Friday, February 15, 2008

Im frustrated

I”m frustrated.

Okay I have an axe to grind (one of many axes) and I will try to make it short.
I use to be a CE junkie. When I got out of school (okay, kicked out of school) I couldn’t get enough. I saw everyone. Linda Miles, Pankey, Nash, Jamison, Bertolotti, Brucia, Christiansen, I went to Dental Boot Kamp, I saw Buchannan, Kanka. You name it I saw it.
I felt like I was really adding to my already fine University of Florida (Go Gators) fine dental education.
I was loving every minute of it.
But lately I have been trying to hone my CE to what is happening in my practice right now. This the issue that is getting me more and more frustrated.

For instance, I started to do more veneers. But I was getting some sensitivity after cementation. Not a lot but enough for me to be concerned. So I made up my mind that I would pay to fly to a meeting that I thought would introduce me to the most people that knew about the most about cements. So I went to the biggest, I decided to go to ADA meeting.
Well it turned out everyone that knew anything about cements was there.
If they weren’t there speaking they were there endorsing a product.
I signed up for a bunch of lectures and I was so excited that I would put an end to this problem once and for all.
Well I went and saw a lecture and he was all into 4th generation bonding. (Just a biomaterials review… 4th generation is etch then prime then bond, 5th is etch then prime and bond together. 6th generation self etching primer then bond and 7th generation is etch prime and bond all in one).
So the guy I saw in a lecture was a 4th generation guy. “Okay” I said to myself maybe this is where cements are going.
I was excited because I thought I found what I was looking for. I was going to a lecture the next day to confirm what I learned today.
Not exactly. In fact, just the opposite. This guy was a 6th generation guy. I was starting to get a little discouraged, but still keeping my head up. I went to the exhibit floor. I felt like if I could talk to a couple of these guys and they agreed with one of the lectures that would be okay. Maybe one of the lecturers was on the moon.
So off to the floor, and it was awesome because the gurus were everywhere. It was like a who’s who of dentistry. So after I fought through the crowds I was able to talk to some of these people.
They all had strong opinions and they all were very passionate but they all disagreed. Some of the gurus would go as far as saying that that other guy doesn’t know what he is talking about.
It turns out they all endorse a product (Except Brucia, kudos to him). And the products are inherently different. They all were endorsing very different products. All generations.
So I spent all this money to go to the biggest meeting in the world and came back more frustrated then when I left. I left thinking the guys that I have been following for the last 10 years might not be all that great. I was doubting myself and my profession.
I was pissed and disillusioned. I read all these articles about veneers and how great they are and how it is changing peoples lives. I want to be a part of it but I can’t go all the way until I know with a lot of confidence that the patient is going to be better off than they were before. Not just prettier but better.
I couldn’t seem to find an unbiased opinion. I could find an opinion that didn’t have a money trail hanging off of it.

So I found an answer in the most unsuspecting place. My dental school.
I stunk at a lot of subjects (mostly because parting got in the way of my studying) but the subject I felt the most inadequate at was biomaterials. I never could figure out what the heck they were saying. In two ways… The first way is because all the professors were from far away countries. Second if they were speaking perfect English I still couldn’t understand the concepts. Elasticity, fracture, MP, and all the other terms.
I just couldn’t grab the concepts like I do now.
I was at my whit’s end so I picked up the phone.
I called Dr. Soderholm and explained to him my problems.
And, you know, what I was pleasantly surprised to understand him and understand the concepts he was talking about. Both moral victories for me.
From “hello” he was great (I guess you can say, “he had me at Hello”). He was happy to help me. I think he is stuck in a lab or administering clinical trials so much that he doesn’t get to much interaction with the outside dentist. He gets to talk to University dentists but maybe not the regular guy in Apopka, FL.
He was gracious and excited about the opportunity to help.
He talked to me about all the products why they work and don’t work and why some of the “gurus” liked some of the products.
He stayed on the phone as long as I needed. He wanted me to call him once I made a decision. He wanted to know what decision I made and why. Then he wanted to know if it was working for me.
I don’t know the moral of this story… I am still frustrated with the guru’s and the way money can influence people. Though, I did find an answer to my immediate need.
I don’t have a solution to this problem…I have Reality and I have CRA but sometimes I have some suspicions there.
But I know sometimes the answers you may be looking for could be in a place where you have already been.

Have a great weekend,


Anonymous said...

Hi John,

I understand your frustration. In the future if you have this happen again, you can always give me a call. I'll be happy to share what I've learned to with you. Some of it might even work :-).

See you at the next Joint Council meeting.

John C.

Anonymous said...

Welll... what'd u decide? Which generation of bonding?? learn anything when doing composites??

gatordmd said...

As far as bonging agents, in general, this is my story.
Long time ago I started using etch, microprime and then PhotoBond.
I got a wild hair and wanted to switch to something more new and exciting. So I went to a 6th generation. SE Bond.
But I didn't believe the study that that said it bonded to enamel well. So I was etching the enamel and then using SE Bond. With average success, but I am not an average guy.
So I went on a quest to find the BEST bonding agents. Do you know how many bonding agents there are? There are over NINETY.
I went to Reality and it said Optibond FL so I did that for a couple years. This was back to fourth generation. (I used this with Variolink to cement veneers). I was again getting average success.
So, again I called the school and he said, "have you tried SE Bond?"
Weeeeeeellllll, I told him my story.
So since then I have been using SE Bond without etch for the last year and getting above average results. Not utopia but very good.


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