeth for a lifetime?” In 1925 L.D. didn’t know the answer. Out of that question he was able to uncover and develop many principles which have proven instrumental in the understanding of comprehensive restorative dentistry and patient education. Therefore, Philosophy, in its most valuable form, is more about asking right questions than with right answers.

How useful the Pankey Philosophy will be to you depends on how willing you are to put yourself in the questions. In the process of moving toward the answers to your questions will help you clarify your goals and ways to accomplish them. Questions can open the floodgates to new insights and information for you.

How do you define and measure success?

The Pankey Philosophy itself seems simple enough at first glance. Each one of us must decide for ourselves what and how to measure our success. Once we have conceived an idea of success, we must believe in it, and then work out ways to achieve it. Achieving the greatest success in dentistry–both gratitude from our patients and financial and spiritual reward, requires a commitment to always give the best you can. This involves knowing yourself, knowing your patients, knowing you work, and applying your knowledge conscientiously.

Dentists can fall into a rut of boredom and frustration.

This sobering statistic may have been attributed to two main factors related to the practice of dentistry. First, dental work is usually confined to a small office, where dentists go day after day, week after week. Second, once dentists become good at what they are doing, their work becomes very much the same. The result could be developing a feeling of not being appreciated by their patients and staff. Or maybe feeling being trapped in their small office. They may think they are not achieving much in the way of mental stimulation, and start wondering to themselves “Is this all there is to dentistry?”

Now, this is not to say that all or even most dentists live lives of “quiet desperation.” Yet most dentists have felt they are in a rut at one time or another, at which point it becomes increasingly difficult to see the real rewards in this great profession of dentistry. Reviewing your questions again can pull you out of the rut.

Dentists can climb out of the rut through increased service to mankind.

In 1947 L.D. began teaching the Philosophy of the Practice of Dentistry which he had been developing since 1932. His purpose was to help dentists confront and move past feelings of frustration and boredom. L.D. wanted to move dentists toward higher levels of excellence in their technical work, improve their communication skills with their patients, and achieving greater satisfaction in their lives through increased service to humankind.

Are your goals clear and well-defined? Are you willing to pay the price to achieve them?

L.D recommended dentist look more closely and objectively at themselves and their individual situation. He would suggest asking his class to really think about their goals. He would ask them,” Are your goals clear and well-defined? Can you measure your goals so you can measure your success? Do your goals belong to you or are they someone else’s goals? Are you willing to pay the necessary price to achieve them? Are your goals and objectives in line with your circumstances and temperament?” Satisfaction is achieved not only in reaching your goals, but also by understanding the progress you are making during your journey as you move slowly and steadily toward them.

As poet and musician Bob Dylan wrote, “He who is not busy being born is busy dying.”


Understanding the Pankey Philosophy can help you transform your experience of practicing dentistry, increase predictability, profitability and fulfillment. The Essentials Series is the path we urge you to take. Essentials 1: Aesthetic and Functional Treatment Planning is where your journey begins.  Following a system of risk assessment, patient ownership and risk management creates technical excellence and predictability.

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Bill Davis

William J. Davis DDS, MS is practicing dentist and a Professor at the University of Toledo in the College Of Medicine. He has been directing a hospital based General Practice Residency for past 40 years. Formal education at Marquette, Sloan Kettering Michigan, the Pankey Institute and Northwestern. In 1987 he co-authored a book with Dr. L.D. Pankey, “A Philosophy of the Practice of Dentistry”. Bill has been married to his wife, Pamela, for 50 years. They have three adult sons and four grandchildren. When not practicing dentistry he teaches flying.

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L. D. Pankey’s Philosophy Starts to Unfold

December 5, 2022 Bill Davis

When L.D. Pankey returned to Coral Gables from the International Congress of Dentists in Paris, in 1931, knew he needed additional education if he was going to follow his personal commitment of not extracting any more teeth. With a recommendation from his new friend in Paris, Dr. Daniel Hally-Smith, the dentist, L.D. wanted to emulate, he signed up for a three-month summer course at Northwestern University in Chicago.

The program was designed to cover all the phases of modern dentistry including how to interview patients and do a proper clinical tour of the mouth so the student could determine what was really needed to give their patients optimum dental care. They were saturated with topics both technically and psychologically related to diagnosis and treatment planning concepts. Most of the information presented was focused on clinical procedures.

The patient psychology course was taught by George Crane PhD. During that summer, George Crane, a trained psychologist, was between his freshman and sophomore years in medical school at Northwestern. He had been hired to teach a summer course to physicians and dentists on how they could better understand and communicate with the patient.

At that time, there were no definitive textbooks about doctor/patient communications. During his lectures Dr. Crane brought in loose-leaf handouts for the class. The handouts later became the framework for his first book on applied psychology. Crane’s course was the highlight of L.D.’s summer, and it turned out Dr. Crane’s course became the foundation of what became the Pankey Philosophy.

Crane’s lectures were centered around psychology to be used by doctors to develop interpersonal relationships between the professional and the patient. The course included an overview of Carl Jung’s work, defining Jung’s four personality types: the introvert, the extrovert, the ambivert and the compensated types. The students also looked closely at the 1905 Binet-Simon Scale to determine the intellectual capacity of children. They studied the first “mental horsepower” test – otherwise known as the IQ test.

Later, when L.D. developed his own philosophy, he used much of the Crane course ideas for his Dental IQ, patient intellectual, sociological, and economic classifications. After finishing the George Crane course, L.D. felt confident that he had taken a giant step toward gaining the knowledge and communications skills that were needed in his practice.

Dr. Crane was a strong proponent of the balanced life and spent a great deal of time discussing Cabot’s “Cross of Life” which emphasized the need to balance work, play, love, and worship for a truly fulfilling life. The cross diagram was developed by Richard C. Cabot (1869-1939), who was a physician, philosopher, and Unitarian minister.

Following his graduation from Harvard University Divinity and Medical School, Cabot started his clinical work at Massachusetts General Hospital where he established a hospital based Social Service Department and became the first Chairman of the Department of Social Ethics at Harvard. Over the years, Cabot wrote twelve books on Medicine and Ethics.

Cabot also became a major educational leader in medicine by publishing monthly “Cabot Cases” in The New England Journal of Medicine. Each month physicians in local study clubs throughout the county would read and study the information provided by Cabot. They would try to determine the diagnosis for the patients in the case. The final diagnosis was provided the following month in The New England Journal of Medicine.

Crane assigned one of the Cabot books, What Men Live By, to L.D. and his classmates to read. The book explored how to achieve personal happiness. According to Cabot, happiness could be achieved by striving for balance in personal life. When explaining this concept to his patients and other professionals, Cabot recommended drawing a simple diagram with Happiness in the middle and four arms labeled Work, Play, Love, and Worship.

What Men Live By was published in 1913 and has long been out of print. Many of the references seem archaic; however, the basic principle of balance has stood the test of time. There are needs for all of us to be productive, to enjoy daily life, to have people in our lives that we care about, and to extend our interests beyond ourselves. An excess or a deprivation of any of these basic needs of life can set our lives out of balance, destroy our sense of self-worth, dull our enjoyment of life, or alienate us from our fellow human beings.

When L.D. Pankey developed his philosophy, he uses the Cabot Cross as a starting point for dentists on their journey to fine personal happiness.

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Bill Davis

William J. Davis DDS, MS is practicing dentist and a Professor at the University of Toledo in the College Of Medicine. He has been directing a hospital based General Practice Residency for past 40 years. Formal education at Marquette, Sloan Kettering Michigan, the Pankey Institute and Northwestern. In 1987 he co-authored a book with Dr. L.D. Pankey, “A Philosophy of the Practice of Dentistry”. Bill has been married to his wife, Pamela, for 50 years. They have three adult sons and four grandchildren. When not practicing dentistry he teaches flying.

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The Story of Dr. Daniel Hally-Smith Part 2—Tell Your Patients the Optimum Treatment, so They Can Decide Based on Knowledge

October 24, 2022 Bill Davis

When L.D. Pankey visited Dr. Hally-Smith in Paris, Hally-Smith was curious about how L.D. could afford to come to the International Dental Congress in Paris. L.D. told him about his benefactor, Mrs. Blanchard. Hally-Smith said, “That is wonderful, just wonderful!” Turning serious, he then said, “You know of course that you will make it. Your benefactor has started the process for you but there are many things you will have to do before you will be there.”

Hally-Smith gave L.D. a personal tour of his office. The office had five dental technicians and three associate dentists. His personal dental assistant was a White Russian woman dentist who had been driven out of Russia during the Russian Revolution. She was wearing a long, highly starched nurse’s gown that went all the way to her ankles. L.D. began to understand what Mrs. Blanchard, his benefactor, was talking about. She wanted him to know some of the outstanding dentists in the world! When she suggested he take the trip, she said, “I think you have the potential of becoming an outstanding dentist.” This was after he had completed her dental work.

L.D.’s time at the Dental Congress was a busy one. There was so much to learn! Even though Taggart had cast the first inlay nineteen years earlier in 1912 by the “lost wax” technique, investments and casting techniques were far from perfect. Many slides were shown, and many papers were given on new techniques in restorative dentistry. New impression materials and impression techniques were shown in lectures and table clinics. Much of the denture information did not interest L.D. because he was mainly interested in saving teeth.

After their first meeting, L.D. made rearrangements to spend an additional week in Paris with Dr. Hally-Smith. Hally-Smith was old enough to be L.D.’s father. One morning, they were talking about patient communications, and Hally-Smith asked, “Did you ever take the Bosworth course?” L.D. said he had taken the course.

Hally-Smith said, “Isn’t Bosworth the dental supply man who suggests dentists say this when speaking with their patients, “I can do a good job for so much, do a halfway job for this much, or I louse it up at a very reasonable price’?” L.D. answered by saying, “That is not exactly what Bosworth says but pretty close.”

Hally-Smith then asked, “L.D., do you like that approach?”

L.D. said, “No, I’ve never liked it, but I have tried it.”

Dr. Hally-Smith became serious and said, “L.D. it all starts with communication. You should tell your patient the optimum way their dentistry should be done. Then what the patient decides is their own decision. If you’re going to make a compromise with them, then compromise based on your patient’s knowledge, not because you have prejudged them. You should tell every patient what optimum dental care would do for them. If they decide to go elsewhere, leave the door open for them to come back later. I have found over the years that a lot of these people return after they’ve lost half their teeth.”

They discussed this premise for a while longer, and L.D. realized how right Hally-Smith was. Tell patients about the best treatment plan. Then, if there were any compromising to be done, let them decide. L.D. realized Dr. Hally-Smith’s way of communicating was easier said than done.

When L.D. returned home from Paris, he never felt comfortable using the Bosworth Plan again. Instead, he presented patients with the optimum treatment plan. If they resisted, he would compromise and do only what they would allow or just put off the work, except for emergencies. After a while, L.D. began calling this compromise time a “Holding Program” – a time of doing only what had to be done until the patient chose to move on to optimum care. With enough time, patients would usually follow through with optimum care, but not always.

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Bill Davis

William J. Davis DDS, MS is practicing dentist and a Professor at the University of Toledo in the College Of Medicine. He has been directing a hospital based General Practice Residency for past 40 years. Formal education at Marquette, Sloan Kettering Michigan, the Pankey Institute and Northwestern. In 1987 he co-authored a book with Dr. L.D. Pankey, “A Philosophy of the Practice of Dentistry”. Bill has been married to his wife, Pamela, for 50 years. They have three adult sons and four grandchildren. When not practicing dentistry he teaches flying.

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A Mother’s Letter

October 3, 2022 Bill Davis

Dr. L.D. Pankey, Sr. (“L.D.”) 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, and then relocated his practice to Coral Gables, Florida, in 1926.

The motivation for his decision to leave New Castle came when he received a letter from his mother. She wrote,” I am happy you are doing so well in your practice, but I hope you are not doing to your patients what has been done to me. I have had all my teeth out and now have dentures. This has been the unhappiest experience of my life.”

L.D. had examined his parents while in dental school and was sure they did not need dentures. After reading his mother’s letter, he made a commitment to practice dentistry in a new way, focused on saving teeth. This was a difficult decision because at that time he did not know how to achieve his commitment. In 1926 the typical dental practice provided examinations, cleanings, extractions, silver and silicate fillings, and complete and partial dentures.

His decision to leave New Castle, Kentucky was driven by the desire to have a new, fresh start and to find his own way to practice dentistry without removing teeth. Over his lifetime, he often said, “When I left New Castle, I vowed that I would never take out another tooth as long as I lived.”

Shortly after arriving in Coral Gables, he was lucky to be invited to join a unique dental study club in Miami headed by an oral surgeon. The purpose of the study club was to study ways to prevent tooth loss. He couldn’t have moved to a better place to learn with and from other like-minded professionals.

What made this club unique was they did not pay an honorarium to speakers., Instead, they paid their travel expenses, and they personally entertained the speakers in their homes for the week. The speakers were happy to have a mini vacation with their families in Miami. This gave L.D. the opportunity to meet and befriend them.

Among the visiting speakers were notables such as Winston Price who talked about nutrition as it related to caries, C.C. Bass MD who talked about flossing and home care (the Bass tooth brushing technique and unwaxed floss), Harry Morton who talked about restorative dentistry and showed them how to use of the Munson articulator to create the curve of Spee and Wilson, and Clyde Schuyler who came down from New York City to discuss his ideas on occlusion.

The letter from his mother launched his unique career and influence on dentistry which has been indelible for the last 90 years. Reflecting on L.D., the person who inspired me most to take the career journey I have been on for over 50 years, I realize his philosophy of dentistry and his friendship still inspire and shape me. His mother’s letter is always on my mind as I continue to teach prosthodontics and chair the Department of Dentistry at the University of Toledo. I can’t imagine a more meaningful life than providing others with optimal health, function, and the happiness of having a beautiful smile.

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About Author

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Bill Davis

William J. Davis DDS, MS is practicing dentist and a Professor at the University of Toledo in the College Of Medicine. He has been directing a hospital based General Practice Residency for past 40 years. Formal education at Marquette, Sloan Kettering Michigan, the Pankey Institute and Northwestern. In 1987 he co-authored a book with Dr. L.D. Pankey, “A Philosophy of the Practice of Dentistry”. Bill has been married to his wife, Pamela, for 50 years. They have three adult sons and four grandchildren. When not practicing dentistry he teaches flying.

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Gratitude and Appreciation

September 26, 2022 Bill Davis

One day an elderly woman came into the office without an appointment. Mrs. Blanchard was a tall woman wearing a large, flowered hat and a black ribbon around her neck. She had the airs of an aristocrat. She had been referred to the office by her next-door neighbor who told her Dr. Pankey was the dentist who did not believe in pulling teeth. When she came in, she refused to sit down and asked to talk to the dentist immediately. When asked why Mrs. Blanchard was there she told the receptionist it was both professional and personal.

L.D. escorted her to his private office. She immediately said, “Dr. Pankey I understand you do not extract teeth.”

L.D. Said, “I do not extract teeth; however, if you need extractions, I will send you to a good oral surgeon in Miami.”

She interrupted, “That is the reason I am here. I do not want to lose my teeth.” She had ready been seen by two dentists and both said she needed dentures. Her plan was to have only Individual teeth extracted when she was in pain. She asked if he would be willing to try to save her teeth. Because she was a walk-in they made another appointment for a proper examination, x-rays, and time for a consultation.

When she came back, he told her he thought she could keep most of her teeth; however, he couldn’t promise all of them. He also told her he had been studying with some of the best dentists in the country and would do his best. Although she did not ask him, he quoted her a fee large enough to allow him to redo work if necessary. She showed no concern about the fee, so they got started.

She needed a couple of extractions and endodontic procedures. During the healing time, he did simple restorative dentistry. Her treatment took three and a half months. L.D. told her everything he was doing and why. She became extremely interested in the process. He used the Munson articulator and followed Taggart’s 1912 “chewing in” technique. All the crowns were done directly in the mouth using compound impressions, amalgam dies, and denture card wax to create a functionally generated path. When everything was completed, he put her on a three-month cleaning regime. Happily, the dentistry lasted until Mrs. Blanchard was 81.

Being a little eccentric, Mrs. Blanchard never wanted to sit in the reception room. When she did come in for her cleanings, she preferred sitting in L.D.’s private office. One day, during the midst of the Great Depression, she was in his office paging through an American Dental Association journal that she had found on his desk. An article about the upcoming International Dental Congress meeting in Paris, France caught her interest.

When L.D. came into the room she asked, “Are you going to this meeting in Paris?” He said, no I am very busy here with my practice and keeping my staff working.”

Two weeks later she returned and asked to see L.D. As usual, she was sitting in his private office when he came in. She said, “I still think you should go to the International Congress in Paris because you have great potential. I want you to go, and I want you to travel first class. I would like to pay all your travel expenses, all your office expenses including your staff, and compensate you for the time lost in your practice. When you go, I want you to travel all over Western Europe because that is where our civilization came from. You need to see London, Florence, Rome, Vienna, Heidelberg, and of course, Paris. Now, are you willing to go?”

L.D. was totally taken aback. Mrs. Blanchard had a great deal of gratitude for the time L.D. had spent learning how to treat her problem and for the care and understanding he gave her during and after her treatment. The enormity of her gratitude and appreciation was whelming.

After talking to his wife and his staff, he did go to Europe, and he did go to the Congress in Paris. Little did he know what a profound impact this gift would have on his life. Mrs. Blanchard had given him the opportunity to expand his knowledge of dentistry and the potential to become a leader in dentistry.

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Bill Davis

William J. Davis DDS, MS is practicing dentist and a Professor at the University of Toledo in the College Of Medicine. He has been directing a hospital based General Practice Residency for past 40 years. Formal education at Marquette, Sloan Kettering Michigan, the Pankey Institute and Northwestern. In 1987 he co-authored a book with Dr. L.D. Pankey, “A Philosophy of the Practice of Dentistry”. Bill has been married to his wife, Pamela, for 50 years. They have three adult sons and four grandchildren. When not practicing dentistry he teaches flying.

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Believe in Your Ideas. Believe in Yourself. 

September 6, 2022 Bill Davis

“Whatever the mind of man can conceive and believe, it can achieve.” — Napoleon Hill

When L.D. Pankey was developing his Philosophy, he studied with many early American business authors and teachers. One such person was Napoleon Hill (1883 -1970). In 1937 Hill published a bestselling book, “Think and Grow Rich” which emphasized a positive attitude and having good communication skills.

Every innovation, every invention, every work of art begins with an idea. Long before the Wright brothers ever flew, Leonardo Da Vinci had sketched and designed an aircraft. Da Vinci conceived of mechanized flight, but the Wright brothers believed it was possible, acted on that belief, and thus achieved flight. Likewise, in 1929 L.D. Pankey had the idea that teeth could and should be saved, although at first, he didn’t know how.

L.D. Pankey’s belief that teeth could be saved was so strong it motivated him to do some research, study what was known at that time, and do the experimentation necessary to make his idea a reality. Belief in himself and his idea helped him persist despite some uncertainty, blind alleys, and many other frustrations.

There is an old Chinese saying, “If you do not know where you are going, you are likely to end up somewhere.” Too many people end up “somewhere” because they have not clearly defined where they want to go. The first step in moving toward greater satisfaction, therefore, is to set specific goals.

Vague goals such as “I’d like to be a better dentist” or “I’d like to be happier” or “I’d like to make more money” are common. Be more specific, for example:

  • I would like to learn about implant placement.
  • I want to have more fun with my children.
  • I want to earn 15% more this year.”

Then, be even more specific and set definite time frames so you can measure your progress:

  • I would like to begin training in implant placement this coming September and be placing implants successfully in June. Tomorrow I will begin by investigating continuing education programs in the science of implants.
  • I would like to have more fun with my children. At dinner tonight I will ask my children about ideas for fun activities, and we will start by doing one of the activities each week.
  • I would like to increase my income by 15% this year. I will meet with my accountant and a dental practice coach this month to look at ways to increase my profitability. I will also do some reading in practice management.

Once you have conceived your ideas, you must believe it is possible to achieve them. Without the power of belief, you will not take them seriously; nor are you likely to weather the many setbacks and frustrations that will probably come.

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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…

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About Author

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Bill Davis

William J. Davis DDS, MS is practicing dentist and a Professor at the University of Toledo in the College Of Medicine. He has been directing a hospital based General Practice Residency for past 40 years. Formal education at Marquette, Sloan Kettering Michigan, the Pankey Institute and Northwestern. In 1987 he co-authored a book with Dr. L.D. Pankey, “A Philosophy of the Practice of Dentistry”. Bill has been married to his wife, Pamela, for 50 years. They have three adult sons and four grandchildren. When not practicing dentistry he teaches flying.

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