The Bias of the “Course“

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Running courses in the recent years , and being also passionate about attending courses my self , I recognized a common attitude coming back to our offices .
After spending 2 or more days with the speaker looking at beautiful or successful cases made with that approach we ignite our enthusiasm in that technique and we tend also to identify the speaker with that particular approach .

Speaking about my personal experience , I’ve been running a course recently with a nice group of doctors from UK, a vertical course .
Of course all this course is centered about the vertical approach and almost all cases are some nuanced variations of the vertical technique in the most different clinical situations. in order to show all the pro and cons of each detail.
People comes back home with the perception that in my office I just do vertical preparations and crowns.
After that , I run a Restorative course with a group of italian doctors with many extreme cases of recovering subgingival margins with direct restorations and during the break one of them asked me : Do you still do crowns ?
The same bias working differently coming out from a different course and experience .
The cherry on the cake has been posting also a ceramic adhesive overlay and both the groups got puzzled with my choice .
For some of them I was the” Michelin star “ Verti-Chef (thanks April Whitlock for this nickname) , for the others I was the Resto Guy.
Being honest I ‘ve to say I experienced myself this problem …coming out from a soft tissue course I remember I was seeing recession and soft tissue deficiency everywhere and I was doing much more soft tissue surgery than ever.

Coming back from the GBR course i was seeing bone defects everywhere and membranes were my way to go in most of the clinical situations.
I realizes that we go through a cycle in all the things we do .It goes like this : we are excited about the technique in a unrealistic way and we also think it’s easier than expected , after we get some problems and failures or complications and we start losing some enthusiasm , also the novelty is no more a novelty , routine kicks back and that enthusiasm fades …
Sometimes we move back to other old techniques that in our hands perform better sometimes we stick to the new one but…after a while ….we do another course and the cycle starts back.

Nowadays we live a strange period about knowledge ..in the past there was NO knowledge ….nowadays we move between two extremes …no Knowledge sometimes but , more easily , too much knowledge leading to confusion so the biggest work that the “expert “ has to do is “filtering informations”.
Doing all these cycles over and over filtering informations and selecting what is working more in the clinical scenarios.

After 20+ years of working , failing , and changing of course I ve some bigger “workhorses” like the vertical prep but there is room in selected cases for other things .
I still nowadays do some adhesive onlays , veneers , adhesive rehabilitations . Sometimes is the clinical case matching perfectly , sometimes is the patient.

The patient and his expectations are one of the biggest variables we don’t speak about enough !
The intersection between the single tooth , the whole mouth , and the patient’s mindset is one of the most important skill a dentist has to acquire to thrive in the real world .
We focus too much on the technical skill but the reality is that this is just a small part of what we need to thrive .
We got our degree thinking to use burs , blades and scissors to get our job .
Yet we have to learn the suble art of communicating properly , the art of persuasion .
With our degree in our hands we think that we have the truth and , because of that , patients have to listen to us ….sadly truth is more nuanced and even if you should have that truth remember that truth explained poorly goes nowhere while old or wrong ideas told compellingly can ignite a revolution.
In our cycle of learning, trying , giving up , relearning we , as doctors , show how busy and emotional we are . Why our patients should be better ?!’
After a course it’s easy to see the world through the lens of that technique , to see black or white but , after 20+years of dentistry if I can share a lesson is that the world is coming in a different color …..and that color is grey .The best technique is maybe a” white” with some shadows , the worst a “black” with some lights.

All the life is like that …not just a lesson in dentistry but a lesson for your life .

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