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Innovation and the Dentist

Second Opinion

Much of the progress occurring in the everyday practice of den-tistry comes from those who involve themselves in it on a dailybasis. Dentists are a very innovative group because there are manytimes we encounter problems that are not in any textbook. What do

we do? We all have to innovate in order to solve some of these out-of-the-ordinary situations.

Four years of dental school gives us the most basic of ideas aboutwhat dentistry is. It isnt until we are out in the world actually prac-ticing dentistry that, if we are lucky, we realize how little we actu-ally know. I was one of those who, after school, thought they knewit all. For nine years I was ignorant of all the potential dentistry hadto offer. Slowly, I became disenchanted and depressed with my prac-tice. I finally decided I could not go on the same way I had beengoing. I had to change. I decided to sell my practice, get out of thearea and become associated with another dentist. I lost money onthe sale of my practice, but I never looked back. I never regrettedthe monetary loss because if I didnt change I think I would have

just given up dentistry.My dental associateship gave me a new life. The dentist I

worked with was a constant student, starting study clubs, going to

courses and always buying and trying the newest products anddevices. Dr. Jack Buckman was my inspiration and mentor, open-ing my eyes to all the developing possibilities that started to emergein the late 1960s and early 1970s.

I had graduated from Temple Dental School in 1958. We hadbeen taught in, what I would call, the Stone Age of Dentistry. Someof the few basic changes I saw in dentistry started with the high-speed air rotor and disposable needles. It is hard to believe now, butin dental school the anesthetic needles were cleaned, sharpened,resterilized and reused. Synthetic impression materials were notheard of in school. We used compound, alginate, wax and plaster ofParis as our major impression materials in school. Changes, such asthe introduction of composites and VPS silicone impression mate-rials, have occurred to make our lives, and those of our patients, eas-ier. When I finally realized all the potential that existed, I becameexcited with dentistry again. My association with Jacks dynamicpractice was opening my potential and career possibilities.

Jack, as I said, would buy anything new. I was very fortunate tobe there when the first practical composite was introduced to theprofession. That composite was sold by Johnson & Johnson and

dentaltown.com

August 2006

William B. Dragan, DDSCentrix CEO

Second opinions are common in healthcare; whether a doctor is sorting out a difficult

case or a patient is not sure what to do next. In the context of our magazine, the first

opinion will always belong to the reader. This feature will allow fellow dentists to share

their opinions on various topics, providing you with a Second Opinion. Perhaps some of

these dentists observations will change your mind; while others will solidify your position.

In the end, our goal is to create discussion and debate to enrich our profession.

Thomas Giacobbi, DDS, FAGD, DentaltownEditorial Director

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I became an entrepreneur, but then again,

every dentist is an entrepreneur in one form or another.

12dentaltown.com

August 2006

called Adaptic. It was a paste/paste material that was mixed in equalparts and placed into a cavity preparation with a spatula. Not anideal method, filling with a spatula, it many times incorporated airinto your restoration. Air in my restorations was a problem for methat became an opportunity and the start of my odyssey into inven-tion. I became an entrepreneur, but then again, every dentist is anentrepreneur in one form or another.

My entrepreneurial exploits started when I became interested inthe problems I was having when I filled class III cavities. Manytimes, I ended up with voids at the surface. I had to redo the restora-tion and hope I would not again incorporate more air. My redosbegan taking too much time in my schedule. To regain control, Ithought and came up with several composite placement conceptsthat were impractical. Finally, I thought I had the right idea to cureproblem of voids in my composites. If I could syringe the compos-ite directly into the cavity preparation from the bottom out, I wouldeliminate or at least minimize the incorporation of air. There wasnot a device on the market to do this, so I made my first two syringeprototypes. This was only part one of the concept. To test out the

whole concept, I had to design and invest in a prototype injectionmold to make a disposable plastic tube, which would be the reser-voir for holding and expelling the composite. This is where youhave to separate the men from the boys. In 1969, the mold cost was

$6,000; all the savings I had in the bank. I had no guarantee thisconcept would work. I made the leap of faith and invested to makemy first syringe with a tube and a plug. The moment of truth came

when I first tried the prototypes and the system worked! I hadsolved my problem, but what to do next?

To protect myself, I decided to spend more money and file fora patent. To reassure myself that my syringe technique was good andI was not blinded by my genius, I gave my other prototype to a fel-low dentist I had known since dental school. He liked it. Now whatdo I do? I was totally convinced that placing composites with asyringe system was the way to go.

We dentists are not taught manufacturing, so I decided to intro-duce Johnson & Johnson to the concept of using a syringe systemto place composites into cavity preparations. Johnson & Johnson, asdid other large manufactures, refused even to look at my concept.This is a crossroad that any independent inventor must consider:Do I invest my own money and form a company? Or, do I just for-get the whole thing and write off my losses as experience? I decidedto form a company. I called my company Centrix, taking thename from centric relation. I truly believed the idea of syringingcomposites would take off and my fortune was made. (A delusionmany inventors have is that a good idea will make you rich overnight. There are exceptions, but it would be like hitting the lottery.)For me, I found my road to success was a long and very hard road.

That was then. Now, I see all the new, unlimited possibilitiesthat are open to all the wet-gloved dentists today. Because there areso many products and techniques that are exciting, I am sorry I can-not physically practice dentistry today. Opportunity exists everydayfor all dentists to be on the lookout for different uses for technol-ogy. Maybe there are ways to improve what you are doing and usingtoday. Every problem, new product and/or technique create oppor-tunities for those who are inquisitive and want to make their lives,and those of their colleagues, easier or more efficient.

Centrix and I have always looked for simple products that canhelp the dentist; and therefore, help make the patients visit less

traumatic. I believe that, for the most part, we do accomplish ourgoal. It amazes me how long it can be before a simple product isaccepted and becomes standard in everyones dental office. My firstproduct took over 10 years to became the accepted method of plac-ing composite resins and this was a simple disposable tube and plug.

I would like to challenge all dentists, young and not so young,to keep your eyes open and be always looking, and especially think-ing, how they might solve the everyday problems that you have or

will have. Dont be afraid to say there may be a better way for bothyou and your patients.

A suggestion to all dentists with an idea for a product or idea:Dont quit you day job. During my time trying to build Centrix, I

was a full-time dentist and practiced for 40 plus years. Keeping yourpractice doesnt mean you should forget developing your ideas. Itmeans you may have to work at night and weekends. The dentist isthe only one truly able to improve the techniques and products thatare and will be necessary. If the dentist does not innovate, the largecompanies will give you good chemistry and large items like digitalx-rays, milling machines and other big-ticket items; but it is up toyou to make them work and work efficiently in your practice.Unfortunately, I have found that it is easy to innovate, but very dif-ficult to get the story across to our colleagues. That doesnt meanyou should be discouraged, it means that you have to believe in yourideas and persevere.

Though it can be a difficult road, there is nothing more reward-

ing than seeing an idea go from the drawing board to actuality, andfinally, become accepted by the profession worldwide. There aremany dentists who have created products dentists use every day. Justa few of these men are Drs. Bob Ibsen of Den-Mat; Dan Fisher ofUltradent; Josh Friedman, who started Demetron; as well as BarryMusikant and Allan Deutsch of EDS. Some other innovators areDrs. Raphael Bowen, who discovered modern composites, and

Angelo Buonocore, who developed bonding resins and preventivesealants. There are many more people who should be on the list, butI havent the space to name them all. Its time for you to join thislist. Centrixs motto is Making Dentistry Easier. I challenge youto keep thinking and dreaming, some dreams do come true.

Second Opinioncontinued from page 10