Using Composite Resin in Aesthetic Restorative Dentistry

Part 7 - An assistants view

Instructors:

Buddy Mopper, DDS

Buddy Mopper, DDS

Dr. Bud Mopper is an internationally renowned lecturer in esthetic dentistry with an emphasis on composite bonding using direct application techniques.  Dr. Mopper is in private practice in Glenview, Illinois, where he has been doing minimally invasive dentistry with composite for 40 years.

Dr. Mopper's assistant describes how to prepare for a composite resin case

When I have somebody come and work with me, we train them in how we want them to work. Not everybody works the same. My partner dentist doesn't work the same that I do. But there . . . all the girls, all the ladies are trained to work with each individual. Grace works with me exclusively when I'm here. She knows every move that I make. In fact, she could do all this stuff, to tell you the truth. And she's . . . I know she could. Unfortunately, we don't have expanded duties in this state, but she's, she's, she really knows what she's talking about. She knows color, she knows, she knows form, she knows shape. So, it's great to have someone that can anticipate your every move and who's not afraid to say something. We don't . . . we want our people to be involved. So if she sees something that I don't see, she's gonna tell me in front of the patient. Nicest thing a patient can say to you is, “Boy, you guys work as a great team.” That's the nicest thing they can say. What, what I think to be a good assistant, you have to, like what you do. You have to really realize that that's what I wanna do. And that's when you're gonna participate, that's where you're gonna learn and pay attention and learn how your doctor is working. And then, I believe, what I'm trying to do and like I said, every doctor is different and they're working differently, but the rules basically the same, like composites, so you need to learn steps, and make sure you have everything ready for the day. I have to say that I'm lucky I am in this practice and I'm working with Dr. Mopper. And not only, I'm working with Dr. Hartlieb also. I'm very lucky, because they trust me, having me next to them. Dr. Mopper trusts me. He knows what I . . . he trusts me what I see, and I can point that, if I don't like something for example, it's not finished properly or some [1:14:25] voids, I can tell him this. And he appreciates that. He knows that, “Yeah, I'm gonna take a look.” And I appreciate that he takes my, my opinions, my comments very seriously. Because at the end of the day, we want our patients to be happy. And I see that transformation. I see a lot of patients come in with their problems. And a lot of them, I would say, they're afraid of dentistry, or be on the chair for a long time. And my role is to make them comfortable, to make sure that I'm next to them and the doctor's doing his part, but I'm there for them. And for me, patients are always first. And I appreciate Dr. Mopper so much what, what basically doctors doing here, their assistants are so valuable for them. And we're trying to learn, and we are passionate, I love what I do, and I'm very happy that I could be in this practice. And I would suggest to assistants that it's so important to give everything from yourself, to be a part of the treatment. And I think this way you're gonna make a very good team, and your doctor's gonna recognize that you're learning, you really participate, you're learning steps, you're learning instrumentation. And once you have this, the whole treatment is gonna go faster and better. Not only for the doctor and yourself, but for the patient basically. Because that's we want. We want them to be happy and always first. I think that, what we do in this practice and Dr. Mopper and Dr. Hartlieb, they're working together. And we have a lot of patients for different treatments. And if we could do minimum dentistry, that's what we do. Dr. Mopper with the bonding veneers or other restorations. But then sometimes we have to, you know, do bridges and porcelain crowns, and then those two doctors are working, they're always talking to each other and make sure that we are on the same page. What is the best for the patient? What is the best treatment for the patient? And I like that, because I've seen in my career, I've been like ten years as a dental assistant, and five years in this practice, and I can say it's a huge difference from where I came and what I see in this practice. And patients really, really appreciate that instead of prepping the whole tooth and put the crown, that we could do resin veneer, or, for surface composite, that's gonna stay and look beautiful for many years. And I think that's , that's awesome what we do. And like I said, again, those two doctors, they're always talking to each other, they always communicate, and, and they're always getting to that point that, this is the best for the patient. I just wanna show set ups that I have here for Dr. Mopper. That's a basic set up and I could suggest it to the assistant to pay attention and learn what your doctor likes to have. I have agent, adhesive, and I always have unfilled resin also next to me, because you never know, he might add some materials, so instead of opening then running back and forth, I would rather have it next to me. And like I said, before, color coded dappen dishes, that's very helpful also. We use our instruments, Dr. Mopper's, and I like to have them, all of them next to me, that he might ask me for one that I don't have it, and I have to run and bring that, so I don't wanna lose so much time, so I like to have it next to me. Also, he's using diamond polishing strips and plastic so I have that also out. That is so easy when he asks me. Plus, I already know when he's gonna use it, so I'm going ahead with my thoughts forward and I know, “Aha, he's gonna use this.” So I would suggest to assistants also, to pay attention and learn that, “My doctor's gonna use . . .” step by step, that's what's gonna be next, and it's so important. I use also sometimes my loops that it helps me to see better of course, but I could also give it suggestion to the doctors. It's, it's a huge difference with the big cases and full bonding veneers, that that's what, it's very helpful. Um, I also have readied discs, so I also know which one's gonna go next and when he's gonna use discs, so I would suggest it to the assistants again, that would be very helpful if they could start to remember all this. Articulating papers, materials, everything ready here, anesthetic . . . like I said, I see, I keep a lot of things on my side, and I like to keep all the instruments on my side, because it's much easier for me, instead of doctor turning around and get that from the back. When he's positioned, in a certain position for the patient, so he doesn't need to move around so much, so I'm here for him every time he needs anything. I'm checking our curing lights like approximately once, twice a week, make sure that the lightbulb is, it's strong enough. They're burning very often, and you have to make sure they're doing their job, that you can cure materials correctly. Now, what I do, I just run for a few seconds and that's actually a twenty which is good. Before I start the day, I know my lights are ready to go, so I don't have to be worried, because I've been in a situation, and I have to mention to the assistants also, I'm curing for one minute, and the material is still not really cured. And this is where the doctor gets frustrated. He doesn't have to be frustrated. So, make sure you have that ready, and correct strength. What I'm holding in my hands is Cosmedent Ultra Thin Diamond FlexiStrip, and that's what Dr. Mopper is using to polish between teeth. But also, he used the same one for our last patient to separate his teeth. What I do, from that one long, I basically cut a small piece, that he could easily slide through the center, between the patient's teeth. So that's what he likes, and I see very good result from that. So I always have this ready when I know procedure, what we gonna do, and I go ahead and prepare that, that I don't need to do this during procedure. So this is important to have it also ready. I'm also holding in my hands, Cosmedent Resin Keeper, that we always use to keep materials covered. It's so easy and I like it, because once we know what shade we gonna use, then I go ahead and cut little pieces and cover and keep it ready. So I always do this before we numb up the patient, we agree what we're gonna use for that veneer and then I get materials ready in a resin keeper. So you could, for me, I learned about different materials, I'm having in my hands Cosmedent NANO material, Hybrid, and Microfill. So I already can recognize them by the consistency and look, and I already know what I have. For assistants that in the process of learning, it's also maybe a good idea to just mark what is what, that you're not gonna be confused. These little dots over here, you could use for tints, so also if doctor's gonna do tinting, then you're gonna put a little of different colors that he's gonna use.