Feedback
Archive Index
David Hornbrook, D.D.S., F.A.A.C.D.
Dr. Hornbrook was born and raised in La Mesa, California. He graduated
from UCLA School of Dentistry in 1986. Dr. Hornbrook's dedication to dental excellence and
uncompromising patient care is well known around the world through his many articles and
lectures. He is a frequent lecturer on state-of-the-art dental techniques and has been
instrumental in the development of new materials and services.
Dr. Hornbrook serves on the faculty of many postgraduate university programs in Aesthetic
or Cosmetic Dentistry, including those at Baylor, Tufts, SUNY Buffalo, and UCLA. He also
serves on the editorial boards of many leading scientific journals devoted to cosmetic
dentistry, including Esthetic Dentistry Update, Practical Periodontics & Aesthetic
Dentistry, Signature, and the American Academy of Cosmetic Dentistry Journal.
Dr. Hornbrook is the founder of the Pacific Academy of Esthetic Dentistry and co-director
of the Las Vegas Institute of Cosmetic Dentistry. He is an accredited member and fellow of
the American Academy of Cosmetic Dentistry.
Current Lecture Schedule
September 5-6
"Practical Hands-on Esthetic Course"
Alberquerque, NM
Contact Art Montaya
505-662-5666
September 7
"Adhesion and Aesthetics"
San Francisco, CA
Contact Angela O'Mara
714-760-1522
September 13
"Mastering Adhesive and Aesthetic Dentistry"
Indianapolis, IN
Contact Joe Futrell
317-897-9434
September 15
"Indirect Posterior Esthetic Restorations"
University of Pacific
Contact Jane Bandy
415-929-6486
September 19-22
"Comprehensive Diagnosis and Treatment Planning of Esthetic Dentistry"
Las Vegas, NV
Contact Marilyn
702-878-1977
September 22
"Practical Adhesive and Esthetic Dentistry"
Ohio State Dental Society
Contact Catherine West
614-486-2700
September 25
"Maximizing Esthetic and Adhesive Dentistry"
Chicago, IL
Contact Susan Hunt
313-454-0300
September 26
"Mastering Adhesive and Aesthetic Dentistry"
Syracuse, NY
Contact Cindy Gorman
315-451-2600
October 2
"Mastering Adhesive and Aesthetic Dentistry"
Dental Arts Lab Florence, Kentucky
Contact Todd Fisher
606-647-4472
October 4
"Maximizing Esthetic and Adhesive Dentistry"
New England Chapter of the AACD
Contact Tom Orent
508-879-4811
October 10-13
"Comprehensive Diagnosis and Treatment Planning of Esthetic Dentistry"
Las Vegas, NV
Contact Marilyn
702-878-1977
October 16
"Maximizing Esthetic and Adhesive Dentistry"
Grand Rapids, MI
Contact Susan Hunt
313-454-0300
October 18
"Maximizing Esthetic and Adhesive Dentistry"
Virginia Beach, Benco Dental
Contact Michele Penrose
301-738-9072
October 19
"Maximizing Esthetic and Adhesive Dentistry"
Atlanta, GA
Contact Mike Kirkpatrick
770-427-5069
October 22
"Maximizing Adhesive and Aesthetic Dentistry"
Seattle, WA
Contact Ray Kubisch
206-241-6554
October 25
"Practical Adhesive and Esthetic Dentistry"
Santa Barbara, CA
Contact David Garber
805-646-1777
October 26
"Mastering Adhesive and Aesthetic Dentistry"
Portland, OR
Contact Kasey Soll
310-312-1408
Oct 30 - Nov 2
"Practical Adhesive and Esthetic Dentistry"
Cabo San Lucas
Contact Garrett Caldwell
916-965-4471
November 7-10
"Comprehensive Diagnosis and Treatment Planning of Esthetic Dentistry"
Las Vegas, NV
Contact Marilyn
702-878-1977
November 14 (13-20)
>"Maximizing Esthetic and Adhesive Dentistry"
Honolulu, Hawaii
Contact Gerry Adachi
808-521-4421
November 21
"Maximizing Esthetic and Adhesive Dentistry"
Red Bluff, CA
Contact Eileen Hyden
916-891-8398
December 5-8
"Practical Adhesive and Esthetic Dentistry"
Charlotte, NC
Contact Ken Owen
704-366-8006
December 12-15
"Comprehensive Diagnosis and Treatment Planning of Esthetic Dentistry"
Las Vegas, NV
Contact Marilyn
702-878-1977
Successful Aesthetic Dentistry Through
Clinical Excellence
An interview with David Hornbrook, D.D.S., F.A.A.C.D.
What does Dental Success mean to you?
Primarily, I think success in dentistry is finding your niche and focusing your efforts on that area of dentistry. For me, this niche happened to be aesthetic dentistry. Originally, I chose dentistry as a way to be a health care provider and at the same time, be artistic and creative. About 3/4 of the way through dental school, I realized that dentistry as it's taught in dental school has nothing to do with being creative. As a result, I was faced with a decision -- whether to drop out of dental school or to search out that artistic and creative side of dentistry.
How did you decide to focus on cosmetic dentistry and ultimately on teaching it to other dentists?
When I got out of dental school in 1986, that's right when aesthetic dentistry and adhesive dentistry and composite resins and bonding were just starting to hit the market place. I had an opportunity to really get into aesthetic dentistry in it's infancy. As new products came out I would order them and try them. Fortunately, having mostly success and minimal failure gave me the opportunity to go the next level.
As new porcelains came out I would try them. As new resins came out I would try them too. Then I started going to a lot of courses on aesthetic dentistry and I saw a lot of lecturers and the techniques and the materials that they used. I felt that I had the ability to teach these things just as well, so I started taking a lot of photographs and contacting manufacturers with ideas. I started writing articles and people would see my articles and then they would want me to lecture. The manufacturers would contact me and it just snowballed.
At the same time that I started getting into the teaching part of the dentistry, my practice profile or my patient pool changed. My patients were no longer asking for gold crowns or no longer asking for silver fillings. They were actually asking for ways to look better and feel better about themselves. Doing more and more aesthetic dentistry for my patients gave me the opportunity to not be mediocre and certainly not be bored in my chosen profession.
You have a reputation as one of the best clinicians in the industry. Would it be fair to say that this is an outgrowth of your desire to be artistic? And if so, what role has the clinical side of your dental career played in your success?
I'm a perfectionist and I'm certainly my hardest critic and I'm flattered that people would say that about me. I don't know whether it's necessarily true but in my own mind I think the artistic side combined with being a perfectionist has allowed me to gain that reputation.
What are two dimensions of clinical excellence that you feel are absolutely essential in order to be a top-notch clinician in dentistry?
Ooohh, that's a tough one! Certainly education. You must be educated. There's a lot of people that have excellent hands and technical skills that aren't fully educated. And there are a lot of very educated dentists that aren't very good technicians. I think that while a lot of it can be learned, a lot of it is genetic or inherited. Like anything else, like athletics or being able to paint a picture, or whatnot. I think dentistry is like that.
The other point is that you absolutely must enjoy what you're doing. I think too many people may, especially dentists who are practicing every day, really hate what they are doing. I can't imagine doing a good job at something that you don't enjoy. I'll give you an example.
When I was in junior high school I used to make leather belts. In the early 70's leather belts and the whole flower children thing was popular. I used to do it for a hobby and I just loved it. I'd make them for friends and family members, and then their friends would call and want one. Then I actually got a contract. I was only 12 or 13 years old... The contract was with a place kind of like The Gap and they wanted about 150 belts a week and at first that was a tremendous amount of money.
hen when I started having deadlines and when the belts started all looking the same, I did not enjoy doing the belts at all. The quality of my work went down, and I couldn't focus or concentrate on what I was doing, and I think that affected the overall quality of my work where I actually had to sit back and say it's not worth the money. I needed to tell this guy I'm not interested, I'll just go back to making one or two belts a week.
I think that it's the same with dentistry. In my lectures I talk about eliminating the undesirables in your practice and that could be a particular procedure, it could be a patient, it could be an employee, it could be location, it could be one or several of a number of things. But you absolutely must enjoy what you're doing. It has always been my contention that the more you enjoy it the better you'll be at it..
What advice would you give to a dentist just discovering his niche who possibly wants to follow in your footsteps and focus on clinical excellence and cosmetic dentistry?
First of all I would tell them to find a mentor. It could be myself, it could be Bill Dickerson, it could be any one of a number of different clinicians in aesthetic dentistry. If it was implants it could be Carl Misch and Curtis Jenson, whatever. You need to find a mentor, someone that can drive you toward excellence. You can aspire to and admire their work and want to be that way or certainly be able to practice that way some day. I think that's a driving force where you can see the light at the end of the tunnel. Certainly be educated, and education definitely does not end with dental school. I think a lot of clinicians think that it does. You must be continually educated. You must be excited about and enjoy everything that you do.
What specific courses or recommendations would you give to somebody who is looking to achieve clinical excellence in aesthetic dentistry?
It's a little biased and self promotional, but I would definitely recommend the Las Vegas Institute of Cosmetic Dentistry with Bill Dickerson and myself. We've developed a hands-on as well as didactic course that is 8 days long. Basically, we designed it on what we thought was the most important from our years of experience. We put this into a very concise program that all the clinicians that have gone through it have said, (and we've got multiple thank you notes and testimonials), that it's the best continuing education course they've ever attended.
The nice thing about our program is that you're in a group of only 20 dentists that are like-minded, they're all interested in aesthetics, they're all interested in clinical excellence and building their practices, and so you get this unbelievable environment. You've been there, you've seen that there's a different atmosphere. Unlike dental school or some of the dental society meetings where they're always telling what you can't do, we're telling them you can do it and your imagination is probably the only limiting factor. I would definitely recommend that program.
Certainly there are some other good programs. Some of the post graduate programs in aesthetic dentistry at Baylor, and SUNY at Buffalo. None of those are hands on programs, but they certainly will give a great introduction and get dentist's motivation and excitement up.
You had mentioned earlier that you had just received your fellowship in the American Academy of Cosmetic Dentistry and that it's 1 of only 13 in the world. Could you tell me a little bit about that and what you go through to achieve this fellowship.
The American Academy of Cosmetic Dentistry basically has 3 levels of membership. One is an active member or general member. The other is a an accredited member where you have to present 6 cases, very detailed, very specific cases to members of an accreditation board. It's a very rigorous process. To give you an example only 2 out of 36 passed this year. You also have to be a member for I think 3 years, and attend the annual meetings, and there are other requirements. You also have to create written reports which are basically like theses. Some people even bind them ... hard cover bind them. That's the second level and that's called an accredited member.
Then after you're accredited, and I think it's 3 or maybe 5 years, you have an opportunity to become a fellow. To become a fellow you have to publish in the Journal of the American Academy of Cosmetic Dentistry. You also have to speak to the group, or lecture in front of the group, as well presenting 50 cases. Out of 50 cases, 2 different evaluators have to accept 45 of the 50 cases. The nice thing about it is that it makes me feel good and certainly I feel honored that I achieved that category. At the same time, I'm evaluated by people that I respect and certainly have the clinical excellence that I think I do.
Is membership in the American Academy of Cosmetic Dentistry something that you would recommend that dentists seeking to excel in aesthetic dentistry should pursue?
Absolutely, whole-heartedly. I think that you cannot continue in the field of aesthetics without being a member of the AACD. It's just an incredible, very giving, group. The kind of people who, if you were sitting in a chair pool-side next to one of them and reading an article in a dental journal by some author who's your hero, and he happens to be sitting next you sipping a drink with an umbrella in it and his kids are in the pool and you ask him what camera he used on this particular picture and he would walk you through the article. That's what kind of group it is. It's a very giving group, very fun. They're are about 2500 members I think. Usually at a meeting they'll be close to 1500 to 2000 in attendance. It's a wonderful, wonderful group.
Sounds like a good place to find a mentor.
Best place to find a mentor, absolutely.
I know you were in Keystone, Colorado for the recent Excellence in Dentistry Seminar in which Gordon Christensen had an opportunity to host a panel discussion on "how to save fee-for-service dentistry," and certainly aesthetic dentistry is directly related to that type of "freedom of choice dentistry" that he referred to. If you could tell us, what are your feelings about managed care and its relationship to the ability, not only to do top quality dentistry in your niche, but also to provide excellent patient care?
Overall, I think managed care is a terrible thing for dentistry. If I cut fees 50%, and my overhead is 60%, I cannot continue to practice dentistry the way I'd like to. Under managed care, if I give you the quality care and quality treatment at the same level that I have been, it means that I either delegate most of that treatment/care to someone else or I cut my overhead or cut my time with you. So overall, if I was forced to limit my fees, the quality of my care is going to go down which is a bad thing for my patients. There are going to be a lot of dentists that are going to think they have to sign up with managed care to make a living because they'll be looking at a large number of charts. What they give up looking at is a number of quality charts.
Managed care is really going to be a bad thing for dentistry overall. As far as aesthetics, or what I call "5-star service dentistry," it's going to be a really good thing for me personally. As much as I don't want it to certainly pass or to become part of the American way of life, it's going to be a good thing for me because of the quality of the service I provide. I think the higher quality service you provide for your patients, the more you're going to benefit from everyone in your town getting on some managed care program.
I use the analogy of the Ritz Carlton vs. Motel 6. If the president of your company decided all their employees were going to say at the Ritz Carlton for the business trip for the whole year, and then the next year they tell you you're going to stay at Motel 6, you're going to find any way you can, even if it's out of pocket, to stay at the Ritz Carlton again, because you're so spoiled, and it was such great environment and great experience that it's going to be worth it to you to make some sacrifice to stay at the Ritz Carlton. What we're finding in our practice, is that even patients who have left because they signed up with some kind of preferred provider or DMO, they now willing to totally discard their insurance and pay out-of-pocket, just to come back and be with our practice. They have experienced what we could offer, and have gone and experienced what PPO or DMO offices can offer, and now they're going to be great disciples for us and they're begging to come back and it's really a good thing for our practice. I think they're in the niche of knowing insurance-related dentistry.
What do you feel about the issue of national advertising and the ethics of promoting and marketing dentistry?
I think that national advertising for dentistry is definitely a good thing. I'm all for it. I think any way we can educate the public in any way, whether it be educate them about aesthetic dentistry, quality dentistry, or even sealants... if you educate the patients about sealants, they're gong to make a trip to the dentist for them. After they come to your office, then it's up to dentists like myself to educate them about the benefits of things like image-improving dentistry. I think that the ADA and other dental organizations are making a big mistake by not doing national advertising. I think we need to do it.
Feedback
Archive Index