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Treatment Options When There Are None with Dr. Bob Margeas



In this episode of The Best Practices Show, Kirk speaks with Dr. Kevin Groth and Dr. Bob Margeas. Bob specializes in restorative dentistry. Based in Des Moines, Bob enjoys the puzzles involved with teaching dentistry and collaborating with other thought leaders in the field.

Bob describes some of the core values that inform his practice, including looking for cost-effective solutions while prioritizing the patient’s health. He does everything he can to help the patient without making them feel like they absolutely have to shell out big bucks.

After talking a bit about lessons learned and best practices regarding esthetic dentistry, Bob and Kevin move to what may be the most important lesson of the episode. That gaining the trust of your patients is paramount. Greater than the temptation, or even the need, to leverage your patients financially, you will always come out on top if you present the truth. Listen to your patients, Bob says, and give them the truth. They will most certainly return to your practice if you’ve earned their trust.

Another key thing to remember is staying transparent. You will have more success in the long term if you are honest about what you actually don’t know. Don’t let your fears of rejection, or anything else you may have as a young dentist, prevent you from admitting when you don’t know. Your honesty and sincerity can guarantee a patient for life.

And lastly, lean on the experience of your peers. They will help you, even those working in competing offices. The profession is respected, but procedures and tech change with the wind. Ask for help. Don’t be afraid to link up with someone more experienced if you’re lost or confused. The community is here to help.

Main Takeaways:

  • You absolutely must know your core values and live by them. (5:06)
  • It takes the pressure off patients to not sell them treatments. (11:36)
  • You need to build relationships to deliver hard news. (16:26)
  • Just tell them the truth—and shut up. (24:36)
  • You need the skill sets and tools to manufacture something that will last. (34:06)


“Man who says job cannot be done should not interrupt man doing the job.”

“If I get a couple rehabs a year, I’m pretty damn happy.”

“Just because you don’t want the right thing doesn’t mean I have to do the wrong thing.”

“I’m just a referee. It’s your decision ultimately.”

“When you feel sorry for a patient, bad things happen.”

“You almost have to go through moments of failure to learn.”

“When you’re young and out of school, you want everyone to like you.”

“If you just treat people honestly…you’re going to come out on top.”

“I still have to remember after 30 years because  materials change .”

“I’ll hold out and do the right thing for the patient.”

“Never alienate other dentists in your town.”

“Always tell the truth. Don’t try to utilize patients for financial gain.”


  • 6:06-7:36 – Bob’s core beliefs
  • 10:26-12:46 – The concept of diagnosing with the “referee”
  • 15:21-18:56 – Helping the patient with little or no options
  • 22:31-24:36 – Inherent challenges with making decisions for patients
  • 26:46-28:16 – Some of Bob’s “MacGyvering”
  • 39:21-41:36 – Good words from Bob and Kevin

Reach out to Bob Margeas:

Register for the The Seattle Study Club Symposium, Jan. 19-21.



Dr. Margeas graduated from the University of Iowa College of Dentistry in 1986 and completed his AEGD residency the following year. He is currently an adjunct professor in the department of Operative Dentistry at the University of Iowa. He is Board Certified by the American Board of Operative Dentistry. He is a Diplomate of the American Board of Aesthetic Dentistry, a Fellow of the Academy of General DentistryAmerican Society for Dental Aesthetics and International Team of Oral implantologists (ITI). He has written numerous articles on esthetic and implant dentistry, and lectures and presents hands-on courses nationally and internationally on those subjects. He is currently the Editor in Chief of Inside Dentistry, on the Editorial Board of Compendium, and is a contributing editor to Oral Health in Canada. His memberships include OKU Honor Dental SocietyAmerican Academy of Esthetic Dentistry, and the American Academy of Restorative Dentistry. Dr. Margeas maintains a full-time private practice focusing on comprehensive restorative and implant dentistry in Des Moines, Iowa.


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