In Walnut Creek, CA, Schmedding has created a practice where he believes doing less means more for his patients, not only in the present but also in the future.
Dr. Troy Schmedding.
"Anytime we tackle a procedure or anytime we're looking into doing direct or indirect restorations, our ultimate goal is to save tooth structure," Schmedding told me in a recent interview. "It's been my battle cry for years that we dentists are probably a little more aggressive with procedures because we're probably not maximizing a lot of what we have in our arsenal when it comes to modern-day chemistry, including products from Kuraray. You combine that with the zirconia, glass ceramics, and composites that are available and that gives us what I call an 'exit strategy.' "
I asked Schmedding what he meant by "exit strategy" and if he could provide me with an example.
"Let's say you have a 28-year-old individual who comes into your office and needs a full coverage type of restoration on the first molar," Schmedding explained. "My first approach would be to think that this tooth will probably need to have restorative work on it a couple of times over its life. Why is it my objective to take that tooth and cut it down to barely nothing, all the way with a 360 margin and place a crown over the top of that? Because I'm simply relying on retention resistance work that's built in in terms of the mechanical focus of dentistry, whereas my thought process turns to how can we chemically utilize the bioemulation of that tooth and capitalize on that to restore it. If I create a restoration for that tooth and if it does fail, it still allows me an exit strategy or ability to place another restoration on it because I did not take away massive amounts of tooth structure.
"I consider it more of a trend that we promote in our office. Even with veneers, I'm doing prepless veneers because I try to get everything done with the least amount of reduction as possible. That's kind of our motto."
It's also something that Schmedding discusses with patients and believes that, by word of mouth, will help set him apart from some of the other practices in the dentist-heavy area roughly 23 miles from downtown San Francisco.
Schmedding believes there is room for the minimally invasive movement in today's dental world, but he also knows it's an uncomfortable thought for many dentists.
"The way we grow is by getting yourself uncomfortable," Schmedding said. "My recommendation to my colleagues is to start by just taking a look at it. Take a look at the research, get an understanding of what you're trying to accomplish, and then start taking some hands-on courses. See where that leads you down the road of adhesion-based dentistry."
What else is important when it comes to having a practice focused on minimally invasive dentistry? Schmedding said it takes the entire team working together to make it a reality.
"I had a practice in Seattle, then focused on education before buying this practice in Walnut Creek," he explained. "My staff had not worked in a minimally invasive environment before I came, so it was a bit of learning curve. Having a staff that is willing to change and adapt to change is so important. At first, my staff didn't understand the concept, but we worked together to make sure everyone was on the same page. I believe your staff will honestly make or break you, so it was important for me to make sure they were comfortable with the direction our practice was heading. And, honestly, they were excited about doing something new.
"You have to have a staff willing to learn, and your staff has to understand how important they are to the success of that procedure. When they understand their roles and how important they are, that drives overall team camaraderie and enthusiasm."
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