June 6, 2022
Dr. Akit Patel, BDS, MFDS RCS, MClinDent (Pros), MRD RCS

Introducing Success Simplified – Know Your Why

Prosthodontic workflows can be challenging, complex and stressful. Learn why you should do what you do – change your perspective so you can simplify and standardize, aiming to get it right the first time, every time.

“There are only two ways to influence human behaviour: you can manipulate it, or you can inspire it.” This is a quote by Simon Sinek from his book “Start with Why.” Why am I starting with this? My point precisely…

“Why” isn’t just a word: it’s a game-changer, a powerful concept. It is one of three parts of Sinek’s “Golden Circle,” theory, made up of Why, How, and What (Fig. 1). To look at how we shape our behaviors towards driving long-term results, we need to first ask ourselves what our purpose is. This can be applied to basically everything we do as dentists, including how we approach prosthodontic procedures. Why do we prepare the tooth for a crown the way we do? Is it because we have learned to do it this way and have never done it differently? Should we change our habits, our techniques? If so, why, how and by what means?

A different perspective – Why, What, How?

Many of us know “what” we do and “how” we do it, but not everyone knows or understands “why.” If we start with the WHY in what we do, however, we can inspire action in a way that allows us to understand the process – e.g., the indirect restoration procedure with its numerous usually interdependent steps – make the right decisions, and make fewer mistakes in the WHAT and HOW. If you look at figure 1, we need to work from the inside out (not the other way round) with the intention to understand, not merely memorise and act out of habit.


Fig. 1: The principles of the “Golden Circle”1

Challenges

The full indirect procedure is complex, intricate, and stressful. There are many different clinical and laboratory steps, and each separate step involves a number of unique clinical challenges (Fig. 2). We have an abundance of materials to choose from, multiple indications, and different starting points. We need to start with the end result in mind and need to understand that each step in this workflow has a synergistic and cumulative effect. Cutting corners will only lead to short term solutions – impacting long-term success rates and your profitability. What we want is for our restorations to be engineered to fit perfectly from the start.


Fig. 2: Example of critical steps in the indirect restorative procedure.

Why tiny changes make a big difference

I believe, if you want better results, then set a goal and focus on the system in achieving that goal. By implementing a system of continuous small improvements, you can achieve a different outcome. There are many ways to upgrade our so-called indirect restorative system, and learning new skills or changing our habits takes time. To build a new habit, you first need to shift your mind-set and then start practicing it. And the most effective way to make practice happen is to adhere to making it easy; to simplify.

“Simplicity is the ultimate sophistication” – Leonardo da Vinci.

The simplification and standardization of clinical protocols involving the use of the most suitable materials lead to the efficiency, reliability, and predictability so urgently needed in today’s busy practice environment. We should try to make things as simple as possible but take care not to reduce anything that is of vital importance. For example, managing tissues effectively during the impressioning stage takes additional time; however, it allows us to achieve more accurate impressions with less effort.

The other important measure is the standardization of clinical protocols: errors are less likely to occur if the whole team is familiar with every single step of the treatment approach. Standardization helps us to establish a time-tested technique, allowing us to be consistent with our approach and improve clarity, quality, productivity and boost morale.

Success Simplified

If we blend simplification (reducing complexity) with standardization (removing process defects), we can try to enable consistent, high-quality results (Fig. 3).


Fig. 3: The principles of the “Success Simplified” program.

The approach above represents the basic principles of “Success Simplified”, a collaboration program between 3M and a group of international experts, of which I am a founding member. It addresses the increasing complexity in the dental market with clinical guidelines aimed at simplification and standardization. The goal is to give clinicians guidance for improved material selection for specific indications, tips for their efficient and successful use, as well as simple tools that help standardize the indirect restoration workflow. It focuses on the seven major steps involved when making an indirect restoration (figure 4).


Fig. 4: The 7 procedure steps of the “Success Simplified” program.

Each specific procedure step discusses the most important options, selection criteria and relevant factors for the decision(s) to be made. The idea is that, based on the clinical situation, the clinician will select the differentiating factors, e.g., substrate (tooth/implant), material and cement options for each case, resulting in a case-specific recommended clinical protocol for each step.

The protocols reduce the number of choices and work steps needed, whilst keeping the patient at the forefront and not compromising on the end result. Minimal invasive and well researched techniques are utilised where possible. Finally, cost-efficiency needs to be taken into account, which is best achieved by saving the most valuable factor in the dental office: the time of the dentist.

Why you’ll love it – minimise complications -> maximise success

  1. Simplification and standardisation of clinical procedures
  2. Skill development on material science, techniques and assistance with decision making
  3. Provide a consensus and best-practice recommendations
  4. Clinical tips and tricks for successful use of materials
  5. Checklists in how to get things right the first time

The essence of the Success Simplified program looks at three main areas of development: education, technical guides and how to get the best out of the materials (Fig. 5).

Education – It is important to have the right skills. Clinicians receive blended educational theory; training concepts across various platforms via a blended learning – lectures, hands-on workshops, webinars, compendium, e-tools, HIIT videos.

Protocols/Checklists – No matter how expert you may be, it has been clearly shown how well-designed checklists can improve outcomes. The best-known use of checklists is in aviation, surgery and now prosthodontics. Checklists protect you from missing a step, forgetting to ask a key question, or, in the stress and pressure of the moment, failing to plan properly for every eventuality.

Materials – Upgrading your skills fits hand in hand with the use of top quality, innovative materials, in keeping with your high standard of work. To ensure your technique is flawless, it makes sense to use materials designed for accuracy and efficiency and ease of use: a symbiotic relationship between training and adhering to protocols.

Success Simplified program


Fig. 5 The three main areas of the Success Simplified Program.

The final word

Capability, predictability, satisfaction, comfort, confidence. Each day is made up of many moments and your choices determine the path you take. The ultimate purpose of habits is to solve the problems of life with as little energy and effort as possible. Make changes so you are fully equipped and coached to be more in control of each step, whereby the whole procedure becomes more consistent, predictable and less stressful. You become slick, and start to really enjoy what you do. As a by-product, efficiency and quality will naturally increase.
When you know your “Why,” the highest level of confidence you can offer is: “I know it’s right.” When you know the decision is right, you can rationalize it and easily put it into words. You are able to communicate this to the rest of the team and most importantly to your patient. A happy patient means a happy dentist. Simplicity is the future, and we have created a simple way of creating good habits and better understanding.

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