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Episode #121 - Visualizing the Treatment Plan From the Wax-Up to Definitive Restorations with Dr. Andrew Cobb
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Dr. Andrew Cobb is the director of core curriculum at the Dawson Academy. This is where they share the core concepts instituted by Pete Dawson decades ago. He also has a private practice and is an experienced clinician and teacher. Today, we talk about Drew’s method for visualizing the treatment plan from the wax-up to the definitive restorations.
He has a method for breaking everything down into steps that he follows with each and every patient. He uses checklists for each of the stages and makes sure to share his treatment planning with other specialists that may be working on the case. Through thorough planning and presentation, the work can be done in an easy and predictable way that gets the results you promise your patient. This process saves time, money, stress, and heart-ache.
You can find Dr. Andrew Cobb here:
Dr. Andrew Cobb Dawson Academy
Andrew C Cobb, DDS on Facebook
Show Notes
[02:09] Drew is the director of the core curriculum at the Dawson Academy. They share the core concepts that Pete Dawson instituted decades ago.
[02:38] The core process of how we deal with patients who have a different need than the tooth by tooth process still stands.
[02:46] It's a format and a protocol on how to deal with all of your patients. It's specifically to identify a process to find ideal treatment with long-term, predictable dentistry for these patients.
[03:01] This process changed Dr. Drew's life as a dentist.
[04:09] Treatment planning is where we live and breathe daily.We have to come up with treatment plans because that's how we fill our schedule.
[04:28] Specialty patients have more advanced needs. We have a process to go through that makes these more complicated cases easier.
[04:44] It's a repeatable process for each patient every time. We like a step wise process to get you from the beginning to doing the dentistry and to have a low stress, predictable outcome.
[05:18] The potential for stress actually gets harder the better you get at dentistry.
[06:47] How incredible it is to improve patient's life and appearance.
[06:57] There are people who fix teeth and there are people who change lives. You just need to decide which one you want to be.
[07:31] The would I do it on me phase. This is about doing ethical dentistry and taking the time to really evaluate your patients. You have additional records and models and photos.
[07:43] You're going to work up the case and that's how you develop what the solutions actually are. The first step is critical. You can't do a good job without doing the first step.
[08:15] The more you guess the more you will be wrong. You don't want to be wrong on the definitive restoration day.
[08:41] The importance of slowing down and doing things right the first time.
[09:19] The importance of checklist thinking.
[10:28] Get good impressions and good laboratory work.Then do a trial run on the models. What do you need to do to fix the functional issues? What do you need to do to fix the aesthetic issues? This is where the plan gets developed.
[11:17] If you don't do the models you can miss things. You learn a lot doing the models.
[12:25] You have to block time to do this treatment planning process.
[15:12] The importance of having an open honest discussion with your patient and letting them decide what they want to have done.
[17:59] They have a 10 step checklist for doing the wax it. The checklist is an easy way to do the wax-up on the model.
[19:33] Send your lab your checklist and they will be thinking the same things that you are thinking.
[20:34] Functionally we start with the mounted models eccentric relation. Where should the front teeth be?
[22:18] Only wax-up the segment that you are going to treat.
[23:59] Figure out the treatment plan in your mind and didn't do it on the model. What teeth do you need to treat? When do you need to do? What specialist do you need?
[25:47] The checklist for sequencing treatment.
[30:21] We are the advocate for the patient's dental health.
[31:22] List all of the treatments. Designate everything as a stage 1,2, or 3. Write notes to everybody on the interdisciplinary team. The better you communicate, the better the result is in the end.
[34:17] Time is one of the most important pieces of your fee. You also need to ad a wax-up into your fee schedule. Estimate for the lab fee. Factor everything in to determine your fees.
[36:41] Money invested in dentistry is some of the best money you can ever invest.
[38:22] Get the teeth healthy. Take care of decay, endo, and perio.
[39:18] Address airway issues and overall systemic health. Set things up slowly. Don't rush to restorative dentistry.
[42:49] With the restorative case start at the lower anterior first. We want stable stops everywhere.
[46:32] Treatment planning is about taking the steps of the case and unraveling them one at a time.
[47:42] How much time do you need to schedule in to do the work?
[49:23] Overestimate don't underestimate time.
[50:07] Give your specialist everything they need to do the best job possible.
[50:55] Stand out from the crowd with great communication and be the go to dentist in your area.
[53:40] Dr. Cobb meets with his specialists and review jobs that are in the pipeline. It's fun and you learn things. Throw in some dinner and wine and make it fun.
[55:07] Talk to the patient. Treatment option review. Outline of whatever you are going to do.
[57:31] Treatment plan and stages written out and in a folder. One fee plus lab fees. They will break it down for insurance.
[01:00:05] Go over the treatment plan and then schedule the patient. Do as much as you can to make it easy for the patient.
[01:02:22] The key is going from the wax-up to the treatment plan. Then to what we really want to do which is the dentistry.
[01:02:52] Pitfalls happen when we don't follow the process. Predictably happens for a reason.
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