‘New’ Blogger

Some time ago, on one of the questionnaires from AGD Headquarters, I answered questions about in which areas I would be willing to serve as a volunteer. One of my positive replies was to be a blogger for The Daily Grind. It was probably one of those times that I felt like I had an answer to everything and I was eager to contribute. Recently I was contacted and asked if I was still interested in contributing to the blog. While honored to be selected, I also thought, “What do I have to offer?” Obviously, I’m here, so I have decided to give it a go.

I decided I would go through the archives to see what previous bloggers had written, see what their backgrounds were, and discover if there was a common theme. What I found was that the topics are quite diverse, but all quite good. These bloggers’ backgrounds, geographic locations, years of practice, and types of practice are as varied as their topics. The underlying theme that seems to be present is that the AGD is such a positive influence on their daily lives.

I found that I have many common values and experiences with the other bloggers, and I can relate to all their topics—but I have one obvious departure from the norm. I think I may be the oldest, or close to it, of the bloggers. If there are other bloggers 65 years of age or older, they are welcome to join me in the geriatric section of The Daily Grind.

My first blog is mostly about how I came to be here, practicing dentistry and participating in the AGD. Hopefully, later I can give less personal and more specific comments on topics that benefit the readers.

I became interested in dentistry as a junior in high school when our local orthodontist offered to let me work in his office. I had approached him about observing to see if dentistry was an area of health care I might find interesting. He said he couldn’t let me watch, but he could give me a job. (I’m pretty certain that he and my father had a prior discussion about my ensuing request.) He put me to work under the supervision of his main assistant, Mary, who taught me to pour models, trim them to “Tweed “ specifications, make Hawley retainers, solder Crozat  appliances, and help with many other lab duties ( i.e., clean up). I even got to tie an occasional arch wire.

One thing I always remembered about the lab was that directly over the sink where we poured the models was a quote from G. V. Black: “The professional man has no right to be other than a continuous student.” I carried that with me as I pursued my education and through this day. For me, the goal of being a continuous student is where the AGD really fit the bill. Unfortunately, because of the type of associateship I was in right out of dental school, I was unable to fulfill this goal to the level I desired, but as soon as I could get started, I did.

What appealed to me, at the time, about the AGD was that it was more focused on continuing education (CE) than politics. Plus, it offered levels of achievement for CE like the FAGD, MAGD, and now, the LLSR. The awards are nice to achieve, but the great thing about them is that by striving for these, the general dentist keeps a balance of education. Even if one doesn’t practice every specific area required to achieve the award, I feel that it is crucial to be versed in all aspects of dentistry in order to recognize when to refer patients for optimum care. When interdisciplinary services are required, it is important to be able to communicate with the specialists in their own focused terminologies. Also, with interdisciplinary treatment, the restoring dentist should be the team leader.        

I have seen, in my 38-year career, many advances in technology, materials, and methodology in our art and science. Earlier, the changes seemed to come at a normal pace, but today we are seeing exponential advancement with digital dentistry, material development, and business philosophy. When I started, most of the direct restorations for posterior teeth were amalgam, and the first composites were A and B monochromatic pastes, which were bulk filled, allowed to set for 10 minutes, then trimmed down and somewhat polished. Now, I haven’t placed an amalgam in years and the composites are flowable, dual cured or light cured, with multiple shades that can be layered or bulk filled, and can be used on any tooth in the mouth.

All crown and bridge impressions were rubber based or an early silicone with set times as long as 10 to 12 minutes. And, does anyone remember the copper band technique for porcelain jacket crowns? Now I take all of my crown and bridge impressions digitally with a scanner. Most of the full coverage crowns were either gold or porcelain to gold or some other alloy, and inlays and onlays were all gold. Now, 99 percent of my individual indirect restorations are lithium disilicate made in-office and bridges are usually porcelain to zirconia made at the lab using digitally transmitted impressions. My go-to cement was zinc phosphate with a copal varnish, but now we have choices of glass ionomer, resin composite, and dual or light cured bonded cements, depending on the restorative material.

Implants (predictably successful) were not being done so much when I started practice, and most conservative dentists felt like the procedure would never become common practice. I now place and restore most of my implants, but I do know when to refer. Using my own 3-D cone beam has dramatically simplified planning and placement and improved the predictability of the outcome.

If I have any advice for the younger dentists, it is to utilize the guidelines for FAGD and MAGD in order to maintain a well-balanced education. Get in a good study club or start one. Stay a continuous student and, don’t forget, always keep your patients’ best interests in mind. As for the more mature dentists, keep the fire alive. Concentrate on areas that make dentistry enjoyable for you, and share your knowledge with those coming up behind you.

My plan is to work as long as I physically can and continue to enjoy my chosen career. This is the most exciting era in dentistry that I have been in and I would not want to quit it now. I hope to slow down the clinical part a bit in order to help train others in the areas of CAD/CAM and 3-D diagnostics, but if that doesn’t happen, I’m still having fun.

Since this is the beginning of the new year, if you’re a resolution maker, I hope some of your resolutions have to do with getting more involved with the AGD, setting some goals to expand your skills, and allowing time to enjoy the fruits of your endeavors.

Happy New Year,

Terry G. Box, DDS, MAGD