Well, we are very excited about this opportunity to start our podcast. The Six Lessons Podcast has one purpose. We want to help you be a better dentist.
And I've been a dentist for 44 years. It's a long time. If you want to do better dentistry every day and stay motivated, then having a system that works well and consistently, that's the key to success. I'm going to discuss a little bit about why I decided to be a dentist. I'm going to include some memories of my early dental education and my early life and how that worked into having the six lessons available now worldwide to dentists who want to be the best dentist that they can.
So let's just start with... how I decided to be a dentist. That goes back to when I was in seventh grade.
Seventh grade was a time when you're starting to think about what you want to do in your life. And I went to a dental school graduation of a dentist who was graduating from University of Southern California. His name was Bob Heath. Bob Heath is still alive today.
I visited with him five years ago. But he... graduated from University of Southern California, where I was living with my family in Monterey Park. And when we went to the dental school graduation, after the graduation was over, he took me into his lab and his little cubicle, which he used at dental school.
And it was quite interesting. They were making some things and had some interesting tools. And he talked about using his hands and how he enjoyed working with patients.
All of those things were interesting. motivating to me. Plus, he was at University of Southern California, which had the best football team of the United States at that time. So being a USC Trojan seemed to be a win-win situation.
I didn't think much more about that until a couple of years later in high school. I, again, actually recorded a newspaper article that I was being interviewed for. because I was the freshman class president at Mark Keppel High School. And they asked me about my future.
And since, you know, I was keeping quiet my plans to become president of the United States, I mentioned that I was going to be a dentist in ninth grade. I said that. And it's recorded in the Mark Keppel student newspaper.
Well, what you say and what actually happens sometimes are two different things. My political success. ended by being not elected as student body president my senior year.
But, you know, becoming a dentist was still a possibility. I have an early memory of my father and his, one of his drawers in his bedroom had a small microscope, very small brass microscope. It's something that I wish I had right now. I don't know exactly where it ended up, but he... He mentioned that that microscope belonged to his father, my grandfather, who I knew he died when I was six years old.
But he lived with us in Monterey Park. He had had a stroke, so he didn't speak very much. But I do have fond memories of him and our dog Sport being outside and sitting in the sun. But my father. was a physicist, very good at mathematics, and his father was the math teacher at Springville High School.
So Harold, my grandfather, taught math his whole career, over 40 years at Springville High School. Algebra teachers weren't really popular in high school then. Maybe it's different now.
But he had five children, and raising five children on... What you would make as a math teacher in Springville, Utah wasn't the easiest thing to do. So he had a second plan to become a dentist. So he started to take more science classes at Brigham Young University. He bought a microscope, made those plans, but unfortunately plans sometimes get in the way of reality.
And he remained his whole career as a... math teacher and raised his family on what they made with that profession. But this microscope intrigued me because you could see things through it and they would get bigger.
And the microscope in dentistry has been the most important technological breakthrough. when I was a student at Brigham Young University, and I did become a pre-dental student after I returned home from my Mormon mission, that pre-dental options for majors, you can major in anything, but I chose microbiology. So in microbiology, you are using microscopes every day, and you're looking very small things.
And you learn the size of a micron. Now, in England and the United States, we like inches perhaps, but millimeters, centimeters, those are the things, the measurements that most of the world uses. And when I learned how big a micron was, as a microbiologist, that's the average diameter of a bacteria. Obviously, it's stuck in my mind to this day, 50 years later.
I know that a micron is 1 500th the thickness of your fingernail. Now, if you look at your fingernail and you divide that in 500s, it's like your mind takes a trip into a world that most people never think about. Microbiology has saved more lives than any other scientific discipline. And I enjoyed my microbiology major. and my chemistry minor.
But the chemistry minor was kind of interesting because I became a chemistry minor for one reason. I asked around my friends at Brigham Young University, you know, what does it take to get into dental school? I didn't really know.
And they would say, well, you got to take the DAT. So that's going to ask you about all your basic sciences. It's going to have some spatial relationship testing, you know, just basically. But The one thing that schools really look at is organic chemistry. The grade you get in organic chemistry will determine whether you get into dental school.
Well, in high school, I think I got a B-in chemistry. It kind of spaced out as soon as I learned that Avogadro's number was 1 to the 2300th. I mean, I can't even remember what Avogadro's number is now.
I got to go back. But anyway, chemistry didn't excite me in high school. But I did get a B minus.
But when I got to Brigham University, then I started taking my freshman year in organic chemistry. Now, inorganic chemistry is acid-base equations and a lot of things that, you know, don't excite you. How to dissolve salt in water. Well, you put salt in water and it dissolves, you know. But you have to be more technical if you're going to be an inorganic chemist.
Ask Ryan Nolan, he will tell you. But I got another B-minus my freshman year before I really decided to become a dentist. But when I started my sophomore year and I was engaged to be married and my wife didn't know if I was smart enough to be a dentist, you know, I was kind of under the gun because I'd never got an A in a dental class.
I mean... chemistry class. And when I started inorganic, I started organic chemistry.
That's seriously the first thing the guy said, you know, Dr. Smith, he said, I know that everybody taking this class wants to be a physician or a dentist or something that's not a chemist. I know this isn't a class for chemistry majors, but you all want to get good grades. because you have these professional aspirations. Melvin Smith said, if you've never gotten an A in chemistry, don't expect to get an A in this class.
And so it's like, I was on the front row, you know, I was ready. And it was like, he was talking to me like, oh man, this was a challenge that I wasn't quite ready for, but it scared the heck out of me. you know i didn't want to tell my wife i don't know if this is going to work because this guy just told me i probably aren't because i'm not going to get an a you know many people do get into dental school without an a in organic chemistry but that being said it motivated me to do more homework in the organic chemistry course than anybody else that was in that course so there was you know probably 60 students in the class and I was in the top three or something like that. So once I... discipline myself in that organic chemistry course. I pretty much felt like I had what it took to become a dentist, but I didn't know that that course was actually going to mean anything in dentistry.
But obviously, I did get accepted to dental school and I had an interest from... shadowing a dentist while I was undergraduate. His name was Niles Herod. And Niles Herod was a specialist.
He was an oral surgeon in Provo, Utah. And this is a memory that's very interesting that maybe some will relate to. I was thinking that an oral surgeon sounded like something cool.
So I'm going to watch this oral surgeon. And I'm thinking I want to be an oral surgeon, not knowing anything. This is before I've been in dental school.
But I go to observe and shadow Dr. Harrod for a couple of weeks. And I'm wearing a dress shirt and a tie. And I'm in this room and they're doing what's called a dilatant hypoplasia.
gingivectomy. If you take a certain anti-seizure medicine called dilatin, your gums grow excessively and you have to remove that excessive growth of gum surgically and it can either be done with electrosurge or with normal scalpels. But anyway, I'm excited. I'm going to be a dentist, maybe an oral surgeon.
And all of a sudden, Dr. Harrods starts doing these surgical procedures where he's basically burning, cauterizing this excess of tissue. And the smell, I started to pass out. And the nurse saw that I was losing it.
And she says, I think you better sit down, maybe unbutton your shirt and loosen your tie. Anyway, so. My first actual experience in my pre-dental education was almost disastrous, but I did not faint. But it did set me on the course to get to know Dr. Harrod.
And actually, after he retired, I was friends with him at the country club I was a member with in Provo for three years. All good experiences. But...
When I did get accepted and we went to dental school, I was ready to, if you wanted to specialize in dental schools, you have to graduate in the top 10%. So if you have 100 students in your class, you better be in the top 10 if you want to be an orthodontist or an endodontist or an oral surgeon or a periodontist, all these specialties that are out there. But during the middle of dental school, my wife and I already had two children, and that was a happy little family. But then we found ourselves expecting our third child in the middle of dental school. And she surprised us with a, you know, three and a half months early.
This baby's born, one pound, 10 ounces. And all of a sudden, she's a medical miracle experiment, progressive patient. We don't know, but she is hospitalized for six months, not six weeks, but six months. Right in the middle of dental school, we are visiting the hospital every day with our third daughter, Megan.
She had many problems, had a stroke at birth. Anyway, that's a whole different story. But it did make me just have one goal, and that's to graduate, because I was so busy with my family and those needs that I had to just try to get my requirements done and just graduate. any idea of graduating the top 10. I just didn't have the time to study all of the subjects and all of the intensity that you need to do that. And so I just graduated.
And when I graduated from University of the Pacific, I was on a scholarship to the Navy. So I went into general practice in the Navy full time. And I was assigned to a Marine Corps base. called 29 Palms, California, where there were eight other dentists, general dentists practicing there.
And we had specialties in endodontics, oral surgery, and prosthodontics. Anyway, those three years, you know, I did the dentistry that I was taught how to do and did it to my best abilities. I remember very specific.
I had a conversation with another dentist who was a year ahead of me. I was there three years and Harvey, the dentist ahead of me, he only had one more year of his payback on his scholarship. And he became good friends.
And I said, Harvey, you know, the one thing I can't figure out though is when do you do a filling and when does it need a crown? And he said, well, you don't really have hard guidelines. You just know that you needed a crown if you're filling or the tooth breaks.
So you fill all the teeth and then if they break, they need crown. And then after three years and getting to know the endodontist, I understood that the reason why endodontics is necessary is because the inside of the tooth. the pulp dies from infection now as an undergraduate microbiology major i understood the decay was a process mediated by these little micron bacteria well if decay causes the softness of the tooth and the softness of the tooth causes the tooth to break and the death of the pulp is related to this decay process. I didn't know anything about cracks because it was obvious to me when these teeth that were decayed underneath fillings broke that, you know, they broke in two pieces.
How did that happen? I mean, these are all things that every dentist who learns how to do an amalgam filling or every dentist who learns how to do a... bonded composite filling that breaks, you know, comes across and like, what do I do now? Well, you know, the traditional profession is, well, you do the root canal and then you do the crown.
And in the military, you didn't have the option to really do that on every soldier. Only the high-ranking officers really got that type of advanced training. Some would get root canals, but they wouldn't get crowns. And then we would see these teeth that were root canal treated without crowns break. And there is a relation there that you learn from experience.
And so when you get into private practice, you say, well, all of my patients that get root canals are going to get crowns. And that was the thinking of the day when I finished my military experience in 1981. I went into private practice and... For 10 years, I did the fillings.
When the fillings broke down, I did crowns. When the nerves died, did root canals or referred them to root canals. And then about 10 years, I started to see teeth break in an irreparable way, which we call a catastrophic failure. At 10 years, I look back in my records and I realize that I'd been for 10 years setting the stage for this progression of fillings getting larger, having... Pulps die, getting crowns, and the crowns fracture in a way that you lose the tooth.
The next stage would be a bridge, and bridge failures become even more short-term successful. And so the emerging ideas of implants that came at this time from mid-1970s to the mid-1980s seemed promising, but they were fraught with failures. And so implants were really not a real viable option until the mid-90s.
And that was the time when I was really becoming depressed, frustrated with my profession, not happy. Of course, we had a growing family. Hillary wasn't even, what year were you born, Hillary?
But the idea is that I became frustrated after 17 years. had started to study history, which had always been interesting to me. And I told my wife my plan was to get a graduate history degree and teach history. I'd be happy doing that.
I'm not happy being a dentist. Of course, she soon found out that history professors, no matter what level, are going to make about half as much as the average dentist. So she had to do the budget and say, wow, I wonder if this is really a good idea. But she was supporting me from 1988 till 1995. I was preparing to make this transition to history, taking graduate history courses.
But then in 1995, a friend of mine, an Army dentist, I was in the Army Reserve for the years from 1983 till I retired 20 years later. But in the Army Reserve, a good friend of mine, Joe Blanche said, you know, I know you're frustrated, Dave, with all this sensitivity and things that don't... go well for dentistry. He said, but there's a, I've heard about this new type of dentistry called adhesive dentistry.
And there's a man, a dentist named Ray Bertolotti, who is teaching courses on this that says, if you do this bonding, you can get rid of sensitivity underneath your restorations. Well, I said, thanks, Joe. I'll look into it.
So I looked into it. And this Ray Bertolotti was teaching a two-day course in 1995 in Surf City, USA. Huntington Beach, California, where I grew up and surfed a lot.
And it was in January. And so, you know, I'd been living in Utah since 1981 to 1995, never been to Huntington Beach in that period. And I'm thinking, I know it's going to be snowing in January. I can either go two days, Huntington Beach in the sun, watching the surfing, listening to about these lectures.
Who knows if they're going to mean anything, but... Two days in the sun, two days in the snow, might be worth a chance. So with Linda's permission, I investigated this new type of dentistry called adhesive dentistry.
After a two-day of lectures, Dr. Ray Bertolotti explained that most of this technology was coming out of Japan, and the companies who produced it, nobody had ever heard of in the United States. It was called Kura-Re. I'd never heard of it. who are Ray and 17 years of being a dentist. So I called my wife up after two days and I said, you know, I don't know if this stuff is real.
I mean, Ray Berlotti has a PhD and a DDS behind his name. So obviously with two doctor's degree, he's done some studying, but this idea of bonding to a tooth and conserving tooth structure rather than removing tooth structure to retain. the filling or the crown, that intuitively did make sense to me. And so I said, if half of what he said is right, it might really change things.
And then came back home and started to investigate the material that Ray Bertolotti had given out at the course. And there were about 25 doctors at this course in Huntington Beach. And I started to collect the information. bibliography, the references that were in the bibliography, and started to read them.
In 1995, the 3,000 articles that are behind me, it starts with one article. And then when you start reading, you have more questions, and the questions were not unimportant. How do you make a restoration last longer?
What causes failure? And those questions have driven me for the last 27 years, 28 years now, in two months, it'll be 28 years, to improve my dentistry using these adhesive methods. And as the adhesive methods developed and advanced and were successful in my private practice, after five to seven years, I asked myself the question, where am I at? in comparison to my other mentors that had influenced me.
Ray Bertolotti does a yearly course in Yosemite, and he brought out a speaker named Gary Unterbrink in 2000. I had actually met Gary Unterbrink in 1998 at the ADA convention in San Francisco. And Unterbrink and Bertolotti were about as good as you got. But because I had been studying for over five years, very intensely, someplace between two, maybe five hours a day for five years, mastering the literature and answering the questions, I saw where early researchers had made their mistakes.
I mean, I appreciate everything that every mentor for me has done, and they all made me a better dentist. But at some point, I had things, I had answers that were better than the best mentors in the world that I... could find in the literature or in face-to-face conversations. And I would include Takau Fusiyama, who mentored Ray Bertolatti.
I would consider the advances that Gary Unterbrink made with Bill Liebenberg as very fundamental, but again, there were things that they got wrong. But that's no criticism other than saying that science progresses by better understanding and long-term following of cases. And so this is the position we're in right now.
We've been following these cases for over 25 years. And every time we have a failure, we've been able to troubleshoot it and progress. And after seven years, then from 1995 to 2003, that's eight years, after eight years, I knew that...
The system that I had was better than anybody else's in the world. And I started to teach that. And the first doctor that I ever trained is still doing it.
Name is Arnaud Note. And the second doctor I trained, Wendell Robertson, is still doing it. Third doctor, Bob Paxson, still doing it. And we have conversations for over 20 years. How's it working?
Great. And so that's our goal is to, in these podcasts, in each episode, we'll be talking about one of the six lessons and break that down. And in that breakdown, we'll be going through the literature that supports it and the literature that is absolutely essential to understand.
And with that, you can be made aware of your options to get further training with many of the dozens of masters that are... teaching around the world right now. And so that's our goal. And in episode two, we'll start down that road. Till next time, we'll see you.
Get bonded, stay bonded.