Dr. Greggory Kinzer: I was a grad student in the prosthodontic program at the University of Washington, and he was an out-of-house faculty member. Invariably, one of the grad students would call him up and hound him to lecture to us, and we wore him down every once in a while, so I got to know him really well. In the spring of my last year in the program, Dr. Spear called to see if I wanted to practice with him. So I went to the facility, lectured his staff, attended staff meetings, took emergency calls, etc. I knew that I wanted to join the staff, but Frank was more cautious. I have practiced with him for the last 12 years, which makes for a really unique opportunity to learn from him and follow in his footsteps. He casts a very big shadow, obviously — it has been great to have a mentor to bounce ideas off of — and to be able to help him in his teaching as well.
Dr. Lee Ann Brady: Originally I was a student. I took his seminars years ago as a private practitioner and then he and I got to know each other personally when I was the clinical director at the Pankey Institute.
WSDA News: Frank Spear is one of the best known, most respected educators in dentistry today. What are the keys to his success?
Dr. Steve Ratcliff: Frank’s success is due partly to his ability to be vulnerable on stage — he is so open and down to earth that people relate to him very well. He is completely unafraid to share his challenges in his practice, his failures and what he learned from them, and that puts people at ease.
He has the ability to break down complex clinical situations into very simple parts, which helps people to understand how they can incorporate the information and skills into their own practice and put what they’ve learned into action. And thirdly, he’s probably one of the most brilliant people I’ve ever met. He can take new information and synthesize it faster than anyone I’ve ever seen. A few years ago a question came up in a lecture right before a break — by the time we got back, Frank had gone online to PubMed, done a literature search, found ten abstracts, and gone through several articles to put together an answer with all the most current information… along with ten slides. Pretty amazing stuff.
WSDA News: You are all lead faculty at the Spear Institute and have the opportunity see the dentists who come for post graduate education. What do you hope that they apply in the treatment of their patients?
Kinzer: Many dentists are taught “tooth-by-tooth” dentistry in school, and there’s nothing wrong with that, but if dentists want to do more comprehensive care they need to learn how esthetics, function and structure tie together to evaluate patients. That’s what Spear Education is about — looking at the big picture. A lot of the people who come to Spear Education programs are really good dentists, but they want to change the nature of their practice, and do types of dentistry that they haven’t been able to provide previously.
Ratcliff: An awareness that you don’t have to know everything in order to do something. Sometimes dentists get so wrapped up in having the right answer and having to have all the information that they don’t put anything into action. I want them to see possibilities for themselves to practice differently and at a higher level of dentistry. If they’re already practicing at a high level, they can go even higher if they choose to. I hope they’re excited about new clinical possibilities and insights. Lastly, I hope they understand that their future is in their own hands.
WSDA News: We are so excited about having each of you present at PNDC in June. What will be your take home message for PNDC participants?
Ratcliff: I think I would want dentists to understand that if they look at dentistry from a comprehensive interdisciplinary approach that they will have happier, healthier patients. We want people to understand the entire system -— it not just teeth, it’s muscles, jaw, joints, it’s the psychology of the patient. They can enlist the help of the appropriate specialist to get better outcomes for their patients.
WSDA News: What do you think about the present state of the art and future for digital impression taking, and laboratory or in office CAD/CAM fabrication of dental restorations?
Brady: We’ve just broken through and we’re perched on the edge of where it can go. Digital impressioning and CAD/CAM fabrication is now an everyday reality for dentistry in the United States. I think that five years from now we’ll be talking about taking traditional impressions as old school. When dentists realize how far superior it is to traditional impressions, how many less remakes they’re going to have, and how much better their restorations are going to be, the cost will no longer be a factor.
Kinzer: I don’t think you have to look too far down the road to see where digital impressioning is going, or that it will soon be the standard of care. CAD/CAM has reinvigorated the whole lab industry, and is continually getting better and better.
Ratcliff: I’m so excited about CAD/CAM! I don’t think anyone has any idea how cool this will be in the next five years. By then, more than half of all restorations are going to be fabricated digitally, whether done by chair-side scanning and sent to a lab, built and then sent back, or done chair-side and fabricated in the office. It’s coming rapidly, is the future of dentistry and is inevitable. It will be better than what we do right now. I believe traditional impression materials are going to go away.
When I was in dental school they told us the half-life of our education was six years. Right now it’s 18 months — meaning that the available knowledge at our disposal in dentistry doubles every 18 months. Who knows what NASA is working on that we might one day be able to apply to dentistry? I have no doubt that in the near future we’ll have some kind of lightweight, wireless wand that we pass over a patient’s mouth that creates a flawless digital impression that can be transmitted any place in the world instantaneously. It’s inevitable. Microchip and digital technology is happening so fast and is very exciting for dentistry.
WSDA News: Will this technology render dental labs obsolete?
Brady: No, the technology makes it more efficient for dental labs to operate, therefore they will be more profitable. I think there will always be a market for a dental laboratory because there is a level at which things that need to be highly esthetic or, when you’re doing bridges or full-mouth reconstruction that’s not going to fit within the framework of someone doing it in their dental office. And from an efficiency standpoint, the dentist needs to be chair-side, not off fabricating. If they are going to pay someone else to do that work, most would prefer to pay a lab versus a new employee whom they have to manage.
Kinzer: A lot of what the master dental technicians provide is art — they truly are artists. Machines are precise and can get some of the nuances, but the artistry that comes from an operator cannot be duplicated. I see this as enhancing the lab industry.