Episode #407: Providing 5 Star Dentistry in a Discount World, with Dr. Keith Phillips 

In a world where dentists are pushed toward valuing quantity over quality, how do you provide the best possible care you can? Dr. Keith Phillips shares his tips for getting better at diagnostics, how to look at the bigger picture, and how to work with integrity. To find out how you can give your patients the five-star care they deserve, listen to Episode 407 of The Best Practices Show!

Main Takeaways:

•  Watching a problem won’t make it better.
• Don’t sacrifice your integrity. 
• What treatment would you want for your own teeth?
• Use all the tools at your disposal to perform a comprehensive diagnostic.
• Listen and work with the patient.

Quotes:

“What I want you to be thinking about is how you were trained in dental school to approach a treatment plan, and how long you have been in private practice, and how that has changed. Do you look at patients differently now? Do you look at their treatments differently? And most importantly, do you look at their diagnosis differently?” (00:45—01:06)

“A lot of dentists frequently don’t recognize the incomplete fractures of teeth. They often diagnose them incorrectly, they look at them and they say, ‘They’re there,’ and they use that phrase…’We’ll just watch that.’ And to quote Dr. Pete Dawson…’What the hell are you going to watch it do, if you just watch it?’ And of course, sometimes they’re treated improperly. Do you treat when you don’t need to? Do you leave them alone?” (02:06—02:43)

“We should start treating teeth more conservatively earlier on.” (04:02—04:09)

“I think there’s a lot of cases that we leave untreated that should be treated. There’s a lot of cases that we treat and we should question should it be treated, or at least how you treat it. And we don’t want to be guilty of doing non-conservative treatment. Does every tooth that has a crack in it need a crown? No. But I would contend that if a crack goes into dentin, we certainly want to treat the tooth somehow…It is your decision to make ethically, combined with talking with that patient.” (11:46-12:27)

“You’ve got to find ways to look at these teeth using cameras, using inter-oral cameras, handheld cameras, transillumination, you’ve got to clean the teeth off, you’ve got to dry the teeth, you’ve got look at all those things.” (14:50—15:02)

“You’ve got to look carefully, you need to look at teeth all these different directions, all these different ways, so that you know what you’re looking at.” (16:00—16:07)

“It’s not this tooth, it’s the entire process of the mouth—what’s the pathogenesis of that?” (25:02—25:08)

“I just have to question every time I treatment plan a patient—would I do it on me?” (26:05—26:09)

“The success was putting Danny in a position to prove to himself that he could manage this.” (35:24—35:31)

“I remember talking about Actinomycosis in dental school, but I never put that together, and the key here is you’ve got a cracked tooth. That bug is in your mouth all the time, but unless it can get to a place where it can thrive in an anaerobic environment, it’s not a problem, such as a cracked tooth or an area of decay. It has to have that portal of entry into a tooth.” (43:36—43:57)

“I think if you’re going to practice in a discount world and you want it to be five-star, you owe it to your patients to be better at diagnostics, to be better at conservative restorations, but most importantly, to look at the cause of everything you’re restoring. How did it get there? Why is it there? Do I need to intervene in the occlusion or the type of restoration we use? All those kinds of things factor into your decision about how to treat the tooth.” (44:32—45:07)

“The problem I find most often though is that I didn’t pay attention to the occlusion. Either it’s sensoric excursion or a complete crossover, and most of the time it’s getting over into complete crossover where I’ve missed something that caused a problem.” (52:04—52:19)

Snippets:

1. 0:00 Introduction.
2. 02:01 Overlooking the incomplete tooth fracture.
3. 03:40 Treating more conservatively earlier on.
4. 06:30 Case study 1.
5. 08:45 Case study 2.
6. 10:31 Maxillary molar case study.
7. 12:28 Cracks in teeth can be hard to see.
8. 16:10 It’s the patient’s decision.
9. 17:27 Inter-oral photography and transillumination.
10. 20:33 Incisal wear.
11. 22:10 Early occlusal disease case study.
12. 25:08 Moderate occlusal disease case study.
13. 26:11 Danny’s case study.
14. 35:46 Treating the patient, not the disease.
15. 36:22 Listening to the patient.
16. 38:57 Why it’s important to look at the whole patient.
17. 44:22 It’s about helping others.
18. 45:28 Q&A.

Reach out to Dr. Phillips: 

Dr. Phillips’ Facebook: https://www.facebook.com/a.keith.phillips

Dr. Phillips Instagram: @docphillips1

Dr. Keith Phillips Bio:

Dr. Phillips earned his Doctor of Dental Surgery degree from the UNC-CH Adams School of Dentistry in 1988. Prior to joining the Adams School of Dentistry faculty in 2019, he served as a Supervisory Dentist at the W.G. “Bill” Hefner VA Medical center for 8 years. In addition, he served as Lead Faculty at the L.D. Pankey Institute and held clinical appointments with the dental hygiene and dental assisting programs at Forsyth and Guilford Technical Community Colleges. Having begun his dental career practicing with his father, Dr. Kenneth Phillips, he maintained a very successful private practice in Winston-Salem, North Carolina for more than 20 years. 

Dr. Phillips began his appointment as a full-time associate professor of comprehensive dentistry within the Department of Restorative Sciences. Phillips’ responsibilities as an associate professor include teaching comprehensive dentistry. He serves as Preceptor/Group leader for 2nd, 3rd and 4th year learners and is a co-team leader of the Adams School of Dentistry’s Clinical Curriculum Development for third- and fourth-year DDS students and a member of the faculty calibration committee.