Shift magazine - Issues in Pediatric Dentistry

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I S S U E S I N
P E D I A T R I C
D E N T I S T R Y
S P R I N G 2 0 1 7
FIRST
LOOK@ Shift Magazine
UNTO THE
LeastOF THESE
Taking time to meet the dental
needs of the remote jungle region
of Rurrenabaque, Bolivia
DrillingTHROUGH THE
Digital Noise
How to grow your
dental practice in
a high-tech age
SUN, SAND,
and an Amalgam
Carrier in My Hand
A look at the pros and cons of
mineral trioxide aggregate
(SmartMTA)
ABRAND
New Beginning
How branding affects trendsetting
in the field of pediatric dentistry
EZPEDO

SPRIG UNIVERSITY DESTINATIONS FOR 2018
NEW ORLEANS 2/16 DOMINICAN REPUBLIC 3/30 VANCOUVER 4/28

www.sprigusa.com / Spring 2017 1
PHILADELPHIA 8/24 LAS VEGAS 9/21 KEY BISCAYNE 12/7SAN DIEGO 7/20

2 Shift magazine / Spring 2017
21LIFE IS GOOD
Providing the Best for
My Patients.
26HOW TO
DEVELOP A
COMPELLING
BRAND
Strategies for Competing
in Dentistry's Shifting
Marketplace.
22A REAL
TOOTH
SAVER
How Our Daughter
Almost Lost Her
Beautiful Smile.
Table of Contents
30DRILLING
THROUGH THE
DIGITAL NOISE
How to Grow Your
Dental Practice in a
High-Tech Age.

42A BRAND NEW
BEGINNING
How Branding Affects
Trendsetting in the Field
of Pediatric Dentistry.
TABLE OF CONTENTS
—
Page 21
LIFE IS GOOD
BY SARAH MATHIAS, DDS, MS
Providing the Best for My Patients.
Pages 22–25
A REAL TOOTH SAVER
BY AUBREE’S PARENTS
How Our Daughter Almost Lost Her
Beautiful Smile.
Pages 26–28
HOW TO DEVELOP A COMPELLING BRAND
BY REMINGTON TONAR, MA, MS
Strategies for Competing in Dentistry's
Shifting Marketplace.
Pages 30–35
DRILLING THROUGH THE DIGITAL NOISE
BY CEARA MILLIGAN, BS
How to Grow Your Dental Practice in
a High-Tech Age.
Pages 36–41
SUN, SAND, & AN AMALGAM CARRIER IN
MY HAND
BY JAROD JOHNSON, DDS
A Look at the Pros and Cons of Mineral Trioxide
Aggregate (MTA)–an Up and Coming Superstar
for Vital Pulp Therapy.
Pages 42–48
A BRAND NEW BEGINNING
BY ALAN SIEGEL, BA
How Branding Affects Trendsetting in the Field
of Pediatric Dentistry.
Pages 52–63
UNTO THE LEAST OF THESE
BY PATRICIA RIVAS, DDS, GABRIELLA
GARCIA, DDS, JEFFREY P. FISHER, DDS
Taking Time to Meet the Dental Needs of the
Remote Jungle Region of Rurrenabaque, Bolivia.
52UNTO THE
LEAST OF
THESE
Taking Time to Meet
the Dental Needs of the
Remote Jungle Region of
Rurrenabaque, Bolivia.
36SUN, SAND, &
AN AMALGAM
CARRIER
IN MY HAND
A Look at the Pros and Cons of
Mineral Trioxide Aggregate
(MTA)–an Up and Coming
Superstar for Vital
Pulp Therapy.

SPRIG ORAL HEALTH TECHNOLOGIES, INC.
FORMALLY EZPEDO, INC.

Sarah Mathias, DDS, MS
Dr. Sarah Mathias is a board certified
pediatric dentist with a practice in
Laguna Hills, Calif. She completed her
DDS degree at the University of Iowa,
eventually earning a master’s degree
in oral sciences and a specialty
certificate in pediatric dentistry. When
not in the office, Dr. Sarah enjoys
spending time with her husband, Dr.
Bobby Ghandehari, an orthodontist,
their sons, and Hans, their German
shepherd rescue puppy.
Ceara Milligan, BS
Ceara is a digital strategist at Gogeddit,
a small-business growth agency
headquartered in Milwaukee, Wis. She
has extensive experience developing
digital and brand strategies and inspiring
creativity across all channels and
touchpoints. Ceara graduated cum laude
with a BS in business administration from
Marquette University.
Aubree’s Parents
Aubree's parents represent countless
other moms and dads who stress
over their children's dental care. They
now take pride in their daughter's
princess teeth restored with Zirconia
Crowns.
Remington Tonar, MA, MS
Remington Tonar is a partner at
Brandsinger, a NYC-based consulting
firm. He previously served as one
of the top strategy consultants
at Siegelvision, a branding firm
founded by marketing luminary Alan
Siegel. He holds Master’s degrees
in corporate and organizational
communication (New York
University) and in theology (Loyola
University Chicago).
Alan Siegel, BA
Alan Siegel is one of the bestknown
figures in the branding industry and
a longtime advocate of clarity and
simplicity in business. Alan is also the
founder and chairman emeritus of global
branding agency Siegel+Gale, one of
the most respected branding firms in
the world.
Contributors
Patricia Rivas, DDS
Gabriella Garcia, DDS
Jeffrey P. Fisher, DDS
Dr. Patricia Rivas, trained as a pediatric dentist in
Columbia and has practiced dentistry in the U.S. for
13 years. Dr. Gabriela Garcia is currently a dentist
at Sanatorio Adventista del Plata in Entre Rios,
Argentina, and volunteers six months a year in various
South American countries, most recently in Bolivia.
Dr. Fisher is a co-founder of Sprig Oral Health
Technologies, Inc. [EZPEDO] and is the editor
of Shift magazine.
Dr. Jarod Johnson, earned his Bachelor
of Science in biomedical engineering
and Doctor of Dental Surgery from
the University of Iowa. He recently
completed a certificate in pediatric
dentistry at The University of Nevada,
Las Vegas, School of Dental Medicine.
He is currently working in private
practice in Muscatine, Iowa.
Jarod Johnson, DDS
ON THE COVER
COVER DESIGN BY MARK BOND
PHOTOGRAPHY BY SLAVA DANILIUK
DENTISTRY BY LEVI PALMER, DDS
Our ﬁrst issue of Shift magazine features
Aubree on the cover. On page 22, her parents tell the
story about how their beautiful little girl almost lost
her smile and how a pediatric dentist from Chico,
California, restored her teeth and gave her the
conﬁdence to thrive.

EZCROWNS
Technology + Design
Inspired by our frustrations as practicing dentists, we’re constantly
developing new technologies and design features to ensure our products
remain the most advanced and trusted solutions on the market.
Our technologies are designed for dentists by dentists to conquer real world
clinical challenges. Our Zir-Lock retention technology uses a patented design
to increase mechanical adhesion. Our Flat-Fit design saves space and reduces
risk of pulp exposure. And, our patent-pending ASAP preparation system using
EZPrep burs enables faster seating and reducing chair time while minimizing
tissue trauma. Together with our use of both computer-aided and hand-finished
design, these features continue to make our crowns the go-to choice for
dentists nationwide.
Learn more at sprigusa.com/ezcrowns

CONTACT US
SHIFT MAGAZINE
Vol. 3 No. 1 | Spring 2017
PUBLISHER
Sprig Oral Health Technologies, Inc.
A: 6140 Horseshoe Bar Road,
Suite L Loomis, CA 95650
P: +1 (888) 539 7336
INT: +1 (916) 677 1447
E: info@sprigusa.com
W: www.sprigusa.com
MAGAZINE STAFF
JEFFREY P. FISHER, DDS
Editor-in-Chief
JAMES FISHER, MSPH, PhD
Senior Consulting Editor
ANN FISHER
Copy Editor
DANIEL VAKARYUK
Art Director
TIMOTHY SHAMBRA
Senior Designer
CONTRIBUTORS
Sarah Mathias, DDS, MS
Elizabeth Chen, DDS
Aubree’s Parents
Remington Tonar, MA, MS
Jarod Johnson, DDS
Ceara Milligan, BS
Alan Siegel, BA
Levi Palmer, DDS
Patricia Rivas, DDS
Gabriella Garcia, DDS
DIGITAL EDITION
www.sprigusa.com/magazine
For new subscriptions, subscribe at
sprigusa.com.
For all other reader services,
including letters to the editor, write
to editor@sprigusa.com.
FROM THE
EDITOR
EZPEDO SHIFTS TO SPRIG
ORAL HEALTH TECHNOLOGIES
Has anyone ever asked you the following rhetorical question? “Who do you think you are?”
Although the question is often used in a derogatory way, the reality is that this question is actually
quite significant. Many of us have never given such an inquiry much thought, but the truth of the
matter is, the question is vitally important. Every individual, practice, and company should take
time to ponder/evaluate/consider it.
Who am I? What core values have I chosen to guide my life? How do I want my patients to view me
and my practice? How we answer these tough questions is critical in determining the success of our
lives. Our identity. Our purpose. Our vision. These intangibles are the threads that, woven together,
make up the fabric of our lives. Simply put, they are the sum of “who we think we are.”
You know our company, EZPEDO, as the maker of the best looking kids’ crowns on the market. We
imagine and create groundbreaking oral health products for children. Building on this reputation,
EZPEDO is excited to announce that we have made a strategic and dramatic move to rebrand our
company. As we transition from EZPEDO to Sprig Oral Health Technologies, we want to present a
clear and simple message of who we are.
• We are trailblazers who are disrupting the field of dentistry to make a positive impact. As the
pioneer oral health technology company, we are consistently pushing innovation boundaries and
challenging the status quo.
• We are empathetic to our customers. Empathy is critical in the field of healthcare. We understand
families’ needs and we design our products to meet those needs. We want to make pediatric dental
care painless and convenient for parents and children alike.
• We are confident about the future of dentistry. There is no doubt that our products are best
in-class. We consider ourselves pioneers and thought-leaders in the field of dental technology. We
are assured that technology will fuel growth and progress in pediatric care.
• We are innovative, constantly improving our products and adapting to patient trends. To stay
ahead of the competition and to provide patients with the best care possible, we are continually
looking ahead, anticipating how to create the “next best thing” in oral health.
So, who is Sprig Oral Health Technologies? We are a cutting-edge technology company determined
to be the compelling force that continues to revolutionize pediatric dentistry with the innovation
both patients and professionals demand. People think of dentistry as tired, old, and stale—and in
many cases, they’re right! In our age of technology and innovation, we believe that the next
generation deserves next generation care—and that together, we can make
it happen.
You will notice that our magazine has a new name—SHIFT. This name change reflects the impact
that EZPEDO has generated in the field of pediatric Dentistry and the dramatic changes that have
occurred over the past decade. These changes—the revolutionary use of Zirconia crowns in place of
SSCs, the transition from using formo to using MTA, and the radical modification from simple
“yellow pages” advertising to social media marketing—are all exciting examples of the shift taking
place in our profession that propels dentistry forward to achieve better patient care. Our guiding
vision at SHIFT magazine is to provide you with inspirational stories, scientific research, and
educational content that will both inform and motivate you to greater heights of
professional achievement.
And remember, I’d love to hear your thoughts and comments not only about the articles in this
issue of Shift magazine, but also about EZPEDO’s transition to Sprig Oral Health Technologies, Inc.
So drop me a line at editor@sprigusa.com.
Editor-in-Chief

SmartMTA
Faster. Healthier.
Smarter.
Sprig’s fast-set MTA is designed specifically for pediatric dentistry. SmartMTA
sets in only three minutes (not hours like other brands), so you can place, prep
and restore in the same visit. SmartMTA causes no discoloration even in the
presence of blood contamination and is designed to tackle mixed-dentition
cases, primary and permanent teeth, bases, caps, pulpotomies and
pulpectomies.
At Sprig, we believe that our next generation deserves safe, natural products.
Made from biologic ingredients and no heavy metals, SmartMTA gives
dentists and parents a smarter choice.
Learn more at sprigusa.com/smartmta

INFORMATION
TECHNOLOGY
ESSENTIALS
TWO TECHNOLOGY
COMPANIES YOU MIGHT
WANT TO CHECK OUT
YOU DON’T KNOW WHAT YOU DON’T KNOW
Meet BirdEye
BirdEye is a reputation marketing platform that makes it
easy for practices to get positive reviews and amplify their good
reputation everywhere. Control your reputation and get more
patients by generating positive reviews from satisfied patients
on sites like Google and Facebook today.
GET NEW REVIEWS
AUTO PROMOTE YOUR BEST REVIEWS
MANAGE NEGATIVE REVIEWS
RANK HIGH ON GOOGLE AHEAD OF YOUR COMPETITORS
For more information, contact Birdeye, Inc.
440 N Wolfe Road, Sunnyvale, CA 94085.
(800) 561-3357 | www.birdeye.com.
Meet WEAVE
Weave offers a full patient communication solution, including
full integration of your office phones. This means your phones
are connected to your practice management software/EHR,
creating a more efficient, more helpful, smarter patient
interaction.
TWO WAY TEXTING
SMARTPOP (Instant, contextual patient data)
AUTOMATED RECALLS AND REMINDERS
CALL REPORTS
CALL RECORDING
DYNAMIC PATIENT TASK LIST
PATIENT BALANCES AND INSURANCE INFO
PHONE SERVICE
REVIEWS
MOBILE APP
For more information, contact Weave.
3401 North Thanksgiving Way #400, Lehi, UT 84043.
(888) 545-8880 | www.getweave.com.

HemeRx
Simple and Superior
Hemostasis
Sprig’s HemeRx retraction pellets deliver simple and superior
hemostasis management for pediatric restorative procedures.
Hemostasis is paramount to the long-term clinical success of Zirconia and
strip crowns, subgingival composite restorations, and pulp therapy. Whatever
the procedure, HemeRx provides essential retraction plus unmatched
hemostasis for less stress and better results. Simply moisten and place.
HemeRx is also kid-friendly, and doesn’t leave that notoriously awful taste
in kid’s mouths, making it the perfect solution for pediatric patients.
Learn more at sprigusa.com/hemerx

AMERICAN MADE
MATTERS
AN ALL-AMERICAN COMPANY
Loomis, California
Sprig crowns are meticulously designed, thoughtfully
engineered and precision hand-crafted right here in the USA,
but it’s the remarkable innovations built into every one of
these crowns that truly place Sprig in a class of its own.
sprigusa.com

EZPREP Diamond Bur System
The Best Tools for
the Best Crowns
Increasing speed and efficiency while reducing operator error are paramount
to successful crown preparation. That’s why we designed our own diamond bur
system with a novel, axial depth-cutting feature that gives dentists the right
amount of reduction every time.
Our EZPrep diamond bur system is the only system specifically designed for
fast and accurate Zirconia crown preparation. With unique cutting capabilities
that respond to real clinical challenges and diamonds specifically selected
for use in precision cutting instruments, our burs are critical to making
Zirconia work for your practice.
Learn more at sprigusa.com/ezprep

GOOD
TIMES
Last years EZPEDO Annual Symposium
was held on the property of the Ritz-Carlton in
beautiful Lake Tahoe, California. Cathy Jameson, PhD
and David Rothman, DDS were guest speakers and
presented on engaging and relevant topics in the
field of pediatric dentistry.
S O C I A LNETWORK
P E O P L E , P L A C E S , A N D P A R T I E S
EZPEDO Symposium 2016
David Rothman, DDS Vance Merhoff and Tina Merhoff, DDS Elaina, Cathy Jameson and Brenda Hansen
Harry Hall Sumner and wife Trice Sumner, DDS
Cathy Jameson, PhD
Andrea Igowsky, DDS and husband Ben

SPECIAL
MOMENTS
It was an absolute joy to spend quality time with familiar faces
and have the oppurtunity to meet new friends. We cant wait to
see you next year, and discuss the future of pediatric dentistry.
E V E N T S
2016
Jamie Marchi, DDS and Trice Sumner, DDS
Cheryl Cooper, and husband Sean Cooper, DDS
Kent Hallmeyer and wife SandyVanessa Hurt
Andrea Igowsky, DDS
John and wife Cathy Jameson, PhD
n
Vicki Sullivan, DDS and her daughter Madeline

Sprig [EZPEDO] Zirconia crowns are the best Zirconia crowns
on the market! They have the most natural shape and color
compared to other brands, and they are the easiest to seat. I
don't have to buy any special equipment or products for my
Sprig [EZPEDO] Zirconia crowns. They bond easily with my
pure GI cement that I use with all my stainless steel crowns,
and I don’t have to bother with annoying try-in crowns. The
space-loss crowns o er a lifesaving option when facing
crowded conditions in the posterior.
I have been amazed with the durability and craftsmanship
of both the anterior and posterior crown collections. I have
experimented with the di erent Zirconia options and
discovered that Sprig [EZPEDO] crowns are the easiest to
place and the most natural looking. Parents agree and are
always pleased with the realistic and natural look. We will
continue to exclusively use Sprig [EZPEDO] crowns.
myconﬁdence.
WHY I CHOSE SPRIG [EZPEDO]
20660 Westheimer Pkwy, Suite A, Katy, Texas 77450
281-579-8700 | kidshealthyteeth.com

A pediatric dentist with a private practice
in Katy, Texas, Dr. Elizabeth Chen comes
from a family of dental professionals.
Every member of her immediate family
is a dental specialist. Dr. Chen is an avid
soccer player and a proud user of Sprig
[EZPEDO] pediatric Zirconia crowns.
DOCTOR TO DOCTOR

EST. 2013
EZPUEZPEDO UNIVERSITY
Register online at ezpu.org
Join Us
Register online at sprigusa.com
OUR KNOWLEDGE.
YOUR SUCCESS.
POWERFUL TECHNIQUES. PREDICTABLE RESULTS.
Sprig [EZPEDO] has more experience teaching doctors how to
use pediatric Zirconia crowns than any other company. After all, we
invented them nearly a decade ago. Since then, we’ve continued to
advance our products, how they’re used, and how we teach others
to use them. Sprig University courses are designed to help you
master our easily repeatable approach to tooth preparation using
the industry’s highest-rated pediatric Zirconia crown, all while
earning 8 CE units at a destination of your choice.

Shift magazine / Spring 2017 21
IN PRIVATE PRACTICE | THE VISION
hen I graduated from residency in Chicago, I had a vision of
being able to provide the highest quality care in a setting that
would actually make children happy to visit the dentist. After
spending time learning from some great mentors in a variety of
practice settings, I was ready to make my vision a reality.
In 2004, I started my own practice, Jungle of Smiles, in South
Orange County, California. We were one of the first paperless
offices. I know that doesn’t seem very exiting now, but it was
cutting-edge practice at the time. We took digital radiographs,
and designed an environment that rivaled the ambiance of
Rainforest Café.
But every day I practiced, I faced the same look of horror on
parents’ faces when it came time to discuss the dreaded
stainless steel crown. The worst part about those discussions
was that I had nothing better to offer that would improve the
situation.
As the years passed by, various manufacturers attempted to
market products that would remedy the situation. And I tried
them all. The results proved less than fantastic. Frequently,
they induced profanity on my part while attempting to place
them, and no one was happy when all the white facing
disappeared sooner rather than later.
So, in Orlando at the AAPD annual session in 2014, I found
myself standing at the EZPEDO [SPRIG] booth, with more
than a little doubt in my mind. I was thinking, “I’m going to
spend a couple grand on a box that will gather dust in the back
of my operatory.” But in the end, I decided to give EZPEDO
[SPRIG] crowns a try. I made the decision largely based on the
recommendation of my anesthesiologist who told me, “My
friend is the one who created these great crowns.”
After placing my first EZPEDO [SPRIG] crown, I was
extremely pleased with the results. So were the parents of my
patients. But, I still was not convinced. What if the crowns
broke, or came off? There had to be a catch. I waited for the
phone call, but none ever came. Success! I continued to place
more crowns, becoming more and more confident that there
really was an esthetic, durable, and reliable crown option
available for children.
Over the past several years, I have placed hundreds of
EZPEDO [SPRIG] crowns. My favorite experience with them is
when a patient comes in, and I don’t even realize the tooth I
am examining is a crown. Then I look at the x-ray, and realize it
is not their natural tooth. That is how esthetic these crowns
have proved to be.
I am happy to finally have a crown that matches my vision for
optimum patient care.
W
LIFE IS GOOD
WHEN I’M ABLE TO PROVIDE THE
BEST FOR MY PATIENTS
by Sarah Mathias

By Aubree’s Parents
In June 2016, our daughter Aubree had an appointment at a
nearby hospital where the dentist had scheduled to treat her under
anesthesia. Our appointment was originally scheduled for 7 am.
Due to a scheduling mix-up, our appointment was changed to 1 pm.
Aubree wasn't allowed to eat anything all morning. The stress was
getting to me, but finally the time came for her surgery. The doctor
said that they were going to take x-rays while she was under
anesthesia and would call me after the x-rays had been processed.
A little later, I got the doctor’s call. He stated that he wanted to pull
all six of her bottom teeth, cap the four top teeth with white caps,
and give her silver teeth in the back. I didn't have anybody there
for support because my husband was at work. I was devastated,
upset, and confused, with no idea what to do next.
I was just getting off work when I received a phone
call from my wife who was in a panic. After hearing
what the dentist wanted to do, I said, “Absolutely
not, and don’t do anything until I get there.”
I was so stressed out because my daughter was
lying there in bed under anesthesia, and the doctor
was pressuring me to make a decision right away.
Once I got to the hospital, the doctor told us that if
we didn't have the procedure done that day, they would
take her off anesthesia, and we would never be seen by
them again. I told them, “Wake her up.” We waited for
the anesthesia to wear off and left.
From this point on, we felt extremely stressed. Although
we knew our daughter needed the dental work, we wanted
it to be perfect and wanted her to have white teeth
without a single silver cap.

ON THE COVER

ABOVE: Aubree enjoys time with her dad
ﬂying like an airplane. BELOW: Mother and
daughter share a special moment together
looking at pictures.
I kept second-guessing myself and wasn't sure if we
had made the right decision. But a couple weeks
later we found Dr. Levi Palmer, and he informed us
that he would be able to fix Aubree’s teeth and
restore her beautiful smile again without pulling
any teeth.
We looked on Dr. Palmer’s website and discovered
he did amazing work. He informed us that Aubree
didn't need to have any of her teeth pulled, and
there was no reason that she should have silver
caps. He told us about Zirconia crowns that would
look totally natural and assured us that no one
would ever know she had them.
I'm so impressed with the work that they did and
am so incredibly grateful that we made the decision
to take our daughter off the anesthesia and find
another doctor.
Aubree’s teeth were treated with Zirconia crowns
the way we wanted without pulling a single tooth
or having any silver in her mouth. We are extremely
happy with the outcome and so thankful we
discovered a natural-looking Zirconia option in
time for her treatment. Aubree now proudly
displays what she calls her “princess teeth”
for all to see.

THIS PAGE: Mom and Dad enjoy a hug with their little
princess. Aubree is so excited that she now has a smile
which enables her to share her beautiful princess teeth
with the world.
DR. PALMER SAVES THE DAY: Dr. Palmer was able to
stabilize Aubreeʼs teeth with the use of silver diamine
ﬂuoride (SDF) to maximize the prognosis for her four
front teeth and decrease the sensitivity that Aubree had
been complaining about. Mom was a little freaked out
with the black color, but a few weeks later, Aubreeʼs
teeth were restored with Sprig [EZPEDO] Zirconia
crowns and today look amazing.
ON THE COVER

HOW TO
DEVELOP A
COMPELLING
BRAND
Strategies for Competing in
Dentistry’s Shifting Marketplace
By Remington Tonar
Dentistry, as with other areas of
thehealthcare industry, has been
subject to recent sweeping
changes. Today’s rising business
costs and shifts in the insurance
industry are driving the
proliferation of ever-bigger group
practices. The democratization of
information is alsoempowering
patients and fueling healthcare
consumerism. Increasingly
expensive care is forcing a
growing number of uninsured,
out-of-pocket payers to be more
selective in their choice of dental
care. The situation is further
compounded by the fact that
both an aging population and an
expanding demand for pediatrics
are dramatically changing the
patient pool in dentistry.
These tectonic shifts are making
dentistry as a whole more
competitive, forcing practices to take
marketing more seriously and to
evolve how they engage existing and
prospective patients. This challenge
is especially acute for solo
practitioners and small officesthat
don’t have the marketing dollars that
larger group practices enjoy.
Unfortunately for smaller practices,
an ad in the local Yellow Pages or a
billboard on the highway are no
longer enough to attract and retain
today’s patients. The days of build-it-
and-they-will-come dentistry are
over.
Dental practices that want to thrive
in the 21st century will have to follow
the lead of many hospital systems
across the country and invest more
time, energy, and financial resources
into buildingtheir brand. While
many dentists understand the
importance of marketing, many
don’t understand how to effectively
build a brand and take it to market.
After all, only a handful of oral
health companies have managed to
become household names, and even
then they’re usually owned by
conglomerates like Procter &
Gamble and Johnson & Johnson.
Creating a strong brand is even more
difficultfor local practices that have
a fixed geographical reach and offer
nearly identical services to those of
their competitors.
Whether you run a solo practice, a
group practice, or even a dental
products company, there are ways to
develop a compelling brand that can
help you stand apart and more
effectively attract and retain new
business.
First, however, it’s important to
understand what a brand is and what
it is not. While the word “brand” is
often associated with products,
companies themselves have brands,
too. A corporate brand is the
manifestation of who an organization
is, how it’s different, and why it’s
valuable. It’s much more than just a
logo or a tagline. It must be both
expressed and experienced,

emerging in what you say and what
you do. For dental practices, this
means not only saying you’re
different, but showing it through
the way you interact with patients,
the way you design your in-office
environment, and even in the
value-added services (e.g. patient
education and community
outreach) you choose to offer.
To create a brand that can own
local markets, dental offices must
first determine how they are
greater than the sum of their
parts and what unique value they
bring to their patients. What do
you have that others don’t? What
can you do that others can’t?
What are you willing to do that
others won’t? What are you trying
to accomplish that others aren’t?
What perspective or attitude do
you have that nobody else does?
What, beyond financial gain, gets
you up in the morning?
Beyond determining how your
brand can leverage its capabilities
and personality to differentiate
your practice, it’s also important
to understand what your market
needs. Many dentists understand
high-level industry trends, but
chasing these trends blindly can
be disastrous for your brand.
For example, increasing dental
demands among baby boomers
has led many practices to double
down on geriatric services. This
groupthink, however, creates a
pediatric dental vacuum in local
markets at a time when
millennials are finally starting to
have kids in increasing numbers.
Thus, the real needs in your
particular marketplace may
diverge from the obvious
demands of the overall market,
and it’s critical to be able to
distinguish the two.
Once you’ve identified who you
are, how you’re different, and
what your market needs, the next
step is to translate that knowledge
into a brand strategy that will
inform and direct everything you
say and do. This strategy usually
takes the form of a positioning
statement that synthesizes what
you’ve learned about your
organization and your market.
This statement can then be
translated into the assets and
experiences—the touch points—
that people will encounter and
interact with, e.g. your logo, your
website, your office waiting room,
your advertising, your community
sponsorships, your value-added
services, and even your chair-side
manner.
EZPEDO, for example, is
positioning itself as the first true
technology company in pediatric
dentistry—an industry not known
for innovation. To deliver on its
claim to hold this position, the
company has changed its name and
visual identity to reflect a more
contemporary, technological
personality. More importantly, it is
aggressively investing resources to
evolve its current product offerings
and create a variety of new tech-
inspired products for pediatrics.
Undertaking a rebranding effort is
not an easy task. It can be time
consuming, pricey, and even
contentious. The dental profession
is becomes increasingly
competitive and consumers (your
patients and their parents) are
continuing to become more
discerning and demanding. In light
of this reality, having a strong
brand that can generate awareness
and trust between you and the
people who matter the most to
your business will become ever
more critical.
It’s much more
than just a logo
or a tagline.
KEY
TAKE-AWAYS
• Brands are built on
strategies that emerge from
who you are and what you
can do that’s better or
di erent than what others
do; they’re more than just
clever, memorable logos.
• The best brands are
informed by qualitative and
quantitative research that
analyzes internal and
external needs, capabilities,
and trends.
• Businesses with successful
brands incorporate their
branding strategy into
everything they say and do,
from marketing activities, to
the services they o er, and
even to the way they interact
with clients.
• Management must be
committed to adequately
funding and enthusiastically
supporting a strategic
brand-building plan in order
for it to succeed.

W W W. F A C E B O O K . C O M / S P R I G U S A
W W W. T W I T T E R . C O M / S P R I G U S A
W W W.Y O U T U B E . C O M / S P R I G U S A
( 8 8 8 ) 5 3 9 . 7 3 3 6
WE’D LOVE
TO CONNECT
WITH YOU.

DRILLING
THROUGH
THE
DIGITAL
NOISEHOW TO GROW YOUR
DENTAL PRACTICE IN
A HI-TECH AGE
By Ceara Milligan

DRAMATIC
CHANGES
HOW THE CURRENT DIGITAL
REVOLUTION AFFECTS
YOURPRACTICE
The digital revolution we are currently experiencing has drastically changed the way in
which people engage with one another and with businesses. This revolution is perpetually
revamping the world of marketing while rendering many traditional advertising channels
and strategies obsolete. Today, people communicate, shop, and research much differently
than they did even a decade ago. The “old” way of doing business in any industry is now
unsustainable. Even medical and dental practices—typically longstanding stalwarts of a
community—must constantly re-evaluate the ways in which they engage and
communicate with their patients.
As a dentist, you profoundly impact people’s lives and their health. Your patients are
seeking brighter, happier, healthier smiles. People visit the dentist because they want to
take care of themselves, boost their self-confidence, and feel more comfortable. People
yearn for an exceptional experience when they enter and exit your office doors.
How can you engage them most effectively in a digital age?

32 Shift Magazine / May 2017
THE DOMINANT IMPACT
OF A DIGITAL GENERATION
Adults in the United States devote an average of 10 hours and 39
minutes to digital media and check their smartphones over 150
times each day. By now, we are all well aware that anything digital
is dominating the marketing game. Although technology
supposedly makes our lives easier, we discover that navigating new
methods of social media and dealing with digital marketing can be
confusing and complicated. One of the deepest desires of today’s
dentists seeking to create a successful brand is to cut through the
digital noise, not simply be part of it.
Dentists searching to build a brand must face this new technological
reality and adapt in order for their practices to thrive in years to
come. A major component of success is being able to attract the rising
millennial audience. Yes, millennials are the “entitled” generation
that has been criticized for living in their parents’ basements, for
being “lazy,” and for making less income while taking on more debt
than their predecessors. However, they’re now growing up and
starting families. Although they may not have adopted the most
economical saving habits, providing them with the discretionary
income their parents had, they are very health conscious. They are
willing to spend disproportionate amounts of their income on health
care, making them a vital consumer of pediatric services.
So how do you attract this new wave of customers while not
alienating your long-time base? The keys to success are
developing a compelling brand and selecting the right digital
platforms. We will explain each of these in detail below.
DEVELOPING A COMPELLING BRAND
It is crucial to create a brand that speaks to your audiences in a
clear, uniform way. The channels on which your brand is
presented, both offline and online, must coexist seamlessly in
order to gain recognition, trust, and loyalty. In today’s cluttered
world, your brand must have a strong identity and establish
both authority (“being the trusted expert”) and empathy
(“understanding your audience”). This can be done by
positioning your brand as the “guide” and your customers as the
“hero.” In other words, put your patients at the center of your
brand messaging instead of constantly talking about how great
your practice is. Many brands struggle with this, so if you can
evolve your messaging to be more patient-centric, you can
create a huge competitive advantage.
To get started, you must have a solid definition of your brand. More
importantly, your customers should have a clear understanding of
who you are and what you stand for. When someone first comes
into contact with your brand, they should immediately be able to
tell—very simply—who you are, what you stand for, and how you
will make their lives better.
While developing your brand online is important, keep in mind that
your in-office experience should be just as memorable, inviting, and
seamless. If your brand is friendly and inviting, a customer walking
into your dental practice should be met at the front desk with
someone who exudes that type of persona. Your brand should be
consistent, reflected in everything from how your storefront and
staff look to how the phones are answered and how patients
entertain themselves in the waiting area.
Consistency in implementing your brand can make or break a
patient’s overall experience with your dental practice. From the
moment they hear about you to the moment they take a seat in
your dental chair, everything about your brand is communicating
to them who you are and what it’s like to do business with you.
Take time to assess if your current brand is working and
communicating the way you want it to. Authentic and transparent
communication is key, especially in the world of healthcare, where
people’s health and wellbeing are paramount.
When you have a successful and compelling brand, your digital
efforts will prove much more effective in growing your practice.
SELECTING THE RIGHT
DIGITAL PLATFORMS
Facebook, Google, LinkedIn, email, print, radio, Instagram, direct
mail, Snapchat, your website, Pinterest—the list goes on. It’s 2017,
and the options available to market your business are seemingly
endless. As a dental practice, you also don’t have the time and
resources that larger corporations do. This makes it even more
important to invest in the correct platforms. Many small businesses
try to have a presence on too many platforms and end up spreading
themselves thin, thus not getting the results they desire.
So where do you start? Go where your target audience is already
spending time and where you can engage and add value to their
experience. For most dental practices, this means having an
effective website and utilizing Facebook, Instagram, email
marketing, and review sites. We will focus on
these options in the rest of this article.
Creating a Website That Drives Action
With 97% of consumers searching for local businesses online, today
your website is more important than ever. It should serve as your
online storefront and should be mobile optimized, stress simplicity,
and clearly call visitors to take action. The design should be simple,
easy to navigate, and provide just enough information to get your
main message across. According to today’s Web standards and best
practices, brevity is key. If site visitors land on your page, and
cannot figure out exactly who you are, how you can make their
lives better, and how to contact you in a matter of five seconds, you
should re-evaluate your homepage.
While navigating your website, visitors should have a great sense of
how you’d be able to make their lives easier. Establishing a sense of
empathy through aspirational imagery and compelling copy allows
your audience to develop trust in your brand’s message. Your website
should also display multiple, crystal-clear calls-to-action. The most
obvious action you want your customers to take is to schedule an
appointment with one of your doctors. Place a “Schedule an
Appointment” button prominently on your homepage (center and
top right) and throughout your site. In reality, customers do not take
action on their own. They must be repetitively and comprehensibly
guided to do so.
Remember that all content on your site should have a purpose. It
should build credibility, show empathy, and guide your visitors to
book an appointment and interact with your brand. Establishing
Questions to ask when developing
a brand-building plan:
• What do we stand for?
• Who is our target audience?
• What problems are they facing?
• What are their aspirations and passions?
• What is our competitive advantage?
• How can we solve their problem(s) better
than the competition?
• How do we want people to feel when they
do business with us?
• What is our brand’s voice? (How do we
“walk and talk?”)
TODAY’S
REALITY
Your brand must have
a strong identity and
establish both
authority and
empathy.

your position as the go-to local dentist should be a top priority.
Once patients are comfortable and happy with their dentist, they
will usually stay with the practice unless they move to a new area.
It’s important to ensure your practice is visible in search engines
for local search terms. Local search engine optimization (SEO)
efforts will help boost you to the top of search engine rankings.
Facebook: The Best ROI for Small Businesses
With 1.86 billion active users and the average U.S. consumer
spending over 40 minutes per day on the network, Facebook is a
great place to reach your target audience and market your practice.
However, only 45% of marketers think that their Facebook efforts
are effective. This shows that although your audience is on
Facebook, you may be struggling to engage your audience and
attract new customers to your site.
Your dental practice’s Facebook page should establish your brand
as an authority and foster a community through compelling
content and informational posts. For example, you can share case
studies, articles from esteemed trade publications, helpful tips,
customer testimonials, and fun holiday wishes. (Note: National
Dentist’s Day is March 6.) With Facebook, you can reach a variety
of people with one post, create ads to drive traffic to your
website, foster dialogue with your customers, share your brand’s
story and testimonials, and provide detailed information about
your practice
Facebook Video Is on the Rise
Over 100 million hours of video are watched each day on
Facebook, and that number will continue to rise exponentially.
Utilizing video on Facebook is another great way to boost
engagement. With its own video and live-stream platforms,
Facebook is set to own the online video world in coming years.
Video adds value and variety to your audience’s news feed.
Facebook videos, like regular posts, should be engaging, yet brief.
With so many items flooding users’ news feeds, your followers’
attention can be diverted elsewhere fairly quickly if your videos
are too long.
Facebook Dollars Are Invaluable
Many modern businesses have been asking, “Do we have to pay
to play on Facebook? If so, how much?”
Back in 2009, Facebook released Business Pages. From then until
2012, businesses enjoyed the free-for-all of 100 percent organic
reach, meaning that if you had 500 fans on Facebook, all 500 of
those people would view your post for free if they were online!
Today, that organic reach has plummeted down to about 2
percent. That said, after working with hundreds of small business
owners over the last several years, we can confidently say that
“Paid Facebook” can be the best return on investment (ROI) for
small businesses. And you don’t have to pay a lot to make an
impact. Many of our small business clients do well with a $50–
$200 monthly Facebook budget.
Over the past few years, Facebook ads and increased numbers of
posts have become key drivers of ROI for brands with a presence
online. Putting money behind your content can greatly amplify
its reach. Additionally, when people engage with your ads (e.g.,
liking, sharing, commenting), your content will gain exposure to
an even larger audience. Businesses can target users with very
specific attributes, such as location, age, gender, interests,
education level, behaviors, and connections. For example, you
can create an ad for your dental practice that is specifically
targeted towards 30- to 40-year-old women who have young
children, live within 10 miles of your office, commute to work
every weekday, own a smartphone, and enjoy drinking coffee.
Crafting the right messages for your target audience at the right
times can grab your patients’ attention and result in one
appointment after another.
Production Pro Tips:
• Keep it brief: 15-second to
2-minute videos are the ideal length.
• Use subtitles: Facebook videos start playing
automatically on mute when a user scrolls
through their news feed. If subtitles are added,
the user is more likely to start watching the
video, resulting in increased engagement.
• Keep it real: High production videos are great,
but don’t sweat if your videos are “scrappy.”
Videos recorded on a smartphone work well
and sometimes even get more engagement
on social media since they are so raw
and authentic.
Execution Pro Tips:
• Target very speciﬁcally: The more speciﬁc you
can be the better. Consider using “lookalike”
audiences, retargeting, etc.
• Use compelling imagery: Make sure the
photos, graphics, or videos used in your
Facebook ads speak to the target audience and
represent the message you are trying to get
across.
• Always test, monitor, and adjust: One of the
great things about Facebook ads is that you
can pause and adjust them in real time. Try
running multiple ads in the same campaign,
see which ones are performing well, and
play around with the targeting.

Instagram: The Hottest Social Network
Instagram is a visual social network that is based primarily on
photo and video posts. The Facebook-owned network has more
than 600 million active users worldwide, with more and more
users joining every day. Of these viewers, 75 percent take an
action, such as visiting your website, after viewing an Instagram
post.
Visual content sparks the mind and fuels engagement. The
benefits of Instagram in the dentistry field include attracting new
patients and referrals, increasing traffic to your website, and
fostering brand engagement. Visual images communicate quickly
and conveniently. An added benefit for dental practices (and
other healthcare organizations) is having the power to humanize
care and to create an emotional connection with the audience.
A New Way to Tell Stories
In July 2016, Instagram launched Stories, an ephemeral photo and
video feature very similar to Snapchat. Stories are temporary (24-
hour lifecycle) photos and videos that are strung together to form a
slideshow gallery that tells a story your followers can view and enjoy.
You can also display live videos within Stories. Similar to how
Facebook’s live video feature works, your followers receive a
notification within the platform that your brand is live.
Email Lives On
Contrary to what some people—even marketers—believe, email is
not dead. In fact, the use of email marketing is increasing each year.
More than 90 percent of consumers still check their email daily,
and email is said to produce a better ROI than any social network
on highly targeted campaigns. Although people’s inboxes seem to
be overflowing nowadays, developing a powerful, effective email
strategy can help grow your practice.
Email is a great way to communicate with your patients on a
consistent basis. Keeping your patients in the loop with reliable,
personalized messages builds trust and provides them with
another avenue to communicate with your office. Email
marketing can be used to notify your patients regarding practice
updates, special offers, industry news, and other relevant,
interesting content. You can also send individual emails to
patients reminding them to schedule their next appointment.
This will establish a loyal patient-dentist relationship.
There are a number of ways to grow your email subscriber list.
Encourage your patients to sign up for your email newsletter on
your website by offering them something of value, such as a
special discount, free dental health tips, or branded products
merchandise. (Someone could probably use a new toothbrush!) It
is also very important that you collect your patients’ email
addresses when they schedule an appointment or check in. This is
by far the easiest and most effective way to grow your email list.
A simply designed email with just a few main sections will grab your
subscribers’ attention better than a long-winded email with an
abundance of information. Be sure to have a purpose for each email
you send along with a crystal-clear call-to-action, whether that is to
schedule an appointment, attend an event, or redeem an offer.
Consumers Depend on Reviews
Before making a decision on which business they’ll buy from, many
of today’s customers turn to review sites. In fact, 88 percent of
consumers trust online reviews as much as they trust personal
recommendations. They will “shop around” online to read about
other people’s experiences with various offices. Chances are, if
people are speaking highly of your brand, their actions will inspire
others to place an initial trust in you. Ideally, readers of these
reviews will test your product and service, and if things go well, they
will also become customers and leave positive reviewsoftheirown.
On the other hand, if someone has a poor experience with an office,
they will likely express their negative opinion using one of these
online review sites.
It’s important to make it a habit to frequently monitor and update
your practice’s page hosted at online review sites like Yelp and
Google. ZocDoc and Healthgrades are other popular review sites
that are specifically designed for the healthcare industry. Patients
can also leave reviews on your Facebook and Google+ pages. Be
sure to respond to these reviews, whether they are positive or
negative.
Why you should take advantage
of Instagram Stories:
• Placement: Whenever you share an Instagram
story, you will appear in the top bar of the
user’s feed.
• Authenticity: People love consuming content in
short video clips, such as behind-the-scenes
looks at your practice.
• Creative ﬂair: Stories allow you to get creative
and add text, stickers, ﬁlters, and other add-ons
to photos and videos.

Conclusion
When the elements of your dental practice’s marketing ecosystem
work together in harmony, your business will run more efficiently,
and your patients will have an excellent experience time and time
again. People in today's digital world expect businesses of all types
and sizes to utilize up-to-date technologies and to employ effective
communication methods. Offices that choose to invest in enhancing
their use of technology and building effective digital
communication platforms will experience more cost-effective
practices, an increase in production, and greater numbers of
happier, satisfied patients. You must decide when to embrace
these technological innovations, not if.
Sources
hubspot.com/marketing-statistics
smilesavvy.com/internet-marketing-for-dentists
expandedramblings.com/index.php/by-the-numbers-17-
amazing-facebook-stats
searchengineland.com/88-consumers-trust-online-reviews-
much-personal-recommendations-195803
brightlocal.com/learn/local-consumer-review-survey
toprankblog.com/2017/01/digital-marketing-statistics-2017
inc.com/larry-kim/9-important-reasons-you-need-to-use-
facebook-ads-right-now-first-90-days.html
About GoGeddit
GoGeddit is a small-business growth agency
headquartered in Milwaukee, Wisconsin. Our mission is to
help small and midsize businesses ﬁnd their voice and cut
through the digital noise, not just be part of it. We provide
services such as digital marketing strategy, brand identity
and design, and website development. We understand that
going digital can be a formidable obstacle, but we aim to
assure our clients that when done right, staying up-to-date
in a digital world is always worth the investment.
For more information, contact GoGeddit.
2680 S. Kinnickinnic Ave, Unit #1, Milwaukee, WI 53207.
(608) 628-3286 | www.gogeddit.com.
You must decide
when to embrace
these technological
innovations, not if.

&SUN, SAND,
AN AMALGAM
CARRIER IN
MY HAND
A look at the pros and
cons of mineral trioxide
aggregate (MTA)—an up
and coming superstar
for vital pulp therapy
By Jarod Johnson, DDS
It all started on a February day when I boarded a plane flying
to Las Vegas for an interview at the University of Nevada, Las Vegas
(UNLV) School of Dental Medicine. My flight took me through
Minneapolis and on to the only location where “the sun goes down but
the city gets brighter.” After a short cab ride to the dental school,
I was soon seated for an interview. Shortly after we began, Dr. Ron
Lemon, graduate program director and endodontist, started talking
about “regrowing pulps.” As a fourth-year dental student, I thought
this was a trick. I smiled, nodded, and luckily received an offer to
enroll in the pediatric residency program despite my ignorance.
My time in the sun allowed me to take advantage of everything
UNLV’s program had to offer. Although they did not offer an
endodontic residency, I quickly discovered that opportunities to
perform endodontic therapy in children were plentiful. This sparked
my interest in learning the properties of mineral trioxide aggregate
and how to handle it clinically in order to best suit the needs of my
patients.
It took me a few cases to learn how to handle the material, but quickly
I realized that the procedures could all be performed using familiar
instruments. I’d like to share the knowledge I learned during my time
in the sun playing with sand, while holding an amalgam carrier in my
hand.
PROPERTIES OF MINERAL
TRIOXIDE AGGREGATE (MTA)
Mineral trioxide aggregate (MTA) is a bioactive material composed of
dicalcium silicate, tricalcium silicate, tricalcium aluminate, and
tetracalcium aluminoferrite. Bismuth oxide is added as an agent
rendering the material radiopaque and giving it a thickness
approximately equivalent to 7 mm of aluminum. 1 This addition gives
the material more radiopacity than dentin and gutta percha. As a
result, MTA is readily detected upon radiographic examination and
ensures proper placement of the material and allows for radiographic
follow up.
When mixed with water, MTA begins to set and releases calcium ions,
which in turn leads to the formation of hydroxy appetite as it
combines with phosphate ions that are present in the body. This layer
adheres to dentin through a chemical bond as the material sets and
provides valuable sealing capabilities. 2
The aggregate material is bacteriostatic due to its basic pH, and has
been shown to be an inhibitor of bacterial growth. Recent studies have
shown that MTA has potential to entomb bacteria in dentinal tubules
as it forms tag-like structures that seal off tubules. This action allows
the material to provide a sealing function in many different clinical
scenarios. 3,4
MTA can be successfully
utilized in primary teeth for indirect
and direct pulp caps, pulpotomies, root-end
filling (apexification), and perforation repair. In permanent teeth,
the uses are even more diverse as they include direct and indirect
pulp caps, pulpotomies, root-end filling (apexification), regenerative
endodontics, orthograde obturation, perforation repair, and
apicoectomy. 5,6
ADVANTAGES
Faster Bridging Than Calcium Hydroxide
MTA has been shown to exhibit faster
bridging qualities than calcium hydroxide. MTA forms a dentin bridge
in a shorter period of time than calcium hydroxide. 7 The bridge is
detectable radiographically once it is 0.5 mm in thickness. 8 The
formation of more tooth structure underneath the material may help
provide a better seal against bacterial leakage, which is a common
etiology of endodontic failures. 9

MT
vs
FOR
Bioactive
MTA has been shown to stimulate hard tissue formation in contact with
vital pulp cells and periapical tissues. Properties of the material
stimulate the formation of dentin, cementum, and the periodontal
ligament. The capability of the material to be osteoinductive when used
in different tissue environments accounts for MTA’s wide variety of uses
in vital and non-vital pulp therapy in both permanent and primary
teeth. 5
Biocompatible
Unlike calcium hydroxide, MTA does not induce a layer of coagulative
necrosis which results in hard tissue formation. As noted above, MTA
has been shown to be compatible with pulp and periapical tissues when
routinely placed in contact with them during therapy. 7 Unintentional
extrusion of MTA out of the apex has been documented in the
literature, and while not advocated, it has resulted in tooth survival. 10
Antibacterial (Basic pH)
MTA has a basic pH which gradually increases from initial mixing to
reach a pH of 12.5 after four hours. 11 This high pH is responsible for the
antibacterial effects of MTA. This material has been shown to be
effective against S. mutans, L. rhamnosus, L. paracasei, and P.
gingivalius—all common microbes present in dental caries. 3 These
properties are advantageous for a material used in vital pulp therapy as
one may expect microbes to remain in dentin tubules despite conscious
efforts to completely remove infected dentin.
Disadvantages
Long Setting Time
MTA sets in approximately two hours and 45 minutes. When the
material is initially placed, its retention is purely mechanical. 1 Over
time, however, a chemical bond forms with dentin. During this setting
time, the material requires moisture, which can be problematic for
many dental materials. Other potential problems for MTA include the
following: 1) material can wash out due to prepping, and 2) MTA cannot
be etched, rinsed, or bonded to. This means that most MTA must be
temporized while it sets, or else the material must be covered with a
moisture-tolerant product such as a glass ionomer cement before a
moisture-intolerant substance such as composite resin can be used.
Experience shows that pulpal therapy is more successful when a
final restoration is placed at the time of treatment regardless of
material placed.
Difficult Handling
Like using any material in dentistry, handling MTA involves a learning
curve. 5 The learning experience is further complicated by the fact that
MTA handles differently based on the amount of hydration involved in
the mixing of the material. This author’s opinion is that the material
handles similarly to sand. Wet MTA will handle like sand that has just
been washed by a wave of the ocean, while dry MTA will resemble a
sand castle that has been baked by exposure to a warm day in the sun.
Achieving the proper mixture is a key factor in ensuring the proper
handling qualities calculated to match the clinical situation. The
hydration properties can be advantageous when placing the material
as an orthograde, root-end filling material in permanent teeth.
If the material is too dry, it can be rehydrated to allow for
apical advancement. 12
Cost
The cost of MTA can be a concern as practitioners look to keep office
overhead low. The cost per use of material varies depending on the
manufacturer and the type of packaging used. MTA requires moisture to
set, and although uni-dose MTA products prevent the material from
being exposed to humidity in the air, a single dose may contain more
material than needed to treat a tooth, thus increasing waste. On the
other hand, MTA that is stored in a multi-dose package, needs to be
sealed from humidity to prevent the material from setting prior to use,
another risk potentially leading to increased overhead costs.
IS IT TIME I T
SOMETHING NE
PULP TRE

TA
s.
RMO
MTA AS A PULPOTOMY AGENT
Fig. 3. MTA has been shown to have equivocal results as FC when
used as a pulpotomy agent in primary teeth. Tooth #K and #L
had deep carious lesions (upper left) and caries removal was
completed for diagnosis (upper right). Tooth #K was hyperemic
and extracted; tooth #L was treated with an MTA pulpotomy.
After disinfection with sodium hypochlorite, MTA was adapted to
the pulp covering the entire pulpal floor (lower left). The tooth
was then restored with a full-coverage restoration (lower right).
MTA AS A DIRECT PULP CAP
Fig. 2. A deep carious lesion was diagnosed with reversible
pulpitis on a permanent molar treated with complete caries
removal (upper left). The pulp was exposed and treated with
sodium hypochlorite, and a layer of MTA was placed (upper
right). The tooth was temporized (lower left) and restored
with a resin composite (Premise) at a later date. At two-year
recall, the tooth remains asymptomatic and shows no signs
of apical pathology (lower right).
MTA AS A BASE
Fig. 1. A deep carious lesion (greater than two-thirds into
dentin, upper left) was treated with an indirect pulp cap (base).
Rubber dam isolation was utilized in case a pulp exposure
occurred. After caries removal (upper right), 1.5 mm of
SmartMTA was placed and allowed to set. Final restoration was
completed with a Tesera resin inlay (bottom right).
THINK ABOUT
EW FOR VITAL
EATMENT?
Base
Pulp Capping
Pulpotomy

A REAL-LIFE TESTIMONIAL
Staining
The staining experienced in the use of MTA is attributed to bismuth
oxide (an added radiopaquing agent) and sodium hypochlorite. 13
Sodium hypochlorite is a commonly used endodontic irrigant which
dissolves organic matter, exhibits bactericidal and lubricating qualities,
and is readily available. The staining can be reversed by bleaching after
therapy is completed. However, this practice may be problematic in
cases where there is no room in the pulp chamber. Newer formulations
of calcium silicate products manifest less discoloration when they
encounter sodium hypochlorite. 13
Conclusion
The field of pediatric dentistry continues to engage in an ongoing
debate regarding the use of formocresol in primary tooth pulpotomies.
Researchers debate formocresol’s toxicity and potential
carcinogenicity, and the value of using MTA as a viable alternative. 14,15
In scientific reviews, MTA has shown equivocal results compared to
formocresol when used as a pulpotomy agent. 16,17 The material is a
viable replacement for the formocresol pulpotomy. MTA is also
superior to calcium hydroxide in direct pulp caps on permanent teeth,
and can be used to replace calcium hydroxide in the Cvek (partial)
pulpotomy. 18,5 The versatility of the material in treating clinical
scenarios of dental caries or trauma suggests that the material should
hold an important place on the shelf of every pediatric dental office.
The use of MTA in the treatment of primary and permanent teeth is
soundly supported by the scientific literature. 5
IN SCIENTIFIC
REVIEWS, MTA
HAS SHOWN
EQUIVOCAL
RESULTS
COMPARED TO
FORMOCRESOL
WHEN USED AS
A PULPOTOMY
AGENT.
THINGS TO CONSIDER WHEN
CHOOSING AN MTA SYSTEM
FOR YOUR PRACTICE:
• Setting Time
• Staining
• Cost
• Unit dose (contamination, setting if
product is open)
• Handling (easy mix, place with familiar
instrument [amalgam carrier])
• Dentin bridging (faster than CaOH, no
bridge forms with Formo)
• Vital tissue is maintained (Formo
mumi es tissue)
• Non-toxic/Biocompatible
• Antibacterial (pH)
• Bacterial entombment
• Diverse use in permanent and primary
teeth (replaces multiple materials
including CaOH and Formo)

1 Torabinejad M, Hong C, McDonald F. Physical and Chemical Properties of a New Root-End Filling Material. J Endod.
1995;21(7):349–353.
2 Sakar N, Caicedo R, Ritwik P, Moiseyeva R, Kawashima I. Physiochemical Basis of the Biologic Properties of Mineral
Trioxide Aggregate. J Endod. 2005;31(2):97–100.
3 Kim R, Kim M, Lee K, Lee D, Shin J. An in vitro evaluation of the antibacterial properties of three mineral trioxide
aggregate (MTA) against five oral bacteria. Arc Oral Bio. 2015;60:1479–1502.
4 Yoo J, Chang S, Oh S, et al. Bacterial entombment by intratubular mineralization following orthograde mineral
trioxide aggregate obturation: a scanning electron microscopy study. Int Jour Oral Sci. 2014(6):227–232.
5 Parirokh M, Torabinejad M. Mineral Trioxide Aggregtate: A Comprehnsive Literature Review — Part III: Clinical
Applications, Drawbacks, and Mechnaism of Action. J Endod. 2010;36(3):400–413.
6 American Academy of Pediatric Dentistry. Guideline on Pulp Therapy for Primary and Immature Permanent Teeth.
Pediatr Dent. 2014;36.
7 Ford T, Torabinejad M, Abedi H, Bakland L, Kariyawasam S. Using minteral trioxide aggregate as a pulp-capping
material. J Am Dent Assoc. 1996;127(10):1491–1494.
8 De Rossi A, Bezerra Silva L, Gaton-Hernandez P, et al. Comparison of Pulpal Responses to Pulpotomy and Pulp Capping
with Biodentine and Mineral Trioxide Aggregate in Dogs. J Endod. 2014;40:1362–1369.
9 Nowicka A, Lipski M, Parafiniuk M, et al. Response of Human Dental Pulp Capped with Biodentine and Mineral Trioxide
Aggregate. J Endod. 2013;39(743–747).
10 Tahan E, Celik D, Er K, Tasdemir T. Effect of Unintentionally Extruded Mineral Trioxide Aggregate in Treatment of
Tooth with Periradicular Lesion: A Case Report. J Endod. 2010;36(4):760–763.
11 Torabinejad M. Clinical Applications of Mineral Trioxide Aggregate. J Endod. 1999;25(3):197–205.
12 Al-Kahtani A, Shostad S, Scifferle R, Bhambhani S. In-Vitro Evaluation of Microleakage of an Orthograde Apical Plug of
Mineral Trioxide Aggregate in Permanent Teeth with Simulated Immature Apices. J Endod. 2005;31(2):117–119.
13 Camilleri J. Staining Potential of Neo MTA Plus, MTA, Plus, and Biodentine Used for Pulpotomy Procedures. J Endod.
2015;41(7):1139–1145.
14 Casas M, Kenny D, Judd P, Johnston D. Do we still need formocresol in pediatric dentistry? J Can Dent Assoc.
2005;71(10):749–751.
15 Lewis B. The obsolescence of formocresol. J Calif Dent Assoc. 2010;38(2):102–107.
16 Stringhini E, Vitcel M, Oliveira L. Evidence of pulpotmy in primary teeth comparing MTA, calcium hydroxide, ferric
sulphate, and electrosurgery with formocresol. Eur Arch paediatr Dent. 2015;16:303–312.
17 Coll J, Seale S, Vargas K, Marghalani A, Al Shamali S, Graham L. Primary Tooth Vital Pulp Therapy: A Systematic
Review and Meta-analysis. Pediatr Dent. 2017;39(1):16–27.
18 Marques M, Wesselink P, Shemesh H. Outcome of Direct Pulp Capping with Mineral Trioxide Aggregate: A Prospective
Study. J Endod. 2015;41(7):1023–1031.
REFERENCES
Do you MTA?
If not, this might just
be the perfect time
to give it a try.

How Branding Affects Trendsetting
in the Field of Pediatric Dentistry
BRANDNew Beginning
A
By Alan Siegel

Alan
Siegel
Branding
Legend
VISIONARY
Alan helped define some of the
most iconic brands of our time,
including the NBA, Xerox,
American Express, Caterpillar,
Girl Scouts, Aetna, Pfizer,
MasterCard, National Geographic
and many others. Always an
innovator, Alan developed the
concept of Brand Voice™ and was
one of the first in the industry to
use the internet as a tool for
brand communication.
ver the past few years, EZPEDO has grown from a
relatively new, niche provider of pediatric dental products to a
dominant player in the market, one competitors are seeking to
imitate. Within this context, EZPEDO approached us at
Sieglevision to help them enhance their role as an industry leader
and innovator. In order to own this position in a largely stagnant
part of the dental industry, EZPEDO is evolving their brand to
better represent their success and ambitions, and to take
ownership of who they are as a company and who they strive to
become.

The dental industry as a whole is also facing a critical crossroads.
Consumers are more health conscious than ever, and their
expectations of healthcare are increasingly being influenced by
technology. This means that traditional practices and antiquated
techniques are not going to cut it. It is up to companies like
EZPEDO to be the pioneers in the field of oral health technology
and influence industry-wide change in order to meet the
heightened expectations of today’s patients.
Faced with these challenges, EZPEDO is refocusing its image and
rebranding its identity. Let me provide some background.
Branding—Who Are You, and Why
Should I Care?
When people hear the word “brand” they often think of logos,
advertisements, or slogans. While these are visible components of
a brand, the essence of your company’s brand is unseen and rests
in your identity—who are you, how are you different, and why should I
care? In other words, what makes your company unique, and why
are you valuable to customers and society? Your brand includes
everything from visual identity to the values that permeate your
corporate culture. Strong, relevant brands engender customer
loyalty, clarify an organization’s purpose, boost business value,
help distinguish a company from competitors, and serve as the
most effective antidote to commoditization.
Today’s most powerful and popular brands have clear identities:
Apple, Google, Starbucks. These companies know who they are
and what they stand for, and their identities drive everything they
do and say. When a company has a strong brand identity,
customers know what to expect from it and trust the company to
deliver reliable products and services. This trust factor is
increasingly important as consumer demographics shift and
millennials take over as the dominant customer base.
O

Creating a Lasting Brand in a
Rapidly Changing Environment
We are now dealing with a consumer base that is much savvier and
consequently more skeptical of brands and the messages received
from them. I’m talking about millennials. Because of their access
to vast amounts of information—ranging from a brand’s pricing to
its product quality—millennials expect their brands of choice to be
authentic, personalized, adaptive and fresh. Millennials seek long-
term relationships with brands and want their brands to create
customized experiences for them. To be successful in this evolving
landscape, emerging brands must be authentic and innovative in
order to connect with consumers and make them feel valued. This
is especially important in the field of healthcare, where patients
are better informed than ever before.
The ‘Healthification’ of Everything
The healthcare landscape is undergoing an exciting
transformation. Empowered by technology, today’s patients are
more informed and more demanding of their healthcare
providers. They increasingly shop around for providers, research
treatments, and take a more active role in managing their
healthcare. Millennials show a greater interest in health and
wellbeing as a whole; and as a result, healthcare is making its way
into seemingly unrelated industries. Take for example, the fashion
industry with the Apple Watch Hermès and even the automobile
industry with the Nissan self-driving cars, to name a few. Health is
everywhere, and the increasingly competitive markets mean that
healthcare providers, suppliers, and equipment manufacturers
have to be more aggressive in how they articulate their value and
differentiate their brands.
The deployment of technology has created a more dynamic
market. Successful emerging healthcare companies are
positioning themselves as customer-centric brands based on value
and innovation rather than traditional clinical brands based on
service offerings. Technology has dramatically changed the way
patients interface with their healthcare providers.
Healthcare Got a Makeover …
and Dentistry Should Too
The demands of today’s patient/consumer have been profoundly
shaped by technology. In addition to using technology to
investigate healthcare options, people are also increasingly
expecting from their healthcare providers the same simple and
seamless experience characteristic of the consumer technology
companies they love. This is why the hottest healthcare startups
look and feel more like Apple than Anthem, with sleek visuals,
edgy personalities, and a heavy focus on customer experience. In
fact, I saw a survey recently that found consumers would rather
have Amazon or Google manage their healthcare than healthcare
companies—now that says something!
Unfortunately, the dental industry has been slow to adapt to these
trends, and consequently patients seldom associate dentistry with
innovation. A longtime friend of mine, renowned cosmetic dentist
Larry Rosenthal, speaks to this perception in his eye-opening (not
to mention mouth-opening) book Open Wide(r). In it, he admits,
“most baby boomers in particular can’t shake the image of the
dentist as a little more than a barber with drills, forceps and
needles.”
Doctor Larry makes a compelling argument for prioritizing your
child’s oral health. He points out that cavities, crooked teeth, bad
bites and jaw issues are often preventable when we are children—
before our adult teeth come in. Proactive means preventive, and
preventive means a happy and healthy child. Maybe what parents
need today is an app to remind them of that.
The problem is, most patients still think of their dental
experiences as unpleasant, painful, and expensive. Although
dentists know that good oral health is critical to a person’s overall
wellness—not to mention their self-esteem—the public will
continue to perceive dentistry as old-fashioned and “uncool”
unless dental companies align their offerings, culture, and brand
with 21st-century consumer expectations.
There is hope, however. Many newer dental companies have
made significant strides. Previously invasive procedures are now
quick, painless, and affordable. New models of care delivery, like
mobile dental practice Studio Dental, have emerged to cater to
the lifestyles of the new consumer. There’s a greater focus on
dental technology that’s simple, healthier, and more natural than
the legacy products of the past. All of these trends, while still in
their infancy, are enormously positive for the oral-health industry.
EZPEDO as a Blueprint
for Innovation
For many upstart oral-health product companies such as
EZPEDO, innovation is in their DNA. They’ve seen the
shortcomings of legacy products and are designing better
solutions for 21st-century patients and professionals. EZPEDO, for
example, is challenging the dominance of traditional stainless
steel crowns in the pediatric dental market. Why would any
parent want to put metal in their kid’s mouth if a more natural,
better-looking alternative was available? EZPEDO created that
alternative, using a biocompatible material called Zirconia and a
patented design that ensures adhesion and comfort.
In order to reflect this spirit of disruption and innovation,
EZPEDO needed to clarify how it is different in an increasingly
commoditized niche. Rather than settle for the brand of a high-
end dental products company, EZPEDO is repositioning itself as
an oral health technology company that’s fighting to bring to
pediatric dentistry the innovation people demand and deserve—
because the next generation deserves next-generation care.
This orientation will help establish EZPEDO as a visionary within
the pediatric dental products arena and compel it to further
expand its offerings to reinforce its position as a technology
innovator. In making this shift, EZPEDO will also be adopting a
bolder, edgier, more aggressive personality that will elevate how it
communicates with parents and customers, verbally and visually.
This shift will help differentiate the company from its peers,
many of which go to market with a safe clinical personality, but
one that ultimately doesn’t align with the expectations of young
parents and professionals.
This point of view and attitude will also help EZPEDO bill itself as
a thought leader in the industry. The company’s magazine and
hands-on training programs are already great platforms for
sharing knowledge and connecting with professionals. The new
face of EZPEDO—Sprig Oral Health Technologies—will help
broaden the scope and reach of these initiatives, providing
relevant and inspiring information to pediatric dentists who share
in the belief that pediatric dentistry can be innovative, relevant,
and exciting.
Alan Siegel is one of the best-
known ﬁgures in the branding
industry and a longtime advocate
of clarity and simplicity in
business. Alan is also the founder
and chairman emeritus of global
branding agency Siegel+Gale, one
of the most respected branding
ﬁrms in the world.

Siegelvision’s
Philosophy
“In a world plagued by
complexity, our work is
governed by a passion
for clarity.”

For young, forward-looking companies like EZPEDO, there is little that
is more important than building your brand. Your brand helps build
awareness during critical growth stages. It defines why you’re valuable
to customers and explains why people should choose you over
competitors. It helps create a consistent and memorable image of your
company in people’s minds. It builds trust and gives your company a
mission and voice that can energize stakeholders.
What Dental Practitioners Can Learn
From EZPEDO’s Success
In recent years, health and fitness companies have broken the mold in
how they go to market, placing a greater emphasis on technological
innovation and avant-garde visual identities. It’s time that the dental
industry follows suit. We must awaken dentistry from its lethargy and
recast the industry as innovative, cool and accessible. Companies like
EZPEDO are leading the charge and are quickly becoming the
exemplars of what dentistry in the 21st century should look like and
stand for.
Dental practitioners can learn from this example. Just because
dentistry has looked and felt the same for a long time, doesn’t mean it
has to remain that way in perpetuity. The practices that will succeed in
the long run won’t necessarily be the biggest. They’ll be the ones that
best align their values with the values of today’s patients. This means
becoming more technologically driven—offering online booking,
tablets in the waiting rooms, and digital patient education solutions. It
means embracing a less clinical, more vibrant experience—more
relevant waiting room reading material, more contemporary furniture,
younger staff. It means investing in your brand and taking control of
how people view your practice.
Don’t settle for being the local dentist. Establish yourself as the only
dentist around that actually understands the values and aspirations of
your patients. Aligning your brand with today’s patients will show
people that dentistry can be different and, in the process, create
evangelists for your practice.
Continuing a Trendsetting Tradition
as Sprig Oral Health Technologies
EZPEDO’s new brand identity as Sprig Oral Health Technologies will
have a profound impact on how the company views itself and on how
the industry views it. Evolving their brand will help the company lead
the way in redefining how parents, patients, and professionals approach
pediatric dentistry. We at Sieglevision have led EZPEDO through a
revisioning and restrategizing process. As a result, they are poised to
cross new thresholds, prepared to lay the foundation for future product
innovations, and primed to further establish their identity as Sprig Oral
Health Technologies—the new innovative, trendsetting leader in oral
health technology.
Same Great
Company.
Brand New
Name.

WE’RE MIXING THINGS UP
NEW BRAND NEW PRODUCTS NEW PROGRAMS
INTRODUCING
WWW.SPRIGUSA.COM

A LOOK BEHIND
THE SCENE
True leaders create their own content
and that’s exactly what we do at Sprig.
So remember, the beautiful pictures of
smiling children in our ads are not
stock photos, they’re all special
because they’re all our patients.

THESE PAGES: A skilled dental technician from
Argentina donates his time to work alongside our
dental team in providing dentures for local
residents near Rurrenabaque.

UNTO THE
LEAST OF
THESE
Taking Time to Meet the Dental
Needs of the Remote Jungle Region
of Rurrenabaque, Bolivia
by Patricia Rivas, DDS | Gabriella Garcia, DDS | Jeffrey P. Fisher, DDS
PHOTOGRAPHY BY R.D. GALLANT
Read about the experiences of three
dentists who had the extraordinary
opportunity to serve at an orphanage
in an under-served area of the South
American country of Bolivia.

ABOVE: Dr. Jeffrey Fisher spends time with Rodrigo and Samir, two brothers who received a
compete oral diagnosis and rehabilitation (including Zirconia crowns) by our dental team
in a local hospitalʼs operating room. BELOW: A high school student from Weimar Academy
helps to teach local children how to properly brush their teeth. OPPOSITE: Monica, a
volunteer from Columbia with basic medical training, translates for one of the many oral
health care classes put on for the local indigenous communities surrounding Familia
Feliz. For some, this was the ﬁrst time to ever use a tooth brush.

ith over 7 billion people on this planet, how
can I make a difference in this world? Many of
us contemplate this question every day as we
serve people in our own little corner of this
beautiful globe we call home. As dentists, we
make our living helping others. Whether
through doing a prophy, a pulp and crown, or
even an extraction and space maintainer, our
professional skills do more than just provide for
our families. They make an enormous
difference in the lives of millions of children
and parents in our communities.
But every once in a while, I feel a call to do more. We in
North America take so many things for granted. It almost
seems like there is a pediatric dental office on every corner.
While there are places with limited access to dental care
here at home, many countries of our world incredibly lack
even the most basic dental supplies, things like tooth
brushes or tooth paste.
Over the last few years, I have enjoyed the awesome
privilege of traveling with my wife and two children to
different countries around the world to serve others.
These short trips have made a profound impact on my
family. While we go to make a difference in the lives of
others, we often experience an even more powerful change
in our own lives—because it is truly through service that we
reach our highest calling.
This year our destination was a rural community in a
remote jungle region of Bolivia—the town of Rurrenabaque.
A short plane ride from the capital of La Paz, this
community tucked away in the jungle is home to a local
orphanage called Familia Feliz. Here our group of over 40
(made up of high school students, medical doctors, dentists,
and other volunteers) would spend the next 14 days.
Housing 60 plus children—many surviving horrible stories
of physical and emotional abuse—Familia Feliz is a safe
haven for children who are starving for love and are
longing for a place where they can feel safe and truly
belong.
During the trip, our dental volunteers served over 900
people from surrounding villages, including soldiers from
two local bases, as well as the many children of Familia Feliz.
Although we made a dent in meeting many of the local
people’s dental needs, so much work still remains to be
done. While our trip to Bolivia is over, our mission has just
begun. And it is that mission that inspires us to keep
looking for the next place to serve.—Jeffrey P. Fisher, DDS
W

THESE PAGES: Itʼs a great feeling when you can save
teeth instead of just extracting them. Dr. Fisher shows a little
girl what her new tooth will look like just before Dr. Rivas
cements it into place. This was the ﬁrst pediatric Zirconia
crown to be placed in the country of Bolivia.

THESE PAGES: Dr. Garcia adjusts a
well-worn Tofﬂemire matrix. The use
of bleach for sterilization often
creates rust on the instruments,
making them hard to twist.
OPPOSITE BELOW: Four young
soldiers from the local army base
wait on an old wooden bench for
their turn to receive dental
treatment. For many, this was
the ﬁrst time in their lives that
they had seen a dentist.

am currently a dentist at Sanatorio Adventista del Plata in Entre Rios,
Argentina. Ever since I was a young girl in middle school, I have had a
desire to serve others. I was assisted in realizing my dream 17 years ago
when a group of American doctors donated a portable dental unit.
Since then I have been serving six months a year as a volunteer dentist
in various countries of South America, the last three years in Bolivia.
I have to admit that this opportunity for service is what keeps me motivated when I am
in my own office. By giving the best of myself, the profit I make at home helps to cover
the expenses incurred during my volunteer trips.
As I write this article I am in Rurrenabaque, Bolivia, where for two weeks we are
providing free dental services to orphanage kids, members of the community, and
soldiers on a nearby army base. Our services include doing procedures such as
restorations, hygiene treatments, extractions, and making dentures.
The needs here are great, and few dentists are willing to do this type of work. My goal is
to devote myself full time to service in this area. I have two big dreams—one is to have a
mobile dental unit complete with a dental laboratory. That way we can provide service in
many different places, spending one or two weeks in each area and providing more
complete dental care that would include offering free dentures to people with the
greatest need.
My second dream is to place implants for patients at cost or completely free to the ones
that can’t afford to pay. To do this, I need to have the sponsorship of a dental implant
company or a dentist who would donate a certain number of implants monthly or supply
us with the implants at cost. I hope to offer implants to every person in need and not just
to society’s privileged elite.
I have been blessed to have the support of a colleague, a dental technician, who like me
is a volunteer, willing to make dentures at no cost. Seeing the transformation in people’s
lives when they receive dentures brings us the greatest satisfaction of anything we do
here in Bolivia. Most people can’t afford to pay for dentures, but when we provide them
free, what a joy to see them being able to chew correctly again. Their self-esteem
increases, their faces look younger, and best of all, they start smiling again without
any shame.
My colleague and I are both willing to dedicate our talents entirely to this mission
without a salary. Material resources are not the problem when God provides. The greater
difficulty is finding the human resources to meet the challenging needs, and we are
committed to serving in Bolivia. Sometimes we may think that it is only the patients who
receive benefit from this type of service, but in reality, we are often the ones most
blessed.—Gabriella Garcia, DDS
I

During my 13 years doing dentistry in the U.S., I have
never experienced such joy and peace in my heart as I felt serving the
orphans and needy communities in Bolivia.
Maybe some of you who are reading this article were one of the generous dentists who
donated or loaned instruments, materials, or equipment for our endeavor. You have no idea
what a great blessing you brought to the people of Rurrenabaque and the orphans of
Familia Feliz.
Our international team included dental professionals from Bolivia, Argentina, the United
States, Colombia, and Mexico. All came with the same goal—to serve. One of our objectives
was to provide every single orphan with a dental screening, a prophylaxis, and a fluoride
varnish. We were delighted that our hygienist and her team were booked to the max.
Sometimes we simply alleviated someone’s pain, and that was as important as it was to
place a composite that allowed a person to smile.
Here in the U.S., I'm used to the formality of having parents or patients fill out a consent
form before doing any work. In Bolivia, on the other hand, we faced the reality that some
of the kids walked for hours just to have an extraction done; and sometimes the oldest
relative with the patient was another kid just 9 years old.
During our stay in Bolivia, we worked under two extremes of practice. Some days we
worked in a modern mobile dental unit or operated in the OR of the local hospital using
general anesthesia. Other days, we worked while patients lay down in primitive outdoor
conditions and with rain pelting our backs. At such times, I couldn’t help reflecting on how,
in the U.S., the front office and the back office are always complaining about the difficulty
of controlling the AC thermostat.
I am a different person after returning from our Bolivia trip, not only because I now realize
the huge resource differential between the U.S. and Bolivia, but also because I have come
to appreciate that sometimes we are so busy with our daily lives that we don't take time to
look at a beautiful night sky, full of stars. We are so busy that we don’t stop to reflect on
what really matters in life. When you aren’t distracted by material things, you start
appreciating people and caring about issues that are truly important.—Patricia Rivas, DDS

THESE PAGES: Dr. Patricia Rivas administers local anesthesia to a young
girl preparing for an extraction. In an area of the world where dental
services are not readily available, itʼs sad to see how simple occlusal
cavities turn into multiple extractions on so many of these beautiful young
people. OPPOSITE BELOW: A time exposure of the beautiful night sky
silhouettes the trees above Familia Feliz—Rurrenabaque, Bolivia.

WHAT INFLUENCE WILL YO
OUR SURGICAL TEAM: The surgical team (from left to right)
consisted of Gabriella Garcia (dentist), Patricia Rivas (pediatric
dentist), Samuel Li (medical anesthesiologist), Jeffrey Fisher (dental
anesthesiologist), Tiffany Fisher (student assistant), along with
Samir and Rodrigo (dental patients).

OU HAVE IN THIS WORLD?

SPRIG ANNUAL SYMPOSIUM 2017
AN INVITATION-ONLY EVENT AT THE PUEBLO BONITO PACIFICA
RESORT AND SPA, CABO SAN LUCAS, MEXICO
My kind of
place.
CABO SAN LUCAS
OCTOBER 19–21, 2017

Shift magazine - Issues in Pediatric Dentistry

Shift magazine - Issues in Pediatric Dentistry

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