I recently returned from Grapevine, Texas and the annual session of the American Academy of Cosmetic Dentistry which was held there. This is my favorite meeting each year because of the quality of the presentations, the opportunity to rub shoulders with the luminaries of the profession, the hands on workshops, and the networking with other dentists who have a similar practice vision.

The location was the Gaylord Texan which is an excellent venue because it has hotel rooms, restaurants, and a convention center all on the same campus and all within walking distance. This makes it easy to access the educational offerings and enhances the networking opportunities.

I was a little disappointed in Grapevine itself because I had borrowed a hat and picked up some boots at Goodwill so I would fit in with the local culture. What I discovered was that people there dressed pretty much the same as anyone in Happy Valley. No bolo ties or chrome belt buckles! I’ve since heard that maybe west Texas would be a little more like what I was expecting.

The challenge that I always come home with from this meeting is to raise the bar of what I offer my patients, I always learn new ways to improve what I can do in terms of health, natural beauty, function, durability, and comfort. And this is really my passion—to learn how to best restore these features when they have been lost due to disease or dysfunction in a way that most closely mimics nature. To this end, here is a description of the courses that were really valuable to me.

I took a hands on workshop for posterior composite placement with an emphasis on reproducing the original contours and surface shape. An optimum restoration involves more than removing the damage and filling in the hole. The restored tooth should look and function as much like the original as possible. This is significant because the new tooth colored composite materials require totally different placement techniques to achieve the best results. We cannot simply use the old mercury amalgam techniques with the new materials and expect a good outcome. I have been doing these types of restorations for over 15 years and there is always something new to learn.

I learned about the subtleties of replacing an anterior tooth in a way that makes it appear to have never been missing. This can be done with either a fixed bridge or more recently with an implant. Matching the color to the adjacent teeth is obviously critical but other considerations are equally important such as the shape of the replacement and the contours of the tissue surrounding the artificial tooth. The work necessary to achieve these results is different in every situation but requires dedicated time and attention and often the services of other dental specialists as well as clear communication with an excellent dental lab technician.

I did a workshop on adding implant retention to an existing mandibular denture. This has become a very predictable technique and is the treatment of choice in cases where patients want more stability for their lower denture. This procedure also prevents the progressive loss of bone that is normally associated with a lower denture. Any amount of stability can be achieved depending on the number of implants placed. The most popular choice is two implants placed near the front that stabilize the denture even though it is still supported by the tissue for chewing.

I listened to a lecture on the selection of ceramic materials for tooth restorations. When I began my career there were no options. If I wanted to make a tooth colored restoration, I used a porcelain fused to gold crown—period, end of discussion. In 2010 there are a plethora of tooth colored materials to choose from, all with different characteristics, and various advantages and disadvantages. It is important to stay current in this area to know how to recommend the best material for each individual situation.

It was an excellent meeting as always. And, as always, I feel like I was drinking water from a fire hose for four days. But in the end it is about me becoming a better clinician and you getting best dentistry available.