Dawson Vistas April 2009 : Page 2

EDITOR’S LETTER do we see so many patients with unresolved problems that are so predictably treatable? And why are we seeing a growing number of patients who are grossly over-treated following concepts that are actually detrimental to long-term sta- bility, health, and comfort? Has slick advertising lured young dentists with false promises of “success”without any clarification of how to measure treatment that is truly successful vs one that falls short of an ideal outcome? A recent visit tomy former practice intensified my passion to help dentists understand that we have reliable criteria for success—and that it is beneficial to dentists and their patients to use these criteria for guiding treatment and meas- uring results.What I saw at the practice was the plight of a patient who had flown to Florida from California in a desperate attempt to find a dentist who could help her. Following extensive and expensive treatment that violated all the principles of correct occlusal treatment,she was miserable with sore teeth, soremuscles,and unacceptable esthetics.Her comment is what inspired me to write this editorial. She said,“Are there no standards for what is right or wrong treatment?” The reason I am so passionate about what we teach is because our profession has the capacity to be so much better than the impression left on this and many other patients who end up with inferior dentistry. Irrational dentistry doesn’t just affect patients. It takes away the joy of practicing with predictably success- ful results.And it is so unnecessary. We do have standards of care that could elevate the status of dentists far above the usual and customary. There are criteria for success that are measurable and achievable.At the completion of treatment,a successful result fulfills seven criteria: 1) The TMJs can accept firm loading with no sign of discomfort. 2) The clench M test is negative—maximum clench produces no sign or symptom in any tooth or in either TM joint. 3) Grinding test is negative—no posterior interferences to any excursive jaw movements. 4) Fremitus test is negative—no fremitus on any ante- rior teeth during tapping, clenching, or excursions. 5) Stability test—no signs of instability.No signs of excessivewear, tooth mobility, drifting of teeth. Supporting tissues are maintainably healthy. 6) Comfort test—complete comfort in teeth, lips, face, and speech. 7) Esthetics test—patient is completely happywith appearance. The above criteria are achievable by any dentist who is willing to learn the fundamental principles of diagnosis and treatment that result in such success. If dentists use these same criteria as a guide for whether treatment is indicated, there will not be a tendency for overtreatment or leaving treatable problems undetected and untreated. If I could haveone wish fulfilled for our profession,it would be tosee every prac- ticing dentist learn the principles that undergirdthe kind of success represented by the above criteria.This is what drives the passion we feel at The Dawson Academy for reaching as many dentists as possible. I hope you will share our passion and enjoy the journey. There has never been a more exciting time to be a dentist. Peter E. Dawson,DDS Founder, The Dawson Academy ost dentists that I know are good people with a strong desire to serve their patients with integrity and a high level of competence.Why then EDITOR-IN-CHIEF Peter E. Dawson, DDS EXECUTIVE EDITORS John C. Cranham, DDS Lee Culp, CDT Glenn DuPont, DDS Joan Forrest, BA,MS Henry A.Gremillion, DDS ADVISORY BOARD Carol N. Brooks, DDS William Bruce,DMD Jane Casada,DMD Andrew Cobb, DDS Kimberly Daxon, DDS Pamela Doray, DDS Robert Frazer, DDS Shannon Johnson,DMD Gerard Kugel,DMD, MS, PhD Parker E.Mahan, DDS James R.McKee, DDS David Newkirk, DDS Shannon Pace Schmidt,DA II Gayle Reardon, DDS Jeff Scott,DMD Vernon H.“Buddy” Shafer, Jr,CDT DeWitt Wilkerson,DMD Laura E.Wittenauer, DDS Rajeev Upadya,DMD

EDITOR’S LETTER

PETER E. DAWSON

Most dentists that I know are good people with a strong desire to serve their patients with integrity and a high level of competence.Why then do we see so many patients with unresolved problems that are so predictably treatable? And why are we seeing a growing number of patients who are grossly over-treated following concepts that are actually detrimental to long-term stability, health, and comfort? Has slick advertising lured young dentists with false promises of “success” without any clarification of how to measure treatment that is truly successful vs one that falls short of an ideal outcome? A recent visit to my former practice intensified my passion to help dentists understand that we have reliable criteria for success—and that it is beneficial to dentists and their patients to use these criteria for guiding treatment and measuring results.What I saw at the practice was the plight of a patient who had flown to Florida from California in a desperate attempt to find a dentist who could help her. Following extensive and expensive treatment that violated all the principles of correct occlusal treatment, she was miserable with sore teeth, sore muscles, and unacceptable esthetics. Her comment is what inspired me to write this editorial.She said,“Are there no standards for what is right or wrong treatment?” The reason I am so passionate about what we teach is because our profession has the capacity to be so much better than the impression left on this and many other patients who end up with inferior dentistry. Irrational dentistry doesn’t just affect patients. It takes away the joy of practicing with predictably successful results. And it is so unnecessary. We do have standards of care that could elevate the status of dentists far above the usual and customary. There are criteria for success that are measurable and achievable.At the completion of treatment, a successful result fulfills seven criteria: 1) The TMJs can accept firm loading with no sign of discomfort. 2) The clench test is negative—maximum clench produces no sign or symptom in any tooth or in either TM joint. 3) Grinding test is negative—no posterior interferences to any excursive jaw movements. 4) Fremitus test is negative—no fremitus on any anterior teeth during tapping, clenching, or excursions. 5) Stability test—no signs of instability.No signs of excessive wear, tooth mobility, drifting of teeth. Supporting tissues are maintainably healthy. 6) Comfort test—complete comfort in teeth, lips, face, and speech. 7) Esthetics test—patient is completely happy with appearance. The above criteria are achievable by any dentist who is willing to learn the fundamental principles of diagnosis and treatment that result in such success. If dentists use these same criteria as a guide for whether treatment is indicated, there will not be a tendency for overtreatment or leaving treatable problems undetected and untreated. If I could have one wish fulfilled for our profession, it would be to see every practicing dentist learn the principles that undergird the kind of success represented by the above criteria. This is what drives the passion we feel at The Dawson Academy for reaching as many dentists as possible. I hope you will share our passion and enjoy the journey. There has never been a more exciting time to be a dentist. Peter E. Dawson, DDS Founder, The Dawson Academy

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