Predictable results depend on paying attention to a process and not ignoring any steps. One missed step can follow through the entire case and leave the dentist and technician wondering what went wrong.
As a dentist and a lab owner I get to see some of the innocent omissions that can come back and haunt the dentist.
The other day a new technician brought me a set of study models sent in from another dentist. She asked me if I thought they were mounted properly because the bite was open and it looked a little funny to her.
I told her to drop the pin and put the casts into maximum intercuspation. She asked me why the dentist would take an open bite. Hmmm, I wondered, “Do you know the difference between centric relation and centric occlusion? I asked.
It seemed like a good opportunity to explain what we know about occlusion and how we apply it in the lab.
I could tell tell that she was interested by the eager look in her eyes. As I went through the explanation she began to understand the reasons for doing everything. I was reminded of a book I read years ago, The Greatest Management Principle in the World, by Michael LeBoeuf. In that book the author explains that managers need to go around the workplace and explain to employees “why” we do things rather than just telling them “what” to do.
Invariably, I have always felt that telling people why, always raises their commitment to the work and puts more meaning in the work.
I also believe that employees feel a greater amount of respect when the manager takes the time to explain things to them individually.
This same principle works for patients as well…I called it a “reason why” philosophy in my book, The Art of the Examination.
Of course, it takes time to do this but you will see it is time well spent.
After explaining the process to my new technician, I asked her for the “first point of contact.”
She looked confused.
I said, “there is no way to know if the models are mounted correctly unless we verify the mounting with some information like the first point of contact taken from the doctor’s examination process.
She said he never sent it. I then directed her to my chart which has a summary of my entire exam process that starts with the mouth and ends with the presentation structure. I showed her the first question on my checklist ( I am a big fan of Atul Gawande’s book, The Checklist Manifesto). The checklist showed her the following question: “Do the models accurately represent what you saw in the mouth?”
Now her eyes really widened. She really began to see the practical application of the knowledge of occlusion.
Now she said she had a job to do.
“What’s that?” I asked.
“I have to call the doctor and get that information.”
Now that’s great learning!