Robert S. Minch, D.D.S., P.A.

I get asked all the time how I became interested in dentistry, or more accurately,”why would you want to put your hands in someone’s mouth all day??!!”- to which I usually respond that there are a lot stranger places in the human body that I could have my hands in……..But seriously, I tell people that I believe that there are 2 pot shots in life: who you marry and the job/profession you choose. In both cases, you might have a fairly good idea of what you’re getting into, but until you really get your feet wet, so to speak, you have no idea of its true reality.

For me, I thought it would be cool to be an orthodontist (putting braces on kids teeth) but it didn’t take long for me to realize that family practice is my calling. I love people and I especially love getting to know them over time. At this point, many of my patients have been with  me for over 25 years- on a daily basis, my office feels like an open house party where old friends drop by to have their teeth looked at and we get a chance to catch up while, at the same time, new patients come in and reinvigorate the office with their energy and desires for an improved, healthy smile.

I got to thinking about this last week when Rachel came to observe our office in action. She is a freshman in college and is considering, in addition to several other options, becoming a dentist. It’s hard to know what comes up for most people when you introduce the image of a dentist- pain producer? nerdy guy in a smock snapped up to the neck?? Steve Martin in the movie Little Shop of Horrors?? caring, educated clinician who helps patients keep their teeth…..hard to know for sure but what I  do know is that a dentist CAN be a very artistic, talented individual who strives to help their patients achieve the beautiful smiles they desire while ensuring its comfort and longevity.

So when Rachel mused about how she might be interested in dentistry, I encouraged her to hang out in our office with us for as long as she wanted to see what kind of magic might happen that day. Now, regular readers of this blog know that I love to teach. And I teach in several different venues: University of MD Dental School where I help out in  the clinic, working with junior/senior dental students- they are just learning the very basics of procedures and are very interested to know how it is “in the real world”. I also teach newly graduated students who are in a General Practice Residency at Johns Hopkins Hospital- they are much more smug about what they think they know , so it’s my job to make sure they understand that their education is just beginning and it will continue for a lifetime. And then there is my favorite teaching venue- Spear Education in Scottsdale Arizona (www.speareducation.com) where I am a visiting faculty. This is where dedicated dentists, in all phases of their career, come to learn how to do the very best cosmetic dentistry that achieve maximum comfort and natural aesthetics.

But to have a college student spend the day with us, is almost the most awesome of responsibilities. Because it presents the opportunity to truly influence an individual and possibly alter their very life. All my patients know that I am very passionate about dentistry, my office, staff and patients. It was very easy for Edie, Cindy , Corinne and I to communicate that enthusiasm while Rachel observed us. I was especially glad that she was able to see our latest piece of technology in action. Our Cerec machine- that’s the one that makes a porcelain crown while the patient waits- no goopy impression, no temporary crown, no having to come back for a second appointment with an additional shot of Lidocaine……..

What made the procedure doubly cool was that I was making a porcelain onlay (a half crown) on my old pal, Lefty, an 87 year old professional fly fisherman who had just happened to have been at my house for dinner the week prior and who had brought me in his latest book complete with a signed message to me. The entire procedure went off without a hitch and Lefty was just blown away by the level of technology and efficiency of the Cerec machine. But more importantly, I hope that Rachel really got how awesome it can be when love of your profession, that you do at the highest level, blends seamlessly with love for the people you work on and the staff you work with. It’s just a genuine honor and privilege to have all those pieces in place on a daily basis to provide a profession and way of life that feels like a genuine blessing! It’s a lot for an 18 year old to take in at one time and honestly, I imagine it can be found with any profession that one truly loves but I feel that dentistry is uniquely positioned to offer a dynamite career.

Like I said, there are 2 potshots in life : who you marry and what profession you choose. I always tell people that I am one for two…..but that’s another story for another time!! Good luck Rachel- I know that you will choose well and be extremely successful with whatever path you choose.

Talk about irony- here I am in the dental chair, 8AM Monday morning after flying to Seattle, connecting through St Louis, the night before. I have my safety goggles on and Dr. Gregg Kinzer is poised above me w/ a needle that looks to be about 8 inches long! (Actually that is not true but I hear that from my patients all the time!) I firmly believe that every dentist should have dental work done once a year so that they can stay connected to what their patients perceive on a daily basis. And of course as he gives me the shot, Dr. Kinzer asks me a question- as if I can answer!!

Actually I have an ace in the hole- I told Gregg that I was writing a blog piece about my dental experience so he has to be on good behavior (and not hurt me). As I wrote about in my last piece, I have flown all the way across the country because I know that Gregg is a uniquely gifted clinician and I want to learn whatever I can so that I can continue to improve my dentistry in all aspects. Conversely, it’s also very affirming when i see that he does exactly what I do in my own office. On this particular morning, Gregg is bonding in 3 porcelain onlays on my back teeth. Regular readers of this blog know that I restore most teeth with porcelain onlays instead of full crowns (full crowns are what most other dentists would do) because the onlays are more conservative and less invasive. The reason other dentists don’t do them is because they are  technically difficult to do well- but that is exactly why I travel around the country to see how to constantly up my game.

So here are a few things that struck me about my experience (or: what can I do to optimize the patient experience):

-pleasant staff at every patient interaction makes for a relaxed atmosphere

-I was the only patient that Gregg had for the 2 hours that it took to bond in the onlays. That made  the experience more relaxed and allowed him to maintain focus on what was truly important- ME!

-Safety glasses- it’s amazing how many dentists don’t give their patient’s safety glasses while they are being worked on. Most people doing woodworking would never think about using machinery without safety glasses. I was handed them at the beginning of the appointment and I was able to relax and not worry about flying shrapnel or dropped instruments hitting my eye!

-Novacaine (actually in this case Lidocaine) is a good thing. I didn’t feel any discomfort and when I had a slight twinge, Gregg threw in a little more and life was good. And honestly, I didn’t fell the injections at all.

-Excellent dentistry is not cheap!! Even though Gregg and I have known each other for over 6 years, he still charged me for his services; and even though I do this work myself for a living, I had no problem paying for his excellent care. (And, to be honest, like many patients, I had to time the treatment so that it fit into my finances). The point is that you get what you pay for. And if I plan to keep my teeth for a lifetime, this ends up being a very wise investment!

So, the end of the story is that I returned to Baltimore with 3 beautiful porcelain onlays on my back teeth that feel very  smooth and polished, my bite is comfortable and I can chew gum again!! And the icing on the cake is that I was able to reaffirm that I actually treat my patients at the same level as the best clinicians in the country . That’s not really news to me; after all, I have striven to provide this level of care for over 25 years. It is actually very good news for my patients- and believe me, I plan to give them that good news at every visit. For in reality, you, as my patient, do not have to fly across the country to get your dentistry done (unless you live on the West Coast). So come on by for an appointment- sit back in the chair, put your safety glasses on and rest peacefully that you are getting some of the very best care anywhere!!!

So I was having coffee with a very attractive woman last week and I was telling her how I was going to Seattle to finish having my teeth fixed (I had gone in July to have 3 teeth prepared and impressions and temporaries made and now I was returning to have the permanents bonded in). She put down her coffee cup (it might actually have been her latte cup I think), pointed a well manicured finger at me and asked quite understandably-”Excuse me? Why are you going all the way across the country to have your teeth fixed??!”

I smiled and settled into my dental instructor mode; my kids know this mode- it means that I am going to answer a relatively straight forward, seemingly easy question with a philosophical, slightly meandering answer that fills all the spaces of the question.” Alright”, I began,” lets start with the misconception that all dentists are about the same (or as the saying goes- a dentist is a dentist is a dentist…) The truth is that there is a huge range out there of dental competence in terms of knowledge, artistry, care, skill and judgement. I can tell you because I teach around the country and I meet many dentists along the way- some good, some not so good but few truly outstanding clinicians who are not only excellent caregivers but genuine artists with their dentistry.”

“Next, let’s talk about the whole insurance issue. The vast majority of dentists who accept HMO or PPO dental plans are actually accepting a lesser fee for their dental services in order to get more patients. Now, I know that this may not be a popular concept in today’s health care morass but the unvarnished truth is that dentistry is a labor intensive industry. In order to make a crown (or root canal or veneers), the dentist has to take his/her time in order to do the best job possible- there are very few short cuts that don’t compromise the end result. So, those dentists that are working faster because they are not getting paid their normal fee have to make some tough choices- cheaper materials, cheaper dental laboratories…. well you get the picture.”

I could see the eyes of my coffee partner start to glaze over so I tried to wrap it up. “Let me finish”, I continued, “with my personal philosophy about being the best dentist possible. It’s all about constant learning and reeducation- staying on top of new technology and new materials. To that end, when I need dental work (after all, I had a real sugar tooth when I was a kid- I loved Bazooka bubble gum and Big Buddy foot long gum, in both cherry and bubble gum flavors; not mention sweet tart lollipops!!….. but I digress) I look for the top clinician that I know of and travel to their office so that I can see how they do their work and what can I do to improve the care I give to my patients.

So, in 2011, it’s Dr. Gregg Kinzer in Seattle Washington. Dr. Kinzer lectures extensively and I have had the pleasure of hosting him in my office over the past 6 years where he presides over a study club that reviews cases and presents new information. My first appointment at his office in July was an amazing experience and I picked up several tips that I was able to incorporate in my office. I am looking forward to a similar experience this time and exceedingly excited about being able to chew gum again!!” At this, I finished my rather lengthy answer and picked up my coffee cup, feeling very proud of my passionate answer and being able to communicate my outlook on excellent dentistry.

Except, at that point, my friend said, “I’m sorry, I didn’t catch that, I was texting my daughter- what did you say??”…….Ah well, for those of you who were following along,  I will write of my final Seattle appointment tomorrow. Thanks for listening!!

Let’s say you need a crown for a broken tooth. The classic scenario that goes on in 98% of dental offices around the country is this: after a little Lidocaine, the tooth is prepared and then an impression is made- you know, that tray full of nasty tasting stuff that gags and stays in your mouth seemingly forever! After that pleasant experience, a temporary crown is made and cemented and then you come back in a couple of weeks for a second appointment to have the real crown inserted…..Wouldn’t it be great if you could avoid the whole impression mess, and get the crown that first appointment- that’s right, no temporary, no coming back for a second appointment

Well the future is here and it is really awesome!! I am writing this blog piece from a training center in Laurel MD. I am awaiting my first training session on the most amazing piece of equipment to come down the dental pike in a long time. It’s called a Cerec machine made by the Sirona corporation. Long story short, the machine mills a crown/ onlay/ veneer while you wait. I simply take a picture with the machines camera and the machine does the rest- no temporary, no coming back for a second appointment….. like I said- really cool!!!

Now to be honest, this technology has been around for 25 years but at its infancy, the quality of the restorations was subpar. Over the years, the CAD CAM 3D technology got more sophisticated and the quality of the restorations got better and better. To the point that today, a porcelain onlay made by this machine rivals any lab-made onlay in the country. Truly a milestone in dental history and I am so excited to be one of a very few dentists that provide this time saving, very comfortable option to restore your tooth.

I will be updating my experience with this new Cerec machine over the weeks and months to come. – for  I am prepared to revolutionize how we create awesome smiles in our office. Stay tuned- the future is here and so bright, we have to wear shades!!!