684: The Evolution of Dental Education – Dr. John Kois & Dr. Christian Coachman

Dentistry has undergone many changes — especially in education. In this episode, Kirk Behrendt and Dr. Christian Coachman bring in Dr. John Kois, founder and director of The Kois Center, to take a look at the past, present, and future of dental education, as well as a few simple ways you can become a better learner. Education has no end! To hear more about The Kois Center and how to become a lifelong learner, listen to Episode 684 of The Best Practices Show!

Episode Resources:

• Learn more about The Kois Center: https://www.koiscenter.com
• Register for Course 165 at The Kois Center: https://www.koiscenter.com/courses/165-treatment-planning-functional-occlusion
• Follow Dr. Kois on Instagram: https://www.instagram.com/koisdentistry 
• Join Dr. Coachman on Facebook: https://www.facebook.com/christiancoachman 
• Follow Dr. Coachman on Instagram: https://www.instagram.com/chriscoachman 
• Learn more about Digital Smile Design: https://digitalsmiledesign.com 
• Register for DSD Residency 1: https://digitalsmiledesign.com/dsd-residency-1-on-demand 
• Subscribe to The Best Practices Show podcast: https://the-best-practices-show.captivate.fm/listen
• Join ACT’s To The Top Study Club: https://www.actdental.com/ttt
• See ACT’s Live Events Schedule: https://www.eventbrite.com/cc/act-dental-live-workshops-306239
• Get The Best Practices Magazine for free! https://www.actdental.com/magazine

Links Mentioned in This Episode:

Read Black Box Thinking by Matthew Syed

Main Takeaways:

Keep a beginner’s mind.

There is no end to improvement.

Educate your mind as well as your heart.

Find ways to stay passionate about dentistry.

Surround yourself with mentors as soon as possible.

Quotes:

“I feel that it's important to maintain a childlike curiosity to continue to grow. I always want to be better tomorrow than I was today.” (4:38—4:48) -Dr. Kois

“I used to talk to my graduate students when they finished their program, and they really did some amazing cases. My comment would be, ‘I hope you just finished your worst work,’ and they'd look at me like I'm crazy. But the idea is if you don't think you could get better, I don't think you can maintain a passion. I don't think you would continue to strive for excellence and moving the needle as far as you can. The way I think about it, it's not a competitive excellence with other people. It's an internal excellence to be better than yourself. And the famous idea, you can't do better unless you know better.” (4:50—5:36) -Dr. Kois

“Educating the mind without educating the heart is no education at all.” (8:56—9:00) -Dr. Kois

“I felt that my role would become trying to be more of a game-changer than what I call an expert regurgitator. I'm not interested in repackaging what other people have already done. I'm always trying to think how I can be better. It started, actually, from my own insecurities. When I finished graduate school, and suddenly, I entered the dental world in another way and my fees were higher, I felt I didn't deserve them. Why should I charge more money if my outcome isn't better? And so, trying to continue to improve, not just in what I believed I was doing but in actual physical survival probability of the work and the outcome for patients, then it became much more compelling for me.” (9:41—10:38) -Dr. Kois

“I find, many times, dentists feel almost embarrassed or uncomfortable because they say, ‘I'm a single-tooth dentist. I'm a bread-and-butter dentist.’ But I believe that single-tooth dentistry doesn't mean simple-minded dentistry. There's a lot of thought that goes into restoring each tooth every single day, and I want to make sure we capitalize on that. So, decisions are key for me, and that's that risk assessment model. Second is figuring out where teeth go in the face. The third is how to make the teeth fit together and function properly. If you could do those three things, you're sustainable. Products come and go. Systems somewhat continue to evolve. But those are the three key things that would keep us sustainable.” (11:52—12:50) -Dr. Kois

“One way to become a better communicator is to be so confident about what you're talking about and know that you are very good at that topic. That's how — because I was shy. I was a very shy adult. I was never extroverted. People think that I am, and I'm not. I realized that my protection was, I'm going to know about this more than anybody can know about this in a way that I will go up and beat my shyness and beat my un-confidence through know-how.” (13:06—13:38) -Dr. Coachman

“One of the barriers to understanding risk assessment is to think that we're good enough and to think that there are not better ways of doing things that improve our outcome. I've certainly been in this long enough that I've seen even things that I created, things that I've been very passionate about, become obsolete. As we do that, we have to continue to move toward paradigm shifts, disruptive innovative technology that's happened in our lifetime, which is quite frankly happening at the speed of thought, which is almost unsettling.” (16:03—16:46) -Dr. Kois

“When I first started, I learned from people that had been doing things for 30 years. Now, it's hard to learn from people that are doing something for even 30 minutes because everybody is doing what they believe is the cutting edge. But does it stand the test of time? And I really became very enamored with embracing the data. I would say the whole idea in risk assessment is understanding what science is really saying, because it's very easy to make mistakes even when we think the science is reasonably good. And so, I've tried to stay as true to the science as possible and use it as my crutch to help me make better decisions rather than my opinions because, for me, rooted in science is always the best way to go.” (17:04—18:04) -Dr. Kois

“I think the challenge for us is being enamored by what would be considered a surrogate endpoint, not a true endpoint. For example, if you're trying to decide on something as basic as what's the best sodium fluoride varnish to use on the teeth, you can read an article about which particular varnish has the best fluoride release. But that doesn't really make the decision endpoint — does it actually reduce the disease we know is caries? So, it's hard sometimes when dentists are not focused on the true endpoint and get deluded by a surrogate endpoint. It makes it very easy to dupe the real reasons that we are using the product to begin with.” (18:36—19:34) -Dr. Kois

“When I started, it was slides. I had to wait a week until they were developed so I can revisit them. Now, it's instantaneous. I can look at something and learn from that at the moment, in the moment, and not after the fact. And it's changing as I'm evolving because that feedback that I get from the digital technology is exceptional that I never had before in the analog world. I mean, you can make an impression, but you can't see the result of it until it's poured and set and separated. But now, it's instant on the screen with an iOS, and so on. There are so many things that that feedback is in the moment, and I was never able to practice in the moment quite like that before.” (21:09—22:03) -Dr. Kois

“[Black Box Thinking is] a fantastic book that I recommend for everyone. The idea is to bring as many objective things into our daily decision-making as possible because otherwise we’re relying on subjective, or embellishments, or feelings — what people believed. That's why we've moved from eminence-based learning to evidence-based learning. It's very important that we stay on that track. I've learned so much with objective data that it's really changed how I make everyday decisions. I think this is the whole piece now with AI because AI is not only allowing us to do this, but it's allowing us to now recapture that information in a way that's now usable, whether it's a chatbot or whatever.” (23:23—24:19) -Dr. Kois

“What I think is happening is dentists have to realize three things in their education journey. It's called the three levels of learning. Level number one is about information. Information is cheap. You can Google it. It's not that difficult, and a lot of younger folks certainly have access to that level of technology. Level number two goes beyond information to knowledge. And first of all, information is free. You could Google it. Knowledge is cheap, right? But knowledge depends on accumulating a lot of the different types of information streams that you're getting. The real key is getting to the third level of understanding, which is wisdom. Wisdom is priceless, and you can't get wisdom unless you understand how to manage all the things that are coming into your brain on an everyday basis.” (27:12—28:24) -Dr. Kois

“Every generation has different access to technology. What I would say is common is, in the younger dentist, things are happening faster for them. It's very easy for them to be bored. They're constantly stimulated, and it's not easy for a teacher to always create that level of engagement because people aren't as patient.” (30:07—30:37) -Dr. Kois

“It goes back to things on tribal leadership and what that is. The problem is many organizations, the actual philosophy of the organization goes back to, ‘I'm great, and you're not,’ and people talking more about themselves than what they could do to help other people. So, the idea in the tribal relationship is how we can help each other to make our life better and to have a higher purpose. I know it sounds unusual, but I actually believe that. I feel that the reason we try to feel the tribe part is for people that have your back, and people that could really help you to become better than you could on your own. I think if we could even accomplish that in some small way, it may be even bigger than actually working on teeth or doing dentistry. People tell me one of the things they gain coming to The Center is more than just the dental background. It's about their life and how it can improve everybody's life. That's the idea, making everybody better.” (34:49—36:16) -Dr. Kois

“When I finished dental school, there were three things I learned — not risk assessment, teeth in the face, and how to make them fit together. It was more about, you had to just keep the plaque off the teeth, put them in centric relation, and give people a night guard. You do those three things, and everything should be fine — and that's not the case. I mean, really? Does everybody think it's that easy? I don't think so. So, it made dentistry — the more I learned, the more excited I became. The more excited I became, the more passionate I became. That's really what continues to drive me. What drives me is not what I know, but what I still don't know but willing to learn.” (38:22—39:12) -Dr. Kois

“I still think the profession is amazing. I think it's only continuing to become more amazing with new technology because we're beginning to actually use the technology to help us understand more, see more, our ability to track the data. So, I have no reservations about moving in a career path for dentistry.” (46:09—46:32) -Dr. Kois

“My recommendation is once somebody finishes dental school, the sooner you find people to be surrounded by that you respect to help mentor you — and that doesn't always mean you have to work together, but to have somebody that you could ask a question to, somebody that could help your growth, because we all face survival needs when we start entering practice. I remember when I first started my practice, I hated it. I really hated it. Every patient was a new patient. I didn't know if they would stay with me. I paid all this money. The debt service was heavy. I was in survival mode. My first year in practice, my adjusted gross income was zero. My second year, I still made less than a hygienist. But I was still confident. We all have to have the growth mentality or what people call the success mentality. It's just like a gold medal figure skater has fallen 20,000 times before they win the gold. You have to be ready for that. And I had to work on that because I took some of the negative things in practice early on as very personal without understanding, without people to help me really see beyond that. I think the sooner that somebody can get to that level, the happier they'll be.” (46:33—48:06) -Dr. Kois

Snippets:

0:00 Introduction.

1:32 Dr. Kois’s background.

4:06 Keep a beginner’s mind.

5:45 Dr. Kois’s path to dentistry and education.

9:03 Dr. Kois’s influences.

12:51 How to become confident on stage.

14:53 Risk assessment, explained.

18:05 The surrogate endpoint versus the true endpoint.

19:36 How digital helps you make better decisions.

24:20 Why you need to take advantage of technology.

25:50 How dental education and students have evolved.

28:51 Dr. Kois’s thoughts on the younger generation of dentists.

31:50 Bring out the fighter pilot mentality in you.

33:00 Don't get beat down in dentistry.

34:06 Tribal relationships, explained.

36:18 The next chapter for Dr. Kois.

39:15 The future of The Kois Center.

41:33 How to maintain a passion for teaching.

43:23 Final thoughts.

45:38 Advice for prospective dentists.

48:34 Dr. Coachman’s final thoughts.

49:28 More about The Kois Center.

51:18 The importance of reaching out.

Dr. John Kois Bio:

Dr. John Kois received his DMD from the University of Pennsylvania School of Dental Medicine and Certificate in Periodontal Prosthodontics with an MSD degree from the University of Washington School of Dentistry. He maintains a private practice limited to prosthodontics in Tacoma and Seattle and is an affiliate professor in the Graduate Restorative Program at the University of Washington.

Dr. Kois continues to lecture nationally and internationally, is a reviewer for many journals, and is the consulting editor for The Compendium of Continuing Education in Dentistry. He is the recipient of the 2002 Saul Schluger Memorial Award for Clinical Excellence in Diagnosis and Treatment Planning and received a Lifetime Achievement Award from both the World Congress of Minimally Invasive Dentistry and the American Academy of Cosmetic Dentistry. Additionally, he is the recipient of the 2014 Dr. Thaddeus V. Weclew Award, which is presented annually to a dedicated educator who embodies the spirit of comprehensive dental care.

Dr. Kois is the past president of both the American Academy of Restorative Dentistry and American Academy of Esthetic Dentistry and is a member of numerous other professional organizations. In addition, he continues to work with restorative dentists at The Kois Center, a didactic and clinical teaching program.

Dr. Christian Coachman Bio: 

Combining his advanced skills, experience, and technology solutions, Dr. Christian Coachman pioneered the Digital Smile Design methodology and founded Digital Smile Design company (DSD). Since its inception, thousands of dentists worldwide have attended DSD courses and workshops, such as the renowned DSD Residency program.

Dr. Coachman is the developer of worldwide, well-known concepts such as the Digital Smile Design, the Pink Hybrid Implant Restoration, the Digital Planning Center, Emotional Dentistry, Interdisciplinary Treatment Simulation, and Digital Smile Donator. He regularly consults for dental industry companies, developing products, implementing concepts, and marketing strategies, such as the Facially Driven Digital Orthodontic Workflow developed in collaboration with Invisalign, Align Technology. He has lectured and published internationally in the fields of esthetic and digital dentistry, dental photography, oral rehabilitation, dental ceramics, implants, and communication strategies and marketing in dentistry.