When a Crown Fell Off: Lessons in Restorative Dentistry with Dr. Edward Feinberg

My guest for Episode #281 of the My Favorite Mistake podcast is Dr. Edward Feinberg, a distinguished expert in restorative dentistry who has dedicated over 40 years to advancing dental care. Dr. Feinberg graduated from Tufts University, was trained by his father, Dr. Elliot Feinberg, a pioneer in full coverage restorative dentistry, and practiced in Scarsdale, New York, before moving to Arizona, where he now practices.

Episode page with video, transcript, and more

He is the Director of ONWARD, an online teaching organization for full coverage restorative dentistry, where he has created over 30 courses and provides a wealth of educational resources.

A nationally recognized lecturer and author, Dr. Feinberg has contributed significantly to dental literature, including his essay collection, "Open Wide: Essays on Challenges in Dentistry to Achieve Excellence." He also serves on editorial boards and councils for various dental associations and has been honored with numerous awards for his contributions to the field.

In this episode, Ed shares insights from over 40 years in the field and discusses his unique approach to saving teeth, which contrasts with the widespread practice of extracting teeth and opting for implants. Dr. Feinberg’s "favorite mistake" involved a crown falling off a colleague’s tooth—a rare but impactful error. Through this experience, he reinforced his belief in trial-based dentistry and using precise techniques to ensure long-lasting dental solutions.

Dr. Feinberg advocates for saving teeth first, using crowns and bridges when appropriate, and stresses that implants should only be used when absolutely necessary. The conversation also touches on the overuse of implants in modern dentistry, the importance of prevention, and learning from mistakes to improve patient care.

Questions and Topics:

• What would you say is your favorite mistake?
• Was that the first time a crown had fallen off, or was it just a rare occurrence?
• Were you able to implement any checks or mistake-proofing to prevent this from happening again?
• Can you explain the difference between focusing on the tooth structure above the gum versus below the gum?
• How do you use temporary crowns, and why do some fall out while others don’t?
• Do you believe dental education is keeping up with advancements in restorative techniques?
• What are your thoughts on the current trends in implant dentistry?
• Do you think a lot of dentists are making mistakes with implants, and why?
• Are there preventive or mistake-proofing methods you apply in your practice to avoid common dental issues?
• Why do you think patients typically don’t seek second opinions in dentistry, unlike in medicine?
• Does the overuse of implants lead to malpractice cases or trouble with insurance?
• Why are patients quick to judge dentists based on superficial factors rather than their actual dental work?
• What are your thoughts on veneers—are they purely cosmetic, and when are they appropriate?
• How can dentists better manage biomechanical stress when performing implant procedures?
• Are there concerns about the future reputation of dentistry due to inappropriate practices?
• What advice would you give to patients about prevention and the importance of regular dental hygiene visits?

Key Topics Discussed:

• Dr. Feinberg’s favorite mistake: A crown falling off a colleague’s tooth and the lessons he learned about precision and correcting errors.
• Restorative dentistry techniques: Focusing on the root structure below the gum for crown and bridgework to ensure long-lasting results.
• The overuse of implants: Dr. Feinberg discusses the inappropriate use of implants and his preference for saving teeth when possible.
• Dental education: Concerns that dental schools are not teaching the best restorative methods and the influence of economic pressures on young dentists.
• Precision attachments: A less common, effective alternative to implants that can save teeth, especially for complex cases.
• Patient care and trust: How patients often judge dentists on superficial factors and the importance of second opinions in dental treatment.
• Preventive care: The importance of regular hygiene visits to prevent periodontal bone loss, which is crucial for long-term dental health.