The real learning happens after the seminar when life and cases get messy.
“What lab can I buy that appliance from?” This is a question I’ve heard many times following an introductory lecture. I reach into my pocket and get out my car keys. With a broad smile on my face, I offer them to the person asking the question and say, “These are the keys to my Boeing 747 airplane. Take it for a test flight.” The startled person usually has a deer-in-the-headlights look on his/her face, requiring an explanation. I make the point that no one would fly an airplane without learning about what makes an airplane fly, HOW to fly an airplane, the substantial “ground school” learning which must be done before one enters the cockpit, and the need for a lot of personal instruction from a trained pilot with experience flying. The flight instructor needs to be totally convinced the student is ready for the first solo flight. Commercial or military pilots are all required to have continual training. Nothing of substance in dentistry can be learned without a similar process.
Dentistry is a “doing” profession with many things we do having multiple steps which must be done in a certain order with no shortcuts being taken. What are the chances that anyone can master DOING something with perhaps dozens of steps that must be done in a certain way and a certain order for success from just one lecture… no matter how good the lecture or how smart the student? If you are a normal person, the answer is “zero.” A skyscraper doesn’t start with an antenna on the top, but with a well-planned, properly engineered and executed foundation in the ground. Dentistry is no different.
The doing process is what dentists want to learn, but the background, planning, and proper execution require far more than showing an outcome and telling someone what appliance to use to achieve the outcome. We might like something to be as easy as a “paint-by-number” picture, but the reality is learning anything requires far more than that.
I’ve had the sad experience of seeing dentists go well beyond their training and do things they have not been trained to do. Unreserved confidence is not a substitute for recognizing, diagnosing, planning treatment, executing the treatment, and learning from mistakes. I’ve seen dental licensing agencies restrict or bar people from doing orthodontics altogether—sometimes with good reason.
Airway problems are multifactorial with many potential causes—some of which we know and others we don’t. The profession has no shortage of answers to the problem. The most common is “expand, expand, and expand some more.” In 2017, I was at a meeting listening to perhaps the best-known sleep doctor in the world talk about expansion, expansion, expansion. In a knee-jerk reaction, my mouth said (without any input from my brain) to a friend sitting next to me, “You cannot expand your way out of an anteroposterior problem.” My mind kicked in and liked what my mouth had said! I’ve used this dozens of times in lectures to various groups since then. I back up this statement with a lecture segment illustrating my point. Learning as much about the entire scope of a problem gives us a better chance of success in addressing the problem.
We teach concepts. We give our mentorship participants background knowledge, and knowledge of traditional treatments as well as shortcomings which accompany them. We discuss things we have learned which do not work but are still popular and being taught by well-meaning folks. We show them why we no longer use such approaches, even though we may have been enthusiastic early adopters years ago. We let them come to their own conclusions as to whether they might use certain popular approaches on a family member. We think our students are smart and learn better when they are shown evidence and not just told WHAT to do and WHAT NOT to do. We teach what we think works today! We hope to inspire doctors to come up with better things in the future. We want them to learn from our mentorship, but most importantly learn the tools to be able to think critically for themselves. Ultimately, our goal is to have them fly the 747 on their own, becoming a “flight instructor” to help others breathe better and have healthier lifespans.
Anything worth doing is worth doing well, and our patients are in desperate need of our help. We are here to mentor doctors and respond to their questions, concerns, and missteps along the way—something I so wished for 40 years ago as I wandered through the continuing education wilderness.
