S3 E01: Fighting the Fear of Failure

Wright: [00:00:00] When was the last time you talked openly about your failures? Hey, hey, everybody. I'm Dr. Arnel Wright.

Ioannidou: [00:00:06] And I'm Dr. Effie Ioannidou. And here today we are having a fail-ebration. That's right. That's right, ArNelle. We are going to celebrate the things our professional failures have taught us and how they help us grow as dentists and as people.

Wright: [00:00:26] Yes.

Announcer: [00:00:29] From the American Dental Association, this is Dental Sound Bites. Created for dentists by dentists. Ready? Let's dive right into real talk on dentistry's daily wins and sticky situations.

Wright: [00:00:45] I'm super excited for us to be coming back into season three. Welcome, welcome to all of our listeners. We're excited about our 100, 000 downloads.

Ioannidou: Exciting, yeah. 

Wright: So we're celebrating that. We received the communicator award. This is just going to be an amazing season. I can already feel it. in the air. So if you're new to the show, once again, I'm Dr. ArNelle Wright.

Ioannidou: [00:01:07] And I'm Dr. Effie Ioannidou. And we are your hosts. Dental Sound Bites, people.

Wright: [00:01:16] (laughs) All right. So we're going to be diving deep into a topic that we don't talk about enough in dentistry, which is really the beauty of embracing our failures or the power of positive failure.

Ioannidou: [00:01:26] So that's why we wanted to talk to Dr. Jarod Johnson. He turned his flops into something really positive. I'm going to let him tell us more about this. Welcome to our show, Dr. Johnson.

Johnson: [00:01:37] Thank you, Dr. Effie and Dr. Wright for having me on dental sound bites. It's super exciting to see the growth of this through the ADA. And I think podcasts are a lot of fun and can provide a lot of dentists, a lot of information, whether you're working out cooking a meal or driving in the car, just another way to absorb information on the wonderful practice of dentistry, because there's so much out there and you're bringing so much light to it. So thanks for doing that.

Ioannidou: [00:02:00] Oh, sure. Tell us a little bit about yourself.

Johnson: [00:02:03] Wonderful. So I went to the University of Iowa for my dental degree. And at that point in second year, I determined I wanted to become a Pediatric dentist.

So I ended up pursuing that route and I ended up applying to pediatric residency programs during my senior year of dental school. And on match day, I woke up and found out that I didn't match anywhere. So at that point, I thought I wasn't going to be able to be a pediatric dentist, a failure there, but ended up applying to schools for a post match.

And I ended up taking a same day flight down and back to Las Vegas. I'd never been there before and interviewed with them. And during the interview. Dr. Ron Levin, who's an endodontist, who was a graduate program director there, was talking to me about how they could regrow teeth. And I had not heard of any of this as a dental student, so I'm glad I kept my mouth shut that day.

But it turns out getting into that program was probably the best thing that happened to me. And we can do a little regenerative endodontics, is what he was referring to there. But down at UNLV, I had a wonderful experience. They only had an orthodontic program, so as a pediatric resident, we were doing, you know, molar endo, we're doing regenerative endodontics, we're doing mesiodens extractions, surgical extractions, and a lot of difficult things.

And it was a great way to be able to offer those to my patients back home. And that's where I am now. I'm in Muscatine, Iowa. I came out of residency and opened my own. Scratch start here in Muscatine Arctic Dental, and we've been now eight years in the process. Student loans are paid off. We are moving forward with life with a young family and trying to manage everything, all the fun things that go with being a practice owner.

Wright: [00:03:39] So much, right?

Ioannidou: [00:03:40] Exciting. Yeah.

Wright: [00:03:40] Yeah. What an introduction. Look at you. I had no idea that that was part of your story, Jarod, like, you know, applying to residency, not matching. I had that same experience when I was in dental school, because I thought that I wanted to be a pediatric dentist as well. Turns out my senior year, I was pregnant with my first son and I was.

thinking about residency, applying in the process. And I was like, okay, when I didn't match, I was like, this was probably for the better. Like I have, I'm starting a family right now. And then like, I just ended up going into practice. So I had no idea that that was part of your story. So thank you for sharing that and kicking us off for the episode with that.

Johnson: [00:04:18] Yeah, absolutely. I think just you look at dentistry and I think there's so many people saying you have to be X, Y, Z, you have to do this and. It's not that way. I think there, you can be a great general dentist and see kids. That's, that's awesome. We need more of you. You can be a great general dentist and do endo.

You can do a lot of different things and get the training and specialize in what you like to do as a general practitioner too. So I don't think there's, I think there's kind of this stigma that you shouldn't as a GP, do some of the specialty work and I still do molar endo and I'm a pediatric dentist and I love it.

So, take the training, take the time to do it. And that's I think part of the stigma around our profession as well. Mm hmm.

Ioannidou: [00:04:55] Jarod, Friday Flops. What exactly is this and what inspired you to start it?

Johnson: [00:05:01] Friday Flops is a case that I either performed personally at my office or someone else did that didn't quite work out the way we wanted to and we post that as well as a description on How to improve so that the same mistake doesn't happen again.

Just trying to be a little different on Instagram. I'm a big ambassador for wellness with dentistry and how tough it is just to be more human because we see in these trade journals, on these presentations, we see. All these beautiful cases and amazing work. And I don't think that all of those dentists that are out showing that, that haven't, they haven't probably made the same mistake you or I have.

Yeah. I can't tell you during my first year of owning my office how many times I had to redo a class to amalgam because my box wasn't prepared deep enough. And I had to redo them for free. And I told the patients that this is broken now and I'm going to replace it and make it right for you. It's just simple stuff like that that we've all probably done that we maybe we're in a rush, the patient was difficult. It's a commonality. I see it in other people's work. I see it in my work and it's okay to realize that, but we need to learn from that as well to try to improve our dentistry.

Ioannidou: [00:06:07] Oh, this is so well said. You touch so many points. The fact that if you really don't learn from your failures and you don't see them as the opportunity for the next step to success, I think this is probably the way that we should live our life, not only our professional life, because we fail, we can fail in so many different levels and so many different layers. But I think this was a very good point that the example of the amalgam and how you had a self critique and try to improve your technique.

I mean, this is like, uh, amazing and it can happen in even harder procedures, right? The other thing that you touched on, I think it's very important. It's the fact that a lot of people in professional meetings. They tend to show these amazing textbook cases, and they show the pre and post, but you never see the in between.

Wright: The messy middle. No one shows the messy middle.

Ioannidou: No, no one shows the messy bloody middle. It's always omitted from the presentation for many reasons. And certainly the audience perceives this as, wow, that's like, these people are gods. They're amazing. They never make mistakes. Everybody makes mistakes, right?

Wright: [00:07:17] Yeah.

Johnson: [00:07:18] Ben Nemptin probably said it best. If you have not seen the ADA Accelerator Series with Ben Nemptin, it's a free one hour CE. Highly, highly recommend going in and looking at that on your wellness journey. Sent on his, one of his Instagram, I guess you call them reels now these days. He said that any step you take, even if it's in the wrong direction, maybe you step in a puddle, or you step in some dog poopoo, or something, you know.

You're not gonna make that step again. You're gonna step a different direction, and that's gonna help you. better long term. Another professor in dental school said strive for perfection and settle for excellence and you can really do a lot of things by doing that for your patients. And honestly, one other thing that we don't do enough of is, I installed the ADA DERE. It's a research exchange and it shows how your clinical skills, how your dentistry is working out. So they judge like sealants, how many of those have not had a cavity after one, three and five years. Restorations that haven't had a crown after one, three and five years. Endo that hasn't had extraction after one, three and five years.

And we don't celebrate, my numbers are pretty high and I'm happy with them, but we don't celebrate all those successes enough. Like if we have a root canal that comes back and the body is healed, that's like huge, you should be showing that to your team and being like, Hey, this is what we did for this patient and be excited about those things as well.

So it's not just about what doesn't work out, but when something's amazing, maybe it's just, hey, this patient came back, they're high caries risk and you don't have any recurrent decay, all your restorations look great. I mean, that's a huge win, I think. And a lot of times we just say, Oh, you look great. And they walk out the door and we don't show our staff or the patient what we have accomplished together. And I think that's something that really helps your team if you can show them out. I had a case recently that came in a molar. It had condensing osteitis. It was a vital tooth. We did an MTA pulpotomy.

It came back a year later, the condensing osteoidosis was gone, and I just went around to all my assistants and said, I can't believe that happened. Look what we did. We avoided a root canal and this body healed. I was like, that is amazing.

Wright: [00:09:16] So amazing.

Ioannidou: [00:09:16] Yeah.

Johnson: [00:09:17] That truly is. So celebrate. Success as well, not just looking at the wrong direction too.

That's important, I think, to keep yourself level headed.

Wright: [00:09:24] I'm so inspired by you already. Oh, my gosh. Like, I'm so glad to hear the way that you articulated all of that. It just has me like pumped up right now to go back and make sure that I share things with my team because I am guilty of not sharing my wins.

I celebrate the win, maybe just internally, but not sharing it with the team. So yeah, definitely point taken.

Johnson: [00:09:44] Yeah, I think a lot of time we normalize it. And, like, that's the way it's supposed to be, right? It's supposed to work out. It's supposed to look like that guy on the presentation or girl that's up there on the stage that just presented an amazing case that's very complex. And dentistry's tough. And appreciate what the skills you have and what you do and all you can accomplish for your patients.

Wright: [00:10:07] Let's talk about the tough part. Shall we?

Johnson: [00:10:09] Yeah, Dr. Wright.

Wright: [00:10:12] So from doing all of your Instagram, um, Friday Flops and, and just including other people's work and just the way that you bring the stories together on Instagram, have any of this changed like for you at work or changed your life?

How has doing the Friday Flops impacted you?

Johnson: [00:10:28] There's a big silent crowd out there. I'll tell you that there's people that message me all the time that are like, Hey, thank you for sharing this with me. I mean, they're open, they ask me questions about dentistry, questions about pediatric dentistry and the things that we do that they have questions are and they are very connected and it's, I mean, I don't have a lot of followers, but I have people that are willing to listen and I think that's what's important to me is not just to be, just to have a community of people that resonates with you rather than all the noise that's out there.

Ioannidou: [00:10:59] So how do you find the time to do all this? Especially on a Friday.

Johnson: [00:11:03] Well, I don't work on Friday. Well, I work, but I don't work, but I ended up coming in the office. So usually I'll look for a case during the week and I'll have that case picked out and then usually come in and put a little video together.

What did we do wrong that we need to help? to make ourselves a better dentist and help make other people a better dentist.

Wright: [00:11:21] Let's transition a little bit and play a game called two truths and a lie, which is going to be our fail edition. So Dr. Johnson is going to tell us about three failures, but one of them is a lie.

Dr. Johnson, are you ready? You have those failures.

Johnson: [00:11:38] Statement number one is I've never had a cavity. Statement number two is I have extracted the wrong tooth. Statement number three is I have removed a premolar and re implanted it successfully in the site of a central incisor.

Wright: [00:11:55] Okay. Okay.

Ioannidou: [00:11:56] Okay. Wait, let's review them.

Let me, okay. So one is you never had a cavity. Correct. The second you extracted wrong tooth and the third and most exciting. You extracted and re implanted the first premolar in the position of the first central incisor, right?

Johnson: [00:12:15] Correct. Yep.

Wright: [00:12:16] All right. That gives us a lot to think about. Yeah. Okay.

We're going to come back to them. And so everybody who's listening right now, make sure that you stick around for the answer.

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Ioannidou: [00:12:58] So, ArNelle, let's go to you now.

Wright: [00:13:03] I know! Hotspot!

Ioannidou: [00:13:05] Yeah! What's a big mistake that you have made and you still think about this?

Wright: [00:13:09] Okay, I'm a little scared of you guys. So, I am one of those people, I'm like, not gonna put my work out there because I feel like the world we live in today, people are always trying to nail you. So, Jarod, you are like, full of courage to do these things because I, that's an area where I do not have courage.

But, um, in this moment, I, I, I will share a moment of vulnerability with you guys, because again, we've all had failures. One of my big fails have been like clinical, and I'm going to keep it to clinical because I have some, some communication things with team, communication things with, um, patients that we can go down that bunny trail too.

But as far as a clinical failure that I can recount was I was doing like a surgical procedure and I was flapping, but I did not retract the patient's lip. And I cut a piece of their lip while I was in surgery. Now, the patient was numb, so they had no idea, and the assistant remained silent. The assistant didn't move.

And I think that was just to kind of see what I was going to do. So I ended up, like, You know, stopping the bleeding. I sutured and everything like that. And I told the patient, the patient had no idea. They didn't look in the mirror or anything like that. They could have just went on their way and found out once they were dismissed for the day.

But I did stop and I told the patient about it and, and that bothered me so much. Cause I was just like, ah, and so now just like you said, or that Ben Nemptin said, like, you will not. step in that anymore. Now, I'm just like, lip, anytime I'm doing surgery, and if my assistant, if I'm not retracting the lip, or if I'm in a spot where they need to be retracting while assisting me, I make sure that I'm just like, hey, don't forget soft tissue, or I'll just say lip, and then they're just like, oh, you know what I mean, because I'm just like, get the lips out of the way.

So, um, that was a big failure for me, and it might not be that big of a deal, because it wasn't a huge cut, but it was just the fact that it was a cut, and it was done on my watch, and um, Like, I just feel like these things, not that they should happen to other people, but I just feel like in my world, they just shouldn't happen to me.

So that's one of my failures that I experienced. And I do still think about it because I don't know. I just feel like I'm still a new word dentist. And I, I hold myself to a very high standard, which is great for my patients, but for my wellness and my well being, so we're talking about two different things here, it could be to my detriment.

You know what I mean? Like, I think in this case, I could probably give myself a little bit of grace because in the end, I did do the right thing. Like the patient was informed, the patient was taken care of, the patient, you know, we did follow ups and all of those things. And it was when I first, first started practicing, not like right now. So that's a fail. Long story short.

Ioannidou: [00:15:56] Oh, that's, that's, uh, that's interesting that you still remember. I bet that it has happened to me in the past, whatever, 10, 20 years, but I don't even remember because this is a common thing that happens, you know, a cut on the lip, especially when the patient is numb, it happens all the time.

It can happen with a burr. It can happen with a sharp instrument. I hate it, but you know, I'll give you my funny story. And this is a funny story. When I first that came to the U. S. for the, for residency, I think somehow that ‘whoops’ was stuck in my mind. So while I was in surgery, I would tiny thing that would happen, you know, an unpredictable thing that would happen during surgery.

I will react in front of the patient with whoops. So you would see the patient sides wide open, like what happened? What did you do? I'm like, oh, nothing, nothing. It's just like, it's my way, my expression. Yeah. So, you know, I, I, I think I under, had I underestimated the significance of the whoops.

Wright: [00:16:55] Very true. I really get, I get frustrated if my assistants do make any noise like that. React. React, yeah. Yeah. I'm not like reacting. So I'm the, I'm the doctor who's behind the patient's head. Like motioning, like no, because I want the patients to feel fully confident. in us and the staff. So no, no, no, don't, don't, don't react during procedures.

Johnson: [00:17:15] And then one of the things I've noticed is, you know, both of you doing the right thing by telling the patient, and I think you'll never go wrong by telling them.

I can tell you all the times that something's happened to me. I've had a bur on the lip too, ArNelle.  You're not alone there. I mean, we've all done some things like that, but letting informing the patient is important because I think some of the malpractice suits I've seen are when the dentist doesn't tell the patient.

Good point. And they don't disclose. Yeah, good point. And they get in trouble. I always try to tell him myself. I think one way to look at this is to tell them what happened and if something's coming back that doesn't look right, a nice way to tell it to the patient that I use all the time. I just say, I see on this x ray here, this there's an opportunity for improvement.

I'd like to fix this for you to make this the way it should be.

Ioannidou: [00:18:03] Oh, this is so right. You're absolutely right.

Wright: [00:18:06] I love that.

Johnson: [00:18:07] When you put it that way. It's a lot easier for you as a provider, number one, and they're a lot more accepting of it, like, Oh, he wants to make this better for me. That's awesome, right? He really cares. Or she really cares.

Wright: [00:18:18] Mm hmm. Right. So, disclaimer, everybody listening, we do follow the guidelines. Just, I might not have explained that very, very well. Listen, you know, you gotta make sure everybody understands.

Ioannidou: [00:18:29] So in many professions, failure can be a springboard for growth, for example, in tech, you know, mistakes happen and they improve the model.

Mm-hmm. , they, they, they're very big on this, right? Mm-hmm. , do you think that in the industry there is something that holds us back as dentists to share this? Things that go wrong?

Johnson: [00:18:48] I think we're territorial,  and we don't need to be

Wright: [00:18:51] Oh, in what way?

Johnson: [00:18:52] Competitiveness. Mm-hmm. . But I mean, there's plenty. I'll tell everyone this, there is plenty of dental decay, periodontal disease to go around for all of us.

Wright: Good point. 

Johnson: There is so much need out there. And I think a lot of times we look at, I mean, we look at something that comes in that maybe is not perfect, and I mean, we really weren't there. We really can't comment. Yep. One way to look at it is, Could you do better than they did in that situation? I mean, if you've got a gagger and you're doing a permanent crown prep on a second molar, I mean, could you really do better than they did?

Ask yourself that question before you start to judge what other people have done.

Wright: [00:19:31] For me. Because of what we just talked about, I think, like, I'm just afraid that someone would twist my words or someone would automatically assume that I'm at fault. You know what I mean? So I feel like I am very careful on, like, sharing certain things that have gone wrong and making sure that I share them in a safe space.

So, like, knowing who I'm talking to. So I share certain things when I'm in study club because this is my study club. We're all, like, there together. But I think, I know for me, that's just, I'm just very careful because I'm like, I'm not sure who's out to get me, but maybe that's a mindset shift that I need to change.

Johnson: [00:20:07] Yeah. I've, when I share my failures, I don't feel like anyone's out to get me. I think when you share it in a way where you're correcting things and making things right and educating people on what you learned from it, how you became better, that self like intrinsic value, I think kind of. Offsets the like, oh, whoops, I did that and we are so much harder on ourselves than other people are on us and keep that in mind because some of the stuff that I see that comes into my office.

I'm like, oh, I did that. Probably gonna be okay. We'll keep an eye on it. It's an area of concern. And I think knowing that You're maybe a little harder on yourself than someone else would be is something to keep in mind as well.

Ioannidou: [00:20:49] You know, I think also the academic community and the scientific community, perhaps it's about time to start publishing failures.

I mean, we very rarely see manuscripts that really showcase something that went wrong. and corrective actions. And I have seen those, uh, papers, but they are very, very limited. Like say you, you find an implant in the sinus, right? And what do you do? Or, you know, you place an implant in the central incisor area and you penetrate the floor of the nose.

So what do you do? So there are so many adverse events that are happening, but especially clinical journals tend not to focus on reporting them. As an editor, I would welcome case reports of failures, interesting failures, obviously, not a fractured feeling, right? Right, right, right. But hey, for a new grad, perhaps more serious, right?

Wright: [00:21:41]A new grad, like a fractured filling, that might be very, very interesting. Like if they're just now getting into practice.

Ioannidou: [00:21:47] Very traumatic, very traumatic, yeah. Yeah, yes, yes. I get it. But you know what I mean, right? Yeah. To welcome the failures, as we said from the beginning, as a springboard for growth and improvement. And I think it's important to share those, these experiences.

Wright: [00:22:01] Right, right, right. So I have a question for everyone. How do you support a culture of failure where you work? We've all heard the phrase fail often, succeed sooner, but that seems counterintuitive in our dental environment. Creating a learning culture or an environment of positive failure seems important but may be hard to do.

Here's Dr. Julie Spaniel with some useful advice.

Spaniel [00:22:23] Hello, my name is Dr. Julie Spaniel and I am joining you today from Nakuro, Kenya, where I'm here with my nonprofit One World Brigades and I'm so happy to join you for this podcast. We're talking today about making mistakes, and actually celebrating making mistakes.

And that's a difficult one for dentists, because I think dentists by nature are perfectionists. Dentistry is technical and we're always striving to improve ourselves. And even as students, we're trying to learn how to be so perfect. But one thing I think we need to remember is that we're human and that by nature of being a human, you're going to make mistakes.

If we plan on keeping up with technology, if we want to try to utilize a new piece of equipment in our office, this is going to be the first time we're doing something and we need to understand it's going to take time to really get it down right. So just accepting that that's going to happen and embracing it.

Maybe somebody at the front desk has overbooked something. They haven't given us enough time. Maybe something took longer. Maybe an assistant has seated a patient. Maybe they took an x-ray on the wrong side. These things happen and they happen in clinical practice all the time. And I think that the most important thing that we can do to support our team is to be sure they know that it's not a big deal.

We're going to work things out. We're going to settle things. And as long as our team knows that if there's a mistake that's made, they're not in trouble. We're going to learn from what happened. We're going to find solutions to it. And sometimes they actually help us find the solution. And in my practice, I'll encourage people.

We work with sometimes a lot of new assistants, some people that are new to dentistry and they're just learning the job. So it's really important that if somebody does make a mistake. that we talk together maybe later on what happened and we figure out the best solution to that problem. Nobody's ever in trouble.

There's never a problem. There's only how do we solve it? And maybe communication isn't good because we're busy. Those are things we can work on. I just find that the most important thing is either with each other, with the team members, Or as a doctor, however, it is that we all are making sure that we are keeping that open line of communication and that we're encouraging people to be able to look at what the problem was and how we're going to maybe do it differently next time.

So never problems, just solutions, mistakes happen, not a big deal, and we can always learn from it.

Wright: [00:24:54] I totally agree completely.

Johnson: [00:24:55] I couldn't agree more. There's a few things that were hit on there. Mm-hmm. like, Hey, we just got a 3D printer two years ago at my office. And like learning that and how to characterize these crown is, it's taken me a year and a half now to finally get to the point where I can do an anterior that looks like it's not a chicklet, I mean , which is great for our patients.

It, it's something that's new and I didn't learn that in dental school, and you gotta take the time to do that. And then, yep. Another one taught, we have dental students come to my office and we have a situation where I was helping this dental student get the experience of doing a hulk crown and we had a kid that needed one and he was sitting in the chair and reviewing the thing and I reviewed the x-ray and I was out in the hallway and he said, I'm going to go ahead and do this.

And I said, ‘kay. And he was supposed to do a hulk crown on L and he did a beautiful one on K. Tooth number K because I said K, so we had a good laugh about that. So we ended up cutting the crown off and doing it on the right one. But we still talk about that and laugh about it today. Like, I was just like, I said, you did a great job, but we'll take this off.

And the parents were OK with it. We were all just laughing so hard because we didn't really do anything, prep the tooth or anything. So it was a fun laughter for us to have and no one got in trouble. Wait, everything was okay.

Ioannidou: [00:26:03] Technology has also evolved so much. Now you're talking about 3D printers. We used to place implants completely blindly based on a Panorex, right? And wish for the best. And now, I mean, we have the scans. We have, I mean, there's, there's so much help out there.

Johnson: [00:26:21] Yeah. I think the technology is awesome, but there's still, you still have to know the basics. I think one example is me. So I was doing a 3D printed ceramic composite hybrid crown on a tooth number, I think it was number 19 and number 18 was still erupting and the software wanted to take the distal contact and put it way over the erupting tooth.

But if I didn't know to go back and look for that because I've made that mistake before or I had to grind down the contact because I, the computer tried to put it in the wrong spot. You still got to know the basics and, um, the computer is pretty smart, but it's still needs to be checked as well, because it still makes mistakes.

Ioannidou: [00:27:00] Damn AI.

Wright: [00:27:03] Oh, goodness. Different topic, right?

Ioannidou: [00:27:06] Yeah, but it's, yeah, very relevant, very relevant. Okay, here are some things we can all do right now to shift the culture at work. I'm going to challenge myself and all of you to be willing to share the failed stories. Make it a part of your huddle once a month or maybe as often as you want.

Wright: [00:27:24] Most advice says learn from it, but really start to think about what does that look like?

Ioannidou: [00:27:29] I think it means, you know, responding constructively to failure.

Wright: [00:27:33] You know, I will also say that it looks like not falling into the blame game, really understanding the root of the issue. Thoughtful experimentation is different than doing something deliberately, and we believe it should be managed accordingly.

Ioannidou: [00:27:45] And I think it's really, really important for people to understand that we are not normalizing negligent mistakes, right? But we are talking regularly of things that aren't working like schedules, intake forms, processes, stuff that really happen on a daily basis.

Wright: [00:28:02] Go Dr. Effie. Okay. Yay. I like it.

Ioannidou: [00:28:07] Okay. Dr. Johnson, Jarod, at the beginning of the episode, tricked us to guess between two failures and one lie.

Wright: [00:28:16] Two truths and a lie.

Ioannidou: [00:28:17] So never had a cavity. Never had a cavity. Wrong tooth extraction. Yep. And then extracted and re implanted a first premolar. I think that's a freaking lie. On the place of the central you why, because I've done, I have done an implantation. And premolar on central, unless you place a crown on this tooth, it doesn't even look like a central.

Wright: [00:28:45] No, no, no. I feel like that could be the truth because it is so complicated. Or maybe I'm just really gullible.

Ioannidou: [00:28:52] I mean, it, it could be the truth. Actually, the Scandinavian is not the truth in this situation. There's plenty of literature on this. However, aesthetically, I find it like, really? You did this? But maybe you did. So I don't know. I pick this as the lie.

Wright: [00:29:08] I was going to pick never having had a cavity. I mean, this could be, but there are people out there.

There are some perfect. teeth people out there. So, you may be one of them, but that's the one that I picked. So, Dr. Jarod, are you going to tell us which one is the lie? I know, right?

Johnson: [00:29:26] Yeah. So, I've had cavities.

Ioannidou: [00:29:31] So you really extracted the first premolar and implanted it in the position of central incisor?

Johnson: [00:29:37] Yes. This has got a story to it. This has got a story to it. So This young kid, mom's on vacation in Las Vegas, and this kid has an accident, falls off his bike, and he evulses number eight. And he evulses tooth, and grandma's got him, and they think it's a baby tooth.

So they don't come and see me. And so the kid comes in and sees me. And I said, well, that's actually your adult tooth. It was a pretty recent accident. We saw him like the next day. So he had a blood clot in there. And the kid had a ton of crowding. He was going to have to have premolars extracted anyways.

So I said. You know, my dad gave, my dad was an endodontist, he gave me all these textbooks and one of those, one of them is called the Atlas of Reimplantation of Teeth, the book's like worth a thousand bucks. So I've been reading that a little bit a few months ago and I said, well, if you want to try this, I'm willing to take this tooth out and put it in this site right now and splint it.

And then we'll do a veneer or crown later. If you're okay with that, you try it. So we ended up doing that. And then we ended up having him in the splint for a few weeks and I took the splint off and he knocked that tooth out. So he knocked out the tooth I just, the premoral I just re-implanted. So I got to do it again.

We did it with his left premoral then and re implanted that into the site. And then, uh, after he healed here, we left the splint on a little bit longer than the guidelines. Um, this time just because of his accident proneness and, um, came back on recall and we did a no prep veneer on that. to, to make it look beautiful again.

Ioannidou: [00:31:08] So, and then five years later,

Johnson: [00:31:10] Well, we'll see.

Ioannidou: [00:31:12] Oh, okay. This is recent.

Johnson: [00:31:13] So he's had his root continue to form. So I think that's good from that standpoint. So I like this. He's high carries a risk. So I don't know. He's got a cavity on eight and. So, uh, that's my concern with the longevity of the tooth, not the re implantation, it's more the caries risk.

Ioannidou: [00:31:28] Not the, uh, resorption, right? That's great. Actually, if you PubMed me, you will see that my very, very, very first publication back in the nineties was, uh, tooth reimplantation.

Wright: [00:31:39] Oh, nice. Look at Dr. Effie, a nice little plug. I see if you PubMed, Dr. Effie.

Ioannidou: [00:31:47] Yes. Yeah, yeah, I have done this. Yeah, we have something in common, Jarod.

Johnson: [00:31:53] I know that down at the University of North Carolina, they do a lot of it. I think it's a lot more done in Europe. And in the United States. Yeah. Fun stuff.

Ioannidou: [00:32:01] That's fun. Look at you, premolar to central incisor.

Johnson: [00:32:05] Yeah, I never thought I could do it. And I was just so excited that I got to do it and it worked out. So I'm pretty pumped about that one. That's great.

Announcer: [00:32:13] On the next Dental Sound Bites.

Wright: [00:32:15] Every dentist has a tale that haunts them. Whether it's a ghoulish case, a ghosting patient, or just an awkward interaction that made us want to scream like a banshee. In this special Halloween episode, taped live at SmileCon 2023, in Orlando, we're confronting those difficult, and sometimes scary, situations, and discussing how we handled them, what we might have done differently, and what we've learned. Dim the lights, grab your favorite pumpkin flavored drink, and get ready to scream.

Ioannidou: [00:32:48] Thank you, thank you, thank you. That was an amazing session. I loved it.

Wright: [00:32:52] This has been a lovely episode.

Ioannidou: [00:32:54] Filled with failures, lessons, successes, communication,

Wright: [00:32:59] Wellness. We covered the whole gambit. Yeah. Thanks so much for being here, Dr. Johnson. Can you tell everybody before you go, tell everybody where they can follow you, subscribe, where they can find more Friday Flops on social media.

Johnson: [00:33:13] Yeah, so there's kind of two routes you could go. I do some continuing education, so if you don't want to hear about my family life and you just want to know the dentistry, I post the same content on both, but on my personal account, you get my family life.

So if you just want the dentistry. It's at Pediatric Dental Seminars on Instagram. If you want to see wellness, my family, kind of a wholesome approach to, I guess, get to know me a little bit better, it's at Dr. Double J's on Instagram. So those are two places I post them. And LinkedIn as well. You can follow me there, Jarod Johnson, DDS.

Ioannidou: [00:33:45] Nice. So if you like this episode, go ahead and share it with your friends and colleagues. We all need to hear, share and learn from other people's mistakes. So we encourage you to go out and try something new this month.

Wright: [00:33:58] And don't forget, the conversation continues with exclusive bonus content. Only on the ADA member app in the spirit of being transparent with our failures. We are going to be sharing them with you. So check out our bonus episode next week in the ADA member app to catch some of our best fails from last season.

Ioannidou: [00:34:00] Bloopers.

Announcer: [00:34:18] Thank you for joining us. Dental Sound Bites is an American Dental Association podcast. You can also find this show, resources and more on the ADA Member App and online at ada.org/podcast.