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Experience speaks Over the years, I've had the privilege of interviewing dozens of luminaries in the dental world—academics, clinical opinion leaders, and industry leaders. Recently, myself and other members of DPR’s editorial staff reached out to some of the current notables and asked them for their observations on where the profession and the industry have come in the last four decades and where they’re headed in the future. We don’t have space here to include every interview (or even all of the featured interviews in their entirety), but you can check them out by visiting our new Web site, www.DPRWorld.com. In the meantime, read on to get an expert perspective on your world, from those who know best—the president of A-dec; the co-founder and chairman of Cosmedent; the founder and president of Den-Mat Corp.; the founder, president, and CEO of Ultradent; the president of Ivoclar Vivadent; Dean of The Scottsdale Center for Dentistry; DPR’s high-tech columnist; a lecturer and key opinion leader with 50 years in private practice; and the "father of esthetic dentistry." –Gail Weisman, Editor-in-Chief Innovative thinkers  Scott Parrish Ken and Joan Austin's ideas about dental equipment may have gone against mainstream thinking when they founded A-dec in 1964, but that outside-the-box view created one of the largest dental manufacturers in the world. A-dec's innovative focus continues today under newly appointed President Scott Parrish, who took over the role in January. Parrish, who is also the couple's son-in-law, has seen a lot in his 23 years in the industry. Q: How do you stay innovative and on top of industry trends? A: We stay close to our customers. We've worked closely with dental schools to try to understand what they’re researching and where they're going. We do a lot of customer sessions to find out where doctors are looking for improvement, what’s most important. You want to spend your time where they think the most value can be added, where they’re most inconvenienced. Q: What were some of the challenges the company first faced? A: Ken is my father-in-law so I've heard a lot of family stories. The original challenge was financing. A dentist loaned him money up front to make the first products and to get going, then it was slowly adding people, space, and products. And acceptance. Ken’s ideas were not necessarily the norm. He made carts with flexible tubings. They were making gas pumps with stainless steel tubing, which were robust but not nearly as flexible. He was bringing new things that maybe were at risk of not being accepted, but they were. He listened to what was needed and then changed some things. The changes were accepted and the company moved forward. Q: How has the profession changed in the last 40 years? What aspects have stayed the same? A: Some of the biggest changes are in the last 10 years with consolidation. You have bigger and bigger companies involved in the business. What’s stayed the same is the dental office. They use different techniques, but they still do a bit of drill and fill. Two-handed and four-handed dentistry hasn't really changed. There are some new advances, but they're still trying to take care of the patient's tooth and do it with a minimal amount of invasiveness.   (Left) A-dec broke ground at its current location in the 1970s. (Right) This 800-square-foot World War II Quonset Hut served as A-dec's first home in 1965. Esthetic pioneer  Dr. K. William ("Buddy") Mopper Dr. K. William ("Buddy") Mopper has been bonded to cosmetic dentistry for some 40 years in his work as practitioner, educator, and co-founder/chairman of Cosmedent Inc. In 1966, he opened a practice in Winnetka, Ill., where he still practices. In 1982, he helped found Cosmedent to educate dentists in the use of esthetic composite materials. He went on to develop a line of microfills and microhybrid composites, resin cements, finishing and polishing products, and specialty items with Michael O’Malley, one of the original co-founders, and now president/CEO. In 1999, when Cosmedent moved to its new international offices, they opened the Center for Esthetic Excellence in Chicago, which is basically a composite resin-based teaching center. The staff includes Drs. Corky Wilhite, Robert Margeas, and Dennis Hartlieb as well as Dr. Buddy Mopper and Robert Mopper. Here's Dr. Mopper's view of the ever-changing world of dental esthetics over the past 40 years: Q: What's the most dramatic change relating to cosmetic and restorative dentistry? A: Today people come in to the dental office wanting cosmetics. Years ago, we were stressing repair, not making people look better; that was sort of taboo. Now it’s a whole different ball game. We're in the realm of the plastic surgeon. People come to you because they want their look changed. Q: What's the most dramatic change relating to direct resin bonding? A: Michael O'Malley and I have always shared an excitement for the vast possibilities of direct resin bonding, not only as a restorative material, but also as a cosmetic procedure that would meet the needs of image-conscious patients. Bonding offered the dentist new opportunities, both as a rewarding artistic experience that made patients feel better about themselves and also as a way to significantly increase office revenues. Q: What's the history of Renamel Microfill, one of your most successful products? A: Our Renamel Microfill composite resin is 23 ½ years old. We were the first to come out with a microfill to match the Vita shade guide, and we're still here. It's well-known for its color range, opacity, natural fluorescence, translucency, ease-of-use, handling, and lifelike appearance. We now have a new nanofill composite, Renamel NANO, for posterior/anterior restorations; it augments our line.  Dr. Irwin Smigel Today, it would be crazy to imagine dentistry without bonding and with no emphasis on cosmetics. But not all that long ago Dr. Irwin Smigel was considered to have "crazy thoughts" about bringing cosmetics into the profession. The longtime New York dentist, known by many as the "father of esthetic dentistry,"performed the first nationally televised dental bonding cosmetic dentistry demonstration for about 50 million viewers of the then-hit show "That's Incredible," hosted by Fran Tarkenton and John Davidson. The show ran from 1980-84.From that day on, both Dr. Smigel and the new procedure began to grow in popularity. The cosmetic pioneer shares his story here for DPR's special 40th anniversary issue. Q: Did you ever forsee this tremendous growth in cosmetic dentistry? A: When I graduated way back, my father was a dentist and the dean came over to him and said, "You know, your son's a good boy but he's got these crazy ideas." They used to think of it (cosmetics) that way. It took me a long time to be able to establish even the concept of esthetics. What made it possible, without a doubt, was the television show, “That's Incredible." For months after that show I would get a minimum of three bags of mail a day. That was one of the impetuses with the American Society for Dental Aesthetics (www.asdatoday.com). Never in a million years could I take care of all of these people myself. Q: Were there some early skeptics? A: When I first started, a lot of people resented it, and some people even bad-mouthed it. But TV made it such a popular name that everyone wanted to do it. Everywhere I went people were after me to ask questions. I was lecturing as much as I could, even though people were begging to come to the office. It was a really tremendous time for me. Once it started taking off, other dentists started doing it and immediately esthetics became so, so very important to the profession. I'm just glad that I had a part in it. Changing with the times  Robert A. Ganley Q: How have you seen the dental industry change as a whole under your tenure? A: The revolution in esthetics changed our industry by changing our expectations. We set higher goals for product performance and patient satisfaction. The beauty of the dramatic move to all-ceramics and adhesive dentistry is that it resulted in an expansion of the market through a growth in patient demand. It was a revolution started by a product—IPS Empress—but sustained by the promise of better dentistry. Esthetic dentistry has proven to be better dentistry; it is the quality dentistry that patients want. Q: How has your message/delivery of product information evolved under your tenure? A: We have always seen the patient as an important variable in the dental equation. Our communication has been built on the belief that the only difference between a patient asking for a particular product or service and not asking for a particular product or service is just one thing—knowledge. If a patient is aware of the options available, they will ask about them. We expanded our communication program to include patient education tools for the dentist to facilitate the communication process to the patient. This strategy continues today and has spread throughout the industry. Q: Where do you see the greatest need for improvement among practitioners in their effort to obtain information on new product developments, procedures, and technologies? Can you share any of Ivoclar's future plans for expansion, product development, etc? A: At Ivoclar Vivadent, passion, vision, and innovation are the driving forces behind the company’s customer-centered products and its leadership status within the dental industry. Ivoclar Vivadent offers every customer quick and professional customer service when they need it. We also have extensive training opportunities and educational offerings. Dental Products Report has been beneficial in helping to keep professionals aware of the innovations and support we have introduced into the marketplace over the years. Today, we have expanded the Esthetic Revolution into a new Digital Revolution. Our material developments in the area of All Ceramics for CAD/CAM have supported the market growth of our CAD/CAM partners. Our recent launch of layered Empress All Ceramics for CAD/CAM signals a new level of productivity and esthetics. We have a clear vision of dentistry and our role in its journey, and we are committed to this new Esthetic Revolution … digitized. Core beliefs  Dr. Dan Fischer Within the past 40 years. Ultradent Products Inc. has mushroomed from a family-owned operation that formulated Astringedent hemostatic on a kitchen table in 1979, to today's more than 500 materials, devices and instruments made by over 800 employees. The company has grown in large part because Dan Fischer, founder, president, and CEO, has held to several empowering beliefs to promote dentistry. They include: The patient Q: How has dentistry changed? A: Our patients are living longer lives! This has great implications, namely helping our patients keep their teeth longer. The profession Q: What do you see as the most dramatic change? A: Preventive dentistry…truly is the most important “minimally invasive” dentistry there is, and it's the goal we should all be striving for. Disease cure Q: What is a focus for your company today? A: At Ultradent, we are driven to bring a cure to caries. The single most prevalent cause of pain in second- and third-world countries is the abscessed tooth. It is shameful that we're still addressing "rotten holes" via excavation after the infectious disease has done its damage! Innovation Q: What do you see as important future challenges? A: People are living longer lives and keeping their teeth into old age. Teeth are like tires—they're good for so many miles, then the tread wears and the sidewalls give out. And with baby boomers arriving to their latter years in droves, we have real challenges ahead of us! At Ultradent, we are passionately driven to enrich quality of life by improving human oral healthcare throughout the world.  Employees assemble Ultradent Astringedent Hemostatic Kits, fall 1991. State of the profession  Dr. Gordon Christensen Renowned lecturer and clinician Dr. Gordon Christensen, who is also Dean of The Scottsdale Center for Dentistry, declares dentistry vibrant, strong, and growing. In a recent interview, Dr. Christensen offered his own “Top Ten List” of reasons it’s great to practice dentistry—and here it is, in no particular order: • Autonomy • The ability to changes lives, not just health • A high level of patient trust and respect • You can live where you want • Eclectic, diverse day-to-day routine • Artistic • Financial independence • Continual change • Little or no governmental or third-party involvement • Creativity STATUS REPORT Here are selected interview snippets that, together, contribute to a kind of "status report" on dentistry in 2007. Fluoride “There has been a significant acceptance of topical fluoride applied by patients—in particular, 5,000 ppm fluoride formulations for professional dispensing. Public health officials estimate that this may have had more of an effect on reducing caries rates than water fluoridation. A related development is the incorporation of ACP and ingredients like Recaldent. Additionally, U.S. dentists are becoming more aware of the value of fluoride varnishes.” Implants “The most significant advancement in my entire career, aside from the air motor handpiece, is implants. In particular, I am very supportive of the small-diameter implant protocol, which permits loading the same day. The minimally invasive implants are so simple…if you can find the bone, you can screw them in; if you have a ruler, you can place them simply, easily, quickly.” Materials “Bonding, light curing, resin-modified glass ionomer, and now nano technology have brought us to a great stage in the evolution of material science.” Technology “Two words—digital radiography. Also, the digital restoration concept, CAD CAM.” Endodontics “For canal preparation, the crown-down technique and rotary instrumentation have been the two biggest developments over the past decades.” High-tech guru  “I have four monitors in my personal office. They are for the patient chart, photos, x-rays, and the daily schedule. I also can bring up the Internet, check e-mail, and do all the other tasks we do with the computer quickly and efficiently. (And, besides, it really looks cool.)” –Dr. Larry Emmott Dr. Larry Emmott is an authority on dental technology, a practicing general dentist in Phoenix, and DPR’s high-tech columnist—he's been writing "Emmott on Technology" since January 2001. Q: What would you consider the most dramatic changes in the everyday practice of dentistry in the last 40 years, as it relates to high-tech dentistry? A: It"s not one thing; it is the whole universe of digital technology. It took me a while but when I finally "got it," I realized that what made all this computer stuff so great was not one component or one application—it was the integration of all the parts that made it so powerful. It is what Bill Gates called, “the Digital Nervous System.” Q: When did you get interested in the high-tech area? What was your first high-tech investment? A computer? What followed? A: I started dental school in 1973 at USC in Los Angeles. In 1972, I learned to program a computer using punch cards. I also learned to type. I had no idea how these skills would be helpful to me being a dentist; I was just interested in them. We bought our first office computer around 1985. It was big, slow, and expensive. In 1993 I bought a Mac for my children, and my life was transformed—that is, when I saw how graphical computers would soon rule the world. I began a quest to apply this amazing technology in dentistry. I soon learned that there was a great deal of confusion and misinformation regarding computer use in the dental office, and I decided to use my talent as a speaker and a writer to help my fellow dentists make wise technology choices. Q: What were you doing in 1967—the year we began DPR? A: In 1967, I was a freshman in high school. I was thinking of becoming a dentist, mostly because my mother wanted me to be a dentist (my grandfather was a dentist). What I wanted to be was an artist or a writer. 50 years of innovative care  Dr. Ronald E. Goldstein Atlanta dentist Dr. Ronald E. Goldstein has been providing top-notch dentistry even longer than DPR has been helping keep practitioners on top of the ever-changing dental world of products and techniques. Prior to that, his father, Dr. Irving Goldstein, founded the practice that has been serving patients for more than 75 years. So the younger Dr. Goldstein has witnessed quite a bit of change in the profession over the years (he just completed 50 years of practice). Q: How has the profession changed, and stayed the same, over the last four decades? A: First and foremost, is the ability to esthetically transform the patient’s smile virtually in one appointment with techniques such as cosmetic contouring, bleaching and bonding. Also now, with the newer all-ceramic crowns and bridges, plus the ever-popular and conservative porcelain laminates, you can do it in just two appointments. Second, the development of technology over the past 20 years has enhanced the efficiency and accuracy of all types of dental diagnoses and treatments. Q: What would you consider the most dramatic changes in the past 40 years relating to prevention and caries management? A: The advances in oral disease control and therapy have helped so many patients prevent ongoing bone and eventual tooth loss. Patients welcome these updated conservative therapies instead of undergoing the typical surgical procedures that we did 40 years ago. And what a difference fluoridation has made in preventing caries! So has the advent of the laser diagnostic device DIAGNOdent, sealants, air abrasion, and hard-tissue lasers, which allow us to treat incipient pit and fissure caries. Q: What would you consider some key changes that will take place in the future? A: No doubt 3-D technology will change the way we and the world work. Already we see 3-D printers that produce 3-D shapes and instruments, and all sorts of new techniques will evolve from this process. 3-D technology will permit much more accurate diagnosis and improve care. Delivering pain-free smiles  Dr. Robert Ibsen California dentist Dr. Robert Ibsen has been providing esthetic-driven care for several years, but makes it clear that if not for advances in materials and minimally invasive techniques, he very well may have given up practicing by now. Following a lecture as one of the keynote speakers at the World Congress of Minimally Invasive Dentistry annual session in August, the president of Den-Mat (www.denmat.com) sat down with DPR to reflect on his career and the dental profession as a whole. Q: Has a shift toward cosmetics and less invasive procedures made your work more rewarding? A: If I had to practice dentistry the way most dentists have to treat disease, I would be retired because it's very stressful. But this is not stressful. This is just rewarding without any stress. That's why people want less-invasive care like Lumineers. Dentists want this. I treat more dentists than I treat regular patients. The question is, what dental procedures do dentists ask for and what dental procedures do patients ask for? Well, people want to look better, if you don't hurt them. Q: Lumineers porcelain veneers have become well known to both dentists and the consumer public in recent years, but what other cosmetic innovations has Den-Mat been involved with? A: Den-Mat has consistently developed products that allow dentists to preserve, restore and enhance without extensive cutting, drilling, and tooth removal that has characterized dentistry in the past. Q: What makes Lumineers stand out from traditional veneers? A: They're all reversible. If you have regular porcelain crowns or reduction of a lot of tooth structure, that's it. But since you can put Lumineers on pain free and take them off pain free, it's basically reversible. There's no harm and negative consequences. While everybody wants a better smile, not everybody wants a better smile if they have to get a shot. People want to look better if you don't hurt them.”
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All-Ceramics
Anesthesia
Bonding Agents
Burs and Diamonds
CAD/CAM
CE/Training
Cosmetic
Curing Lights
Digital Radiography
Endodontics
Equipment
Hand Instruments
Handpieces
Hygiene
Implants
Impression Materials
Infection Control
Intraoral Cameras
Lab Equip./Supplies
Lasers
Materials
Office Furn./Supplies
Operatory Supplies
Orthodontics
Patient Education
Periodontics
Pharmaceuticals
Practice Management
Prosthodontics
Restoratives
Cone Beam
Whitening
