Creating a passion for dentistry

Dr David Hornbrook is one of dentistry’s most talented clinicians and has helped thousands of dentists fall back in love with their profession. He shares his knowledge and expertise with others and helps them discover the passion they need to improve the quality of patient care.

All this is done through the work his company, The Hornbrook Group, does. They specialise in offering continuous education to dentists and Dr Hornbrook is its executive director.

During a question and answer session with Dentistry, he discusses what he feels the future holds for continuing education and why it’s something all practising clinicians should be participating in.

Q: What would you say is the best way for dentists to learn new skills in aesthetic dentistry?

There are so many ways that clinicians can learn about the new and exciting materials and techniques available today. Most clinicians don’t learn about adhesion and aesthetics in dental school, and so post-graduate education is becoming increasingly important to help them keep up with all the changes. This education can include reading articles from leading journals and actually treating a patient under the direct supervision of a leader in dentistry.

For many, attending over-the-shoulder or live-patient treatment programmes have also helped their aesthetic and adhesive careers.

Q: What’s the best way to keep abreast of the constant changes going on in adhesive and aesthetic dentistry?

Ongoing education is key, but it is virtually impossible for the average, practising clinician to keep up with all the new changes going on.

Many educators have made it their life ambition to work with dental manufacturers in product research and development, and they get to evaluate these materials long before the general dental population. This gives them a unique advantage over the full-time practising clinician, and so they often become a useful source of knowledge to them. Periodicals based on the changes in this exciting facet of dentistry are also indispensable to practitioners.

Q: What change has made the biggest impact in aesthetic dentistry over the last five years?

I can think of three things and they are increased research and development in easy-to-use predictable dentinal adhesion, advancement in metal-free restorations, and lasers.

In terms of dentinal adhesion, the concept of self-etching primers has opened new doors for those clinicians concerned about post-operative sensitivity and predictability in the past. Whether the agents that are available today are the answer or meet our needs long term has yet to be seen, but they are certainly the predecessors of the dentinal bonding agents of the future.

The manufacturers of metal-free dentistry are continuing to provide strong, aesthetic materials that will replace the need for metal support. Materials such as lithium disilicate and zirconium have allowed clinicians to eliminate the unaesthetic compromise that metal has historically provided.

In the realm of direct resins, manufacturers have aimed their research and development toward more lifelike ‘enamel mimicking’ materials containing more filler particles for strength, durability and handling.

Lasers were first used in aesthetic dentistry back in the early 1990s as a means to rapidly polymerise composite resins. However, research has shown that the technique may have decreased the physical attributes of these materials and that using lasers for this purpose saved practitioners little time.

Today, lasers are used to contour gingival tissue in anterior aesthetic cases in order to achieve ideal symmetry and better height to width ratios.

The diode laser is the most popular one to use for this treatment. I probably use a diode laser in over 95% of my anterior aesthetic cases and we have incorporated their use in our Hornbrook Group live-patient programmes. Even those clinicians that have previously not emphasised the importance of gingival tissue in achieving ideal aesthetics of a smile instantly see the advantages of the diode laser once they see it in clinical use.

All in all, we have seen a general trend towards more conservative dentistry, with the emphasis being on

providing our patients with beautiful, invisible and long-lasting dental care.

Q: What are the current trends in continuing education?

Recently, the over-the-shoulder style of teaching programme has become more popular. This style of teaching usually consists of an educator treating a patient, while attendees look over his or her shoulder watching the treatment. This programme has many advantages. Teaching is focused on a small intimate group, questions are encouraged and students can easily see what is going on.

I have been involved in several of these programmes and have prepared and seated ceramic restorations on a patient while 10-to-20 clinicians watched. Seeing an experienced clinician and the manner in which the bur is oriented or dentinal adhesive applied, for instance, in three dimensions can be invaluable.

The ultimate in aesthetic education is the live-patient treatment programme. Over two weekends, clinicians treat a patient under the guidance of leading dentistry educators and clinicians. The popularity of this type of teaching has grown dramatically over the past seven years.

These programmes require clinicians to travel away from home, but the cost of this is soon forgotten once the educational value is realised.

Q: Is this the Hornbrook Group’s take-home message?

This is the ‘platinum age’ of dentistry, and there has never been a better time to be a dentist. If excellence and perfection is a destination, education and learning is the journey.

There is simply no substitute for education and we need to advance our knowledge if we want to offer our patients the very best care we can. If we want our patients to place their trust in us, then it is our responsibility to be equipped with as much knowledge as possible.

The journey of education breeds passion, and that is the catalyst to achieving excellence and enjoyment in this profession.

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