Specific CE Recs for new grad

[dentalchamp98]

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Hey all! Recent grad here who is settling into general dentistry practice. I want to start building a stronger foundation in occlusion and/or clear aligner therapy, but I'm trying to steer clear of courses that are basically Invisalign sales pitches or pankey occlusion that is too advanced for me at this time

A few things I'm hoping to get input on:

• Any occlusion CE you'd consider must-take for someone early in their career?
• Solid clear aligner courses rather than just "here's how to use our software"
• Any CE courses (extractions, endo) not necessarily Invisalign or occlusion that you wish you'd taken sooner (or skipped)

Thank you so much in advance!

 

[New_Vegas]

Solid clear aligner courses rather than just "here's how to use our software"

Yeah, an orthodontic residency. You should have a very solid understanding of the principles of orthodontics before you try to use clear aligners. I've seen a fair number of poorly treated ortho cases by general dentists... Then the patients start to figure out that you aren't actually an orthodontist and can get pretty pissed that they wasted their money on you. It can backfire on you if you don't know what you are doing.

or pankey occlusion that is too advanced for me at this time

And by the way, you should understand occlusion in the deepest sense before even trying to move teeth.

 

[Bentley242]

Yeah, an orthodontic residency. You should have a very solid understanding of the principles of orthodontics before you try to use clear aligners. I've seen a fair number of poorly treated ortho cases by general dentists... Then the patients start to figure out that you aren't actually an orthodontist and can get pretty pissed that they wasted their money on you. It can backfire on you if you don't know what you are doing.

And by the way, you should understand occlusion in the deepest sense before even trying to move teeth.

^

 

[dentalchamp98]

Yeah, an orthodontic residency. You should have a very solid understanding of the principles of orthodontics before you try to use clear aligners. I've seen a fair number of poorly treated ortho cases by general dentists... Then the patients start to figure out that you aren't actually an orthodontist and can get pretty pissed that they wasted their money on you. It can backfire on you if you don't know what you are doing.

And by the way, you should understand occlusion in the deepest sense before even trying to move teeth.

This is just hilarious to me. I do not plan on becoming an orthodontist nor am I trying to steal your business. I finished a GPR residency in which we had ortho lectures every week by orthodontists. All I am trying to inquire is some courses that will allow me to treat simple ortho cases as a general dentist and assist with case selection. I find it a common theme among orthodontists to feel as if they are being attacked by general dentists. Trust me I do not want to deal with complex ortho cases and it will be an easy no-brainer for me to send out a referral.

And thank you, I realized I need to understand occlusion, hence the reason for my post lol.

 

[Bentley242]

This is just hilarious to me. I do not plan on becoming an orthodontist nor am I trying to steal your business. I finished a GPR residency in which we had ortho lectures every week by orthodontists. All I am trying to inquire is some courses that will allow me to treat simple ortho cases as a general dentist and assist with case selection. I find it a common theme among orthodontists to feel as if they are being attacked by general dentists. Trust me I do not want to deal with complex ortho cases and it will be an easy no-brainer for me to send out a referral.

And thank you, I realized I need to understand occlusion, hence the reason for my post lol.

That’s the thing, though. I’m currently in orthodontic residency and have already seen hundreds of cases over the past couple of months. There have been countless cases presented in seminar that I initially thought would be relatively simple Invisalign cases, only for them to turn out to be extremely complex.

The exact opposite is also true. I’ve seen cases that I initially thought would require something like MARPE, significant expansion, or multiple permanent-tooth extractions because of the amount of crowding. Then to find out the treatment was much more straightforward, sometimes involving only extraction of a primary tooth followed by typical treatment.

Obviously, I’m still learning, and I am sure recognizing these things will become much easier as I progress through residency. I have realized how much goes into treatment planning: figuring out case difficulty, diagnosis, occlusion, growth, biomechanics, etc.

I am not saying you are trying to steal anyone’s business. I just think ortho and especially identifying which cases are “simple” is more complicated than some GP-oriented orthodontic courses can make it seem.

 

[New_Vegas]

That’s the thing, though. I’m currently in orthodontic residency and have already seen hundreds of cases over the past couple of months. There have been countless cases presented in seminar that I initially thought would be relatively simple Invisalign cases, only for them to turn out to be extremely complex.

The exact opposite is also true. I’ve seen cases that I initially thought would require something like MARPE, significant expansion, or multiple permanent-tooth extractions because of the amount of crowding. Then to find out the treatment was much more straightforward, sometimes involving only extraction of a primary tooth followed by typical treatment.

Obviously, I’m still learning, and I am sure recognizing these things will become much easier as I progress through residency. I have realized how much goes into treatment planning: figuring out case difficulty, diagnosis, occlusion, growth, biomechanics, etc.

I am not saying you are trying to steal anyone’s business. I just think ortho and especially identifying which cases are “simple” is more complicated than some GP-oriented orthodontic courses can make it seem.

OP- The only courses I know of go deep into complex cases. And Bentley what you said is true. Occasionally a "simple" spacing case with aligners can result in significant mesial crown tip of the U6s. Attachment design is key, and knowing how to dig yourself out of complex problems that can arise out of "simple" cases is also important. I still dont know what a simple orthodontic case is because so many unpredictable things can happen along the way.

To me, all cases are simple because I understand how teeth move and I know how to get out of problems. I also know that whenever a patient is non-compliant, or when a case isn't going how I planned, I can switch to braces. Studies have shown that more than 1 out of 5 patients who use aligners dont wear them enough to get results. What's your plan for what you will do in that situation? Continue to do refinements for 5 years, and lose money on the case, and finish the case with bad results?

 

[dentalevidence]

Colorado surgical Institute has some good courses.
MOD Institute in North Carolina
Kois
For aligner cases many appreciate Mollis course
Also Invisalign does alot of free courses and has free courses on their website
You can learn alot from Youtube as well if you follow the right dentists

We also are developing a site that helps young grads improve their clinical knowledge base called www.dentalevidence.com

 

[MaxArch]

The orthodontists on this thread are pretty funny. OP is just asking for resources to get the best education he can so he can competently treat straightforward cases, and the response is basically, “Go to ortho residency.” By that logic, should general dentists never do ortho? Should we send every RCT to endo? Every complex restorative case or collapsed VDO to prosth? Every extraction to OS?

There’s always going to be a place for specialists, especially when cases become complex or fall outside a GP’s training and comfort level. But part of being a good general dentist is knowing how to expand your skills through quality CE, properly select cases, understand your limitations, and refer when appropriate. Telling a GP that residency is the only acceptable way to learn to treat straightforward ortho cases seems a little ridiculous.

 

[New_Vegas]

The orthodontists on this thread are pretty funny. OP is just asking for resources to get the best education he can so he can competently treat straightforward cases, and the response is basically, “Go to ortho residency.” By that logic, should general dentists never do ortho? Should we send every RCT to endo? Every complex restorative case or collapsed VDO to prosth? Every extraction to OS?

There’s always going to be a place for specialists, especially when cases become complex or fall outside a GP’s training and comfort level. But part of being a good general dentist is knowing how to expand your skills through quality CE, properly select cases, understand your limitations, and refer when appropriate. Telling a GP that residency is the only acceptable way to learn to treat straightforward ortho cases seems a little ridiculous.

I had a general dentist attempt to extract a fully erupted premolar on one of my patients this week. The crown snapped and the patient had a root tip that was left behind. The general dentist had to send the patient to an oral surgeon to get bailed out. I see things like this a lot.

Yes, a patient absolutely should see a specialist to get specialist procedures done.

Would you go to a general dentist to get a molar endo done? Would you go to a general dentist to get impacted third molars extracted?

There's a general denstist nearby me who does "ortho", even braces. He has a Hygienist. Guess who the Hygienist took their child to for orthodontic work? To my office. She's probably sees the poor quality of work being done at their office and realizes that general dentists shouldn't be messing around with things they didn't get adequate training for.

Every transfer case I have received and thought "what the hell was the previous doc doing?" I look into it and later realize the case was being treated by a general dentist.

 

[schmoob]

Meh, I personally don’t like doing ortho cases, even though it can be profitable. I don’t want to rely on someone from Costs Rica to treatment plan a case for me and paying thousands in lab fees. So I send my ortho patients to a local ortho that I have trusted for many years, to include my own kids at a very very nice discount.

 

[mjzccle19701]

The orthodontists on this thread are pretty funny. OP is just asking for resources to get the best education he can so he can competently treat straightforward cases, and the response is basically, “Go to ortho residency.” By that logic, should general dentists never do ortho? Should we send every RCT to endo? Every complex restorative case or collapsed VDO to prosth? Every extraction to OS?

There’s always going to be a place for specialists, especially when cases become complex or fall outside a GP’s training and comfort level. But part of being a good general dentist is knowing how to expand your skills through quality CE, properly select cases, understand your limitations, and refer when appropriate. Telling a GP that residency is the only acceptable way to learn to treat straightforward ortho cases seems a little ridiculous.

General dentists are only good for hygiene checks

 

[TanMan]

The orthodontists on this thread are pretty funny. OP is just asking for resources to get the best education he can so he can competently treat straightforward cases, and the response is basically, “Go to ortho residency.” By that logic, should general dentists never do ortho? Should we send every RCT to endo? Every complex restorative case or collapsed VDO to prosth? Every extraction to OS?

There’s always going to be a place for specialists, especially when cases become complex or fall outside a GP’s training and comfort level. But part of being a good general dentist is knowing how to expand your skills through quality CE, properly select cases, understand your limitations, and refer when appropriate. Telling a GP that residency is the only acceptable way to learn to treat straightforward ortho cases seems a little ridiculous.

Exactly. As GP's, we can pick our battles and our cases. We don't send everything to specialists, we do what we think we can do and that's where the problem occurs sometimes. If it's beyond your capabilities and/or if it isn't worth our time nor profitable, send it out. A specialist doesn't guarantee that the work will be good, but it does increase the chances theoretically. The best providers perceived by the general public are not the ones that are the most clinically skilled. A lot of it has to do on the doctor's demeanor.

I had a general dentist attempt to extract a fully erupted premolar on one of my patients this week. The crown snapped and the patient had a root tip that was left behind. The general dentist had to send the patient to an oral surgeon to get bailed out. I see things like this a lot.

Yes, a patient absolutely should see a specialist to get specialist procedures done.

Would you go to a general dentist to get a molar endo done? Would you go to a general dentist to get impacted third molars extracted?

There's a general denstist nearby me who does "ortho", even braces. He has a Hygienist. Guess who the Hygienist took their child to for orthodontic work? To my office. She's probably sees the poor quality of work being done at their office and realizes that general dentists shouldn't be messing around with things they didn't get adequate training for.

Every transfer case I have received and thought "what the hell was the previous doc doing?" I look into it and later realize the case was being treated by a general dentist.

As the gatekeepers of the general dental population, it goes both ways. I think it's important to maintain good relations with your fellow specialists, and vice versa (and not just for referral purposes). Just like specialists can get dumped cases that they couldn't finish or execute, GP's also help fix some of the things that our fellow specialist colleagues need help on. Some examples are referrals that I get from ortho to close black triangles/gaps with veneers or crowns or endo on a tooth that went necrotic during ortho treatment. Other examples are crowns that get broken or bur damage from extractions that need to be repaired... or perfs from endo that needs me to extract the tooth without throwing them under the bus. We're here to help our specialists just like we would want specialists to help us in our time of need. Things happen, more than what we would like.

I get a lot of referrals from ortho and many of them are willing cash patients. I wouldn't burn the ortho bridge by doing ortho, since many need perio and restorative treatment to be able to proceed with ortho treatment. Not all specialists are good at what they do. If I knew a GP could do something well, I'd have it done to myself. The specialty designation doesn't always mean the work will be good.

On a final note, if you can't deal with the complications of an extraction such as root tip retrieval, they probably shouldn't be extracting in the first place.

General dentists are only good for hygiene checks

Hahaha, yeah, but for the most part, we're still the gatekeepers of the procedures and referrals 😜

Edit: On a final note, most dental CE's are useless. It's a requirement for your license.