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A Hands-On Experience in Dentistry w/ Dr. Dennis Hartlieb
80 Plays1 year ago
Dr. Dennis Hartlieb and I had the opportunity to talk about honing in and building the craft of dentistry through hands-on opportunities, how photography in dentistry is essential, and propelling forward with continuing education.
Dr. Dennis Hartlieb is a graduate of the University of Michigan School of Dentistry and maintains a full-time practice committed to cosmetic and restorative dentistry in the Chicago suburb of Glenview, Illinois. Dr. Hartlieb is an instructor at the Center for Esthetic Excellence in Chicago and is formerly an Adjunct Associate Professor at the Marquette University School of Dentistry in Milwaukee, Wisconsin. Dr. Hartlieb has authored numerous articles on restorative and esthetic dental techniques
Dr. Hartlieb is an Accredited member of the American Academy of Cosmetic Dentistry (AAACD), American Academy of Esthetic Dentistry (AAED), a member of the American Academy of Restorative Dentistry (AARD), the American Dental Association, the American College of Dentists, and the American Academy of Dental Sleep Medicine. He is the founder of Dental Online Training (DOT), an online hands-on training program for dentists, dental auxiliaries, and dental students. Dr. Hartlieb is also an examiner for the AACD Accreditation process.
Check out Dental Online Training
Connect with Dr. Dennis Hartlieb
Connect with Dental Online Training
Connect with New Dentists on the Block: @newdentistsontheblock
Connect with Tanya Sue Maestas: @tsmaestas.dds
Full video on Youtube
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Transcript
Introduction to 'New Dentists on the Block'
00:00:00
Speaker
Welcome to New Dentists on the Block, a podcast featuring new dentists sharing their experiences in the world of dentistry. Successes, challenges, and life in between, navigating dentistry together one experience at a time.
Meet Dr. Dennis Hartleib and his journey
00:00:16
Speaker
So excited to share this conversation with someone that I spoke with at Voices of Dentistry.
00:00:22
Speaker
Though not a new dentist, Dr. Dennis Hartleib offers an excellent opportunity for hands-on learning education through his platform DOT. Dr. Dennis Hartleib is a graduate of the University of Michigan's School of Dentistry and maintains a full-time practice committed to cosmetic and restorative dentistry in the Chicago suburb of Glenview, Illinois. Dr. Hartleib is an instructor at the Center for Aesthetic Excellence in Chicago and is formerly an Adjunct Associate Professor at the Marquette University School of Medicine
00:00:51
Speaker
in Milwaukee, Wisconsin.
Dr. Hartleib's educational contributions
00:00:53
Speaker
Dr. Hartleib has authored numerous articles on restorative and aesthetic dental techniques. He is an accredited member of the American Academy of Cosmetic Dentistry, American Academy of Aesthetic Dentistry, a member of the American Academy of Restorative Dentistry, the American Dental Association, the American College of Dentists, and the American Academy of Dental Sleep Medicine.
00:01:13
Speaker
He is the founder of Dental Online Training, DOT, an online hands-on training program for dentists, dental auxiliaries, and dental students.
Creating Dental Online Training (DOT)
00:01:22
Speaker
Dr. Hartlieb is also an examiner for the AACD accreditation process.
00:01:27
Speaker
I have followed Dr. Hartlieb for a few years now and have also participated with some courses on DOT, which is an awesome platform if you haven't checked it out. Dr. Hartlieb and I had the opportunity to talk about his experience in dentistry and what DOT has to offer. Let's get to it.
00:01:44
Speaker
Welcome everyone to New Dennis on the Block. I'm very excited to have Dr. Dennis Hartley with us today. A not so new Dennis, but somebody who has a lot to share for New Dennis and who will talk a little bit about his platform with DOT and a little bit about his story. So I'm going to send it over to Dr. Hartley.
00:02:02
Speaker
All right, well, thanks for having me. So I've been practicing in the Chicago area for about 35 years. I was also on faculty at Marquette Dental School for about 25 years. So I have really a very strong place in my heart for dental students and for young dentists.
00:02:17
Speaker
So my practice is restorative practice. I don't do any surgery. I restore teeth. I restore implants. And then that I've been doing over the years. And I have principally a cosmetic-based practice, though I do still do some general restorative dentistry. I started dental online training about five years ago, six years ago.
00:02:38
Speaker
And my concept was I've been teaching hands-on courses a lot through Cosmodent, if people use Cosmodent materials and I've done other stuff. And I love teaching and I love teaching hands-on courses because what I like about hands-on courses is it's immediate, right? When you give a presentation, when you're just giving up a lecture, you're not really sure how much people are really taking in.
00:02:59
Speaker
And for me as a learner, I learned so much better by actually getting materials in my hands and then working with them and then getting feedback on what I'm doing right and what I'm doing wrong. So I love doing hands-on programs. Back in 2016, I was doing a hands-on program.
Challenges in teaching dentistry
00:03:15
Speaker
We had about 15 dentists. And usually when you're teaching a hands-on program, people are sort of like in a bell curve. You got really advanced students and they're literally always in the front row.
00:03:26
Speaker
And then you have the middle of the bell curve and they are literally in the middle rows. And then you have the laggards, the people who just aren't familiar with the information and they are always in the back row. And so, I mean, it really is the bell curve.
00:03:39
Speaker
This particular course had a really weird curve to it. We had three really excellent students that were right in front of us. And the other dozen students or so really had almost no experience with anterior composites. And so it was one of the most challenging courses I've ever taught because I couldn't go slow enough for the people who were really accelerated.
00:04:00
Speaker
I'm sorry, I couldn't go slow enough for the people who didn't have much information, right, who needed it. And I couldn't go fast enough for the accelerated people. And I was so disappointed at the end of the course, I went and had a beer with a colleague of mine who's an IT guy, a friend of mine. And I told him, you know, it isn't that the people, the laggards, not that they're dumb, it's just that they're not familiar with the material. And I said, I can guarantee if I was in their office, I know they could get this information. It's not that difficult.
00:04:27
Speaker
And it was actually through our conversation where we decided, well, why don't we make it available for people to do in the comfort of their own practice?
00:04:34
Speaker
And then as we talked more and more, and as I started developing the concept, I wanted to develop hands-on learning that was affordable. Because if you take courses at, you come out to Spear, you go out to Cosmonet, you go to Coise, wherever, there are thousands and thousands of dollars. And as a young dentist, I'm very sensitive to the fact that many of these young dentists are hundreds of thousands of dollars in debt, literally up to half a million dollars. And so then to take off the time, to pay for travel, to pay for the course itself,
00:05:03
Speaker
If you're an associate, maybe your boss will pay it for you, you know, the owner practice, but maybe not. It's a lot of money, it's time away, and it's time when you could be practicing dentistry and earning an income. So I wanted to make something that was easy for people to be able to access and for people to be able to learn at their own pace.
00:05:23
Speaker
without the expense of travel. So essentially my concept was let's do hands-on learning for people in the comfort of their own home.
Innovative course structures at DOT
00:05:30
Speaker
So we have pre-recorded courses. Say you want to learn how to do an invisible class four.
00:05:36
Speaker
So, you sign up with our DOT stuff, we send you a kit that has the same model that I'm going to be working on, the same opakers, the same tints, the same composites, same burrs, and then I show the technique step by step through my microscope, and then when you get your kit, you open up the webpage and you go to that course, and you follow along step by step.
00:06:00
Speaker
And at any point, you can you can write in a question, you can upload photos and get feedback. It's not real time because I'm not on the computer or accessible, but I'll I answer questions usually at the end of the day or the next day and help participants get better at the dentistry that they're doing without the expense that you have when you go to, you know, to a live in person course.
00:06:20
Speaker
Yeah, the platform is very comprehensive. I had the opportunity of trying out the platform a few years ago. I don't know if it was when you all launched, but I want an Instagram giveaway and that was really cool. And so I got to tinker a little bit with the platform and it is really cool to see how much it's grown. And I like to see that there are also some live opportunities and you provide feedback during that time as well too.
00:06:43
Speaker
Yeah, so what's what's sort of moved on from just having the on demand courses. Now we're doing several live courses. So this year 2023, we have five live virtual courses. So from the comfort of again, of your own, you know, your own kitchen or your own dental practice, we send you the kits, and then they're either a two day course or a one day course. And we do everything from six direct composite veneers to veneer preparation design,
00:07:07
Speaker
We're doing a posterior course for the first time this year. We do a worn dentition course or if you're dealing with patients with worn teeth. That's a great, the CPR for the worn dentition was probably one of the first ones that I watch with the DOT program and it's really good. I'm very proud of that course and this is, I say my, any technique that I'm teaching is information I've stolen from other people and it's an amalgamation of
00:07:31
Speaker
What I learned from Frank Spear with facially generated treatment planning. Jeff Rouse and Bill Robbins with global diagnosis and some of the airway stuff right from Jeff Rouse. Buddy Moper with all his bonding techniques. Corky Wilhite who was first person who introduced me to transitional bonding almost 20 years ago.
00:07:49
Speaker
So all these people I've been just sort of bringing their information together, Dawson, all that stuff and bring it into one course to help dentists safely treat patients who have worn teeth because we're all seen it's epidemic in our practices. Oh, absolutely. And it is so nice that you can do it from you know, the comfort of your practice, the comfort of your home, if you have that technology at home, I have a set of hand pieces at home that I can I can run and you literally can do it from your kitchen.
00:08:14
Speaker
That's in many of our participants are sitting there, you know, sitting in the living room or their kitchen doing the hands on. You don't have to take time away from your practice and from your home life. You just have to make a little bit of time to take some of these courses. Another thing that I really like about these courses is they are PACE. You have a PACE certification. We do. So AGD PACE, if you're in the AGD and you're working towards your masters.
00:08:36
Speaker
So those live classes that you take, those live hands-on classes will likely count for hands-on participation. Yeah, exactly. And so we worked with the AGD and we're doing some courses with the AGD, but we wanted to make sure that we're fulfilling all the obligations that the AGD asks for to make sure that these courses then are allowed for the hands-on workshops. Yeah, that's awesome. That's really, really cool. Where do you see the future of DOT going?
Future plans for DOT
00:09:01
Speaker
Boy, we're just expanded, so we started doing some TMJ stuff because we were getting a lot of questions about working with occlusion. And the way I was trained, I was trained at Michigan just sort of understanding the teeth, but not the joint so much, right? Even though I work with an articulator, it wasn't until I sort of started learning from Dawson and people like Jim McKee, who teaches out at Spear, about sort of joint-based occlusion.
00:09:27
Speaker
So Jim McKee has come on and he's doing a number of courses for us understanding joint-based occlusion, why we should be taking CBCTs of our patients if we have questions about patients with joints, understanding MRIs and how to read MRIs, how to read CBCTs of the joints, and then being able to understand how to do the dentistry based on that.
00:09:46
Speaker
That's so much more beyond what we learn in dental school, right? I would argue that you don't get a whole lot of that. One, I would say that it's difficult to articulate. It's difficult to understand from a student perspective. And so I think having qualified people to teach that is difficult to find. And so, you know, trainings like at Dawson or one of the other continuing education continuums, I think is really, really huge.
00:10:11
Speaker
But it's great to hear that you're incorporating some of that to a DOT for those who maybe want to learn more of that. But at this precise moment, they're unable to get away from their family and get away from their practice. Exactly. And I think the other thing, I would never want online or virtual learning to replace in-person learning. Right. I think in-person learning is critical. That's how I learn best.
00:10:36
Speaker
I think if someone can have a certain amount of knowledge in their pocket, so when they walk in and they go to take a course and say they're going to spend several thousand dollars, if they already understand what an MRI is, if they know how to get the basic readings in MRI, then you go out, then you're really accelerating your learning.
00:10:53
Speaker
If you understand composite materials, what's the difference between a hybrid, a nano fill, and a micro fill? If you understand the layering, and you've played around with the material a little bit, then you go and take a hands-on course. You're going to be so much more ahead of the game, right? Because you're not going to be fiddling around trying to understand the basics. You can start thinking more advanced in your concepts. So we're looking at doing, or we are doing now, we've already filmed several TMJ stuff. Cool. And then we're also going to be doing some removable
00:11:22
Speaker
Nice. Yeah, that's that's huge. There is not so I work in public health and I do a ton of removable and there is not enough. There are not enough continuing education courses or resources available to teach on removal. There are a few people who are doing it excellently and some older stuff as well, but nothing nothing like that. I can envision what you're maybe hoping to bring to your platform and I don't think there's anything like that available.
00:11:47
Speaker
Not that I've seen I mean I'm pretty excited about it because it's a topic that it's sort of like the, you know, see, it's the ugly cousin it's a thing people don't want to talk about they don't want to teach it no one wants to discuss discuss it knowing, you know, I think that it needs more attention because
00:12:04
Speaker
The reality is a certain part of the population, certain percentage of population cannot afford dental implants for missing teeth. And it is what it is. And there's certain population where dental implants have failed, or they're not good people for implants. So we need to make sure that our removal techniques are awesome. And we have such great information out there, it's just need to be shared in a good way. So we're looking to start filming that in 2023 is all.
00:12:29
Speaker
That's awesome. And many have mentioned and have shared that dentures can be foundational towards a smile design. Absolutely. If you understand dentures, you understand occlusion in dentures, you will be better when designing or doing a smile makeover.
00:12:47
Speaker
out. I love setting denture teeth. I don't do dentures anymore. My partner does that in the practice, but I love setting denture teeth because you got to you got to control the aesthetics. And so I'd send my dates in the wax. I do my wax room. I'd order to the teeth. I would set the interiors.
00:13:03
Speaker
And I would do a chair side where the patient was there. And it was, I'd have them preset, then patient come in, and then it would start rearranging. And it was, it was a great experience for the patient, because they could see what the art that was going into it. And it was real time I could start looking at subtleties and changing angle, angulation and shape. And I loved it. And so
00:13:23
Speaker
I think it's really important for dentists to understand this is so critical for our understanding of aesthetics. I do quite a few dentures of being in public health, but setting teeth is not my strength. It's hard to manipulate the wax in the teeth, but that's so exciting. Going back a little bit towards continuing education for a new dentist who's coming out of practice, what would be the best advice or the greatest advice that you would give to them?
00:13:53
Speaker
The advice that I got early on, and I pass that along, is get solid in occlusion. You know, and I mean, aesthetics is awesome. That's, you know, implants and aesthetics, that's all super sexy. But none of that's successful if you don't have a good basis in occlusion. And so whether you're going through Spear or Cois or Dawson or Pinky, or any other, you know, learning program, get really get a good foundation in occlusion. I do believe that joint based occlusion is critical understanding that starting in the joint
00:14:21
Speaker
If you have if you have a displaced disc in the joint that's going to change the occlusion. We, if you've been practicing more than a year you've had situations where patients have come in where they've said they can't open their mouth, right where they're limited opening or they haven't been able to close understanding joint leads you to being a better dentist, right.
00:14:41
Speaker
Secondly, I think getting into airway, I think airway is critical. The more that I practice, the more that I see airway is going to be foundation into the dentistry that we're doing.
Advice for new dentists
00:14:52
Speaker
That's where I would start out. I think that especially understanding occlusion and joint-based occlusion, I think that's critical for any dentist coming out and the rest of it, you'll just add on, you'll be more successful doing the other procedures if you have a strong basis in occlusion.
00:15:06
Speaker
That's excellent advice. And those two areas, I feel are two areas are not taught well enough in dental school and and great areas where you can build. And those are areas that I'm definitely still learning about myself as a new dentist. And one other thing I would suggest. Yeah. And I was just thinking about this.
00:15:24
Speaker
Photography is critical in dentistry today. And whether you're going to be using your iPhone, which is great. And I think there's some great add ons to your iPhone to make your images even better. Or if you want to get a deeper dive into photography using a 35 millimeter camera and SLR, regardless, you need to document your cases.
00:15:44
Speaker
When I grew up in dentistry, x-rays were king, right? You had to protect yourself from malpractice with x-rays. I will tell you, I think it's even more critical today with photographs. As we're doing more and more cosmetic dentistry, as we're making changes for appearance-related issues in dentistry, you have to be able to take good photographs. You have to be able to protect yourself.
00:16:05
Speaker
And it also allows you to start having a conversation with patients about their smiles and about their teeth. I mean, it's what I love to do. I love helping patients with their smiles. I love appearance related dentistry. It all starts with a photograph. And it's amazing how often and just actually just Tuesday, Wednesday, I was a new patient, they came in related to a single tooth issue.
00:16:29
Speaker
And before we were done, after we showed their photos and we looked at their photos, all of a sudden they realized that there are multiple teeth in their mouth and their smile that they don't like. And once we started talking about it, they led the conversation because they would say, well, what about this tooth? How come that tooth is on an angle? What can we do about that? And so it opens up conversation. And in my experience, where I failed early on is I would do one tooth
00:16:54
Speaker
And if the patient didn't have a nice smile, they'd be like, eh, OK. But if we're able to give patients a nice smile, it changes everything. Now, they may not want to do everything, and that's OK. But if they only want a concert on one tooth, that's fine. As long as they recognize there's other things that are going on, they're going to take away from the effect of the smile. And as long as they're OK with that, that's cool. But it's nice to give them the opportunity to have a conversation about it.
00:17:20
Speaker
What a great tool to help increase patient communication. Without question, it's the most important tool. Oh, I would agree with that. And it's a great way to evaluate your own work. If you want to learn how to do better dentistry, take photographs of your dentistry. And then force yourself to look at it. And I will tell you, it's hard for me to still look at my photographs. I've been doing this a long time. And the more you learn, the more you see. And the more you see, the harder it is to execute it sometimes. But that's how I've gotten better at my dentistry, is forcing myself to look at my dentistry.
00:17:49
Speaker
When I do any anterior composites, still to today, I take photos of every step, every layering step. That's great. So that when I finish, if it didn't come out right, I can take a look back and see where did I miss it? What step did I miss it on? Did I push the dentin too much? Was there a problem with my palatal shell? Did I not opaque enough? Did I push it too much in value? But it helps me get better at doing the next case I'm going to do. So I would say photography is critical also.
00:18:18
Speaker
That's huge and actually now I have another question for a case like CPR for the warrant intention. What does that look like chair time wise for you?
Prototypes in dental restoration
00:18:29
Speaker
So CPR for the worn dentition, I call it concept to prototype to restoration. My experience many years ago, I had a worn case that I needed to treat both arches. Upper and lower arches need to be treated. Patient can send it to treatment. We did provisionals on the upper arch. The patient came back and said, I don't want to do the lower arch.
00:18:50
Speaker
Well, the whole treatment is dependent on doing both arches. It's almost like doing, well, I can do the tires on the left side, but the right side, right tires, I got to leave them. And no matter of me trying to convince the patient, she said, I'm only doing the upper arch. And so the case became just, it was fine. It was fine. I was completely disappointed by it. I don't know how well it lasted. The patient didn't stay in the practice. So I don't know how long it lasted, but I would consider probably not very long.
00:19:17
Speaker
So it was after that case, I said, I got to protect myself. Right. And one of the things as you practice more and more dentistry, we will all run into the cases where we'll say, I wish I'd never started treating this patient. Right. Absolutely. And so my, my thought with concept for the warned or CPR for the warned dentition, we go from the concept that is sort of like the design. It could be an analog design, a digital design. It's a design of what you want the teeth to look like.
00:19:42
Speaker
And as I explain to patients, I say, look, this is like a car. If you're going to get a brand new car, wouldn't you want to have that car tested by the manufacturer, right? Absolutely. Right? And so what they do is they make prototypes. And I explain to patients, I grew up in Detroit. My dad worked for General Motors. He built cars on the assembly line for General Motors. And they would build the prototype. And they would run the prototype to make sure that it worked. So for worn dentition cases, I will build up the case in composite. So aesthetically and functionally, so that we can open the vertical dimension,
00:20:12
Speaker
We can create the aesthetics that we want, and we make sure that the patient can tolerate it, that we're not also all of a sudden introducing a lisp into their speech, right? And functionally, we can have them test drive it for several months and make sure that we're not going to have failures, right? We're looking for, we're not looking for success as much as we're looking for failures. Right, right. Because if we find failure, then maybe there is something wrong with the occlusal skin that I'm using. You can adjust it. Right? I can change it, right? Make changes to it.
00:20:37
Speaker
And patients fundamentally understand that. What's also great is, let's say it's a full mouth reconstruction. And usually when you have worn dentition cases, it's both arches. The patients can then budget the case. So there's a certain amount to pay for the prototypes. They're bonded on, they're individual teeth. And then they can leave those indefinitely. And then they could say, all right, we have the aesthetics that we like, we have the bite that we like.
00:21:03
Speaker
Now we can say, let's replace it 6 for 11 with ceramics, and we'll leave the posterior units in the lower for this year. And then next year, why don't we do the upper right, following you, we can do the upper left, or follow along as the patient wants. Or we can do it all in ceramics and just get done. Or for a good portion of my population, they leave the transitional bonding. You see what? I like the prototypes. It doesn't have the best polish because it's just a hybrid or nanofil composite.
00:21:30
Speaker
They're thrilled with it because now they can chew well. They function so much better. They look so much better. Yeah. Right. It's a big change for them. Big change. And so, you know, for me, it's really, I've been able to do full mouth reconstructions with composites that's reversible because on most of those cases, I don't touch the teeth with a bird. I literally clean the teeth, sandblast them. It's all additional. It's all additional. That's great. I'll go over restorations. I'll bond to old crowns.
00:21:58
Speaker
a bond to old amalgams. I don't care. I just want to make it all additive because I've had three patients in all these years who have not liked it.
00:22:08
Speaker
and I've been able to literally subtract it and bring them back to where they were, bring their occlusion back to where they were, remove any of the anterior binding. And it's very few of all the cases I've done. It's only been a few, but it's been nice to be able to take it off and give them their money back and say, okay. It didn't work. We tried it. Yup. Wow. And thank God I didn't go into prepping the teeth with provisionals. Right? Yeah. That you can't go back from there.
00:22:33
Speaker
Once you put the bird on the tooth, man, it's a marriage. Yeah. And you're married to the patient too. And you know, 50% of marriages end up in divorces, I'm saying. And with patients... Pick your marriages wisely. Yeah. And pick your patients wisely. And it really does give you an opportunity to see if this is a patient that's really going to be, you know, that's going to work well. And there have been patients that I haven't wanted to go to the ceramics.
00:22:55
Speaker
because I don't want to do with the nuances of the patient. So I encourage them to stay with the transitional bonding because I'm nervous of getting into that next layer with them. I think that's an excellent thought process and hopefully our listeners will want to learn more. And if they do want to connect with you further, what's the best way to
Connecting with Dr. Hartleib
00:23:16
Speaker
do so?
00:23:16
Speaker
So you can check out our website. It's dot hands on.com. So it's all one word dot hands on.com. You can find me on Instagram. Hartlieb h-a-r-t-l-i-e-b d-d-s. That's on Instagram and Facebook's probably the same who knows. And if you just want to email me directly, it's Hartlieb d-d-s at dot hands on.com.
00:23:39
Speaker
The Instagram is excellent if you want to start there to find out more about DOT. I think there's excellent pearls on there and you all give some frequent seminars and CE complimentary. I think there's one coming up. We do, yeah. Besides doing our webinars and or doing our courses, we have like a monthly webinar that we do. We invite people in or I'll do a live demonstration of a technique
00:24:02
Speaker
We also have a study club. We meet one Friday a month. In fact, this morning before Voice of Dentistry, I was doing my study club. Awesome. So we have a number of members who join in and then we treatment plan. People will bring cases in or I'll bring an interesting case that I've just been working on and we'll just sort of walk through the details of that. Very cool. Yeah. Well, hopefully our listeners will want to find out more and thank you so much for your time, Dr. Hartlieb and tune in next time for another episode.
00:24:28
Speaker
Thank you for tuning in to this episode of New Dentists on the Block. If you would like to connect with Dr. Hartleeb, you can find him on Instagram at HartleebDDS. You can also follow him through his platform Dental Online Training at Dental Online Training. If you'd like to check out a course with DOT and Dr. Hartleeb, they're having a CPR for the worn dentition on May 25th and 26th.
00:24:54
Speaker
For more information, check out the website dothands-on.com. Please make sure you subscribe to the podcast on YouTube and on all major podcast platforms. We'd love if you would leave a review of the podcast. If you have a new dentist you would like to recommend for the podcast, be sure to send an Instagram message to at newdennis on the block. If you'd like to connect with me, you can find me on Instagram at tsmiss.dds. We'll catch you next time.