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Q. You are known as the God of dentistry? Please describe your journey?
A. I come from a family with very little money. My mother & father prodded me for education. After dental graduation I started with the military. I was & still am interested in all aspects of dentistry. As time went on I started speaking in local societies. Then I started speaking in national level meetings. I kept speaking & finally went international. I helped start the school of dentistry in Kentucky University. Years ago it was not considered acceptable to say that whatever brand is the best. I started mentioning brand names which was criticized. I always believed in unbiased evaluations. I helped start the dental school at the University of Colorado.. I worked with many dental committees nationally & internationally. Then I thought why not start on independent not –for-profit organization to evaluate dental products. We started in a very small room. It started as a study club. Then we started evaluators which become the nucleus if our team. My wife, Dr. Rella Christensen, administered it for 27 years. I kept on speaking. I spoke on real world prosthodontics, real world surgery, & all aspects of dentistry. Always I have written in journals over & over again
There were lot of sacrifices that I had to make. I had to stay away from home more than I desired. I was pushed in lots of situations in which I had no control of time. I had to stay many times substandard hotels. Everyone has to overwork to be successful.
Q. You are visiting India after 6 years? What differences do you see?
A. Changes are obvious in all aspects of dentistry. Dentists are much more refined and advanced. There are several organizations promoting dental education. There is a good group of higher end dentists who are into newer things. Digital radiology is here. There are more dental schools then required. Country at large is progressing. There are better roads & beautiful hotels. The bottomline is: there is gross improvement
Q. What are the major changes in dentistry in these 6 years?
A. Dentists have become more tech savvy. There is very high interest in esthetic dentistry. There is more specialization. There has been a very high orientation to elective dentistry. There is more esthetic dentistry, more tooth colored restorations, veneers etc. Composite fillings are the standard. The usage of amalgam has gone down. There is more retention of teeth. The singular major change is implantology. There is a lot of potential of implants. CAD/CAM is coming up.
Q. The effect of economy on dental practice in USA?
A. The recession has driven dentists in a very problematic situation. Many dentists have gone bankrupt & some of them have been forced exit from the profession. People are putting off their needed dentistry. There has been great reduction in esthetic treatments & rehabs. The good side is that overtreatments have also become less. But now the economy is picking up.
Q. Activities of CRA, now named Clinicians Report or CR of late?
A. We have remodeled the entire facility. We have put in election microscopes digitized devices to measure wear, microorganism identification devices, and we have a totally new clinic which is state of art. We have CEREC/E4D/Digital radiography. In our courses dentists can get a hands on feeling for newer equipments in it. We are doing research in all aspects of dentistry.
Q. The role of RMGI’s in clinical practice?
A. Dentists like RMGI’s as they have acommand set. In a difficult area this is an advantage. However fluoride release in conventional glass ionomer is better. For me both are useful.
Q. Should GDP’s be doing sinus left surgeries?
A. If they are doing implants for long enough time than they can venture into sinus lefts. GDP’s should venture into sinus lifts if there are sufficient number of cases in their practice.
Q. On bonded amalgams?
A. We have not done much research on it. They desentisize well but they do not add to the bond strength.
Q. Future of full ceramic crowns?
A. Zirconica Restorations will replace PFM. They are the future.
Q. Is it mandatory to use rubber dam for all composite restorations?
For me yes. For most posterior direct restorations & for some anterior or restorations. For most others it could be no. There are mechanical devices available & now-a-days ISOLITE II is also available. However rubber dam is highly desirable. In C I; C II & C III cases it is desirable. In Class 4 it is not. It is difficult to judge color when tooth is dehydrated.
Q. On shrinkage in composite restorations ?
A. Shrinkage in normal composites is 2%. In flowables it is up to 6%. in some brands.
If shrinkage is 1% or below there would be no white lines when finishing. We need to develop composites where shrinkage is below 1%. Heliomolar is still very competitive.
Q. State of metal bonding in dentistry?
A. It is not very pertinent in dentistry. It is transient bond because metal & composite expand & contract at different rates.
Q. Should GDP’s be doing orthodontics?
A. Yes to a level. Take simple cases. Take complex cases after training.
Q. The future of glass ionomers in clinical practice?
A. It will be USEFUL for geriatric & pediatric dentistry.
Q. How should a GDP introduce implantology in his/her practice ?
A. To begin with you must have a interest in surgery. Take an overall course and not just a company sponsored course. Take a course by in impartial speaker, someone who is not paid by the company. Start doing implants on animal heads. Practice it over and ever again in your own surgery. Select the first patient who is an mandibular edentulous patient with reasonable bone. He should be a patient whom you can trust. The first case should be an overdenture. Start with mandibular type I bone. Then move on into bone grafting & difficult sites. Finally you can venture into sinus lifts.
Q. Future of amalgams:
A. Committees internationally are trying to critique amalgams. In many countries it is banned. In USA 68% of dentists do amalgam at some point of time or other. About 3% of population have some overgrowth of gingiva or some allergy to amalgam. Years from now people will laugh & say what they were putting into teeth.
Q. Future of CAD/CAM:
A. I am not very happy with the slow integration of the CAD/CAM into general pratice. It is moving very slowly. It is still not main stream. The devices need to be smaller & less expensive. The concept will work. It has a great potential with modifications.
Q. Between fibers & fiber post which is better:
A. Fiber posts are better. Fibers are unpredictable
Q. Please describe be how you schedule your affairs:
A. My schedule is fixed for 3 years ahead. I believe in life planning. For me first is family & then is profession. Than come the meetings & practice. I also spend time in the church. I divide time between family, vocation, community, religion, self. I never let it float. I plan it all together. At least twice a year I go to a resort area alone to plan & introspect
Q. An approximate distribution of outgoings in a dental practice?
A. An average GDP can pay 20% of his gross revenue for staff salaries. 6% is for materials. Lab bills could be 10%. For me staff salaries is 30% since I demand more out of my staff. My lab bills are 20%.
Q. Some tips to dental surgeons to increase their productivity & profitability?
A. Produce faster, easier, higher quality dentistry. Delegate to staff to the maximum. There should be emphasis of patient education. Plan for multiple patient scheduling . Make & work towards goals of time management, financial goals, family & community. Find good staff & educate & train them. After implementing the above you can increase your productivity & profitability
Q. Comparing India & China?
A. Both have large populations. Both have high level & low level dentists. Indians have high ethics. China is better economically.
Q. Your comments on http://www.dentistrytoday.info ?
A. It is an excellent site. Dentists well get updated if they utilize the site regularly. I have nothing but praise for it.
Q. The importance of dentists posting regularly on http://www.dentistrytoday.info?
A. It is very desirable. It will raise the level of clinical practice of the participating dentists.
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