Episode 109
109: Why Your Redo Isn't Your Lab's Fault - How to Better Communicate - Dr. Andrew Cobb
Dr. Drew Cobb of The Dawson Academy is here today to talk about why your redo isn't the lab's fault, and how to communicate better. If you don't know who Drew is, he has a practice in Washington DC, and he is an amazing dentist. Drew's father was a faculty member at Georgetown and taught Drew on his first day of dental school. You could say dentistry is in his blood, and it shows in his practice and his teaching.
After practicing dentistry for 10 years, Drew realized that there were still things he needed to learn. He went to the Dawson Academy and learned how to treat more complex cases in a predictable way. He also learned how important continuing education is. Now Drew teaches at the Dawson Academy, and he uses those methods in his practice for treating complex cases in a predictable way. The basics start with good communication with your lab, and Drew shares the exact methods to do this and have great outcomes.
You can find Dr. Drew Cobb here:
Dr. Andrew Cobb The Dawson Academy
Show Notes
[02:18] Dentistry runs in Drew's family. His father even taught him on his first day of dental school. He had a great foundation and practiced that way for about 10 years. Drew realized that his work wasn't lasting as long as he wanted and some complex cases were more than he could tackle.
[03:10] He read Pete Dawson's book and wanted to go to one of his lectures. It was about predictability, being a better dentist, and stopping the rat race.
[04:00] It was the best thing he ever did. Post Dawson is a lot more fun and he is hugely more profitable than before.
[04:47] Pete Dawson changes the way dentists think. Getting better as a dentist is being able to solve more complex problems.
[05:30] How dentists need to give the lab technicians the right information to do their jobs. Most only get a fraction of the information they need.
[06:17] The foundation for restorative work is based on communication. If you don't start with that, you don't get a good result.
[06:47] What's the most important step for any procedure? The one you are working on. You have to take good impressions with good materials.
[08:12] You need an accurate team member to make sure everything is measured right.
[08:34] You have to have a great team and take them on the journey with you.
[10:29] Ask what a remake costs your practice? You want to known for solving problems and predictability.
[11:56] The would I do it on me rule when making treatment plans. It's not about talking people into dentistry they don't need. It's about identifying their problems, finding solutions with the least amount of dentistry, and then providing them with that care predictably.
[13:35] Start with accuracy and accurate materials and models for good predictive dentistry. Have good clean impressions. You have to have the whole anatomy of the patient to make accurate decisions.
[14:57] Start with accuracy.
[15:57] Dental blueprint foundation. Take the before models and put them on a model in a trial run. Work it out on the models first. Work it out in your mind, and then on the models, and then on the patient.
[17:19] This should be worked out a couple of times before working on the patient. Figure out your plan to know your pathway.
[18:02] 3D checklist for how to do a wax up.
[19:16] Once we have everything it has to get to the lab accurately. We have a checklist for how to communicate to the lab. How labs spend a lot of time trying to get information they didn't get.
[22:31] It's easier to make changes in plastic than in glass. Design the prototypes the way you want and get that info to the lab.
[23:28] How the person sending the communication holds the responsibility of communicating clearly.
[24:12] With complex cases, you can't figure out how to charge without a plan.
[25:43] Have a script to communicate to the lab.
[26:23] What would you need to make a wax up? All of this information is in the Dawson Diagnostic Wizard. The lab needs everything that you would need if you were doing it.
[27:46] This is a great way to differentiate yourself to the labs.
[28:12] After the wax up, have the treatment option review with the patient.
[28:43] Three types of wax ups. Minimal - putting the wax where you need it to differentiate the change. Starting and full coverage. Case presentation wax ups.
[30:46] 3D wax up function, aesthetics, treatment plan. Now you know how to schedule. You used the wax up to do the next stage. Now you can work backwards.
[33:02] You are probably exceeding your production goal with this one patient. Give yourself the time you need. Don't try to rush and create stress.
[34:31] Primary care time blocked for longer patients. Secondary care is going from room to room.
[35:22] All dentists have general patients.
[36:16] It's your practice, you get to decide the type of cases you want to do and how you are going to practice.
[38:41] Visualize in space where things go before starting irreversible dentistry.
[39:14] Where should the front teeth go? Then find exact proportions of the teeth. Take the 2D photo and make it a 3D wax up model. See if it works functionally on the articulator.
[40:49] The importance of following a checklist. Predictability drops when not following the checklist.
[42:02] There is a person attached to what we do. Talk it out with the patient before beginning the work.
[44:49] Virtual restoration is where we are going. Figure out the change before doing something irreversible.
[45:47] Using a ct scan to do a digital wax up.
[46:53] Explain to your lab technician about what you are trying to do and why, and ask them how they want the information sent to them. Create a pathway for communication.
[47:44] After a case, do everything again and see what could be done better to make the labs job easier.
[48:29] Listen to your technician and check your ego at the door. Then celebrate your finished cases.
[49:21] Also send the end result to multidisciplinary specialists.
[50:56] The Dawson Academy is about how to do more complex cases and do dentistry that is predictable.
Links and Resources:
Functional Occlusion: From TMJ to Smile Design
Free Whitepaper Confessions of a Lab Technician
Functional Occlusion – from TMJ to Smile Design
