Industry’s Educator
Gordon Christensen believes in education anywhere and everywhere - at local and national meetings, newsletters and magazines, the new Scottsdale Center for Dentistry, and even on motorcycles in a national park.
It was, he says, a flip of a coin at a frat party that helped Gordon Christensen decide what to do with the rest of his life. Dentistry had held his interest since junior high. But so had medicine and engineering. Whatever it was, he figured his career would involve one or more of the three. And he was right.… But back to the coin toss. "It was a fraternity party. I am a non-drinker, but others were drinking," he admits. Someone had the bright idea to flip coins to decide their futures. "I flipped the coin and dentistry won. I’ve been very happy ever since."
Born in Logan, Utah, on Nov. 10, "a long time ago," Christensen was raised in rural northern Utah. He still loves the outdoors. In fact, he and his wife, Rella Christensen, Ph.D., participate in a "Motorcycle Ride & Learn" course, in which they have combined motorcycling through national parks and monuments with dental continuing education. Some of their other hobbies are horseback riding, all-terrain vehicles and fishing - and, he adds, getting their grandchildren involved in all of them.
In addition to his interest in dentistry, medicine and engineering, Christensen has always had a keen interest in the military. In fact, he was in ROTC in junior high, high school, and college. He received a commission in the U.S. Army Medical Service Corps in 1956 and went to dental school at the University of Southern California. He received a further commission in the Army Dental Corps and served two years active duty at Fort Lewis in Washington. After that, he served in the Army Reserves during the Vietnam War. When he got out of the military, he attended graduate school in restorative dentistry/prosthodontics at the University of Washington in Seattle. But the military left a deep impression on his life. "I learned as much in the military as I did in dental school," he says.
Christensen plunged into his career with energy, setting up a private practice in Seattle while in graduate school. He assisted in the development of two dental schools: the University of Kentucky and the University of Colorado. In 1976, he and Rella - who has doctorate degrees in physiology and microbiology - founded Clinical Research Associates. CRA is a non-profit organization that evaluates dental materials, devices and concepts for clinical efficacy. It is to dental products what Ebert & Roeper are to movies. Gordon Christensen remains a consultant, advisor, evaluator and speaker for CRA. He continues to offer the "Gordon J. Christensen Dentistry Update" course with reports from the CRA Foundation, in which he discusses various dental technologies and their effectiveness. Rella Christensen is the director of the newly reorganized CRA Foundation.
Pursuing another strong inclination of his - to be an educator - Christensen in 1981 founded Practical Clinical Courses, an international continuing education organization for dental professionals. Based in Provo, Utah, PCC offers a variety of courses and learning materials on technical topics, including periodontics for the general practitioner, implant surgery, oral surgery, esthetic restorative dentistry and fixed prosthodontics, and many other courses. He has presented about 46,000 hours of continuing education.
In 1994, he wrote and published a book called "Consumer’s Guide to Dentistry," which provides practical information to consumers about dental health and treatment options. The book is now in a second edition.
Christensen founded the Academy of LDS Dentists in 1977, which sponsors an annual gathering at Brigham Young University in Salt Lake City, Utah, for dentists and their families. As part of his Mormon faith, Gordon and Rella Christensen served a two-year mission in Los Angeles as directors of the Los Angeles Temple Visitors’ Center. In 2005, he was awarded the Irwin Smigel Prize in Aesthetic Dentistry, presented by the New York University College of Dentistry, for his work in advancing education in aesthetic dentistry.
In January 2007, Christensen took on a new challenge by accepting an invitation to be dean of the Scottsdale Center for Dentistry in Scottsdale, Ariz. Opened in April 2007, the $50 million, 65,000-square-foot teaching facility includes a stadium-style auditorium, a six-operatory dental practice of the future, a 10-operatory and 36-lab bench training facility, and other educational offerings. Christensen will continue to administer Practical Clinical Courses, and be senior consultant for CRA while fulfilling his new duties at the Scottsdale Center.
First Impressions recently spoke with Christensen about his career, technology and education in the dental field.
First Impressions: Tell us about your first practice.
Gordon Christensen: My first practice was in the military. But my first private practice was in Seattle, where I took over the practice of a gentleman who had died. It was a simple, high-quality restorative practice. I was in grad school at the time, and so practiced from 6 in the evening till midnight. It was heavy-duty work; I was even doing the lab work. My wife, Rella, was the hygienist and office manager.
FI: Did you consciously set out to differentiate your practice from those of other dentists in the area? If so, how?
Christensen: I aimed primarily at offering high quality and service at moderate fees, and making the patient a friend who could trust me. Those have always been my goals.
FI: Do you still practice today?
Christensen: Yes, though not a lot. I was called by my church on a religious mission several years ago. My son, Dr. William Christensen, took over the major portion of
the practice. My small practice
is comprised primarily of dentists who come from everywhere to
see me.
FI: Why did you and your wife
start Clinical Research Associates
in 1976? What was the need
you identified?
Christensen: There is a plethora of products - hundreds and hundreds of them. At that time, the only agency evaluating products was the [American Dental Association]. I served on its evaluation committee. They were doing a credible job,
but it is an overwhelming task. I believed that evaluation of products could be done more rapidly than
it was at the time. And that stimulated the initiation of CRA.
CRA was oriented at that point - and still is today - toward providing a service to the profession; it is not
a money-making scheme. It was oriented around the practitioners, not academic research (although
it subsequently evolved into
both). The need was clearly identified: Dentists don’t know what to buy.
At the time we founded CRA, it was considered unethical to mention a product by name at a lecture. I was probably the first one to do so, and I was criticized for it. But how can you help someone without mentioning specific products? Gradually, we got to the point where we could say something about specific products, rather than saying "Brand A" and "Brand B."
FI: In your opinion, what are the top two or three
most significant technological developments of the past 30 years?
Christensen: Going way back, almost 50 years, is the Borden Air Rotor, which brought us from low-speed dentistry to high-speed dentistry. Then, about 45 years ago, implants were introduced.
More recently, the most significant technology advance in some time is digital radiography, which is exploding into digital tomography and the digital cone technique. We’re quite behind Western Europe, where most dentists use it. In the United States, it is estimated that between 25 and 40 percent of practitioners use it. Some of the technology was invented in Scandinavia, and it has evolved much more rapidly in Europe than here. I think usage in the United States will gradually get to the same level as in Western Europe. Still, people question whether they should go to digital. That’s like asking in 1906 whether you should ride a car instead of a horse. The obvious answer is "Yes."
FI: In your opinion, what technologies will most profoundly change the practice of dentistry in the next five to 10 years?
Christensen: The first would be computer-driven milling of crowns and bridges. That’s CAD-CAM [computer-aided design and manufacturing], and it is developing very quickly. The second would be the growth of offshore dental laboratories. About 10 to 25 percent of American laboratory work is now done offshore. There are 12,000 dental laboratories in America, and many will go out of business because of their inability to compete with labs in China and India. The two issues are interrelated. Some milling is done in the office. But roughly 50 million units of crowns, fixed prostheses, and veneers are done in laboratories each year.
FI: You founded Practical Clinical Courses in 1981. What was the need you perceived in the market?
Christensen: In my opinion, dental continuing education was not as aggressive and progressive as it could have been. Many times, dentists needed hands-on education, but couldn’t find it without going back to dental school, which many did not want to do. And they wanted a more exciting environment.
Today, there are so many new techniques and concepts introduced, it is impossible to teach all of them in the four years of dental school. When new dentists get out of school, they’re unprepared in such areas as esthetic procedures, implants and practice management. The schools simply don’t have enough time to teach all these things. But a graduate coming out of school with up to $175,000 in debt needs to be in touch with new technology. That’s why there’s more of a need now for continuing education. That is one of the reasons why the Scottsdale Center was built.
FI: Talk about the Scottsdale Center.
Christensen: It was the dream of Imtiaz Manji [co-owner and CEO, the Mercer companies, Scottsdale, Ariz.], with whom I have been friends for many years. He is business-oriented, and I am clinical-oriented, and we have taught courses together for many years. He talked to me some time ago about building a continuing education center.
The Center has the potential to change all post-doctoral education. With over 20 departments, it will involve every aspect of dental education, including education for the staff. All courses will be taught by a very recognizable faculty; these are people from all over the world. Part of the program will be the Christensen Fellowship, which is a two-year program for dentists of all ages, and which will involve 20 days of continuing education with world-class teachers spread over the two years, plus one Webinar per month. We have identified at least 25 additional elective, hands-on courses, which will help students learn about every aspect of dentistry.
It will be the most complete and up-to-date continuing dental education facility in the world today, with no commercial orientation, which I think is critical. Currently, there is commercial orientation in much of dental continuing education. We will continue our pure orientation toward education. The tuition fees will be moderate.
FI: Have you changed your approach to education and instruction to fit the needs of today’s dentists? If so, how?
Christensen: The environment is much different for dental graduates than it was in the past. In the past, dentistry was oriented toward "need" dentistry; it was pain-oriented. Today, approximately 50 percent of general dental practice is oriented toward "want" dentistry, that is, dentistry to increase the patient’s esthetic level. That’s a very significant difference, and it’s not being taught as adequately as desirable in dental schools - again, because they don’t have enough time to do so. The Scottsdale Center will cover the entire gamut - both "need" dentistry and "want" dentistry."
Sidebar
Thumbs up - or down
Clinical Research Associates has the industry’s ear.
Years ago, the now-defunct brokerage firm E.F. Hutton aired an ad in which a roomful of busy people stopped everything to listen to its investment advice. "When E.F. Hutton talks, people listen," was the tag line. Gordon Christensen’s pronouncements about dental products carry pretty much the same weight.
Christensen and his wife, Rella Christensen, Ph.D., founded Clinical Research Associates in 1976 in order to give dentists the facts about new dental technologies. The non-profit, independent research institute tests and compares dental products and techniques to confirm claims about efficacy and clinical usefulness. Gordon Christensen remains the organization’s chief spokesman, senior consultant and "face," while Rella Christensen serves as its director. "Amazingly, Gordon and Rella have been volunteers to this organization since its inception," says Derek Hein, co-CEO of CRA Foundation. "It has truly been their gift to the dental profession."
CRA conducts research on three levels: multiple-user field evaluations, controlled long-term clinical research, and basic science laboratory research.
"CRA evaluators have been integral to the success of the CRA concept," says Hein, who joined CRA in 1990. "Like Gordon and Rella, they volunteer their time, expertise, staff, office and patients to test product performance." CRA sends products to more than 400 evaluators, who try them out and report back to the organization. As many as 700 new products are marketed each year, and CRA attempts to get as many as possible into the hands of its evaluators, says Hein.
Products that appear to be outstanding in the field are further characterized in the CRA laboratories using basic science testing. "Long-term clinical research combines the clinical placement or use of restorative and therapeutic products with the evaluation of their performance over time, using both clinical and in-house standardized grading," says Hein.
No product is too small to be evaluated by CRA. That said, they must either be (1) innovative and new on the market; (2) less expensive, but meet the use standards; (3) an unrecognized but valuable "classic"; or (4) superior to others in its broad classification. Of the hundreds of products marketed each year, about 20 percent meet their marketing claims, says Hein. "This is why CRA’s work remains so relevant after 31 years – clinicians don’t want a cupboard full of duds."
Hein is proud of CRA’s track record. Never once has the organization printed a retraction. "Products do change, and what may have been a top performer in 1995 may no longer be the best in 2007. It’s important that dentists keep updated."
CRA is undergoing some changes. "Management of information is much more automated in 2007 than it was even 5 years ago," says Hein. "Our ability to receive information from many more practicing dentists has dramatically improved and we wish to involve more dentists worldwide on our evaluation team."
But CRA’s mission will remain the same as always. "Many changes are already taking place, and dentists worldwide are making difficult decisions as they consider staying with time-proven procedures
or changing to new concepts being introduced," says Hein. CRA intends to be there for them.
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