Dr. Stephen Lee: Who are the Legends of Dentistry?

On a slow day at the office recently, an online discussion forum  titled “The Legends of Dentistry” lured me in. The conversation focused on how these “legends” operated in their own practices on a daily basis.

I found the whole premise a bit troubling, as the discussion mentioned various names of dentists that we’ve all heard of, but whose rise to “legend” status had less to do with their daily dentistry and more to do with their ability to put together a good presentation and spend years flying around the world, promoting themselves through the presentation of cherry-picked cases.

Many “legends” might produce beautiful cases on their good days. But to me, the measure of a dentist isn’t how good they are when they’re at their best, it’s how good they are when they’re not. What do the worst 2% of everyone’s cases look like?

Early in my days of practicing with my dad, he shared cautionary stories of his experience with people who had seen “legends.”

One patient had been treated by a “legend,” then moved to our area, and my dad saw him.  The “legend” missed some very basic things on the patient’s health history that could have caused them real harm. The artistry in the mouth was very nice, but the sloppiness of the health history review – and the risk it posed – more than offset that.

He attended another “legend’s” lecture that showed a major reconstruction from start-to-finish.  By chance, my dad knew the patient socially, and later asked the patient how the work was holding up. There were a lot of complications that the “legend” conveniently forgot to mention.

Excellence in dentistry requires mastery of many, many disciplines. Photography, social media, money-making, and salesmanship are pretty low on that list for me.

Instead, the real legends are the dentists who can make a fearful patient calm and perform proper diagnosis and treatment planning. Legends can get to the root cause of complex pain, or work through a patient’s health history to get them better outcomes with their MD. Legends might grind out long days at the public health clinics doing quadrants of cusp capping amalgams that will last decades.  Unfortunately, these real-life legends are so busy helping people that they don’t have time to produce and present slick PowerPoints. Their real world, dental plan-dictated fees don’t allow paying a lab $400/unit for a super-customized crown. Chances are, the real legends send high quality work and good communication to a reasonably priced lab and get the best out of them.

Some of my best dentistry has been convincing patients to get sleep studies, extracting a painful tooth that split in half on a weekend, or diplomatically convincing a patient to see a mental health specialist because the pain and headaches from their stress-induced bruxism are only managed— not fixed — by the TMD services I provide. In many cases, the best dentistry is the work in collaboration with specialists, not work kept in-house, away from the eyes of colleagues.

The real legends of dentistry are still human, and they still make mistakes. What makes them legends is that the frequency and severity of their mistakes is low, and when it happens, they admit it, make it right, remember it, and humbly pass those lessons learned on to their colleagues.

We would be wise to seek out these real legends. They can be hard to find because they would never claim to be legends, and some of them might not even know how good they are. They won’t promote themselves to you, but they’re out there. When you find them, welcome the opportunity for them to elevate your skill as a clinician and a human.