Second Opinion: Innovation and the Dentist By William B. Dragan, DDS
Centrix, CEO

Much of the progress occurring in the everyday practice of dentistry comes from those who involve themselves in it on a daily basis. Dentists are a very innovative group because there are many times we encounter problems that are not in any textbook. What do we do? We all have to innovate in order to solve some of these out-of-the-ordinary situations.

Four years of dental school gives us the most basic of ideas about what dentistry is. It isn’t until we are out in the world actually practicing dentistry that, if we are lucky, we realize how little we actually know. I was one of those who, after school, thought they knew it all. For nine years I was ignorant of all the potential dentistry had to offer. Slowly, I became disenchanted and depressed with my practice. I finally decided I could not go on the same way I had been going. I had to change. I decided to sell my practice, get out of the area and become associated with another dentist. I lost money on the sale of my practice, but I never looked back. I never regretted the monetary loss because if I didn’t change I think I would have just given up dentistry.

My dental associateship gave me a new life. The dentist I worked with was a constant student, starting study clubs, going to courses and always buying and trying the newest products and devices. Dr. Jack Buckman was my inspiration and mentor, opening my eyes to all the developing possibilities that started to emerge in the late 1960s and early 1970s.

I had graduated from Temple Dental School in 1958. We had been taught in, what I would call, the Stone Age of Dentistry. Some of the few basic changes I saw in dentistry started with the high-speed air rotor and disposable needles. It is hard to believe now, but in dental school the anesthetic needles were cleaned, sharpened, resterilized and reused. Synthetic impression materials were not heard of in school. We used compound, alginate, wax and plaster of Paris as our major impression materials in school. Changes, such as the introduction of composites and VPS silicone impression materials, have occurred to make our lives, and those of our patients, easier. When I finally realized all the potential that existed, I became excited with dentistry again. My association with Jack’s dynamic practice was opening my potential and career possibilities.

Jack, as I said, would buy anything new. I was very fortunate to be there when the first practical composite was introduced to the profession. That composite was sold by Johnson & Johnson and called Adaptic. It was a paste/paste material that was mixed in equal parts and placed into a cavity preparation with a spatula. Not an ideal method, filling with a spatula, it many times incorporated air into your restoration. Air in my restorations was a problem for me that became an opportunity and the start of my odyssey into invention. I became an entrepreneur, but then again, every dentist is an entrepreneur in one form or another.

My entrepreneurial exploits started when I became interested in the problems I was having when I filled class III cavities. Many times, I ended up with voids at the surface. I had to redo the restoration and hope I would not – again – incorporate more air. My redos began taking too much time in my schedule. To regain control, I thought and came up with several composite placement concepts that were impractical. Finally, I thought I had the right idea to cure problem of voids in my composites. If I could syringe the composite directly into the cavity preparation from the bottom out, I would eliminate or at least minimize the incorporation of air. There was not a device on the market to do this, so I made my first two syringe prototypes. This was only part one of the concept. To test out the whole concept, I had to design and invest in a prototype injection mold to make a disposable plastic tube, which would be the reservoir for holding and expelling the composite. This is where you have to separate the men from the boys. In 1969, the mold cost was $6,000; all the savings I had in the bank. I had no guarantee this concept would work. I made the leap of faith and invested to make my first syringe with a tube and a plug. The moment of truth came when I first tried the prototypes and the system worked! I had solved my problem, but what to do next?

To protect myself, I decided to spend more money and file for a patent. To reassure myself that my syringe technique was good and I was not blinded by my genius, I gave my other prototype to a fellow dentist I had known since dental school. He liked it. Now what do I do? I was totally convinced that placing composites with a syringe system was the way to go.

We dentists are not taught manufacturing, so I decided to introduce Johnson & Johnson to the concept of using a syringe system to place composites into cavity preparations. Johnson & Johnson, as did other large manufactures, refused even to look at my concept. This is a crossroad that any independent inventor must consider: Do I invest my own money and form a company? Or, do I just forget the whole thing and write off my losses as experience? I decided to form a company. I called my company “Centrix,” taking the name from centric relation. I truly believed the idea of syringing composites would take off and my fortune was made. (A delusion many inventors have is that a good idea will make you rich over night. There are exceptions, but it would be like hitting the lottery.) For me, I found my road to success was a long and very hard road.

That was then. Now, I see all the new, unlimited possibilities that are open to all the wet-gloved dentists today. Because there are so many products and techniques that are exciting, I am sorry I cannot physically practice dentistry today. Opportunity exists everyday for all dentists to be on the lookout for different uses for technology. Maybe there are ways to improve what you are doing and using today. Every problem, new product and/or technique create opportunities for those who are inquisitive and want to make their lives, and those of their colleagues, easier or more efficient.

Centrix and I have always looked for simple products that can help the dentist; and therefore, help make the patient’s visit less traumatic. I believe that, for the most part, we do accomplish our goal. It amazes me how long it can be before a simple product is accepted and becomes standard in everyone’s dental office. My first product took over 10 years to became the accepted method of placing composite resins and this was a simple disposable tube and plug.

I would like to challenge all dentists, young and not so young, to keep your eyes open and be always looking, and especially thinking, how they might solve the everyday problems that you have or will have. Don’t be afraid to say there may be a better way for both you and your patients.

A suggestion to all dentists with an idea for a product or idea: Don’t quit you day job. During my time trying to build Centrix, I was a full-time dentist and practiced for 40 plus years. Keeping your practice doesn’t mean you should forget developing your ideas. It means you may have to work at night and weekends. The dentist is the only one truly able to improve the techniques and products that are and will be necessary. If the dentist does not innovate, the large companies will give you good chemistry and large items like digital x-rays, milling machines and other big-ticket items; but it is up to you to make them work and work efficiently in your practice. Unfortunately, I have found that it is easy to innovate, but very difficult to get the story across to our colleagues. That doesn’t mean you should be discouraged, it means that you have to believe in your ideas and persevere.

Though it can be a difficult road, there is nothing more rewarding than seeing an idea go from the drawing board to actuality, and finally, become accepted by the profession worldwide. There are many dentists who have created products dentists use every day. Just a few of these men are Drs. Bob Ibsen of Den-Mat; Dan Fisher of Ultradent; Josh Friedman, who started Demetron; as well as Barry Musikant and Allan Deutsch of EDS. Some other innovators are Drs. Raphael Bowen, who discovered modern composites, and Angelo Buonocore, who developed bonding resins and preventive sealants. There are many more people who should be on the list, but I haven’t the space to name them all. It’s time for you to join this list. Centrix’s motto is “Making Dentistry Easier.” I challenge you to keep thinking and dreaming, some dreams do come true.