Ask Dr. Christensen

May 1, 2003
In this monthly feature, Dr. Gordon Christensen addresses the most frequently asked questions from Dental Economics readers. If you would like to submit a question to Dr. Christensen, please send an email to [email protected].

by Gordon J. Christensen, DDS, MSD, PhD

Question ...
Do you believe that the current rate of change in our industry is unprecedented, given the advancements in patient care, practice-management technology, digital imaging, and dental technology in general? Is this level of change a challenge to the current educational infrastructure, and if so, what suggestions would you give dental-service companies that would like to support the industry with training opportunities?

Answer from Dr. Christensen ...
Over my many years evaluating dental products and new concepts, I have never seen more changing concepts, new materials, and techniques than today. Although our in-house organizations have many people evaluating the changes on a daily basis, it still is nearly impossible for me to keep up. It is an overwhelming task for individual practitioners to observe even the major scientific journals, not to mention the commercial magazines and other publications. Additionally, some of the many dental continuing-education courses often are more confusing than helpful.

You asked what dental-service companies can do to support the profession with education. I feel that the dental service companies have both altruistic and commercial responsibilities to assist the profession with education. The service companies want the best up-to-date oral care possible for their subscribers, but they also want that oral care to be as successful, long-lasting, and cost-effective as possible. Many of the popular courses on the dental lecture circuit are based on developing and relatively unproven clinical materials and techniques, while others are primarily related to practice administration and finance. These courses are interesting and useful for many practices, but, in my opinion, neither of these types of courses is highly effective for improving the quality of day-to-day dental care offered to the public.

Dental schools are overwhelmed with too much to teach, so I suggest that dental-service companies do it themselves.

If I were in charge of the continuing education offered by a dental service company, I would meet with the people in my company who are working with payments and patient complaints. I would have them help determine what clinical techniques are taught by observing the reports of patient dissatisfaction and the necessity to redo treatment. I suggest that some example items would include:

• Postoperative sensitivity in Class II resins

• Lack of contact areas on Class II resins

• Ceramic breakage off porcelain-to-metal crowns

• Need for endodontic therapy after seating crowns

• Failing endodontic therapy

• Temporomandibular dysfunction

• Poorly fitting lower dentures

I would then look at the clinical areas where most of the funding is going and analyze what procedures are most accomplished by dentists, and which receive the least complaints.

After identifying successes and failures, I would make a major effort to locate speakers on the dental-lecture circuit who are most accepted and in demand for the areas of activity and challenge in which your clients are interested. Recruit those dental-lecture speakers who will teach the subjects your clients need the most, and set up lecture and seminar courses in local hotels, hospitals, dental schools, or community colleges. If you have a clinical facility in your geographic area, rent that facility for smaller attendance "hands-on" courses.

For those dentist-clients living in low-density population centers, offer video education as a benefit for their participation in the plan. Our group, Practical Clinical Courses, has offered practical continuing-education videos and courses to thousands of dentists for 22 years, and we would be willing to help with the education of any individual or group of dentists.

Dental service companies have a great opportunity to help the public and themselves by providing continuing education to the dentists in their geographic areas.

Question ...
I am a 27-year-old computer science major who is considering the possibility of pursuing dental school. Is there a solid future for dentistry? What steps should I take to learn about becoming a dentist?

Answer from Dr. Christensen ...
Dentistry still has great appeal to me after many years of practice, teaching, and research. I would select it again without any reservations. Let's look at some of the factors that will influence the future of dentistry.

1. Third-party payment plans (managed care): There was a time a few years ago when some dentists thought that these plans would destroy the profession and the high quality of service in American dentistry. That has not happened. Although some underfunded DHMOs have been genuine frustrations to dentists and patients alike, they are gradually dying. PPOs are growing, but dentists are learning how to deal with them — or not to join them — and the result is livable. The private practice of dentistry is still alive, and it is obvious that it will survive, unlike other areas of medicine that have been devoured by managed care.

2. Public interest and demand: The public wants dentistry. New, aesthetic procedures in the profession have increased the activity of dentists and the positive influence of this area is still growing. The aging population requires more oral therapy than other age ranges, and each year this group increases in the United States.

3. The Economy: None of us can change the economy. However, a great deal of oral therapy is required because of pain or unsightly appearance, and, in spite of the health of the economy, dentistry is still needed and appreciated.

4. Changes in oral disease frequency: Dentists treat three major diseases or conditions — 1) dental caries (decay), 2) periodontal disease (bone and gum diseases), and 3) malocclusion (improperly positioned teeth), as well as some other less frequently occurring conditions. Every one of the conditions dentists treat is occurring more frequently. We also continue to see an increase in the patient's desire for aesthetic dental procedures.

5. Changes in the dental workforce: The number of dentists in the workforce per 100,000 patients is decreasing, and the population in the U.S. is projected to increase significantly over the next 50 years. It is predicted that there will be more therapy for dentists to accomplish, as well as more preventive procedures to teach to patients.

6. Changes in dental education: Constant change is taking place in dental education to keep up with the many innovations taking place in the profession. Although difficult, dental school can be an exciting and rewarding experience.

7. Major breakthroughs in research: Most of the research advancements have produced new and exciting products that keep dentists and the public interested in the profession and what it offers.

The following new PCC videos will help your patients and your enjoyment of practice. We invite you to view them. They are V4798, "Advice for the Ideal Practice, What Every New Dentist Should Know," and V4796, "Dr. Christensen's Most Frequent Failures and How To Avoid Them." They are available in VHS and DVD formats. Contact PCC at (800) 223-6569, by fax at (801) 226-8637, or go online to

Dr. Christensen is a practicing prosthodontist in Provo, Utah. He is the founder and director of Practical Clinical Courses, an international continuing-education organization for dental professionals initiated in 1981. Dr. Christensen is a co-founder (with his wife, Rella) and senior consultant of Clinical Research Associates, which, since 1976, has conducted research in all areas of dentistry and publishes its findings to the dental profession in the well-known CRA Newsletter. He is an adjunct professor at Brigham Young University and the University of Utah. Dr. Christensen has educational videos and hands-on courses on the above topics available through Practical Clinical Courses. Call (800) 223-6569 or (801) 226-6569.

Dr. Christensen's views do not necessarily reflect the opinions of the editorial staff at Dental Economics.

Coming soon . . .
Are you looking for answers about bleaching and whitening? The June issues of Dental Economics and Dental Equipment & Materials will take an in-depth look at the topic, from both an economic and product-driven standpoint. Be looking for it next month ...

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