Interviewing A Giant of Dentistry

Dr. Joe Blaes sits down with Dr. Peter Dawson

Dr. Peter Dawson is one of the giants of dentistry. During his 50 years in dentistry, his name has become synonymous with excellence and teaching. His achievements are many but he is probably best known for the courses that he offers through the Dawson Center for Advanced Dental Study. Many dentists throughout the world are better because of the courses they took from Dr. Dawson. Dental Economics is proud to bring you this interview.

Dr. Blaes: Where did you begin your career in dentistry? What are your roots? Did you always practice in Florida?

Dr. Dawson: My career in dentistry started as an apprentice technician in my dad's dental lab. I was 13, and I knew that dentistry was in my blood. By the time I got into dental school, I could do every procedure in the lab and I loved everything about it. After dental school I spent two years as a crown and bridge prosthodontist in the U.S. Air Force. I then opened my own practice in St. Petersburg, hired a technician my first year in practice, and concentrated on crown and bridge prosthodontics. I really thought I knew what I was doing, but I was practicing with the mistaken belief that regardless of how good we did the dentistry, it would take time for patients to get used to it. The common belief was that it was "harder to fit the mind than the mouth." Then I met Dr. Sigurd Ramfjord and he changed my practice life forever. He taught me how to equilibrate an occlusion to centric relation. I called my crown and bridge patients back in and found deflective inclines I hadn't known were there. The response in my patients was so dramatic that I started getting referrals from a wider and wider area.

My success with getting occlusions so routinely comfortable was also resulting in some astounding resolution of TMJ pain as well as the elimination of a lot of headaches. The more successes I had, the more complex the problems I was called upon to solve. I knew I had to become better at all phases of dentistry so I attended postgraduate courses throughout the country. I developed great friendships with L.D. Pankey, Clyde Schuyler, Alvin Fillastre, Charles Stuart, and many others. Through these relationships, I met just about every leading clinician in the country. It was a fantastic time in dentistry as everyone shared and fought for their beliefs. Someone described some of our meetings as "blood all over the walls" but then we could go out to dinner together as friends. It forced me to back up my clinical beliefs with solid facts about anatomy and physiology and an in-depth knowledge of the literature. Parker Mahon, Dr. Harry Sicker, and others contributed greatly to my understanding, and my teaching led into a book that became a best-seller. My seminar schedule became so busy I eventually had to curtail my practice hours so I could concentrate on teaching and writing, but I restored many mouths and traveled to many meetings before I reached that point.

In 1979 I founded the Dawson Center for Advanced Dental Study in order to bring together a multidisciplinary group of specialists in active practices. By working together and acting as a multidisciplinary "think tank" for dentistry, we have expanded our capabilities in diagnosis and treatment while sharing what we learn through a concerted teaching effort. I stay tremendously stimulated by this association as its scope expands.

Dr. Blaes: You are known in the profession as a great teacher. You have that knack of making the difficult simple and understandable. How do you do that?

Dr. Dawson: It is often a real challenge to make complex concepts understandable, but it is the part of teaching I enjoy the most and work the hardest to accomplish. It is a big advantage to have nearly 50 years of extensive clinical experience in restorative dentistry. That experience includes exposure to enough different philosophies to learn what doesn't work versus what dentists can do with the highest level of predictability. I really want my students to understand why some concepts work and others don't. I've found the best way to help dentists understand is to break concepts and procedures down into bite-sized pieces. I also try to back up every point I make with scientific research that verifies the basis for what I teach.

Dr. Blaes: How did you get started teaching your great practice-management courses? They were always exciting and filled with all kinds of pearls.

Dr. Dawson: For many years, I concentrated on teaching clinical concepts of complete dentistry. As dentists learned more about how to diagnose and treat problems that they had previously ignored, they were faced with the need for better management and better communication skills. I always enjoyed — and worked hard at — developing good management concepts for my own practice and just felt a need to share what I had learned. I really like to do this because I've met so many good dentists who fall short of their potential because they don't know how to manage. Leadership and management are skills that can be learned and the process can be life-changing. I wish more of these skills would be taught in dental school.

Dr. Blaes: Do you have a favorite course? Is there one that is more rewarding for you than others?

Dr. Dawson: I love to teach all of the courses in our core curriculum, but my favorite is Seminar One on the Concept of Complete Dentistry. In that seminar, I explain the 10 "must know" factors of occlusion. I enjoy this course so much because dentists get so excited learning ideas that most of them didn't know. As I said earlier, there are so many misconceptions to correct, and I love to take each one of those confused concepts and make it simple to understand. It is fun to see the lights turn on, especially knowing what a positive impact it has on their practices. For many, they tell me it is a life-changing experience, and that is just what I want it to be.

Dr. Blaes: What innovations in design or equipment or general office management do you envision in the future for dental offices? What should dental practitioners be thinking about?

Dr. Dawson: There is almost no aspect of dental practice that will not benefit from new advancements in equipment and materials. Digital systems for everything from imaging to management keep getting better. Diagnostic aids and computer programs for recording examination data are already useful, and I believe it is just a matter of time until CAD/CAM and lasers are used routinely. The one thing that will not become obsolete is the clinical skill and diagnostic acumen of the dentist. I think now, more than ever, dentists should be concentrating their major efforts on learning more about how to diagnose and treat all types of masticatory system problems, including a broad understanding of occlusion and TMJ disorders.

Dr. Blaes: Compare today's typical dental patient to one from 30 years ago. What were and are their priorities?

Dr. Dawson: I started practice 50 years ago so let's start there because there is a huge difference in the perceived priorities of patients then versus now. I say "perceived" priorities because patients have always wanted healthy, good-looking smiles. The major difference is that 50, or even 30, years ago, they didn't know it was possible to do what we take for granted today. So a typical patient had either lost several teeth or was planning to lose them. Missing teeth were not the stigma of today and full dentures were considered by many to be inevitable. We almost never saw a child who didn't have a mouth full of decayed, missing, and abscessed teeth. Those same children are now the Baby Boomers and everything has changed. They want beautiful smiles, and healthy, comfortable mouths. Losing teeth is unacceptable. Furthermore, for the most part, they expect dentists to fill that need -- and they will pay to have it done.

Dr. Blaes: Compare today's typical dentist to one from 30 years ago. What were and are their priorities?

Dr. Dawson: To answer that question, we'll have to separate typical dentists into the tier in which they choose to practice. Too many dentists fail to recognize that the typical patient wants what dentistry can do for them, but doesn't know to ask for it.

Dentists who shortchange their patients with incomplete exams or who fail to educate their patients about the implications of not treating problems in a timely manner will go on filling holes. They think their patients just "want" the cheapest, fastest service as long as insurance pays for it.

The typical dentist who is a continuous learner and takes advantage of all the new and wonderful advancements will have different priorities and will thrive in the market for quality, caring, dentistry. I have no doubt that we will soon be seeing a major shortage of dentists. The legitimate needs of the millions of Baby Boomers will raise the demand for quality care to an unprecedented level and those dentists who prepare themselves to fill those needs will benefit beyond their imagination.

Dr. Blaes: What is the biggest mistake dentistry is making?

Dr. Dawson: Dentistry is making several mistakes and most of those mistakes are already having serious consequences. I've already commented on the fast-approaching shortage of dentists. We've been asleep at the switch to not recognize the growing need for dentists to care for the largest influx of patients in history. The "over 50" market is huge and growing, and their needs are great because they still have their teeth. They also have periodontal disease, excessive wear problems, cracked teeth, and a ton of deteriorating amalgams, and most all of them want good-looking smiles. Some serious planning needs to get started because when patients can't get the care they need, there will be an uprising and everyone loses.

A second mistake I see is a serious inadequacy in educating dentists in proper diagnosis. Today's dentists should be trained as physicians of the masticatory system, and that includes the TMJs and the many facets of occlusal disease. We have conducted extensive questionnaires and interviews through our Center and we don't find one dentist out of 10 who has an adequate understanding of the factors that control the health of the masticatory system and the long-term stability of the teeth or the joints. Occlusal disease is a major cause of excessive wear, tooth fractures, hypersensitivity, masticatory muscle pain, and a whole plethora of signs and symptoms. Dentists need to be trained to diagnose and treat all these problems. What's really scary is if they don't know how to do this, they can't be sure they won't be the cause of these same problems.

The typical tendency when proper diagnosis is shortchanged is to treat symptoms and ignore signs of progressive disease. This has been the general approach advocated for orofacial pain problems, most of which could be treated successfully by correcting the cause of the problem rather than covering up the symptoms with medication. I see this as a major shortcoming that could be changed by a concerted educational approach in the dental schools and continuing-education programs.

Dr. Blaes: What is the greatest thing dentistry is doing?

Dr. Dawson: It is obvious that the profession is doing a lot of things right. The advocacy of fluoridation probably cannot be fully appreciated by dentists who were not in practice before fluorides were added to the water supply, but the change in the dental health of both children and adults who have benefited is monumental. The advancements in implantology, new adhesives, more lifelike materials, tremendous advancements in periodontology, bone augmentation, and caries control have all been noteworthy. Advances in endodontics are spectacular when compared with the procedures we used when I started practice. Tremendous advances in imaging have made diagnosis of TMJ disorders and other structural causes of pain/dysfunction a practical capability even for a general dentist. Constant improvement in restorative materials has resulted from cooperative efforts between manufacturers and clinicians, and a trend toward evidence-based research has improved the validity of scientific reporting although there has been some abuse of the rules. Overall, our profession is in a period of dynamic improvement. I am optimistic that a growing number of dedicated professionals will keep the positive trend moving ahead. For a person of integrity and dedication, there has never been a better time to be in dentistry.

Dr. Blaes: What are your plans for the future? I know you are not ready to retire!

Dr. Dawson: My plans for the future are to keep teaching as long as the good Lord allows me to stay healthy. My enthusiasm has never been higher and I'm stimulated by a very clear insight that the need has never been greater. I'd feel selfish if I didn't pass on what I've spent so many years learning.

The program will address the broad range of issues affecting today's dental professionals, from current trends in implant dentistry with Dr. Carl Misch, to functional occlusion with Dr. John Kois; from the role of TMJ in complete dentistry with Dr. Mark Piper, to marketing the aesthetic practice with Dr. Michael Koczarski. Additional topics include "Market Like a Leader" with Dr. Paul Homoly; the doctor/technician partnership with Dr. Glenn DuPont and Lee Culp, CDT; and the power of vision with David Weber. Additionally, Dr. Homoly and Dr. Susan Maples will conclude the meeting with the program, "Practice Like a Leader." Dr. Dawson will address the session, speaking about his reflections of the past 50 years in dentistry.

Tuition for the three-day program is $1,295 per doctor/technician before Feb. 1 and $695 per team member. After Feb. 1, tuition is $1,395 per doctor/technician and $750 per team member. Interested participants are urged to call the Dawson Center staff at (800) 952-2178 to reserve their place. Space is limited. Tuition includes continental breakfast Thursday, Friday, and Saturday, lunch Thursday and Friday, cocktail reception on Thursday evening, and anniversary banquet on Friday evening. Attendees will also be provided with 15 CE credits.