Paralysis by analysis

Feb. 1, 2012
I speak to thousands of dentists each year, and I see one common malady that probably affects the majority of dentists ...

Louis Malcmacher, DDS, MAGD

I speak to thousands of dentists each year, and I see one common malady that probably affects the majority of dentists — the “paralysis by analysis” syndrome. Dentists, by our nature, like to become comfortable with one thing and then stay with it for a long time, even though dentistry is constantly changing for the better. Dentists may study something for months or even years before they decide to use it.

I sometimes hear dentists say, “I’ll wait for the evidence-based dentistry before I consider this product or technique as a treatment option.” These dentists have probably never researched to see what evidence already supports this new technique or technology.

Many times they don’t even know where to look to find evidence-based studies, and 90% of the time they aren’t able to evaluate whether the scientific study was run properly or not. Evidence-based dentistry is not a replacement for your brain or your years of dental experience.

I am not picking on evidence-based dentistry. Just the opposite — dentists are using it as another excuse to remain complacent when we should be expanding our treatment options and giving patients greater access to treatments that really work, especially when those treatments are already supported by evidence-based research.

Let me share some examples

1) No preparation veneers — Many dentists still have not adopted no/minimal preparation veneers (Cristal Veneers, Aurum Ceramics), which in many cases is the best treatment option for patients’ esthetic needs.

In this category, I will talk about another facet of “paralysis by analysis,” and that is complacency with laboratories. Many dentists tell me, “I’m not really happy with my dental laboratory, and the esthetics are just OK.” What happens is they put in no prep veneers that don’t look very good, yet they don’t want to change laboratories.

If you are not happy with the results of your dental lab or with their communication abilities, change dental laboratories immediately! Stop being complacent and do what is best, both esthetically and functionally, for your patients.

2) Botox and dermal fillers — These are now well established in dentistry, with studies regarding dental therapeutics going back nearly 20 years. It has been estimated that nearly 20% of dentists have been trained in the use of Botox and dermal fillers. With proper training, these procedures are easy to accomplish and provide a number of new dental treatment options for your patients. There is no capital investment involved.

I can already hear the “paralysis by analysis” syndrome working in your brain — “I’m not sure; I don’t know; let me see the studies.”

The American Academy of Facial Esthetics at has already trained more than 5,000 dental professionals from 48 states and 26 countries in these procedures, and has more than 1,300 members worldwide. The literature about Botox and dermal fillers in dentistry is well established. So then what are you waiting for?

3) Dental lasers — Every dentist should have at least a soft tissue diode laser, especially since these have become more affordable, such as the Picasso Lite (AMD Lasers). There is just no excuse why every dentist cannot be a laser dentist. For every soft tissue use, you will find more precision and faster healing when you use a diode soft tissue laser. With uses like laser troughing for impressions, esthetic and periodontal uses, and more, you will find a diode laser an integral part of your daily practice. Diode lasers have been in dentistry for years and are now well proven.

It is our legal, ethical, and moral duty to give patients all of the available treatment options that will serve their needs. To do this, you have to know what is going on in dentistry, what products, techniques, and technology are available, and become trained in them so that you can properly treat patients by offering them all the options.

Make it your New Year’s resolution — say goodbye to “paralysis by analysis” forever, and build your practice now more than ever.

Dr. Louis Malcmacher is a practicing general dentist and internationally known lecturer, author, and dental consultant. An evaluator emeritus for CLINICIANS REPORT, Dr. Malcmacher is the president of the American Academy of Facial Esthetics at Contact him at (440) 892-1810 or email [email protected]. His website is, where you can sign up for a free monthly e-newsletter.

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