Safe & Reversible Techniques for the Worn Dentition

Episode #379 with Dr. Dennis Hartlieb

As you move into more complex dentistry, you will attract a more demanding population. So, how do you financially and emotionally protect you and your practice from those patients? One way is reversible dentistry, and it can even help you enjoy your career! And to teach you how, Kirk Behrendt brings in Dr. Dennis Hartlieb, CEO and founder of Dental Online Training, to share his learnings about techniques for worn dentition. By doing more reversible dentistry, you can make your patients, your practice, and yourself happier. To learn more benefits of safe, minimally invasive, and reversible treatment, listen to Episode 379 of The Best Practices Show!

Main Takeaways:

Minimally invasive, reversible dentistry is safer for patients and dentists.

When you don't do reversible treatment, the patient owns you.

Reversible techniques can reduce the opportunity for conflict and surprises.

Be skilled with composite and porcelain so patients can decide what's best.

Understand the relationship of worn dentition to joints and airway.

The problem isn't below the nose, it’s above the nose.

Quotes:

“What was good about being an average student was that I had to work harder than my classmates to be decent at dentistry. And it’s been a real advantage for me. I was the person in the lab at night that was re-prepping teeth, and re-prepping teeth, and re-prepping teeth because it didn't come easy to me, and it wasn't natural to me.” (3:16—3:37)

“I've probably prepped more plastic teeth than I have human teeth, and I've been doing this for 30-some years. But as they say in football, to get ready for Sunday, it’s all about Monday through Saturday. And I think in dentistry, it’s not just about the days that you're seeing the patients, it’s the days you're not seeing the patients and how you're getting your skills better.” (3:49—4:08)

“Mentorship, I think, is the key to dentistry. It’s key to everything in life, but especially in dentistry because of the skillset that we need, the techniques that we need to learn. It’s so difficult to learn them just haphazardly.” (6:29—6:45)

“I allow the patient to make the decision that's right for them. Some patients, it’s all about durability, ‘Give me the strongest material. I want something that's going to last the longest. I don't want to worry about it. I travel a ton.’ That's fine. Porcelain is the answer. Other patients are like, ‘Don't drill my tooth. I don't want you to touch my tooth. If you can minimize how much you drill the tooth, then I will own the fact that there's going to be more maintenance with a composite veneer than what there will be with porcelain veneers.’ I think the key for dentists is to have both skillsets so that you can allow the patient to make the determination and not you choose. And I'll tell you, it’s really rewarding because when patients have made the choice, then they own their choice, for better or for worse.” (13:26—14:06)

“The challenge, I think, is when you're looking at these patients with worn dentition, very often, what's happened — it happens in my practice, as much as I hate to admit it — there are a lot of patients who've been long-standing patients in your practice, and you're just very slowly watching their teeth wear away. And you don't know what to do. You don't know how to intervene. It’s certainly not something that we’re taught in dental school, and the only intervention techniques that we are taught are full-mouth reconstructions.” (15:19—15:46)

“Corky [Willhite] had talked to me about a case he had just done where he had used bonding to open up somebody’s bite. And I said, ‘Corky, this is brilliant. You've got to start teaching this.’ And the very next case, it was a worn...