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Just what makes you want to be a dentist, anyway?
Where do you find your motivation each day when you walk into your practice?
These are important questions to ask ourselves -- and to address as we progress through our careers.
Where do you find your motivation each day when you walk into your practice?
These are important questions to ask ourselves -- and to address as we progress through our careers.
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If you just do IT every day, you’ll be enormously successful.
What on earth is IT?
IT is constantly and consistently making what author Jeff Olson calls “Slight Edge" decisions. Like these:
Make your lunch and take it with you. This avoids the takeout. In your lunch, include healthful foods like fresh vegetable strips, cheese, boiled egg…
Decide to walk some today. You can even do some flights of stairs in the stairwell at the office.
Read something you can learn and grow from.
Skip the donuts and pastries today at the coffee stand.
Skip Facebook and Instagram and get on your work project instead.
Make a life-goal list and look at it three times today.
Spend time with your family, without TV or other devices.
Leave your cell phone on the charger and sit down for a morning coffee with your beloved.
Write an old-fashioned letter with pen and paper to that elderly family member or friend.
Mail it.
Truly listen to your children, looking into their eyes, and loving them.
Eat no food between meals today.
Write down three things for which you are grateful.
Feel the gratitude.
You are on your way. You’re doing IT.
Love,
What on earth is IT?
IT is constantly and consistently making what author Jeff Olson calls “Slight Edge" decisions. Like these:
Make your lunch and take it with you. This avoids the takeout. In your lunch, include healthful foods like fresh vegetable strips, cheese, boiled egg…
Decide to walk some today. You can even do some flights of stairs in the stairwell at the office.
Read something you can learn and grow from.
Skip the donuts and pastries today at the coffee stand.
Skip Facebook and Instagram and get on your work project instead.
Make a life-goal list and look at it three times today.
Spend time with your family, without TV or other devices.
Leave your cell phone on the charger and sit down for a morning coffee with your beloved.
Write an old-fashioned letter with pen and paper to that elderly family member or friend.
Mail it.
Truly listen to your children, looking into their eyes, and loving them.
Eat no food between meals today.
Write down three things for which you are grateful.
Feel the gratitude.
You are on your way. You’re doing IT.
Love,
Each new day, consistently and constantly make what author Jeff Olson calls 'Slight Edge' decisions.
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There are some important "blocks" to use when you build the foundations of both your dental practice and your life. The quality of those building blocks will determine the quality of what's built upon them.
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No matter whether you have a dental practice in the USA or a ladies' saloon in Abu Dhabi, great relationships are absolutely essential between a business and its customers.
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Who in the world are the right people? The ones who build you up, who challenge you, who believe you CAN do the good stuff.
Who in the world are the right people?
The ones who build you up, who challenge you, who believe you CAN do the good stuff.
“You are the average of the five people that you spend the most time with.”
~ Jim Rohn
If they are negative, you will be surrounded and enmeshed in negativity.
If they are positive and happy, you will find it easy to be positive and happy.
If their lives revolve around eating, sleeping, partying, random entertainment, social media and generally getting by, you will find yourself involved in gossip, complaining, unhappiness, and boredom.
Love, living with purpose, being healthy, and constant and never-ending improvement will be difficult to explore or even broach with those folks - and even more difficult to do.
Your future will be shaped by your level of consciousness and the energies of the people around you.
Who do you want to become?
Who do you spend time with?
Do they match what you want to become?
Surround yourself with people who hold you to a higher standard than you hold yourself.
Choose your people wisely. Spend your time wisely. Go for your gusto!!
Love,
The ones who build you up, who challenge you, who believe you CAN do the good stuff.
“You are the average of the five people that you spend the most time with.”
~ Jim Rohn
If they are negative, you will be surrounded and enmeshed in negativity.
If they are positive and happy, you will find it easy to be positive and happy.
If their lives revolve around eating, sleeping, partying, random entertainment, social media and generally getting by, you will find yourself involved in gossip, complaining, unhappiness, and boredom.
Love, living with purpose, being healthy, and constant and never-ending improvement will be difficult to explore or even broach with those folks - and even more difficult to do.
Your future will be shaped by your level of consciousness and the energies of the people around you.
Who do you want to become?
Who do you spend time with?
Do they match what you want to become?
Surround yourself with people who hold you to a higher standard than you hold yourself.
Choose your people wisely. Spend your time wisely. Go for your gusto!!
Love,
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The problems of missing and ectopic second bicuspids
Severely ectopic LR5 had to be removed. © 2018
3 Facts for your consideration:
5 Things that can throw the system off:
Lower: the “c” exfoliates and the 3 erupts the “d” and “e” exfoliate about the same time and the 4 and 5 erupt without the 6-year molar having time to mesialize.
5 Things you do to reduce the risk of FIVEs not jiving. (Which will help provide better chance of the necessary factors above.)
- The “5’s”, or second bicuspids are statistically the third most-commonly congenitally anomalous teeth, misshapen, ectopic eruptive positions, and missing. (The first two are wisdom teeth and upper laterals.)
- The predecessor primary/baby tooth, the “e” tooth, is typically 2-3 or more mm wider mesio-distally than the 5’s.
5 Things that can throw the system off:
- Missing permanent 5’s.
- One or more bicuspids in poor developmental/eruptive position
- Eruption sequence out of order, so space is lost early, OR held too long by a primary tooth, most often the “e”.
- Ectopic position after eruption, often rotations, sometimes as much as 90∘
- There is no space for lower 12-year molar eruption, and 5’s are crowded out.
- Profile is protrusive, and if all teeth remain in the arch, the protrusion is unesthetic.
- All permanent teeth are present.
- All permanent teeth must be in relatively good eruptive position.
- The sequence of primary tooth exfoliation is ideally...
Lower: the “c” exfoliates and the 3 erupts the “d” and “e” exfoliate about the same time and the 4 and 5 erupt without the 6-year molar having time to mesialize.
5 Things you do to reduce the risk of FIVEs not jiving. (Which will help provide better chance of the necessary factors above.)
- Clear the path (extract primary teeth that are in the path)... as early as the panoramic demonstrates an ectopic trajectory is obvious... ascertain LLA (lower lingual arch, Nance or upper lingual arch)... is in place to avoid any mesialization of the 6 year molars (save the precious “e” space)
- Use a UAW (Utility Arch Wire) to create space
- If severely ectopic trajectory, removal may be needed at some point
- Utilize various orthodontic techniques to derotate a rotated bicuspid as soon as it erupts, before the interosseous and interdental fibers develop
- Include in a comprehensive orthodontic treatment plan, the removal of a bicuspid that will facilitate successful eruption and successful occlusion of other teeth, including the 12 year molars, or removal of bicuspids when it will facilitate the most beautiful profile.
No space for 7’s and protrusive profile: plan to extract L5’s. © 2018 Dr Chris Baker.
UAW’s to create arch length for 3,4,5’s. © 2018 Dr Chris Baker. All rights reserved.
Unerupted L5; parents don’t want to remove now; hope for eruption. Completed ortho, removed braces… 5 is holding bone for implant. © 2018 Dr Chris Baker
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Relationships are transformational for your dental practice. Deal with your patients with absolute love in your heart.
"If words come out of the heart, they will enter the heart. If they come from the tongue, they will not pass beyond the ears." - Suhrawardi
"If words come out of the heart, they will enter the heart. If they come from the tongue, they will not pass beyond the ears." - Suhrawardi
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It’s so easy to make a tiny decision that can change your life.
That decision may be to move in a positive direction... just a 15-minute walk today, OR,
• eat a healthful dinner, OR
• read a few pages of “pumped-up stuff”, OR
• sit for five minutes on the side of your bed in the morning and think of the wonderful things in your life.
Any of these are pretty easy to do.
And - they are easy not to do.
Instead, you can walk tomorrow, OR
• eat better tomorrow, OR
• play on social media instead of reading the “good stuff,” OR
• sleep another five minutes, throw the covers back and hit the shower running, feeling stressed and hurried.
That’s pretty easy to do as well.
Whichever way you go, leads to a path - a path toward the life you want, toward the joy of living, or a path of more frustrations and difficulties.
Your tiny decisions will decide by and for you where you ultimately end up.
Easy to do, easy not to do. Choose well.
Love,
That decision may be to move in a positive direction... just a 15-minute walk today, OR,
• eat a healthful dinner, OR
• read a few pages of “pumped-up stuff”, OR
• sit for five minutes on the side of your bed in the morning and think of the wonderful things in your life.
Any of these are pretty easy to do.
And - they are easy not to do.
Instead, you can walk tomorrow, OR
• eat better tomorrow, OR
• play on social media instead of reading the “good stuff,” OR
• sleep another five minutes, throw the covers back and hit the shower running, feeling stressed and hurried.
That’s pretty easy to do as well.
Whichever way you go, leads to a path - a path toward the life you want, toward the joy of living, or a path of more frustrations and difficulties.
Your tiny decisions will decide by and for you where you ultimately end up.
Easy to do, easy not to do. Choose well.
Love,
It's so easy to make a tiny decision that can change your life. That can be as "trivial' as getting out of bed on time!
Be able to look back at the end of each day and see that you've made a positive difference in the world.
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Missing upper 2's, missing lower 5's, ectopic canines. © 2018 Dr Chris Baker
The Panoramic radiograph. You may be surprised to discover the amazing information you can find about a child patient in that x-ray. Can you name five really important findings in a panoramic on an early mixed dentition patient?
Can you name six? Seven? Let’s go for double that figure! (And we won’t include decay, as it’s not the best diagnostic tool of decay. Well, on second thought, maybe we will include some possible decay-related findings at the end of our discussion.)
The panoramic should be taken when any permanent teeth are erupting. Often those first eruptions are the lower incisors, or the six-year molars, but no matter what teeth, take the pano then. (You may find opportunity to change the child’s life because of the secrets that x-ray holds.)
Start by counting/identifying all teeth (Sounds pretty tame and familiar so far!) :
Here’s an important opportunity to do outstanding diagnosis for your patient, and be paid for your care. You’re in dentistry to care for people, and in business to make a living.
Can you name six? Seven? Let’s go for double that figure! (And we won’t include decay, as it’s not the best diagnostic tool of decay. Well, on second thought, maybe we will include some possible decay-related findings at the end of our discussion.)
The panoramic should be taken when any permanent teeth are erupting. Often those first eruptions are the lower incisors, or the six-year molars, but no matter what teeth, take the pano then. (You may find opportunity to change the child’s life because of the secrets that x-ray holds.)
Start by counting/identifying all teeth (Sounds pretty tame and familiar so far!) :
- Missing teeth. Count ‘em. Every single one. Be sure. Most often upper lateral incisors, and bicuspids, but maybe any incisor, any tooth actually. While severe “anodontia” is typically related to Ectodermal Dysplasia, and other developmental disorders, any permanent tooth can be missing even without identifiable developmental disorders "with names.”
- Extra teeth. Supernumerary teeth can be anywhere. One of my patients had one that looked like a canine, but about the size of a primary canine, in the floor of the nose, over the bicuspid root area.
- Malformed and unusual teeth. While ectopic and unusual trajectories of eruptive paths can cause dilacerations, there may be malformed crowns as well. Note any taurodontic primary molars that may hinder exfoliation, dilacerated roots that may hinder eruption, or if the dilacerated root is next to a missing tooth space, it could prevent implant later. Notice now. Notice incisors with talon lingual cusps/dens evaginates, and shovel-shaped incisors with scooped out lingual surfaces which may be more at risk of decay at the cuspal interfaces, and may create occlusal issues in contact with the lower incisors.
- Variations in sizes of teeth. Notice particularly large lateral incisors as well as peg or small laterals which may also interfere with occlusal harmony.
- Fused or possibly fused teeth; or geminated teeth.
- Ectopic teeth positions, which can portend huge difficulties in getting the teeth into the arch later, or even contribute to transpositions of teeth, and certainly to extended orthodontic treatment. If normal eruption does not occur, ectopic teeth may need to be orthodontically moved over larger than normal distances, and past other tooth roots. This predisposes both the ectopic teeth as well as the teeth in the path of the movement to potential damage, including root resorption, loss of vitality, alveolar bone loss and gingival and per problems, and some ankylose,
- Stage of exfoliation and eruption
- Poorly resorbing roots on primary teeth - is it due to ectopic position of succedaneous permanent tooth? Is the permanent successor missing?
- Submerged primary molars - actually probably due to an ankylosis or other failure of the tooth to undergo normal eruptive growth with the adjacent teeth.
- Crowding. Eruption issues to come. Opportunity to clear the path of eruption and prevent more complex problems and need for extended treatments.
- Third molar positions. While not usually evident in the earliest mixed dentition panoramic x-ray, often are notable within a year or two. Horizontal and severe ectopic positions may affect the eruption of the twelve year molars, and should be monitored for need for early removal to allow eruption of the twelve year molars.
- Twelve year molars that do not have the space to erupt in the mandible. As human jaws get smaller, and teeth do not, we are seeing more 12 year molars that will never be able to clear the mandibular ramus, like many third molars. Not frequent, but more and more so.
- Class II or III occlusion (at least as screening, to be evaluated further.)
- Atypical incisive papilla alveolar bone area. Again, screening, to be confirmed with diastema, low and deep pull frenum, etc.
Here’s an important opportunity to do outstanding diagnosis for your patient, and be paid for your care. You’re in dentistry to care for people, and in business to make a living.
Missing LL5, and severely ectopic LR 5, which had to be removed. © 2018 Dr Chris Baker
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Using the right systems is the "secret sauce" to successfully implement an orthodontic program in a general or pediatric dental practice.
