The false myth of experienced dentists

There is a common belief in dentistry…that with time we get better with our work.
This is quite logic cause with time we gain experience but are there any real data behind this?
Reading the book of K.Anders Ericcson I was amazed by this research. According to the author, research in the field of medicine proved that doctors practicing from 20-30 years were worst than doctors just specialized.
What Ericcson found was the the mere repetition of a task every day is not, as usually thought, related to improving nor maintaining this skill.

Just doing is not enough…

I read this sentence a while ago and it was something like floating in my mind looking for some other connections till yesterday.
Reading another book (yes, you’re right! I am a compulsive reader !) I stumbled in a sentence from a great thinker, John Dewey.
The sentence was : we don’t learn from experience, we learn if we have time to think about that experience.

Reading this sentence my brain immediately made the connection with Ericcson’s one.
These sentences are so connected and meaningful together, cause this is what I see in dentistry.
The first bias we fall into is a sort of selection bias or confirmation bias.

Most of the times when we talk about experienced colleagues we look at the top of that category. But if we look to the whole segment of doctors practicing from a long time what we see many times is “not so acceptable ” dentistry …the point is that we just don’t look at these people, yet they are the majority. People working in the same way since 20 years. People bored by the repetition of the same task losing the right focus and getting even worst.

According to Ericson what we need in order to thrive is what he calls ” focused practice “, and this word is perfectly matching with Dewey’s one.

What we need to thrive infact is not only to gain experience but to gain experience in a correct way. The most important part is getting feedback.
If you’re lucky enough to have a mentor you’re already in a good position. I think that having a mentor driving you is the best accelerator of your learning curve.
Like a coach in a football team, a mentor is able to drive you, to accelerate your results.
But, unfortunately, not everybody are so lucky to have a mentor.
I hadn’t at all….just to say one.
In the ideal world each one of us would need a mentor. But we live in the real world and, for truth’s sake, this is hardly the rule.
No mentor, no help.
I still remember my early years…20 years ago …
Alone in my office fighting with patients. trying to getting better in this hard job called dentistry with its claustrophobic space and so many limitations of space.
How to solve this scenario? a real scenario for many colleagues like me at that time? Are there any solutions?
And here came to my mind Dewey’s sentence…time for thinking.
What I did in my first years was to collect documentation about what I was doing and, every day, i was looking again at my photos comparing them with the photos of books and courses trying to analyze the main differences, which steps had I to manage in a different way.

Without a real awareness I did what Dewey suggested …thinking to my experience in order to improve.

If you have the chance to read Benjamin Franklin ’s biography you will understand that his life has been a paradigmatic example of self improvement, and among his daily habits there was to retire in a quiet place and think to the spent day. He was thinking to any action, the right ones and how to make them stronger, the wrong ones and how to avoid them and he was writing strategies in order to harvest the best information from each day.

I started unconsciously doing something like this just with dental photos almost 20 years ago. .

20 years passed since that day and. .you know what? I became every year more diligent and organized in doing this sort of approach, I expanded this action beyond dentistry moving to other fields of my life.
And the result had been a huge step forward in my dentistry and in my life. The time I take for thinking and reflecting on topics related to clinical and extraclinical skills has been the most valuable time of my life.
But to think you need to build material …so if it is about clinical work you have to collect photos, documentation, data and analyze them, compare the,, check the follow up over the time. If it is about extraclinical you have to write a sort of diary and write and test your ideas. There is not a single and perfect recipe but I know the wrong one: …to think that time and mere work will bring you towards excellence.
Remember John Dewey ‘ s words : we don’t learn from experience, we learn if we have time to think about that experience.

If you wanna read more about my experience, what I learned and my struggles take a look at my free ebook ” Reality in dentistry “, you will find my mistakes, my lessons and How I arrived to choose some techniques in my daily practice…

Download it for free here: https://educational.studiomaiolino.net/ebook-reality-in-dentistry 

Not to be enough…

NOT TO BE ENOUGH…
Scrolling on Facebook and instagram some bios and some dental cases there is just a feeling you can feel …not to be enough.
Beautiful cases , beautiful people , probably wealthy people , beautiful photography.
The narrative behind these stories is quite similar .
It’s the story of a golden life with happy patients , successful cases , predictable work .
Each one of these successful guys has his own recipe for getting this .
Most of the times the recipe is not complete for all the needs you have ,but each one of them has a small recipe for success.
Follow this protocol and you will be successful in endodontics .
Follow this selling protocol and you will be able to increase your acceptance rate .
Advertise in this way and you will get plenty of implant patients.
In the last decades all over the world we have moved toward a different kind of society .
Competitivity and anxiety become the main movers of our era .
Nobody want to be below expectations so what happens is simply this : people tries to leverage your anxiety and your fears in order to see you something .
Of course the award has to be exceptional in order to push you even more .
The recipe is almost the same : push hard on people’s fears and problems in order to make the problem bigger and after make them dream about an amazing solution .
There is nothing really wrong about this approach . We know that humans are quite lazy so we have to push a little bit harder in order to make them change something .
The problem is just one …and it’s on the “seller “ …what is he selling really? which actions is he performing exactly?
Being simple ,the actions we perform in our life may be collected in 4 actions :
1. we look for improve our situation at the expense of others
2. we look for improve ourselves and in the same time others
3.we look to improve others situation at the expense of our life
4.we damage ourselves together with others.
The most frequent action I see is the first one…the problem is that often this ends up with the fourth .
Selling something with scarce value to the world , pushing the product with all the available marketing tools in the hope of selling enough so to improve his /her economical status , to improve his small personal world .
What happens after time is simply the loss of reputation and the final failure ….so..number 4: we damage ourselves together with others.
Useless to say …..the number two , the real number two , is what we have to strive for …
Improving our situation and in the same time improving others giving them a real help in their life .
So when you do your work for example and you wanna be successful what is the real goal you have to aim for ?
Make your patients happier and satisfied , your success is just the proportional measure of their success.
But to make patients happy is not just about giving a good clinical work , we are humans being with multiple needs beyond a mere “restorative work “ or a “root canal “. We are human beings with human ’s perceptions so you r real work is beyond dentistry .
That’s why for example I started focusing many years ago on patient centered outcomes and started redesigning all my dentistry toward that concept , against the traditional process or doctor centered outcomes.
And that’s why in the last years I expanded the concept of patient centered outcomes far beyond the clinical needs…
And which dentistry are you practicing ? which courses are you following?
If you wanna learn more about my approach and my idea of dentistry and the protocols I follow have a look at my ebook , it’s free and it ’s about my 20 years journey in dentistry and the lessons I learned. Download it at :It’s the story of a golden life with happy patients , successful cases , predictable work .
Each one of these successful guys has his own recipe for getting this .
Most of the times the recipe is not complete for all the needs you have ,but each one of them has a small recipe for success.
Follow this protocol and you will be successful in endodontics .
Follow this selling protocol and you will be able to increase your acceptance rate .
Advertise in this way and you will get plenty of implant patients.
In the last decades all over the world we have moved toward a different kind of society .
Competitivity and anxiety become the main movers of our era .
Nobody want to be below expectations so what happens is simply this : people tries to leverage your anxiety and your fears in order to see you something .
Of course the award has to be exceptional in order to push you even more .
The recipe is almost the same : push hard on people’s fears and problems in order to make the problem bigger and after make them dream about an amazing solution .
There is nothing really wrong about this approach . We know that humans are quite lazy so we have to push a little bit harder in order to make them change something .
The problem is just one …and it’s on the “seller “ …what is he selling really? which actions is he performing exactly?
Being simple ,the actions we perform in our life may be collected in 4 actions :
1. we look for improve our situation at the expense of others
2. we look for improve ourselves and in the same time others
3.we look to improve others situation at the expense of our life
4.we damage ourselves together with others.
The most frequent action I see is the first one…the problem is that often this ends up with the fourth .
Selling something with scarce value to the world , pushing the product with all the available marketing tools in the hope of selling enough so to improve his /her economical status , to improve his small personal world .
What happens after time is simply the loss of reputation and the final failure ….so..number 4: we damage ourselves together with others.
Useless to say …..the number two , the real number two , is what we have to strive for …
Improving our situation and in the same time improving others giving them a real help in their life .
So when you do your work for example and you wanna be successful what is the real goal you have to aim for ?
Make your patients happier and satisfied , your success is just the proportional measure of their success.
But to make patients happy is not just about giving a good clinical work , we are humans being with multiple needs beyond a mere “restorative work “ or a “root canal “. We are human beings with human ’s perceptions so you r real work is beyond dentistry .
That’s why for example I started focusing many years ago on patient centered outcomes and started redesigning all my dentistry toward that concept , against the traditional process or doctor centered outcomes.
And that’s why in the last years I expanded the concept of patient centered outcomes far beyond the clinical needs…
And which dentistry are you practicing ? which courses are you following?
If you wanna learn more about my approach and my idea of dentistry and the protocols I follow have a look at my ebook , it’s free and it ’s about my 20 years journey in dentistry and the lessons I learned. Download it at :eautiful people , probably wealthy people , beautiful photography.
The narrative behind these stories is quite similar .
It’s the story of a golden life with happy patients , successful cases , predictable work .
Each one of these successful guys has his own recipe for getting this .
Most of the times the recipe is not complete for all the needs you have ,but each one of them has a small recipe for success.
Follow this protocol and you will be successful in endodontics .
Follow this selling protocol and you will be able to increase your acceptance rate .
Advertise in this way and you will get plenty of implant patients.
In the last decades all over the world we have moved toward a different kind of society .
Competitivity and anxiety become the main movers of our era .
Nobody want to be below expectations so what happens is simply this : people tries to leverage your anxiety and your fears in order to see you something .
Of course the award has to be exceptional in order to push you even more .
The recipe is almost the same : push hard on people’s fears and problems in order to make the problem bigger and after make them dream about an amazing solution .
There is nothing really wrong about this approach . We know that humans are quite lazy so we have to push a little bit harder in order to make them change something .
The problem is just one …and it’s on the “seller “ …what is he selling really? which actions is he performing exactly?
Being simple ,the actions we perform in our life may be collected in 4 actions :
1. we look for improve our situation at the expense of others
2. we look for improve ourselves and in the same time others
3.we look to improve others situation at the expense of our life
4.we damage ourselves together with others.
The most frequent action I see is the first one…the problem is that often this ends up with the fourth .
Selling something with scarce value to the world , pushing the product with all the available marketing tools in the hope of selling enough so to improve his /her economical status , to improve his small personal world .
What happens after time is simply the loss of reputation and the final failure ….so..number 4: we damage ourselves together with others.
Useless to say …..the number two , the real number two , is what we have to strive for …
Improving our situation and in the same time improving others giving them a real help in their life .
So when you do your work for example and you wanna be successful what is the real goal you have to aim for ?
Make your patients happier and satisfied , your success is just the proportional measure of their success.
But to make patients happy is not just about giving a good clinical work , we are humans being with multiple needs beyond a mere “restorative work “ or a “root canal “. We are human beings with human ’s perceptions so you r real work is beyond dentistry .
That’s why for example I started focusing many years ago on patient centered outcomes and started redesigning all my dentistry toward that concept , against the traditional process or doctor centered outcomes.
And that’s why in the last years I expanded the concept of patient centered outcomes far beyond the clinical needs…
And which dentistry are you practicing ? which courses are you following?

If you wanna learn more about my approach and my idea of dentistry and the protocols I follow have a look at my ebook , it’s free and it ’s about my 20 years journey in dentistry and the lessons I learned. Download here!

The frustration of the invisible quality in dentistry

The work we do is often invisible to the eyes of our patients … Do they know the quality of the adhesive ? the brand of that expensive implant ? or the diligent “know how” hidden in a procedure ? “know how” maybe developed during a long course travelling abroad.
There are details of quality that we are the only ones able to see and recognize and we feel often frustrated….. a lot of work, a lot od care to details for what?!’ nobody knows, it seems nobody cares.
And after all your care you have maybe a patient asking : Why this treatment, doctor, is more expensive in your office than others ?!?
The world collapses in these moments…I know. .cause I ‘ve been there.
I had the feeling I was doing that sometimes just for a sort of feeling of “duty” without any reward for my effort. Just the fear of feeling guilty was bigger. So I was going on with a slight sense of frustration.
But That was just the surface …finally I understood what was beneath the surface …and it was when I started reading about a sport I was not really aware of ….Aikido, a martial art.
A good Aikido athlete when goes over the ring (tatami ) is dressed with a special dress (called hakama), this uniform has very long and wide pants completely hiding the feet.
Coming over the ring the athlete will take his place before the match…. sitting in a traditional position (za-zen) :
Knees of the floor, weight on their heels, straight back, a neutral expression on their face and, despite nobody will recognize this …they will force themselves to put the big toe of the left foot over the big toe of the right foot.
Everything happens under the big pants covering feet.
Who could recognize that he is performing everything int he right way? the answer is easy…
Nobody but himself.
Doing this small gesture he is taking a commitment with his teacher, with the art of the discipline he is training for and, moreover, with him self.
Knowing he is performing in the right way gives harmony to the soul of the person.
Knowing that he is doing the right thing shapes his behavior in order to improve his discipline.
The discipline he is building, along the time, gave him the strength to struggle for a goal.
The discipline he is building, is the key to improve the trust in himself and the motivation to overcome the struggles of the life that, soon or later, always arrive.
The discipline he is building soon or later will grow in something other people can recognize..confidence.
So when you re figthting in silence on your dental chair, don’t think you re doing this without a reward.
It’s a ritual you ‘re doing, a ritual where you’re building discipline, determination and confidence in yourself.
You have to wait for the reward…it’s not about doing this a couple of times but hundreds of times.
Like all rituals, the daily gain is invisible but, along time, the result is huge.
Patients recognize the confidence you have built in yourself, and they are attracted by people with real confidence, they accept their treatment plan and they are willing to pay more.
But gaining confidence is not something you can buy, or that you can obtain with shortcuts.
Gaining confidence is a long process, day by day, and everything starts like in Aikido with two big toes in the right, maybe painful, position ….with a neutral and relaxed face waiting further instructions from their sensei, their teacher.
So when you re struggling on your dental chair doing the right thing, don’t think you’re wasting energy, don’t think to the feedback of that single patient.
You’re building something greater…
You just need time.

If you like my articles , have a look at my free ebook on dentistry and what I learned in the last 20 years . Download it at https://educational.studiomaiolino.net/ebook-reality-in-dentistry/

The frustration of the dentistry we ve been taught

When I started attending courses I think that the word that represented better my feelings was frustration .

At the beginning the frustration was easier to accept cause it was related to a lack of technical skill…

“I just had to exercise exercise, struggle for a while and i will succeed” …that was my inner voice motivating me along the journey.

So I started my journey learning to place properly the rubber dam, learning to use sectional matrices, learning to layer composites….I attended many courses in order to improve my technical skill and after some time I was getting quite good….yet frustration was always there …

My cases were seldom similar to the cases I was looking going at courses and congresses.

In these places most of the cases were ideal cases …crowns fully erupted, teeth aligned, cervical margins easy to isolate with the rubber dam cause never subgingival, abundant enamel on the cervical margin .

My cases, my everyday ones …were much more challenging…wide inter proximal spaces that no matrix was able to cover, subgingival margins making the isolation so tough and, there after, the never-ending fight between the matrix unable to seal and the wedge deforming and collapsing the matrix. 

Time was also an issue cause layering was a complex procedure and time consuming.

So if the frustration of my early stage was easy to overcome, the later was tougher …

Cause it was related to the kind of patients and teeth I had in my office …

My scenario was never the ideal one I was doing at my perfection courses..

My feeling after a while was that even if my “ideal “ technical skill was good, the daily “field “ was damned…

I had the feeling like a F1 driver forced to drive in a street full of holes…unable to express his potential and skill….literally stopped by a battered road..

Being short daily frustration was the norm ….the distance between my daily work and what I was expecting was wide .

I spent years in this kind of scenario….before solving this unpleasant state….

The first step I did in improving my emotions was a day when i was looking at an olympic athlete training in an average day .

He was a weightlifter and he was training his lifts…but he was lifting much less than his actual maximum..

I started getting curious about how professional athletes train and I understood that they NEVER perform at a top level always…they train themselves at, let’s say, cycles of load between 70 and 90% of their maximum and they perform at their maximum just on some selected days.

Maximum performance is not something you can do really every day …it’s the peak of performance, not the average result.

I realized that even in dentistry is the same ..we claim to perform at our best everyday but it’s not realistic…

So I started questioning what was a good and acceptable and realistic daily routine ?

Something that made possible going back home with a smile my face, proud of the working day, satisfied .

Satisfied like a professional athlete going back home after his training day knowing that despite being below their maximum performance, the training day was a productive and proficient one.

So I started a slow process of rethinking all my goals…

so it was not about placing a rubber dam in a perfect way but it was perfectly ok as long as I was able to work in a dry environment.

It was not about using super colors and doing fancy anatomy but doing a good contact point .

I started changing my goals and priorities and, almost without any will, in the same time I started redesigning my idea of dentistry.

An idea of what really dentistry is …of what is really achievable on a daily basis .

AN idea of dentistry that allowed me to become satisfied with most of my working days.

An idea of dentistry that, I discovered along the path, is also much easier to match with patient requests.

So i found that my dentistry was not only real dentist-centered but also more patient centered.

I realized that many times we indulge in a sort of self -congratulation cause we have been able to follow the “protocol”, the “gold standard “ : We feel ourselves satisfied and “protected” in our ability to work according to “academic rules “.

Yet I realized that the sentence “ Surgery was perfect yet the patient died “ is something we can say also to our treatments …perfect shoulders with crown breaking after 5-7 years, endodontic treatment straight to the apex with the precision of a sniper collapsing after some years for other complications.

I realized that we have different definitions of success ..and each definition is related to the desired outcome.Outcome may be related to the adherence to the protocol like a endodontic treatment erfectly at the apex, or outcome may be related to patient’s perception and needs.

What I found along my journey is that the road of focusing on a patient centered outcome was also the road to a better practice and much more satisfying.

All my dentistry is designed around this concept .

Vertical prep, bioclear restorations are just the technical expressions of my thought. They may change in the time. But now they represent the best technique allowing me to follow my goal. 

A patient centered practice. 

No frustration.
Pure satisfaction.

If you wanna learn more about my techniques follow my website educational.studiomaiolino.net and subscribe to my mailing list. 

Last vertical course for 2022 is planned for 25-26 November

A Great Educational Month and what’s next!

In the last 6 weeks I’ve run 4 courses , two were vertical courses in english , one Bioclear Posterior course in Italian , and a virtual Bioclear anterior course .. a great educational month!!
I wanna thank all the attendants of these courses cause in each course I got some interesting ideas in order to improve the next editions!
Ideas related to my favourite topic : real daily dentistry . Far from the fake scenario of some courses and congresses what I really love is to spread an educational model based on the daily work.
Some speakers may push you toward excellence in dentistry . I am not that kind. What I wanna to improve is your “average “ dentistry , to bring your daily dentistry forward . I just think this is  what we really need!
In July and August I will work editing new ideas and I wanna share with you my calendar after summer holidays . This is the list of the event where you can meet me .

30 sept -1-2- october Prod Up Milan

Most of you already know I am really interested in extraclinical skills , soft skills . Organization , management , marketing become fundamental pillars for any office willing to thrive today . It’s one year and half I am working with  an amazing guy , Marco Belzani  , expert in this field from 15 years , building something new . Prod up is Marco Belzani ’s event focused on personal and office ’s productivity . i will be one of the speakers and i will tutor all the dentists at the event  in order to “translate”  concepts used in bigger companies to our field.The event is in Italian with live translation in English .
Marco Belzani will run  a 3 hours  webinar for free on 14 of July  . We have been able to organize a live translation in english so all , italians and english are invited . Follow this link and welcome to this webinar https://lp.prodability.com/en/lp-academy-planning-july-2022-dentists
7 October: Bioclear course for Italians (many have asked a bioclear course for foreigners , I am planning a 2 days course covering basic and advanced cases for the end of the year
22-23 October: Brno Czech republic. 2 days vertical course in English   (First day lecture , second day half day hands on for limited attendees)
12 November 2022  Varese , italy . 1 day course (only lecture ) on Restorative (posterior and anterior ) in Italian
25-26 November: Vertical course III edition of 2022 for foreigners  (English language )
January 2023: Bordeaux (France ) for a vertical course .

I hope to see at one of these events! 

Expectations in dentistry

Peter Lynch, one of the best investors of our time said : “if you’re terrific in this business, you’re right 6 times out of 10”. 

This sentence started to rumble in my mind. . cause I started to think about our expectations. . and how they have to be adjusted to the field we are working.  

If you re driving a plane for example you must be perfect every time. . and that is what in that field they achieved. . one accident every 1,4 million of flights.  

This ratio of course shapes your expectations. 

But there are other fields like investing for example where as Peter Lynch said you get a huge number of mistakes. . so your expectations in this case, even if high, have to be adjusted to the reality of your field.  

There are also other fields ,we can say, where you can be at least pretty good nearly all the time.  A restaurant chef, let’s say. 

And where is dentistry and medicine in this puzzle ? 

Statistics say that we are really far from perfection, the number of medical mistakes is scary. 

The problem our case is the gap between our expectations and world’s expectations. 

Science in the last century has surged to the ultimate authority.  Sort of error-free … so doing errors in this field you will find scarce understanding…. much easier you will be blamed. 

Often the first who will blame is yourself . 

Our expectations elevated to the impossible level of perfection in a field where perfection doesn’t exists. 

We have to change our mindset. 

We are much similar to a restaurant chef. 

We have to be pretty good nearly all the time.  

I work everyday in a private practice and I work with patients, ON patients, I work with my staff, other dentists and yes…despite my 20 years of dentistry i always find small imperfections in my cases. Do I like them ? NO, Do I accept them ?  finally yes. 

But we have another problem…

The problem is that we are surrounded by a multitude of perfect cases.  …you go to courses and congresses, you open your mobile on facebook and instagram. 

Perfect cases everywhere, complex cases solved in an exquisite way.  

Flawless.  Period.  

The biggest fraud of our time.  

Cherry picking the top 1% of dental practice and show it as a “normal routine”.  

It’s not the cherry picking itself the problem…. many famous comic actors test their jokes in small clubs before doing their great show in TV for example.  

They test their 1000 jokes in order to select the best 20 for doing a great show.  

But nobody will argue about this …indeed people will approve this behavior. 

So it’s not being against cherry picking. . it’s about the underlying meaning. 

In dentistry we show our finest selection pretending it’s daily routine.  

In dentistry we learn protocols and procedures with the claim they can control all the clinical situations. 

So you come back from your last course and you find the old patient, with many drugs and medications, anxious, small opening, financial limitations and all your “science “ disappears. . 

We have to be realistic about our field and build correct expectations. 

We are not in the aviation sector.  

We are like the restaurant chef. 

We have to be pretty good nearly all the time. 

So much better to learn things raising our technical’s level from 6 maybe to 8 that learning something with a 10 yet applicable in selected cases. 

There is why in the last 20 years of work I moved a lot in my dentistry.  

Being competitive and results oriented by nature in the past I ve been running for years the wrong race looking for the “ best “ cases with the most fascinating techniques. 

After I stopped. 

I started simplifying procedures and trying to make them applicable in the daily routine as much as possible cause that is what I really care. . to improve my daily life and not the single day when you do the perfect case. 

Because now it’s clear what I do …clear my expectations: to be at least pretty good nearly all the time. 

If you like these articles follow my blog on educational.studiomaiolino.com , subscribe to my mailing list and have a look at my videocourses and hands on.. the distillate of my 20 years experience. 

Value of documentation

What is the value of documentation?

Fold a piece of paper , put it around the small flash  attacked to that long bracket  on your camera …and you will obtain a softer light  for stunning photos . 

But if you want more it should be mandatory to put  a third light n order to balance shadows …this is especially important when you want to do artistic portrait ….of course just in the final photos where you want to put a special emphasis on the finished work .

Initial full face photos have to be made with cold straight light so that the before /after is charged with  a special effect .

But this is not enough …not all the available rubber dam on the market reflect the light of the flash in the same way so be careful to select the right one..usually the light blue nictone is a great choice .

Now everything it’s up to your artistic side to mix in the photo the right instruments and the right color …try to think to the wonderful contrast of colors when you mix the white teflon with some drops of water and a nice purple etchant on a blue background (the nictone)……wanna more tips ? 

Today’s dental world is full of courses about dental photography , you can spend 2 days learning all the tip and tricks behind   a nice photo …I did these courses and i also enjoyed doing these but I realized after a while that there is a problem … a huge one .

There is nothing wrong behind the desire to improve our photographic skill , but sometimes we start to run behind this goal forgetting the real aim of the documentation.

I understood that the same equipment we have in our office for doing photos can serve different goals….

To improve the beauty of our photos so that even a anonymous case without any special clinical meaning may become interesting for the eye of the viewer , this is the typical congress scenario where we select super clean patients  with perfect soft tissues , we select reliable procedures and we spend  a good amount of extra time in order to collect these photos and show them to the world in order to boost our ego …most of these cases in my experience are like snapshots . Time zero just  with delivery or very short follow up is  the typical case . 

Looking at these cases is like looking a movie at the cinema…beautiful yet not so useful for our real working life.

But the same equipment can do something different …it can records the life and history of that treatment for  a long period , years , also more than 10-15 years in some cases , maybe more …sharing informations , sharing what is working after these years and what has failed …giving valuable informations allowing us to grasp  a part of the truth we  are looking for . 

The big problem of dentistry is the delayed feedback….when we play golf , we immediately see the result of our action , and in a day we can adjust our attempts many times looking at the final outcome . 

In dentistry instead most of the times we see the result of our action after years and , without a documentation , everything is lost . Doing dentistry without documentation is like going around a ocean  without trying to draw  a map : the easier outcome is to go around without a destination .

Showing cases with long follow up is the most useful thing (especially with failures ) we can do in order to allow people to develop ideas and test their actual ones.

If you wanna test your ideas under the proof of time there is just one thing you have to do : you have to start to use your camera now , tomorrow , the day after and so on for years … and like a cultivated land soon or later you will be ready to harvest something ..your experience , your truth !

ON 19-20 may  and 20-21 June I will share my +20 years “documented “ experience on what I learnt in prosthetic dentistry sharing the “Vertical Technique “ ,the real workhorse of my office .June is fully booked .  there is just one place left in May . Book it on sending an email to info@studiomaiolino.net

The Paradox of choice in dentistry

Would you like a shop where you can choose just between Coke and Pepsi?

Would you prefer more choices or fewer ?!? the intuitive answer is always one : MORE !  and , for the same reason ,  business owner run behind this idea offering several variations  of a product trying to meet the expectations of different kind of customers..yet is there a threshold to the amount of choices  or not? 

A very famous experiment at Columbia university evaluated the effect of choice on a simple product : fruit jams . 

They organized two different kind of selling : in one just 6 flavors , in the other 24 …4 times more . 

Intuitively you expect that the larger assortment would attract more people and sell more product.

Yet data are counterintuitive . 

The larger assortment attracted 50% more people but , the amount of buyers was scarce .Just 3% bought something .

The smaller assortment instead sold to 30% of potential customers . …10 times more !

Too many choices can create more indecision , friction ; the customer got  lost pondering options, maybe he get away  trying to decide  thinking to come back later ..but often he doesn’t.

There is a threshold in the number of choices and in every field this changes. 

For Jams is clear that 24 is worst than 6 but in dentistry ?!?

I see many colleagues following the golden rule to “inform “ the patient  on his/her  situation trying to explain advantages and disadvantages  of every treatment plan …

We know that the amount of possible treatment plan in dentistry , especially in complex cases is wide…removable or fixed ? bone regeneration or short implants ? Connective tissue graft or just some  composite on some recessions ? on and on …we can spend so much time describing pro and cons of each treatment …and , last but not least , do we wanna talk about the economical side of the treatment ?!? we can move from  a cheap removable treatment to a complex and expensive rehabilitation . 

In dentistry , moreover , i realized that the dentist and the patient play a sort of Killer game . The dentist starts to explain the different plans highlighting pro and cons , the patient has some problems understanding exactly the meaning of these pro and cons so he start placing some questions . But more questions lead to  a bigger amount of other informations , other pro and cons.

Complexity raise , comprehension doesn’t.

In the Barry Schwartz book “ the paradox of choice “  this approach has been tested in the field of salesman . The result is that the information oriented approach increases the likelihood of refusal up to 50% .

Much more effective is instead the prescriptive approach where the patient/customer is guided toward a specific solution that has worked in a  very similar situation 

Using this approach the results are stunning , this increases the likeliness of purchasing ease by 82%  and also drops the probability of buyer remorse by 37%.

It’s a win win scenario of managed in an ethic way .

The patient is driven in a comfortable way to a solution without the hassle to feel the weight of decisions in fields where he has zero expertise.

The dentist raise his acceptance ability  but at a cost . 

The weight of responsibility is shifted on us . 

I started using this approach long ago , after reading books and testing different approaches  with patients. 

In my office I can guarantee that this approach works much better but we have to change completely our approach.

We have to learn how to interview the patient , we have to learn how to listen at the patient , we have to learn how to understand the person behind  failing teeth  or missing ones…and  we have to accept the weight of being responsible for the choice .

Giving choices to people is easier …we don’t choose , they do . 

Giving one solution , they don’t choose , we do …and we can do mistakes also , and we have no one to blame apart ourselves . 

In the past I was not sure how to move between these two approaches , sometimes I was trying to combine them .

With time , yet , I realized that using the first approach most of the patients were deciding just on an emotional basis …some were accepting , by default , the most expensive treatment  ( believing this was the best ) . Some , confused , afraid to make a mistake , were deciding the cheapest one or they were just saying the most hated words : Thank you doctor , i will decide in the next day and will let you know.

I realized that in this unbalanced relation we doctors have with patients using the first approach the number of mistakes was much higher .

The second approach  was , eventually , more precise .

So I started removing PLAN a , PLAN b , PLAN c , I started trying getting really interested at the  person in front of me and I started being easier and essential in my communication regarding dental details and spending more time on relational /behavioural /time  needs and expectations.

And , again , I learned that everything in life is not absolute . Every thing we meet in our life has a correct measure …not too little , not too much . 

Not enough choices is a problem like too many choices . 

Not enough freedom is a problems like too much freedom , leading to what se wee nowadays in modern countries where the excess of freedom , paradoxically , has brought a sense of losing social and familiar connections  and has  created more loneliness and depression than ever.

Not doing mistakes is  a problem like doing too many .

Everything has a balance .

Life can only  be understood backwards , but it must be lived forwards.

P.s. if you’re still struggling deciding which prosthetic technique choose , I will solve your problem 🙂 Just have a look at my brand new “in person “ course in Syracuse about vertical prep!

Coming back home with great NEWS

Just back from Scottsdale, Arizona where I lectured about deep margins and their managmeent pushing the boundaries of saving teeth and …GREAT NEWS !

Me and David Clark have decided to open a Bioclear learning center in Italy, the 5th in the world!

Bioclear material will be also available for the market here. So stay tuned …soon we will organize practical courses on this method…cause the Bioclear stuff is not just a restorative kit but a real philosophy of patient centered dentistry!

Cheers!

Bioclear Summit 2022 – Scottsdale, Arizona

A MEETING OF RESTORATIVE DENTISTRY’S TOP EXPERTS AND INNOVATORS

FEBRUARY 3 – 5, 2022 | SCOTTSDALE, ARIZONA

I’am excited to invite you to attend the return of an in-person Bioclear Alumni Summit, to be held at the Westin Kierland Resort & Spa in Scottsdale. The theme this year is “Come Together,” where i will be one of the many summit presenter with my personal pitch.

An invitation-only event, the Summit brings together an elite group of Bioclear Alumni dentists and staff, acute engineers, innovators, and forward-thinking dental professionals. It’s an opportunity to grow your expertise and bring back to your practice the latest advances in the Bioclear Method.

See you at Scottsdale!

Where It’s At

THE WESTIN KIERLAND RESORT & SPA
Scottsdale, Arizona
USA

When

FEBRUARY 3 – 5, 2022

More at https://bioclearsummit.com/