I am continually amazed at what life throws at us. Now that I have been in the dental field for 28 years practicing general dentistry and teaching, I see there is a certain historical perspective that one gains. I actually have a few historical perspectives in dentistry – one as a general dentist with a private practice, and the other as a consultant, researcher, and lecturer.
I get to spend time with patients in the office, and I get to spend time with many of the key leaders in dentistry, as well as many of the dental manufacturers. At my lectures, I also get to spend a lot of time with general dentists all over the world. I’ve probably learned the most from you, the general dentist, who sees and treats patients every single day. Whenever I think I’ve seen it all, all I have to do is talk to a fellow dentist who has a new idea or a perspective on a challenge that has cropped up. Dentists are very creative problem-solving people, which is why I love to spend time with my fellow peers.
What I have really learned is that what goes around comes around. When porcelain veneers first came out 30 years ago, they were a very conservative alternative to full crowns. Porcelain veneers, way back when they were first talked about and developed, were for cases that needed very little tooth reduction. They were attached to the outside of teeth with this new thing called bonding and could give anyone a Hollywood smile, without having to do full crowns.
Nowadays, when you see most porcelain veneer cases in dental journals, you see three-quarter crowns being called porcelain veneers and being touted as a conservative alternative to full crowns. Unfortunately, many times these preparations are being done on virgin teeth. Don’t misunderstand me – there are many instances where preparation is necessary for these porcelain restorations, such as with discolored or rotated teeth. However, there are many situations in which porcelain veneers can be done with little to no preparation in the enamel only.
There is finally a major paradigm shift happening in the dental industry where we are going back to what porcelain veneers were originally intended for, and that was either no preparation or minimal preparation cases. In my lectures, I always call this “Back to the Future,” because this is exactly what is happening with porcelain veneers. So many dentists that I talk to, once they understand what a porcelain veneer should be, often tell me that years ago they remember doing no or minimal preparation porcelain veneers and really just kind of forgot about it. They still see those patients every single year or twice a year on recall and the patients and the veneers look absolutely great— but they just kind of forgot about the technique and got swept up in the heavy preparation three-quarter crown porcelain veneers.
The DenMat Corporation deserves a lot of credit for staying the course with this technique with their Lumineers. It’s nice to finally see this technique become the preferred method of doing porcelain veneers. So I guess what goes around really does come around.
Valplast partial dentures are another example of what goes around coming back around. I remember doing Valplast dentures some 20 years ago. It looked like an interesting technique, so I tried it on a few patients and had some successes. Over time, I tried other partials and just forgot about Valplast. I tried a few cases a few months ago with Valplast again and couldn’t believe the results I was now getting.
My good friends at Trident Dental Laboratories suggested Valplast on a case, guided me through the process, and now I am doing Valplast partial dentures again. The dentures are thin, esthetic, and much lighter than anything else on the partial denture market. Like anything else we do, you need to know if your patient is a good candidate for using Valplast (they work best on a teeth-born partial denture). Once that is determined, you will find it a valuable, successful technique that has been around for many, many years. It may not have received as much marketing as it deserves, but it is becoming popular once again. Another example of what goes around comes around.
Sometimes the best things in life are not new things but time-tested techniques that had been innovations years ago that were way ahead of their time. Let’s take a look at what has been successful for dentists and patients for the last 25 years and bring those successes back to our offices. Let’s use “what goes around comes around” to our advantage to provide the best we can for our patients.