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University of Utah Graduate Alex Piedra Discusses His Dental School Experience & Post-Graduation Plans

Posted by THE NEXTDDS on Fri, Jul 13, 2018 @ 09:07 AM

24058800_1378101282300794_8764131376291630063_nAt this time of the year, dental school graduates are prepping themselves for the professional dental world. One of those students is Alex Piedra, who recently completed his 4th year at the University of Utah School of Dentistry. In this interview with THE NEXTDDS, he discusses his dental school experience, his post graduation plans, and what he plans to contribute to the profession.

THE NEXTDDS: What does the field of dentistry mean to you?

AP: Dentistry is a field where you can really change a life in many ways. One way is helping a patient smile. Also, proper dentistry is a way to fight one of the biggest infections that we have in the mouth, which is dental caries. It’s incredibly important for dentists to combat that infection.

THE NEXTDDS: Explain the difference between “fixing” and “prevention.”

AP: Prevention is key. Upon graduating from dental school, I will be going to a pediatric dental residency. As a pediatric dentist, I want to help kids have a positive dental experience and show them the proper ways to brush their teeth and take care of their mouth so they do not develop caries later in life.

THE NEXTDDS: What did you enjoy the most about dental school?

AP: I simply loved working toward a profession that has the ability to change the lives of others. I also greatly enjoyed developing relationships with my fellow students, as well as with patients and faculty. I realized the world is smaller than we think and that we can really make a change in our patient’s lives.

THE NEXTDDS: Very understandable! What role did social media or educational sites play in your dental education?

AP: I feel that a lot of us were able to visit certain social media platforms to watch procedures, just to see how they were exactly executed. I’ve read online articles and listened to audiobooks to find out about the business aspect of dentistry. The digital aspect of dentistry has helped students in several ways.

THE NEXTDDS: Absolutely! How do you see yourself improving the patient experience?

AP: I would focus on creating an amazing environment for them. If I were to own a private practice, I would make sure my hygienists, assistants, and front desk manager are all motivated to create an environment that’s inviting and friendly. I want my patients to look forward to follow-up visits. I want to make it a special experience for every patient who walks in to my office.

THE NEXTDDS: Great idea! During your tenure as a student, did you take advantage of dental outreach opportunities? 

AP: Of course! I grew up in an environment in Washington where we had a core community and I remember not seeing a dentist or doctor as a child growing up. Our community helped me and my family a great deal during this time. Dental outreach became very important to me and I feel inclined to give back to the community through education or clinical work to those who cannot afford treatment. I plan to continue giving back once I complete my residency.

THE NEXTDDS: That’s very honorable of you. What key challenges did you face as a dental student?

AP: During my first and second years of school, I felt there was a lot of material to learn in a short amount of time, which was very overwhelming. Managing my time adequately and balancing my personal and school life was very challenging. I was in school from 8:00 AM to 5:00 PM and would study from 6:00 PM until midnight, then wake up at 4:00 AM. It took a while for me to acclimate myself to that routine.

THE NEXTDDS: That’s definitely a challenge! What is your philosophy on how oral health relates to overall health?

AP: Oral health is the gateway to understanding your body’s overall health. There are a lot of research studies that link xerostomia, dental caries, and even cancer to poor oral health. Activity in the mouth in terms of poor oral health may be an early precursor or indicator of what is going on in the rest of the body.

THE NEXTDDS: What are your post-graduation plans?

AP: I plan to do a pediatric dental residency for 2 years. I hope to see a lot of children and give them the proper treatment they need, because they are our future. I’ll be speaking with them and figuring out how I may best serve them and give them the best oral health experience. I want to create an environment in which the kids look forward to returning for appointments and hopefully, they share their experience with others. Watching kids return one by one, over the years until they become adults with no cavities would be awesome!

THE NEXTDDS: It surely would be! What do you think you will contribute to the dentistry profession?

AP: I want to change the way we think about dentistry. Sometimes, I feel that we only focus on the teeth and oral cavity, but we need to remember that there is a person attached to those teeth. My goal is to constantly create a good experience for my patients. Also, I want other dentists to understand that every person in that chair has a life, goals, and aspirations as well, so we need to uplift them. I want every one of my patients, adult or child, to feel inspired when they leave that dental chair. We need to create that positive environment for them so they walk out with a smile.

THE NEXTDDS: What a great way to end this interview! Alex, thank you taking the time to speak with us and a special CONGRATULATIONS from all of us at THE NEXTDDS for completing dental school! We wish you much success in your future endeavors!


Tags: children, dentistry, outreach, graduate, children's health, dental caries, pediatric patients, patient trust, oral health, disease prevention, new dentists

The Top 7 Podcasts of THE

Posted by THE NEXTDDS on Mon, Jun 04, 2018 @ 03:33 PM

Over the years, THE NEXTDDS has done numerous podcast interviews with students, established dentists, and other dental professionals. Many interviewees have shared thoughts regarding the dental school journey and their mentors. Here are 7 favorite interviews according to readers of THE NEXTDDS.



Dr Mykel Anderson (February 2016)

Dr Mykel Anderson ’17, a graduate of Arizona School of Dentistry and Oral Health, is currently enrolled in an Orthodontics Residency program at Roseman University of Health Sciences. In 2016, as a 3rd-year student, she spoke with THE NEXTDDS about the importance of digital education in dental school, experiences that influenced her to pursue dentistry, and her rewarding outreach trip to South Africa.


Gary Kadi (August 2017)

Gary Kadi is the CEO and founder of The Next Level Practice. In 2017, Mr. Kadi sat down with THE NEXTDDS and discussed his 3-fold perspective of the common challenges most dental students experience, his Treatment-Decision Matrix, and the importance of business and teamwork. His interview was broken into 2 parts. Listen to the second here.


Dr Emma Guzman (April 2016)

Dr Emma Guzman ’17, a graduate of the University at Buffalo School of Dental Medicine,  is now a Dental Resident at the Bronx Lebanon Hospital Center. In her 2016 interview, Guzman discussed her first patient experience, her meaningful mission trip to the Dominican Republic, and her unique story of how she first became interested in dentistry.  Listen to the second half of her interview here.


Dr Mai-Ly Duong (April 2017)

Dr Mai-Ly Duong is a general dentist and Assistant Professor at the Arizona School of Dentistry and Oral Health. Recently, she was listed on the American Dental Association’s 10 Under 10 List for her excellent work in the field. In an interview with THE NEXTDDS, she shared why she strives to make a change in the dental profession.


Dr Nick Letteri (March 2016)

Dr Nick Letteri ’17 is a graduate of LECOM School of Dental Medicine and currently works out of a DSO-supported practice in Tampa Bay, Florida. As a 3rd-year student, he sat down with THE NEXTDDS to express why social media is incredibly important for dental students and professionals alike. He also discussed how attending a mission trip in 8th grade led him to pursue dentistry.


Dr Jeri McCombs (May 2016)

Dr Jeri McCombs ’16 is a graduate of the Chicago College of Dentistry at the University of Illinois. She is currently a practicing dentist at Beaver Dam Dental in Chicago. On the cusp of her graduation, she spoke with THE NEXTDDS about her award-winning presentation of her case study at the American Prosthodontists Annual Session.


Pamela Ibeto (December 2017)

Pamela Ibeto ’19 is approaching her 4th year at Howard University School of Dentistry. After completing her GPR, she plans to open a private practice with her sister. In her interview, Pamela spoke about the importance of shadowing, maintaining good oral health, and her then-upcoming outreach trip to Nigeria. She also shares how she plans to improve the patient experience in a very interesting way.










Tags: digital, dental education, dentistry, continuing education, social media, philanthropy, networking, oral health

Dr. Gerald E. Davis II Discusses His Dentistry and Education Journey and His 10 Under 10 Award

Posted by THE NEXTDDS on Tue, Apr 10, 2018 @ 12:00 PM

Davis_220The American Dental Association announced the recipients of its inaugural 10 Under 10 Awards which recognizes 10 new dentists who graduated less than 10 years ago. The winners were chosen because they are making a difference in their work, science, research & education, philanthropy, leadership & advocacy, and inspiring others. One of the 2017 10 Under 10 awards recipients is Dr. Gerald E. Davis II. According to the American Dental Association (ADA), he has demonstrated dedication to dental education through his work as the Assistant Dean of Academic Affairs and as an assistant professor at Meharry Medical College in Nashville, Tennessee and as a member of the ADA Test Construction Committee. At Meharry, he worked with Microsoft to make the college a development site for innovative new dental student training technologies.

In this interview, Dr. Davis discusses his transition from student to professional, the importance of lifelong education, and offers good advice for this year’s graduating class.

THE NEXTDDS: What exactly led you down the dentistry route to begin with?

Dr. Davis: I stumbled into this field. When I was in the 8th grade, I attended programs at Baylor College of Dentistry, where we had the opportunity to conduct dental research. The research programs were meant for high school students, but they allowed me to participate. Being exposed to the field of dental research at that age gave me the initial spark. From there, I went on to other programs they had, such as the dental admission program, post baccalaureate programs, etc. At some point along the line, I applied to dental school at Meharry. When I was in college, dentistry became a full-fledged commitment.

THE NEXTDDS: Great! What did you learn in dental school that you’ve carried on through your professional career?

Dr. Davis: There were so many golden nuggets I would say. The main lesson I learned was the realization that I chose a field in which every day was a final exam, and each one of those exams were gatekeepers. There are many gatekeeper moments for the educational pathway. I remember thinking to myself, “If I don’t pass this course or exam, everything will be on the line.” You must acclimate yourself to this testing lifestyle. One thing occurred to me one day. I realized even after graduating from dental school and becoming a licensed dentist, when I see a patient on a given day, I can make a poor decision right then and there that results in the same outcome, whether it be a lawsuit or malpractice. You can still be back at square one. It’s the reality check of knowing that this is a perpetual way of life. Bottom line, you are always being tested to make sure you stay on your toes at all times.

THE NEXTDDS: Very important! The ADA states that the award recipients are “making a difference and inspiring their colleagues through their work.” Was the idea of “making a difference” a reason why you pursued this field initially? Discuss the importance of having an impact on the profession.

Dr. Davis: My passion is education. I’ve always been in love with knowledge and helping another person understand something. I’ve seen so many cases where I’ve been in classrooms with professors who would belittle students by saying, “You don’t get this.” Or “You should’ve learned this last year.”  One of the main areas of impact I wanted to have was the ability to relay information in such a fashion so that anyone who wants to pursue this field can do so successfully. That was really my desire. Getting into dental school or the field itself was hard and very selective. Only the people who knew someone in the field were guaranteed entry, so I wanted to find a way to extend this to anybody who isn’t connected. Basically, my passion is to help others become successful in this field. I want learning and teaching to be relayed in a fashion people can understand. I’ve been pursing that goal actively.

THE NEXTDDS: Fantastic! What steps did you take to prepare yourself for the transition from student to professional?

Dr. Davis: Whatever you want to be; I believe you already are. An oak tree is still an oak tree as a seed. All the elements for it to be an oak tree are housed in that seed. I’ve been preparing myself for this transition for years. In dental school, I carried myself a certain way. My peers would joke about me carrying a briefcase to school or in clinic when I was seeing patients, as well as humorous acts that showcased my professionalism. The point I’d like to drive home is this: If you are passionate about something, rather than abandon it and go in a completely different direction, find a way to marry what you are doing with the field that you’re pursuing. In my case, I was a biology major, but took all the prerequisite courses for education, so I tried to find a way to incorporate the dental and educational field in my profession. Some people see the way others do something and believe that’s the only way to do it, as opposed to realizing what they have is a uniqueness that will diversify the field and make an impact. If you want dentistry to propagate to the field that it can, you must diversify and bring in researchers, teachers, computer scientists, etc., not solely clinicians.

THE NEXTDDS: Wonderful insight! Are there a few things you know now as an established dental professional that you wish you learned as a D1 student?

Dr. Davis: I was doing better than I thought I was. There were times where I would think the world is coming to an end if I failed an exam. I used to be very hard on myself. I later realized that I was progressing just fine. As an academic dean, I have access to my own dental records and I saw my class rank and realized that I was not doing as bad as I thought I was. I was too critical on myself. A part of me is glad that I had that mind state because it pushed me to go forward. However, I do think to myself, “If I had known this, where would I be today?”

THE NEXTDDS: Discuss the importance of continuing education. How do you continue learning?

Dr. Davis: For me, it’s not good enough to have…for lack of a better term, if you have a gun, but no bullets, it doesn’t serve a purpose. I’d like to think that having the ability to teach and articulate information in a way others can understand is beautiful. However, if you don’t have any information to articulate then you don’t have anything to say. By default, I need to have enough information that’s worth relaying and a need to address. I focus on these 3 areas: lifelong testing, lifelong service, and lifelong learning. I’ve been involved with organized dentistry with the American Dental Association. I’ve attended programs such as UC San Diego’s Faculty Development for the Underserved, as well as free clinics for dental services. I also obtained my master’s degree in dental education at University of the Pacific. Now I’m enrolled in USC’s Oral Facial Pain and Oral Medicine program. Clearly, I’m not a stranger to continuing education, and I would encourage everyone to try to learn and to gain more information, so they can be better clinicians and simply be better the field.

 THE NEXTDDS: Very motivating! What is your best recommendation for a student who is beginning this transition?

Dr. Davis: My best recommendation would be to marry your passion with the field. If you were originally an engineer or whatever your previous background was before dentistry, understand that that makes you an expert in that regard, and unique in this field. My mother used to tell me, “If you want to make an impact, you must find a need to fill it.” As a recent graduate, take the time to find a need and figure out how you can be a solution to that need. It will be hard because we all have mountains of student loans to pay back, but I believe that if God provides you a vision, He will also provide the provision. If you have the vision to follow a path, the provision to do so will come. I am a living witness of that story and belief. I would encourage any dental school graduate to try to do that same pursuit.

THE NEXTDDS: What a great message for this year’s graduating class! Dr. Davis, thank you for taking the time to share your dentistry journey with us! Congratulations on making the ADA’s 10 Under 10 List!


Tags: dental education, continuing education, networking after dental school, new dentists

A Conversation With Dr. Robert Lowe Regarding Removing Existing Restorations

Posted by THE NEXTDDS on Thu, Mar 08, 2018 @ 10:32 AM

There are several things to keep in mind when removing existing restorations. A successful procedure requires great preparation, focus, and precision. With 3 decades in the dental profession, Dr Robert Lowe has the experience and a wealth of knowledge regarding this topic. Below Dr Lowe answers questions posed by several dentists who attended his virtual event, “Three Keys to Removing Existing Restorations.”bigstock-Woman-Teeth-before-and-after-d-136044017-1.jpg

Dental Student: For a single tooth crown prep, do you parallel your contacts, that is, take a disk to the interproximal surfaces of the adjacent teeth to achieve a broader contact to make delivery easier and more hygienic?

Dr Lowe: I worked with a guy who took a disk to a tooth once. He ended up cutting a tongue in half during the procedure. I never take a disk to a tooth. I’m not going to broaden the contact. Contacts in the posterior should be elliptical, located to the buccal of the central groove. So, the answer is no; I don’t make contacts larger and broader. It does not make seating easier; it makes cleanability more difficult. Stick to your anatomy and what you learned. 

Dental Student: That’s incredibly important. If you don’t have enough incisal gingival height for a prep, how do you handle it?

Dr Lowe: One way to handle this is by crown lengthening. Take a look at your x-ray. How much tooth is above and how much is below the gum? I always say that once you get past that minimum incisal height of 3 mm, you’re compromising the resistance and retention form of any restoration. There is no cement that we can bond to a flat stump. If you have a short cervical incisal prep, first see how much tooth is under the tissue. Then consider a surgical approach to reposition the tissue and gain more height of the tooth to prepare, or make the contact real tight and tell the patient gravity will affect it if it’s an upper.

Dental Student: Do you remove an existing restoration like that amalgam before or after crown prep?

Dr Lowe: The answer is yes. When I’ve got an old amalgam that I know I’ve cleaned out, and now years later for whatever reason, tooth fracture or what have you, I’m not quick to take it out immediately. I’ll prep it, and if the margins are clean, I may elect to leave it if it’s still a sound, marginally competent core. If someone else does the procedure with evidence of decay and the margins are incompetent due to poor fit, I’ll take it out and build the core immediately. It’s case dependent. You can’t go wrong by removing any old core and replacing it.

Dental Student: Completely understandable. Is there a certain measurement that you go by in order to determine if you want to close an anterior contact with a veneer or a crown if you are deciding between those two?

Dr Lowe: It’s not really a measurement. It has to do with the contour of the existing tooth, relative to both the facial and lingual surfaces. I’ve seen too many people try to be conservative and just do a facial veneer, and then have patients end up with class III composite restorations in the lingual because of crowding, poor contours, or places where it’s difficult to maintain effective home care. It’s not just the number of microns of enamel you conserve; the patient must be able to maintain what you do. Many teeth are sacrificed on the altar of false conservatism. It’s not conservative to shortcut your prep and have a long-term difficulty with maintenance and function. Cut your loss at the beginning, create upper thicknesses and proper contours in whatever you do that first time. You’ll have a much better chance for long-term success.  

Dental Student: Very helpful, indeed. We touched on zirconia crowns earlier in the lecture. What is your approach regarding instrumentation? What’s your handpiece selection when cutting into the dense material?

Dr Lowe: I use an electric handpiece, but it has to have constant torque. How much do you want to spend on handpiece repair? If you beat the heck out of an air turbine trying to get these things off day after day, it will really damage your handpiece. If you don’t have an electric handpiece, consider purchasing one. I have an electric and an air rotor on every delivery unit. Because the electric handpiece has constant torque, it is less damaging to the instrument when removing something as dense and difficult as zirconia. 

Dental Student: Interesting! Do you vary your approach at all if you have a patient who has a high lip line when you’re working in the anterior? Does that influence your margin selection at all?

Dr Lowe: Sometimes. I’ve seen patients with a high lip line who have root recession. Some do not care that they have yellow roots showing and teeth above them. For some patients, I don’t necessarily cover everything that is above the pink. If their aesthetic outcome is such that you are doing something with a higher lip line and they don’t like that, then you may need a combined approach with the periodontist to do some gingival surgery to level things out. Maybe shorten the teeth and cover the roots to the existing height of the tissue. My best advice is to talk with your patient and find out if it really matters.

Dental Student: Great advice! What’s your preferred temporary material for a crown? What’s your current temporization technique?

Dr Lowe: We have a lot of good temporary provisional materials out there. Most of them are visicryls, light composites that have been improved over time. The knock on early visicryls was their brittleness. Some people still use laboratory-process . One company makes a rubberized urethane, which is not a visicryl, and it’s more impact resistant, so that’s another selection for long-term temporization. Some of the newer provisional materials are now using nanofiller because people are realizing that you should make the temporary look good due to patient demand. I don’t have one provisional material I prefer; I have about 3 or 4 depending upon the shade and whether it’s aesthetics or long-term I’m going for, and the technique is pretty much the same. It’s an indirect technique; I either have a preoperative wax-up or a mock-up made with composite on a model that’s adjusted so that I can make a putty stent or a suck down from that. Once I prepare the teeth by lubricating them, I fill the space for the crown with the provisional material; the lubrication allows for easier removal. Afterward, I place the stent over the teeth for the appropriate time, remove and carve it, and finally finish the margins and cement it.

Dental Student: Your practice has exposure to CAD/CAM crowns and you’ve also used the phrase “smoothing and polishing your prep.” Do you make any other adjustments to your prep technique or specifically the CAD/CAM crowns?

Dr Lowe: First, I don’t use chairside, however, I’m not against it. I think it’s one good option for indirect technique. I still use a laboratory process for most of my restorations, although some of them are made from traditional impressions, as well as hammers or optical impressions. Remember when you make an optical impression, it’s still a picture. It’s 2D, which is why I think the preparation design is even more critical. Irregularities are even more of a problem. So, if you are using today’s scanners, make sure your preparations are smooth and the margins are very distinct with no irregularities. If you follow this, you’ll have a better result because of the technique by which they’re made, which is optical information. They literally can be made without a dye.

Dental Student: What’s the best way to remove existing composite without sacrificing tooth structure?

Dr Lowe: If you’re working without magnification, get that fixed right now. If you’re using 2.5 loupes, you’ll learn that they do not magnify enough. I’ve used 4.0 since I was a dental student. If you want to effectively take out a composite differentiated between , use magnification and you will not have a problem. The same applies to cutting off a tooth-colored crown.

Dental Student: This is the last question for you, Dr Lowe. For a full zirconia crown in the posterior (you’re going to take a traditional impression and send it to the lab for fabrication), in your world would that be a heavy chamfer or a shoulder margin that is dictating your choice here?  

Dr Lowe: There’s still a little bit of controversy on whether you can prepare zirconia like gold or whether you should prepare it of porcelain. The answer to your question regarding zirconia crowns is yes, but the bigger question is this: Most teeth that I prepare for zirconia are not virgin teeth. Most of them have had existing restorations. What is the number one thing that determines what your margin will be? Well, what was there to begin with? If there was already a big wide shoulder, you cannot make it smaller. A lot of these back teeth that I’m finding going to zirconia have had either previous crowns on them that have broken, or have had large fillings on them. There’s no cut-and-dry answer. We’re not preparing virgin teeth here. You need to look at what you’re facing. What is core? What is old filling? What is healthy tooth? How much is above and below the gums? Do you have ferrule? A 2-mm ferrule effect is required for retention. If you don’t have 2 mm of tooth structure above the finish line, you don’t ferrule effect, and that could adversely affect retention and the ability of the crown to stay solid.

Thank you, Dr Lowe, for taking the time to share your extensive knowledge with our user community! Click here to watch other videos from THE NEXTDDS regarding Topics in Dexterity, Hand Skills, and Instrumentation.












Tags: dental restoration, teeth restoration, restorations, removing restorations

Deciding Between In-Office Vs Professional Handpiece Repair

Posted by THE NEXTDDS on Wed, Jan 31, 2018 @ 01:00 PM

bigstock-The-Dental-Instruments--163393169- edited.pngHandpieces are the life blood of a dental practice. Given their importance in daily practice, however, it is no surprise that a dental handpiece will need occasional repair even when properly lubricated and maintained by you as a practitioner. When this step is needed, there are two primary repair options to choose from: fix the device yourself or outsource handpiece repair.

Deciding which repair option to turn to takes some thought. Turnaround time and cost are two major factors in the decision. In his presentation titled, “5 Simple Recommendations to Maintain Your Dental Handpiece”, Mr. Glenn Williams discusses everything from turbine lifespan to handpiece maintenance. Here are the pros and cons of both repair options.


In-Office Repair

One option for fixing a balky handpiece is in-office repair. You can order a new turbine from the manufacturer, open the handpiece, clean it, and install the turbine yourself. With this method, clinicians will save valuable time and have the opportunity to get the instrument right back in rotation. Make sure to avoid replacing the original turbine with an inferior generic turbine. Installing a new OEM (original equipment manufacturer) turbine is the best option for efficient use of the handpiece, but this can be costly. While some dentists also decide to rebuild their own turbines, this consumes valuable time and most are not trained in this process. You may ask yourself, “Is this the best use of my time and dental education?”


Professional Handpiece Repair

Sending out the handpiece is a way to receive the best possible repair. Handpiece manufacturers are well-equipped with the knowledge, components, and skills to fix a failing instrument. After all, they created the device. Time and cost are two important considerations, however, for this path to repair. While professional repair will restore the device to optimal function, this alternative is generally more costly than self-repair and can take several weeks.

The dentist can similarly use a dealer repair center, internet repair option, or a local repair services—but be mindful of a few things:

  • Ask to speak with the technician if possible;
  • Ensure the faulty turbine is replaced with a turbine of equal performance and value;
  • Make sure a new turbine is installed in the handpiece instead of rebuild; and
  • Be clear about exactly what components you wish replaced or serviced.

Local repair companies can be a valuable resource in this capacity. Most are small, family-operated business with good customer service and fast turnaround. Local options can often offer solutions tailored to the practitioners’ needs and budget.

Dental handpieces are integral to daily patient care and most effective when properly maintained and/or serviced. There several different pros and cons with in-office and professional repair and, as you become a new dentist, it’s best to know all methods and ultimately determine the approach that best fits your situation.

Watch Now


A Conversation with Mr. Glenn Williams Regarding Dental Handpiece Maintenance

Posted by THE NEXTDDS on Wed, Jan 24, 2018 @ 11:45 AM

bigstock-dentistry-medicine-medical-e-119855579-592999-edited.jpgMr. Glenn Williams has a wealth of knowledge in the dental handpiece business, which includes the recognition of different components, how handpieces work, and how to reduce spending on costly repairs. At the conclusion of his presentation titled “5 Simple Recommendations to Maintain Your Dental Handpiece,” Mr. Williams answered questions posed by the students in attendance regarding maintenance, repair, and importance features of the handpiece.

Dental Student: At school, we have a two-piece, high-speed system: the handpiece as well as the coupler. There is some controversy among the students about whether or not to sterilize the coupler. What are your thoughts?

Mr. Williams: That’s a controversy in the industry as well. The current FDA guideline is to sterilize that which goes into a patient’s mouth. The consensus is that you do not sterilize the coupler because you’ll then have to sterilize the hose, and you’ll be working backwards. The handpiece is designed to be separated and sterilized. The coupler doesn’t go into the patient’s month technically so it’s not required to be sterilized by the FDA.

Dental Student: When it comes to the failures, do the handpieces start to break down all at once or is it a gradual process?

Mr. Williams: Yes, it is a gradual process. As soon your bur stops turning concentrically and starts to wobble, that’s a sign that the bearings are going. You’re going to hear an increase in noise and you should feel it in your hand. You can absolutely tell when it’s going, and we would urge you to send it in sooner rather than later because when the bearings go, everything else gets damaged--which leads to handpiece replacement rather than repair.

Dental Student: Are there certain features that are most important to a dentist who’s going to be using a handpiece on an ongoing basis in daily practice?

Mr. Williams: The best handpiece is the handpiece that suits you well. It needs to fit your hand shape. Handpieces are becoming more and more ergonomic. Head sizes are very important as well. One of the things that we’re seeing now, which is great for practitioners, is the multi-port water spray, in which water comes all around the bur and never gets blocked by the tooth. If you go distal, you still have water on the back side, which comes down and irrigates the bur. Here’s the tradeoff: Doctors want power so they can work efficiently. The bigger the head, the more powerful the handpiece. However, with the large head, the tradeoff is now access and vision; you cannot exactly see what you’re doing. Smaller heads provide better access and visibility but they are not as powerful. There are the tradeoffs you’ll have to deal with when using a handpiece. Word to the wise: never buy a handpiece without try it out first.

Dental Student: Are there areas you repair most frequently on a handpiece? Bearings? Fiber optics?

Mr. Williams: Always the bearings. In a handpiece there’s only one moving part; that’s all there is to fix. You can have a chucking issue where the bur is being released, which leads to a patient safety issue. Fiber optics are going away. We used to do large business in replacing optics. We quit replacing them because dentists increasingly use headlight systems. We are seeing more and more non-optic handpieces.

Dental Student: From your expertise, do you repair air or electric more often?

Mr. Williams: Air is predominant. Electric has grown to become 18% of our business last year. Once you’ve invested in electric handpieces, you cannot go back to air. The power difference is tremendous. The problem is, for a doctor in an existing practice, it’s a big investment. Each unit costs $3,500 and each handpiece can run to about $1,500. The barrier to entry is the cost.

Dental Student: When do you anticipate future advances will come in handpiece technology?

Mr. Williams: Size. Everything is about getting small. After years of making heads smaller and smaller, the electric motor itself is a pretty good-sized object that you have to hold in your hand. With all the gears and everything you see inside the body, the bodies got heavy and fat. The goal is to get the electric motors down to a certain size.

Thank you Mr. Williams for sharing perspectives and knowledge with us and THE NEXTDDS user community! Click here to watch other videos from THE NEXTDDS regarding topics in dexterity, hand skills, & instrumentation.


Tags: dental handpiece, handpiece maintenance, air-driven handpiece, electric handpiece, dental handpieces, dental handpiece maintenance

A Conversation On Dental Handpieces with Dr. Marty Jablow

Posted by THE NEXTDDS on Fri, Jan 19, 2018 @ 10:15 AM

dentist using dental handpiecesMarty Jablow, DMD, is a clinician, speaker, and authority in dental technology. In his presentation titled “The Dental Handpiece & Its Role in Daily Practice,” Dr. Jablow discusses the history of handpieces and the differences between air-driven, electric, and hybrid electric handpieces. Read below as THE NEXTDDS talks to Dr. Jablow for his insights on using handpieces to access difficult areas, proper hand treatment after procedures, and his daily maintenance routine for dental handpieces.

What’s your approach when using a high-speed electric handpiece to cut through a zirconia crown?

Dr. Jablow: First: I would knock down the rpms from 200,000 to 100,000. I do not bond every crown in because I don’t think it’s necessary if you have good resistance and retention form. What you would do is slice into this; cut through it on the buccal at about a 1/3 or 1/2 way across the occlusal and, if I can get an instrument in there, I can crack the crown into two pieces and it comes out fairly clean. It’s much easier using this than an air-driven handpiece.

Share some insight on how you access difficult areas like mandibular lingual, maxillary molars, etc.

Dr. Jablow: There are huge advantages to isolation. Do I put a rubber dam on every patient? The answer is “No.” What we use in my office to make things easier are isolation systems. My system of choice includes mouthpieces that retract the tongue and the cheek and provides vacuum suction and illumination. It’s also important to use thing like cotton rolls, retractors, and other hand-held instruments; those make your access much easier.

How should dental students build up their hand skills with their handpieces as they think about making their way into the clinical environment?

Dr. Jablow: It’s just about cutting and taking the time to do it. You are going to go through a whole bunch of things. I believe teeth are not contiguous enamel and dentin; they do not cut the same. Some enamel in the teeth is harder. With practice, practice, and more practice, you will eventually develop the skills. The main thing is the frustration. Let it go, it’s not always easy, just keep practicing. There is no magic to this.

You also talked about your daily upkeep of your handpieces. How long does your maintenance routine take and who’s responsible for that in your practice?

Dr. Jablow: After you use the handpiece, run the water through it for 30 seconds or so; this procedure is done every day in the morning. We also flush the lines and place the oil. This is the manual way of doing it. There are also handpiece cleaners/centers where you can actually put the handpiece on the attachments and they will lubricate and blow the air through it.

Sounds very effective. What do you to help with your hands before a long procedure?

Dr. Jablow: Take a break. Give yourself enough time. If you going to do a long procedure, make sure the patient has break time and you have break time. Sometime I simply flex my hands and stretch them out. If you’re having hand issues, you should speak with an orthopedic surgeon or hand surgeon.

Any tips for the new dentist on handpiece positions? For example, if you’re preparing tooth #2 or #15 distobuccally for a crown?

Dr. Jablow: First thing: use magnification. I know in many dental school students are required to buy loupes but not everyone is wearing them. That’s a big deal; if you can see it well, you can do it well. This is very important for preparation. Obviously, isolation is a little harder back there. If you’re concerned about lacerating cheeks, absorbent pads and dry shields will help prevent that. You may even have to get out of the chair and do those non-ergonomic things for an effective procedure.

Thank you very much for your time Dr. Jablow! We greatly appreciate you taking the time to share your knowledge with THE NEXTDDS user community!

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Tags: dental handpiece, handpiece maintenance, air-driven handpiece, electric handpiece, dental handpieces, dental handpiece maintenance

How to Create and Maintain a Successful Budget for Your Financial Goals

Posted by THE NEXTDDS on Wed, Jan 10, 2018 @ 10:00 AM

bigstock-Young-Couple-Calculating-Their-budget-small.jpgWith looming student loan debts affecting almost every dental student, it’s important to implement a budget in order to live smart and keep a strong financial profile. Don’t guess where your money is going: Even if you think you have disposable income, you shouldn’t be spending your money blindly. As soon as you start spending, keep an eye on it before you run into trouble. Keeping track of your expenses is the best way to find out exactly where your money is going. For new dentists, living within your means is a big aspect of becoming an associate dentist.

Check your income, and divide up a certain amount of money to be used for each aspect of your life. Use one portion for your living essentials, another for savings, an emergency fund, etc. Continue down this path to dispersing your income, and focus on keeping your spending under control. Save the house, car, restaurants, and expensive vacations for the future once your career is thriving.

Courtesy of Dr. Janki Patel, a THE NEXTDDS virtual training event entitled “Maximizing Your Earning Potential & Paying Down Your Student Loan Debt” discusses topics such as credit health, types of debt, and much more. Here are the major dos and don’ts for how to best create and maintain a budget.

The Fundamentals of Creating a Budget

Research your net income. Identify how much money you have coming in, and don’t overestimate your total salary as how much you’re able to spend. Subtract your deductions: Social Security, taxes, 401k, and other flexible spending account allocations. Research these deductions to see if there are any different options in different states. This might be a good indicator of a relocation, if that is in your plans. The money left over is your “take home” pay, and what you’ll be able to use as you continue your budget goals.

Track and limit you spending. Categorize your spending to better understand where you can make adjustments. On what are you spending the most money? Where could you cut back (or cut completely)?

Writing down all your fixed expenses is a good place to start, and should be at the top of your list. These include regular monthly bills such as rent, mortgage payments, utilities, or car payments. Since you cannot cut these off completely, it’s helpful to know how much of your monthly income they consume.

Next are variable expenses, or ones that may change from month to month. These include groceries, gas, and entertainment. This is where you might cut back. Check your credit card and bank statements as they itemize your monthly expenditures. Could you spend a little less at the supermarket, or cut back on movie tickets and other entertainment luxuries? Do a number crunch—will this free up money? Even these small savings could mean a huge difference in the future.

Mark your goals, and make a plan. Determine your short- and long-term goals. Short-term could be paying off one of your credit cards within the next year. Long-term could be saving to acquire a practice, something that will take years to achieve, but is still on the horizon. These goals don’t have to be a complete focus, but it may be easier to visualize your budget relative to those short-term goals. With your compiled expenses and goals in mind, make your budget. Get a sense of your monthly habits, break your expenses into “needs” and “wants,” and predict how much you’ll be able to save and spend. Even some “needs” could be cut down accordingly, albeit at a more difficult level. Weigh your options and make the best with what you have.

Other Important Notes and Factors on Maintaining Your Budget

In the case of credit cards, checking accounts, and mortgage loans, maximize your spending by looking at what benefits are included. Use an online search tool such as NerdWallet to find the best deals and benefits that work for you, and take advantage of other free online resources available. Keeping an Excel spreadsheet for logging your finances is another good tool to use.

Prepay your loans and credit cards bills, starting with those that most affect your credit worthiness. If your loans are in deferral, don’t start frivolously spending money you don’t have! Find a certified financial planner, and see how you can work with him or her to create a sustainable plan with your money.

Check-in. Revisit your budget periodically to see how you’re doing. Your budget is constantly adjusting to your habits. Did you get a raise or promoted in the practice? Have your expenses increased since you last made your budget? Have you reached a financial goal and want to make a new one? Keep asking these questions to yourself and review where you need to change your budget.


You wouldn’t travel without directions, just as you can't expect to reach your financial goals without developing a plan for spending and saving. Creating a budget can be overwhelming, but the effort is surely worth it. Developing a budget that you can maintain over time can help you build wealth, while simultaneously helping you get out of debt and cut expenses. Luckily, you will soon be in a position where your income will grow, and you will be able to put more towards your loans and major expenses.

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Tags: financial security, student loan debt, budgeting, financial goals

5 Simple Recommendations to Maintain Your Dental Handpiece

Posted by THE NEXTDDS on Wed, Jan 03, 2018 @ 11:00 AM

bigstock-Dental-Tools-On-Dentist-Chair--137501039-338816-edited.jpgDental handpieces have a long and storied history and remain a vital, daily part of dentistry today. The care and maintenance of these handpieces are essential to preserving their lifespan and proper functionality. While traditional air-driven handpieces are more common in daily practice, the increase in electric handpiece availability means that they have now become more widely used.

Understanding how to properly clean and maintain handpieces and their components will help you provide optimal care to your patients. Knowing when to replace or rebuild handpiece turbines or knowing when to clean and lubricate handpieces are essential steps to achieve long-lasting quality. While every dental handpiece will need to be serviced at some point, properly maintaining your handpiece will be crucial as you move through your day-to-day operations.

Courtesy of Mr. Glenn Williams, a recent THE NEXTDDS virtual training event entitled “5 Simple Recommendations to Maintain Your Dental Handpiece” discusses the recognition of different components of dental handpieces and how they work. Mr. Williams also shows the viewers how to reduce spending on costly handpiece repairs, increase the life of turbines between repairs, and improve handpiece maintenance knowledge and skills. Here are the five recommendations from the presentation:

1. Air Pressure

Air pressure has the most effect on the life of a handpiece and is an important consideration. Handpieces have tiny precision bearings that have a certain operating envelope, and if they are taken past the recommended pressure and pushed beyond their limit, they will have an accelerated failure and become prone to constant repairs. Small, inline gauges can be used to make accurate readings of air pressure, which is important because handpieces have frictional air loss as air travels through the tubing, which may lose as much as six pounds of pressure from the dental unit to the handpiece. Consistently checking your handpiece’s air pressure should be paramount in your practice.

2. Lubrication

Many questions come into play when discussing lubrication:

How often should you oil the handpiece?

You should oil your handpieces every single time you autoclave it. This procedure is now universal, as every manufacturer has guidelines to spray the oil, run out the excess buildup, and then begin the autoclave proceedings.

Where does the oil go?

A four-hole or four-line handpiece has an exhaust which is usually the biggest hole on the handpiece. Here, you don’t want back pressure building up on the handpiece which will slow the handpiece down. Instead, the smaller of the two large holes is called the “drive” hole that drives the turbine where the air is going under pressure. This is where you want the oil to go.

Oils come in a dropper and a spray. Which one is better to use?

Droppers usually don’t penetrate the bearings enough when compared to sprays, which means that you’re relying on the pressure of the air to drive the oil to the bearings. Sprays take out these variables. In addition, using the correct tip on the handpiece can be a huge factor as different brands may have intricate qualities that prevent proper cleaning.

Why should you run out excess oil?

Running out the excess oil is important for several reasons. First, it allows the oil to not “bake” into the bearings, which would cause the handpiece to become sluggish. Secondly, it allows the oil to not spray into the patient’s mouth. Finally, it allows the oil to not contaminate the operating field. In this way, flushing stations are a good option to use after lubrication in the sterilization area.

Does it matter what type of oil I use?

If you bought the handpiece from a manufacturer under a product warranty, you should use the manufacturer’s oil or risk voiding out your warranty. Thus, it is important to use only one brand of oil for that handpiece’s lubrication. However, if you do not have a warranty, the type of oil you use does not matter, as long as you consistently and routinely lubricate your handpieces.

What about automatic lubrication machines?

Automatic lubrication machines offer both positive and negatives to the practitioner. While these machines create more staff time to do other tasks, can consistently clean multiple handpieces at a time at a measured pace, and can extend your warranty in some situations, they can be expensive, fill counter space, and can possibly fail through longtime use. When taking these machines into account, know that staff can be easily trained to do the manual task of lubrication.

3. Sterilization

The type of autoclave you use and how you perform sterilization are also factors that impact the life of your handpiece. Compared to conventional autoclaves, the cassette autoclaves advocated by Williams have no rise time compared to the 30-minute wait for water to steam in conventional machines. There is no corrosion and down time as the vacuum pump removes all air from the cassette without oxidation and removes all steam from the cassette. Thus, cassette-type autoclaves take a total of 12 minutes compared to the 60-minute wait time for conventional autoclaves.

4. Chemical Wipedown

You should not use any chemical wipes of any kind with your handpieces, as this process is redundant, harmful, and useless. There’s no reason to wipe the handpiece with a disinfectant (where you are just going to introduce chemicals into the head and bearings) when you’re going to kill everything through sterilization. Handpieces should be brushed under running water only to remove external bioburden prior to sterilization.

5. The Practice Type and Number of Handpieces

Some things are outside your control, such as what type of practice you are in, that effect the lifespan of a handpiece. For example, a prosthodontist may use their handpieces more often than a periodontist or an orthodontist. The number of handpieces you have in rotation also plays a factor. If your inventory is tight, it will make a huge difference when one handpiece breaks down and has to be repaired.


The introduction of dental handpieces has revolutionized dentistry. They are an essential part of dental practices as dentists rely on them daily. Despite their importance, however, education is needed to fully understand the intricacies of their design, maintenance, and overall performance. Understanding how they work will extend their life and keep repair costs down. When it does come time to do the necessary repair protocols, it pays to be aware of what steps need to be taken.

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Tags: dental handpiece, handpiece maintenance, air-driven handpiece, electric handpiece, dental handpieces, dental handpiece maintenance

How New Dentists Build Relationships with Team Members

Posted by THE NEXTDDS on Wed, Dec 06, 2017 @ 01:00 PM

pds3.jpgMany dental school graduates will soon be finding themselves in the practice setting, and despite being an associate dentist, there is a lot of responsibility required in the position. From the onset, associate dentists are given many opportunities to be more than just a supporting team member. As one grows in the position both clinically and as an employee of the office staff, associates will soon be looked to as leaders. In this bigger role, managing a team requires gaining the trust and respect of peers. Once promoted to a senior dentist or becoming a practice owner in the future, how can this connection be sustained?

Courtesy of Dr. Cody Mugleston, THE NEXTDDS virtual training event entitled “3 Proven Ways to Find Mentors & Build Leadership Skills” discusses topics such as the importance of mentorship, how to develop leadership skills, building relationships, and pursuing clinical excellence. Below are several key points outlined in the Mugleston presentation.

Developing into a Leader

It’s important to become accustomed to the responsibilities of a leader in a modern practice setting. Creating an open communication channel between you and your staff, being an active listener to their feedback and concerns, and showing appreciation and care for those who are working effectively—these are all tools that will impact you, your team, and the patients you treat. Once you get to a spot where you can delegate responsibilities to your staff and cultivate a “group pride” feeling in your practice, you will soon be seen as a collaborator who works well with others, many of whom welcome the added mentorship and guidance.

Form a quick, 15-minute daily huddle every morning as the workday begins: start by going over how you will handle the day’s tasks, review the schedule and collectively making a plan with your team. Go back to yesterday’s workday: What were the successes? What were some of the missed opportunities that you can work on in the future? Garner feedback on these issues and other topics of the day. When necessary, troubleshoot problems with your team altogether so you’re not hung up on past mistakes during the day. Create a tight-knit group.

During these interactive staff meetings, reiterate your practice’s mission statement. Allow everyone to contribute equally, and rotate the team meeting leaders, allowing each person to run the ship and improve their own leadership skills. Make sure that everyone contributes and no one’s voice is unheard. Over time, you’ll have a clear vision, and your team will truly believe in the culture of the practice. Champion a company of “ours” rather than “mine” or “yours.”

Being Open with Your Staff

How are you as a listener? Your ability to respond to feedback and course-correct when necessary depends on your role as a listener. For your patients and staff members to feel like their opinions matter in decision making, being open to these responses is vital.

Effective communication requires the two-way exchange of information. Interpret what is being said, repeat back your understanding of what was said, consider the implications of what you hear, ask if your take is correct, and dig deeper with more details. As a psychological tool, active listening can be a good way to provide good communication to your patients and staff. Whenever possible, you should get the entire picture before setting off towards potential solutions.

Showing Appreciation

It’s imperative to show appreciation to your staff. Even something as simple as a positive affirmation at the end of the day could mean the world to a member of your staff who, despite a rough day, plowed through and still did a great job. Will you recognize these achievements on an individual or team level? In a public or private manner? You should certainly show your team that they matter, as the need to feel appreciated is one of the most important things to display to coworkers. These small comments can improve the overall morale of the practice, preserving a collaborative team that increases practice production.


With just a small investment of your time, you can be better positioned to lead your team to a positive experience on a daily basis. When you make connections with your team members, they know that they can trust you and that you have their best interests at heart. Being an effective leader means using all of the tools at your disposal to engage staff and patients alike in moving the practice towards success, creating a unified team that is proud to work alongside you.

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Suggested Readings

The Truth About Staff Training

Communicating Your Practice

Advice from Dr. Aldridge: Building Your Practice (Part I)

Attitude is Everything

Tags: mentorship, mentoring, teamwork, relationship building, new dentists

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