Generalists? Specialists? The world needs both kinds to thrive—a notion this year’s unprecedented 40 Under 40 embody with grace, skill and professionalism.

Since the first iteration of the Incisal Edge 40 Under 40 nine years ago, I’ve been one of the judges who reviews the doctors’ nomination forms. I’ve read through literally thousands of surveys and recommendations for potential candidates.

Reviewing the accomplishments of some of the industry’s most talented up-and-comers has been rewarding. These dentists have demonstrated outstanding characteristics as clinicians, professional leaders, community pillars and family and friends to those around them.

The 40 Under 40 has always been a survey of general practitioners and specialists, but this year we’ve expanded those boundaries to separate the two classifications—a development I favor. The previous limit of 40 exceptional doctors meant that many times we ended up excluding some exceptional candidates—those lost, for whatever reason, between the cracks. Now we’re able to honor a much broader range of clinical excellence.

What goes into judging the candidates? A lot of time, effort and careful attention to detail. The request for nominations is constant, and there are more great entries every year. I suppose we could have made it easier on ourselves from the beginning by limiting it to Benco Dental customers, but Incisal Edge is about all of dentistry. This year, after backing up and taking a big-picture view of the entries I judged, something stood out.

Don’t believe what you hear in the media about Millennials not being engaged with their communities, organizations and careers—such generalizations don’t do justice to this rising generation. It’s full of many outstanding citizens, both worldly and community-minded. They’re attentive to others’ needs and contributing in a multitude of ways. When you read the stories of the doctors—general dentists and specialists alike—selected for this year’s honors, you’ll truly be engaging with the best of the best, both personally and professionally.

What defines people, dentists or otherwise, as exceptional? Not just professionally so, but beyond: exceptional in their work, their personal lives, their engagement with the world outside their doors. I recently read (and listened to) David Epstein’s book Range: Why Generalists Triumph in a Specialized World. It came recommended by none other than Malcolm Gladwell, who ought to know. (Among much else, Gladwell is famous for his theory that one needs to practice 10,000 hours to master a given skill.)

Epstein’s book makes a great case for the importance of generalists, who see outside the narrow bounds that specialists many times use, of necessity, to hem themselves in. Those 10,000 hours might be necessary for a pro golfer, musician or programmer, but not (necessarily) for dentists, lawyers, accountants, teachers and many others. Personal experience, outstanding mentoring, being able to register and process vital information—that’s what makes a great young dentist.

The goal of a dental-school education, after all, is to train top young minds to be on the front lines of patient interaction, diagnosis, treatment planning and treatment. When a problematic diagnosis or treatment arises, general dentists—I count myself among their number—are the crucial link for referral to a specialist. The same thing is true in other areas of medicine. The importance of the primary-care physician, whether a family practitioner or an internist, stems from enabling the patient at last to begin the journey to accurate diagnosis and successful treatment.

Likewise, the general practitioner in dentistry is the gateway through which the patient can return to ask questions of the clinician with whom they’ve already developed a relationship over many years. There is, in other words, a vital role for both primary-care physicians and general practitioners, and for specialists. The hard part is knowing when (and when not) to consult each.

I’m convinced the current system of encouraging a direct path to specialization immediately after dental school is flawed. I’ve worn many hats in dentistry—practitioner, educator, researcher, CE presenter, author, dental-manufacturer adviser and consultant—and as such I have some clearly defined values and opinions. I’ve changed my mind many times as I gleaned new information. I’ve seen first-year dental students, before their first day of class, already setting their sights on getting into a specialty program. They’re already primed to be an endodontist, oral surgeon, orthodontist, what have you.

Yet there’s a piece missing—a number of pieces, in fact. Consider the following (possibly apocryphal) story: When interviewing candidates to be his research assistant, Thomas Edison is said to have offered them a bowl of soup. Why? He wanted to see whether they would add salt or pepper before tasting it. Anyone who did was automatically ruled out. Edison wanted people who didn’t make assumptions, given that blithe assumptions tend to be innovation killers.

My many years of observation have taught me this simple truth: You can’t find your own path without wandering around a bit beforehand. Epstein’s book fine-tunes this notion with ample evidence—research and inquiry that help solidify the case for a broad range, as the title has it, of experience and education.

Gladwell would argue, citing the idea of the 10,000 hours, that greatness is within virtually anyone’s grasp, as long as they put in the time to master their chosen skill. Analysis of Nobel Prize winners across countless fields has shown that virtually all have outside interests utterly different from their own professional accomplishments. While they look like specialists—and are amply rewarded as such—they are in fact generalists in their daily lives. For me, living a full life is looking and living outside the lines, using those around us as mentors and as examples for true self-fulfillment.

This issue’s 40 Under 40 exemplify all those notions wonderfully, whether they’re generalists or specialists from 9 to 5. They’re remarkable individuals, all of them—and they’re the mentors of tomorrow for doctors yet unformed. I can’t speak to the state of the world at large, but the future of our profession, at least, is in only the best of hands.

HOWARD STRASSLER, DMD is a professor and the director of operative dentistry at the University of Maryland School of Dentistry. He practices in Pikesville, Maryland.



Hints From Howard

Getting Your Daily Fiber

Sometimes, inevitably, certain products we’ve used successfully in the past, perhaps even grown to love, fall by the wayside. Time marches on; materials improve and others obsolesce. Consider fiber reinforcement ribbon.

These ribbons—I’ve had my best results with a leno-weave polyethylene—offer many advantages for periodontal splinting (a single-visit fiber bridge using a natural tooth crown or composite pontic), and for reinforcing and strengthening a large tooth preparation or endodontically treated posterior tooth that’s being restored with composite.

The improvement of the physical properties and fracture-resistance of composite stems from the polyethylene fibers—aramid fibers similar to those used in Kevlar vests—act as crack stoppers when a composite resin has a crack that’s propagating.

These fiber ribbons are worth looking at for use in restorative procedures. There are some excellent YouTube videos that demonstrate the technique. First, though, view this Hints From Howard for an introduction to oldie-but-goodie fiber-reinforced composites—and the materials and cases you can use these materials to manage successfully.