The treasured relationships we form with our patients, our peers, and our auxiliaries are among the greatest rewards that dentistry has to offer. But no less important are the relationships we form with those professionals who mentor us throughout our careers.
Mentors in Dental School
Often if we are fortunate, we discover a mentor early in our career as dental students. For too many of us, especially among older dentists, our dental education was tantamount to a process of professional hazing.
I graduated from the Ohio State University College of Dentistry in 1981. I had an impossible time relating to most of the full-time faculty. Some of this I brought on myself. Most of the abuse was delivered by a host of vagabond professional roustabouts who served as faculty.
My first assigned and designated advisor was an alcoholic. His morning coffee was always laced with cheap whiskey. He freely consumed alcohol-based mouthwash in patient clinic areas. He was legendary for his brutal mood swings and beratement of students. He would pound his index finger into students’ chests as he literally sprayed verbiage and ethanol-tinged spittle into students’ faces. No, I was not spared this sick ritual.
My school also had another renowned tormentor. On my first day of entering the clinic, I was assigned to the periodontal department, where this abuser was a member of the faculty. Our patient was a middle-aged female direct from the hills of southeast Ohio or east Kentucky. These patients, who came from poverty and had little formal education, migrated to Columbus seeking modest opportunity.
This professor took up his dental hand mirror and periodontal probe. Within five seconds, he asked our patient, “When you go to the proctologist, you wipe your (expletive), right? So, when you go to the dentist, why don’t you brush your (expletive) teeth?” I just stood there in shock.
On one sweltering summer afternoon, with the lecture hall packed with 200 students, another professor droned on about aspects of the parathyroid. The air conditioning couldn’t keep up with the outside temperature of 90, with a relative humidity at the same figure. The speaker had already exceeded his allotted time by 10 minutes when he offered his perfunctory conclusion. “Any questions, doctors?” he asked. None were expected.
Like a jack-in-a box, I jumped to my feet and repeatedly pumped my hand into the air. “What’s your question?” asked the instructor. I responded, “Doctor, please tell us how to make a hormone.”
The professor took a step back with a quizzical look on his face. He paused. I then blurted out the punch line to this lame joke from antiquity. “You don’t pay her.”
The room was deadly silent. Then slowly, a distant rumble of chuckles built up. The crescendo peaked to a rolling thunder of laughter. My stupid humor was just a method to dissipate the collective frustration.
What I failed to realize was that the clinical faculty was gathering in the rear of the lecture hall. They were in attendance to honor, in the next hour, the top 5% in class standing with a ceremony. Obviously, that wouldn’t include me.
One of the faculty approached me as I exited the room. He was laughing, unlike the other professors, and held out his hand. I shook his hand, and he told me his name. He already knew my name and apparently my reputation. He immediately told me I already had what it took to be a successful dentist. He also told me I was now totally blackballed with most of the full-time faculty. But since he was part-time faculty and worked for a living, maintaining a private practice, he’d look out for me. He became my beloved mentor.
I soon gained a reputation for entertaining my fellow students, with mocking impersonations of faculty members, as well as department chairmen and deans. Some of the most amused were part-time faculty. These doctors relayed some truly horrendous experiences as former students. They seemingly delighted in my standup comedy.
My new mentor took charge of my clinical education. He demanded I never work solo, but always with one of two dental assisting instructors. These women each had well over 20 years of experience in dentistry. They physically slapped my hand if I ever dared reach for an instrument. I was continually admonished about my spine and neck posture. This training was the complete antithesis to what my peers experienced, as they worked two-handed dentistry like Cirque du Soleil contortionists.
Thanks to my mentor’s education about ergonomics, I continue today to practice clinical dentistry. He taught me methods to deliver near painless local anesthetic. He helped refine my crown and bridge preps. He taught me tricks with retention slots and grooves to gain additional resistance and retention form. He was a stickler, stating, “Always give your lab tech adequate space to work their aesthetic magic. Let’s see another half millimeter of reduction on the occlusal (or facial).”
I very quickly left Ohio upon graduation. It was a time of factory closings, interest rates nearing 20%, and numerous personal bankruptcies. I didn’t return to Ohio until almost 15 years later to attend a friend’s daughter’s wedding. Since I was in Columbus, I also decided to attend an educational program hosted by the dental school’s post-college assembly.
During the luncheon, I sat with numbers of notables in Ohio dentistry. One was a former president of the Ohio Academy of General Dentistry. Another was the current president of the Columbus Dental Society. Still another served on the state dental board. As desert was served, a eulogy was presented for a former chair of the fixed prosthodontics department.
Throughout the eulogy for the deceased, doctors at my table heckled him. “I thought the old bastard would never die,” one said. “That SOB will give Satan a run for his money,” said another. And on it went. The entire room was laughing. The reader paused on occasion only to receive the next round of jabs. I have never or since witnessed a eulogy devolve into a roast. This educator was universally despised within the Ohio dental community.
As our table consumed desert, each doctor in turn offered a personal story about the deceased. Each anecdote was more troubling than the next. I described how he had threatened to hold me back from graduating with my class, even though I had completed clinical requirements a quarter (more like a semester) early, largely due to my mentor’s outstanding mentoring. The departed professor demanded I keep producing income for his department. My story was topped by a prominent doctor who had that threat carried out by the deceased.
That’s also where I inquired about my mentor. Tragically, he had passed a couple of years earlier from complications of HIV. I never had the opportunity to tell him how much I appreciated his assistance. He meant a great deal to me.
Dr. Paul C. Belvedere
During an earlier phase of my career, I practiced in a small town Maine. I monitored incoming phone calls to the office and tabulated results for requested services.
Number one was “How much for a haul?” A haul was a local colloquialism meaning a tooth extraction. It was derived from local fishermen who “hauled” lobster traps.
The second most common incoming call asked if the practice accepted Medicaid. The state provided a printed listing to Medicaid beneficiaries of all credentialed Medicaid dental providers. Unfortunately, that listing read like a rogues’ gallery of doctors. Therefore, many Medicaid recipients tossed the list and phoned every dentist in the phone directory. As the expression goes, when you pay peanuts, you only attract monkeys.
I clung to the flawed philosophy of “Build it, and they will come.” I attended a growing number of advanced continuing education courses. In those years, I was on the cutting edge of ceramics in dentistry and implant dentistry, yet I couldn’t seem to educate my patients to demand advanced services.
Then I met Dr. Paul Belvedere. I attended every lecture he delivered in northern and central New England. More importantly, I signed up for every over-the-shoulder clinical presentation. They had small class sizes, and they were highly conducive to questions and answers.
Paul was an innovator. He worked like a magician in molding composite resin. He espoused different methods and angles for dispensing resin from the compule tip, depending on the result desired. He focused on injection molding concepts derived from plastics engineering and manufacturing. He physically altered translucent matrix bands to create ideal mold forms. He developed exquisite methods to isolate and shape the cavity form and the ensuing restoration.
After a presentation, Paul rarely left. He continued answering questions, no matter the time. He sat down to eat and swap stories over beers with his students. That’s where he questioned me about my thoughts on his theory of trans-enamel polymerization. This theory had then recently been allegedly refuted by a study at the University of Minnesota. In fact, Paul was largely dismissed and rebuked by the academic community until very late into his career.
I told Paul that the university study was flawed. The researchers assumed that resin polymerized toward the center of mass. They placed micro-motion sensors upon the resin surface. The curing resin surface was drawn away from the light and seemingly toward the body of the resin mass. The researchers failed to consider the oxygen inhibition layer, upon which the micro-sensors were attached.
The oxygen inhibition layer doesn’t polymerize. Micro-sensors will be pulled toward the first resin, which will polymerize and is immediately proximal and under the surface of the oxygen inhibition layer. A faulty illusion of resin polymerization toward the center of resin mass is created. Thus, Paul’s theory on the efficacy of trans-enamel polymerization was valid, and the accepted academic rationale was flawed. I doubt what we discussed more than two decades ago is accepted even today.
Paul also inspired me to research and contribute to the dental literature. If it weren’t for his mentoring, I would have never developed the concept of the amalgam wedge effect. He pushed me to analyze superior properties of direct resin dentistry versus the accepted standard of amalgam dentistry. This was during the time when those moving toward posterior resin dentistry were primarily anti-mercury. Paul encouraged me to stick to accepted standards in engineering and material mechanics.
Paul pressed me to reach the maximum number of colleagues feasible. “What good are peer reviewed journals if nobody reads them?” he frequently contended. I took his advice to heart and poured out multiple articles to his favorite dental publication, Dentistry Today.
In two articles from 1998 and 2000, I presented problematic issues generated by conventional amalgam dentistry. In 1996 and 1999, I presented viable solutions, and in 2001, I published a paper specifically detailing a number of Paul’s resin restorative methods.
My wife loved Paul. She knew how depressed I was, attempting to bring modern healthcare to a population that didn’t see its value. After visiting with Paul, I was always recharged with new methods and materials. I felt in the game of the dental profession and not a remote bystander languishing in a backwater practice.
She affectionately called him “Polyester Paul.” His suit jackets weren’t designer specials or Italian custom made. His clothes were right off the rack. This made him approachable. He was a regular guy who loved ice hockey, dentistry, and his wife Gail—not necessarily in that order.
I had a wonderful discussion this year with Dr. Doug Lambert during a break at one of his lectures. He continues Paul’s legacy in his clinical practice and in reaching out to doctors with classes on direct resin dentistry.
Paul died on November 1, 2017. Doug told me how much I meant to Paul. My eyes were welling up with tears, and I could barely look directly at Doug. I wish I could have told Paul what he meant to me in person before he passed.
Dr. John O. Grippo
Many know John Grippo through his work on noncarious cervical lesions. He specifically coined the term cervical abfractions. I met John in Longmeadow, Massachusetts, after I sold my practice in Maine, and he was about to retire. At that time, John was the senior partner in a group practice. He still wanted to continue his research on dental occlusion, dental mechanical stress, and specifically noncarious cervical lesions.
John trusted me to give several of his many peer reviewed papers a pre-review before submission to editors. I witnessed John’s research and understanding evolve over time. Initially, he saw abfractions as nearly an exclusive result of occlusal stress and strain. Over time, he developed a philosophy of multifactorial lesion causation. He also added the term biocorrosion to the dental lexicon.
John supported my early study of cervical abfractions and assisted me with a journal article. My small contribution was an examination of periodontal architecture in relation to cervical stress lesions, as well as restoration of these lesions. He also agreed to contribute to a roundtable discussion by occlusion experts, which I wrote up in 2003 for the Journal of Cosmetic Dentistry.
My wife and I were good friends with John and his wife Connie. They visited our home in New Mexico several years ago when John came to lecture at a Bio-Esthetics study club in Albuquerque. John was an extrovert who exuded not only his rich Italian heritage, but also a genuine love for study in dental science.
I knew of John’s health problems and frequently emailed him humorous stories, and he did the same for me. As John neared the end, he was confined to bed and was unable to operate his computer keyboard. His cousin thankfully notified me.
I was able to mail John a letter about how special he was to me as a mentor. Members of his family read him my letter as well as others from his colleagues in his bed, prior to his death. John passed away October 5, 2019, at his home in Longmeadow.
We all can access mentors during our careers. Don’t allow these opportunities to pass. They enrich one’s work and especially one’s quality of life.
It shouldn’t go unnoticed that my mentors were exquisitely focused on clinical dentistry and dental research. That was my professional direction for the initial part of my career. I genuinely love clinical practice and research. By nature, many of us are problem solvers. We want to advance methods, materials, and overall understanding. We do this chairside and benchtop. We do this all as a means of assisting our patients and the public overall.
Modern dentistry has changed. Our profession today is assaulted by invaders, including the insurance industry, government, supply companies, self-serving nonprofit groups, and corporate dentistry. We contend with an education-industrial complex whose thrust is to maximize new grads regardless of employment opportunity and outrageous debt loads. Now, they’re on to the market of dental therapists. Increasingly, doctors don’t view themselves as colleagues but as competition in a tight and unbalanced marketplace.
My direction needed to change. Yes, I could hide under a rock and maintain a track limited to clinical practice and clinical innovation, which I still do. But that’s not the ultimate lesson my mentors taught me.
We need to support our brother and sister colleagues. We must have their backs. The modern employment environment for recent graduates is often horrific. Doctors who’ve built many years of trust and love with their patients are too often swindled upon sale of their practice to the suits.
Patients frequently aren’t viewed as friends and neighbors, but as dental consumers to be upsold on needless services and tempted with bait-and-switch scams. The doctor/patient relationship often has been usurped by unlicensed management, many times at the direction of the private equity industry.
Seemingly, modern dental mentors have a different appearance. Most no longer practice clinical dentistry or do research. They’ve moved on. They fly in private jets, collect antique automobiles, acquire trophy wives and ancillary girlfriends, wear designer clothes and expensive jewelry, attend events with cultural and political elites, live in McMansions, and are otherwise removed from practice. These dental leaders spend more time with their attorneys than with dental colleagues. A grandiose external appearance of riches has replaced true inner wealth.
It’s now very evident why I spend weekends reviewing legal depositions and contracts for attorneys representing abused patients and doctors. I also give of my time to generate background data for media investigating those elements that swindle the dental public. Additional effort is freely given to public prosecutors who want to keep the bad actors in check.
I also write for you, even though we may never meet. My curriculum vitae is full of articles designed to assist doctors with employment and contract decisions. My hope is to alert colleagues to the scam artists who target our noble profession.
I realize I’m far closer to the end than the beginning of my professional career. I need to make my remaining limited time and effort count. I also recognize the false prophets in our field. Their roads lead to dead ends, if not right off a cliff.
My objective is for you to enjoy a very wonderful, fruitful career. Find a mentor or two. They probably won’t be wearing $700 Gucci shoes or driving a Lamborghini. They won’t be selling you on some get-rich-quick scheme. The only thing they desire from you is to see you give your best effort. They want you to be the best doctor and human being that you are capable of being.
Dentistry has enjoyed a rich history and legacy of mentoring. Don’t let that die out. Take part and become connected.
Dr. Davis practices general dentistry in Santa Fe, NM. He assists as an expert witness in dental fraud and malpractice legal cases. He currently chairs the Santa Fe District Dental Society Peer-Review Committee and serves as a state dental association member to its house of delegates. He extensively writes and lectures on related matters. He may be reached at firstname.lastname@example.org or smilesofsantafe.com.