Five things I should have done five years ago

by Robert Mongrain, DMD

Welcome to a new and exciting year in dentistry. I hope you have great plans for this year. I want to share five things with you that I should have done five years ago. I want you to understand that this is not about regrets, but rather about surprise and satisfaction. The five things I am going to discuss have had a big impact on my life and in my practice. My hope is that you will look at these actions I have taken — and perhaps some actions you have considered — and begin taking the necessary steps to get started.

One of the many new things I have learned is this: “Small changes can have big results.” Start today. Do something small — or perhaps big — that will have positive results in your practice. Small beginnings are not to be despised.

The five things I should have done five years ago are:

1. Invisalign®
2. Single tooth implant placement
3. LOGICON Caries Detector Software from Kodak
4. Digital impressioning with E4D Dentist™ and iTero™
5. A personal attitude of being open, flexible, and positive every day

1. Invisalign

Approximately nine years ago, I was first certified in Invisalign. It was a good technology at the time, but after a few cases, I chose to quit. Then, last summer, I realized I was missing a great opportunity. I attended a course to recertify, and I have to say, wow! Has Invisalign changed over the past nine years. With the recent launch of G4, the capabilities of Invisalign therapy have expanded significantly. In addition, the educational support and community has expanded by light years. With all the in-person advanced training and hundreds of hours of online education and teleconferences, there is no reason why dentists who are so inclined cannot include many Invisalign cases in their practices.

In these challenging times, the best way to grow is to provide more services for those patients who already trust you. There are many reasons our patients’ health would be improved with properly positioned teeth, but many will not do traditional orthodontic treatment. Invisalign is for them.

2. Implants

In 2010, I attended a course to learn to place CAMLOG® implants. Why? Our patients are now expecting implants to be one of the treatment options we provide for them. The day of long or even short bridges is nearly over. My patients prefer that I provide most of their treatment whenever possible; therefore, referral to the surgeon is not their first choice. I don’t feel that I have to place every implant myself; I am happy to work with my referral partners. With the use of CBCT 3-D radiography and implant-planning software such as E4D Compass, many relatively simple and predictable cases can be done in the general practice.

3. LOGICON Caries Detector Software from Kodak

I am so excited that we have started working with the LOGICON Caries Detector Software with our new Kodak digital X-ray system that utilizes the RVG 5100 sensors through Carestream Dental. I look forward to the day when this software will be available for all systems.

For me, diagnosing interproximal decay with bitewing radiographs has always been an unsure science. Research on film and digital X-rays reveals that we are only about 50% accurate in finding decay and avoiding false positives. Published research in 2011 shows that with LOGICON Caries Detection Software, we can achieve accuracy in the 80% to 90% range in both of these respects. This technology allows me to diagnose more decay and feel confident when telling my patients about their disease.

4. Digital imaging for impressions

I have worked with CAD/CAM technology since 1998. For the last three and a half years, I have used the powder-free E4D system. I have been doing what I call “same-day dentistry” successfully for many years. Last year, we began to do digital imaging for our lab cases as well. I am exporting files from my E4D system for laboratory restorations. We also now have an Itero system for our lab cases. The most exciting new feature of the Itero system is the ability to scan our Invisalign cases directly in the mouth. No more impressions needed for Invisalign! Digital imaging, regardless of the system you use is more accurate, more predictable and more acceptable tothe patient. If you have not had a dental material impression taken in recent years, make sure you have one taken, preferably full arch. It is not a fun experience. Digital imaging will give you greater profitability, greater opportunity for delegation, increased patient satisfaction, and the highest possible accuracy.

5. A new personal attitude of being, “open, flexible, and positive” every day.

Early in 2011, we affiliated our practice with Heartland Dental. It has been a great experience for my practice and me. Allow me, if you will, to focus on one simple concept I learned. It is so simple that it seems rather silly to write about it, but it has been a life-changer for me. I have learned to strive every day to be open, flexible, and positive whenever I am faced with any new or potentially challenging situation. Over the years, I had gradually closed myself off to many opportunities without really knowing I was doing it. Trying to be successful, keeping up with my practice, not failing, and just getting through the day, had all taken their toll. Before I realized it, I had closed myself off to many things. It took someone from the outside to give me a new perspective on myself. At our educational programs, I was continually exposed to this simple idea of just being open to change, trying new things, and taking chances a little at a time. I was not really turning my world upside down, just making small changes and being consistent with them.

What do these words mean?

Being open is such a simple concept. For me, it means being a good listener, a good observer, and being willing to consider other people’s viewpoints. My goal for my first response to any situation is to consider the opportunities that lie in front of me, consider other possible solutions, and be willing to receive input from those around me. One aspect is to separate my “ego” or self-worth from the situation. Separating emotions from the issue — not ignoring emotions, but just keeping them in their proper perspective — has made a difference in my life. It’s really not all about me!

Now let’s examine flexibility. It is so easy to develop patterns of thought and behavior that are protective, but restrictive. I am working to be open to continual change — controlled and planned, but continual. Change is the very foundation of life. Without flexibility, we cannot grow.

Finally, what do I mean by staying positive? This word complements the others. For me, it really reflects my attitude toward every situation. The idea is that I believe I can achieve the best solution to every challenge I face each day. Whatever clinical, business, or personal situation I am facing, I need to seek out — in collaboration with those around me — the best possible outcome that can be achieved. Being positive means staying out of my comfort zone. It may not mean hanging ten on the surfboard the first time I’m in a big wave, but it does mean always stretching my personal envelope every day.

These simple words have enabled me to accomplish more than I ever thought possible in 2011, and I expect 2012 to be even better — better dentistry, better life!

Robert Mongrain, DMD, is a 1979 graduate of the University of Florida, College of Dentistry. He currently has a private practice in Tulsa, Okla. Dr. Mongrain speaks internationally on restorative and preventive dentistry and technology, and jaw joint and concussion protection in sports. Email him at [email protected] or call him at (918) 250-9528.