The first is biological issues that cause cavities or gum disease. Our first thing is to diagnose these issues. We know we can’t eliminate bacteria, but we can control it. We can create an environment that can be cleaned by the patient – smooth fillings, no deep periodontal pockets. This helps patients take care of their teeth, so they’re more likely to keep natural teeth for life.

Secondly, we must control stress or forces on teeth. There has to be harmony with jaw, muscles, and teeth to distribute forces evenly. As we move the jaws, we want no damaging lateral forces on back teeth. We must establish balance with jaw movement.

Lastly, we keep teeth looking natural for “invisible” dentistry. If a patient is unhappy with the look of his teeth, size, shape, position, and color can be changed for better esthetics. You need to tell patients what they need to do. First focus on bacterial and occlusal issues for health, then move to elective procedures.

Dr. John Cranham owns a private practice in Virginia. He is a partner and Director of Education for The Dawson Academy, a postgraduate dental learning center dedicated to excellence in the field. Visit Dr. Cranham online at www.dawsoncenter.com or www.cranhamdentalseminars.com.

Learn more about Dr. Cranham here, or visit his website at www.VirginiaVeneers.com. You can also visit www.DawsonAcademy.com to read about Dr. Cranham’s upcoming teaching and speaking engagements.

We also use Bite FX, which is oriented more to TMD issues. It’s not quite as well known, but it is the best on the market for TMD patient education.

A consult is usually done at a second appointment. First we do the exam, then workup the case, then meet again for the case presentation and patient education. I recommend dentists consider the location for case presentation. We educate patients in a consult room with big monitors, so the patient can see and understand the issues they have. We show them pictures, X-rays, and videos at this time. But we also focus on chairside education when appropriate and beneficial.

Read Dr. Cranham’s profile here.

Dr. Cranham is a director with The Dawson Academy and runs a private dental practice in Virginia. He is well known for his clinical expertise, seminars, and teaching.

When a seasoned dentist like myself looks toward transition, he or she should realize, there’s a lot of opportunity to work maybe two days or three mornings a week. You can sell practice, or bring on an associate, and create a structure that allows you to stay involved and have a really nice professional life, but also slow down your pace.

When we look at the number of dentists leaving school and those facing retirement, we see a real problem in trying to deliver all the dental care necessary for the population of the future. We’re training 50% women, which has never happened in our industry to date. A consideration with this, though, is that not all women want to practice full time, particularly once they have a family. Many international students graduate in the states, then go back home. Clearly, to meet the needs of our population, young and experienced dentists will need to work together. Personally, I see this as a great opportunity to continue to practice at a slower pace and to focus on the kind of dentistry I truly enjoy.

Dr. Cranham runs a private practice in Chesapeake, Virginia, focusing on cosmetic, restorative and implant services. He is a Partner and Director of Education for The Dawson Academy bases in St. Petersburg, Florida. Additionally Dr. Cranham founded Cranham Dental Seminars which provides a combination of lecture and mobile hands-on programs. Dr. Cranham can be reached at www.dawsoncenter.com, www.cranhamdentalseminars.com, or at smildoc@aol.com.

Only after thorough diagnosis can you create a solid treatment plan. You must do X-Rays, photos, workups, etc. Many dentists have stopped doing thorough evaluations and exams, but this will lead to not creating good treatment plans. In this situation, you could actually create your own recession in your practice! Hold your patients’ hands now, and keep them stable and healthy. Some will do major dentistry now, but many phase their treatment to accommodate a reduced personal budget.

My team focuses on expense control – and it’s a great time to cut the fat. It’s also a good time to increase systems consistency and make your practice run as efficiently as possible. If you decrease expense and develop complete treatment plans, you’ll have enough work to keep you busy through the slow times. Then, when the economy turns around, you’re set up for explosive growth!

I will say, amalgam is the most forgiving material for fillings. If it’s impossible to isolate a tooth, amalgam is better than composite. In fact, a poor amalgam is better than a poor composite. When composite fillings fail, they fail big. Dentists have more room for error with silver filling materials. So there is still a time and place for amalagam. Dental students will continue to use it. Elderly patients with root caries under the gum will need amalgam. From a health standpoint, we don’t need to scare the population about amalgam fillings.