Nine Turning Points that Changed the Practice of Dentistry…
a tale that teaches us how to create a life that matters
M. William Lockard, Jr., D.D.S. Original Cadre Teaching Assistant, Associate Faculty, and Board of Trustees Member
The path of a master is a commitment to a lifelong process of learning – doing – and applying what was learned. That is the essence of the story I am going to tell about just such a man, Dr. L.D. Pankey, who conceived a philosophy for a meaningful life through total patient care that changed the practice of dentistry and the reason there is a Pankey Institute.
History as we all know is only important for what lessens we can learn. This story is significant because we learn that a commitment (not hope or wish) to improve another’s quality of life is the Power of Purpose that creates a life that matters.
Dr. Pankey was frustrated by not being able to help people understand the importance of saving their teeth for a lifetime. When his mother’s teeth were removed and she was so unhappy wearing dentures, Dr. Pankey made a commitment to never again remove another tooth and dedicate his life’s work to teaching dentists and patients the importance of saving teeth for a lifetime of comfort, function, health and aesthetics.
After he made the commitment, he said it seemed that an invisible hand guided him into relationships with people and involvement in situations that provided the learning he needed to achieve his purpose.
This may be your opportunity — a turning point, if you will — to take Dr. Pankey’s philosophy as your own and live it. Build a balanced life of love, play and worship, in harmony with your work focused on technical excellence to improve your patients’ quality of life. Be concerned withunderstanding the total health of patients… not just the tops of their teeth but the whole person desiring and deserving the best oral health, function and esthetics you can help them achieve.
Enter Daniel Hally-Smith
- Daniel Hally-Smith was born in 1879 in Jamestown, Illinois on his parent’s farm where they bred and raised horses.
- As a young child he thought he wanted to be a physician like his relative.
- One day, Daniel and his cousin argued over the last cookie in the jar. They decided to cut the cookie in half. So, naturally, the best thing to use would be a hatchet.
- His cousin held the cookie. Daniel swung the hatchet, and yes, you guessed it; he severed his cousin’s finger.
- Daniel was so horrified at the sight of blood that he decided to never be a physician.
- Later, as Daniel grew older, he became attracted to working with gold and porcelain in restorative dentistry in order to avoid surgery.
- Daniel attended Northwestern University Dental College from 1898-1901, when G.V. Black was Dean.
- During the summer of 1899, after his freshman year, the family finances reversed, making it doubtful that he would be able to return to school in the fall. He worked in the office of Dr. Frank Davis on Michigan Avenue, in Chicago, doing odd jobs. (The significance of this will become apparent later.)
Enter Mrs. Murphy… the 1st Turning Point
- One day while Dr. Davis and his family were on vacation, Daniel was cleaning the office when he heard music coming from Michigan Avenue below. He looked out the window and saw a circus parade. He went down to the street to watch the parade pass by.
- Down on the street, the parade stopped, Mrs. Murphy, a chimpanzee, was in the cage in front of him.
- Daniel noticed that the chimp’s upper lip was severely swollen, and there was swelling under both eyes.
- He went to the trainer and asked, “What is the matter with the animal’s face?” The trainer said they shortened the long “eye teeth” and could not get anyone to treat the animal now.
- Daniel told the trainer he was a dental student and he could help her if the trainer would bring Mrs. Murphy up to the office after the parade. “I’ll bet she has abscessed teeth,” he said.
- Both of Mrs. Murphy’s cuspids were abscessed. Gently, ever so gently, Daniel opened the nerve canals to drain them, releasing the pressure. The next day she returned with almost no swelling.
- Several appointments later, he filled the canals and placed gold crowns on both cuspids (most likely – gold shell crowns). He was constantly careful not to cause Mrs. Murphy pain.
- At the last appointment, Mrs. Murphy jumped into Daniel’s lap and gave him a big hug. The trainer said the chimp only did that with people who were especially nice to her.
- Daniel said, “My reward was enormous! At that moment I felt so enriched. I knew that I could experience these feelings and help mankind through my profession.”
- “As they left, the trainer handed me a box. The gift was enough money to assure my
re-enrollment at Northwestern. We hadn’t discussed money at all. I hadn’t done the work with money in mind. What a lesson I had learned, and at the right time in my life.”
- For several years the circus advertisements included a picture of Mrs. Murphy, the only chimpanzee in the world with gold teeth. (Note that if Daniel had not treated Mrs. Murphy, he would not have become a dentist and Dr. Pankey’s #1 mentor.)
- Daniel graduated from Northwestern University Dental College in 1901.
- He became an associate to Dr. Goode, a famous esthetic restorative dentist on Michigan Avenue. Daniel learned advanced technical dentistry and was impressed by how much he didn’t know.
- He met many wealthy patients and liked the life style money could buy.
- Daniel and a French dentist, who had come to learn Dr. Goode’s advanced techniques, became friends. The French dentist invited Daniel to visit him in France. Daniel’s vision was expanding, and he wanted to see how people in Europe lived.
Moving to Europe… the 2nd Turning Point
- In 1902 Daniel went to France to visit and decided to stay. It took six years to learn French and acquire a European dental degree and license to practice in Paris. (If Dr. Hally-Smith had not moved to France, Dr. Pankey would not have met him 32 years later)
- He traveled widely. In a dental office in Germany, he met Kaiser Wilhelm who invited him to his estate to see his horses and spend time.
- As he progressed, he met many leaders of the world who became his patients. Years later, the Aga Kahn gave him a Rolls Royce as a token of appreciation for his excellent care.
- Dr. Daniel Hally-Smith married a former Russian Countess and lived a life of the rich and famous.
Enter Lindsey Dewey Pankey
- L.D. Pankey was born in 1901, in Shawnee, Illinois. His father owned a dry goods store. Working in his father’s store taught him the importance of keeping the overhead low to increase the profits. He also liked working part-time in a local dental office.
- The High School in Shawnee was not accredited. The family moved to Evansville, Indiana so he could graduate from an accredited school. He worked part-time for an advertising dentist.
- Dr. Pankey went by the name of “L.D.” He graduated from the University of Louisville Dental School in 1924,
- L.D.’s first main goal was to make money to pay his dental school loan.
- L.D. wanted to practice in Louisville. However, Dr. Crutcher, his advisor and owner of a dental supply company, said that he needed experience and advised him to go to the small town of New Castle, Kentucky for a few years and then come to Louisville.
L.D. Moves to New Castle… the 3rd Turning Point
- Dr. Crutcher knew that Dr. Hamilton was retiring to Coral Gables, Florida. He offered to loan Dr. Pankey $5,000 to buy Dr. Hamilton’s practice in New Castle. Dr. Pankey accepted his offer.(If Dr. Pankey had practiced in Louisville, instead of New Castle, he may not have later moved to Coral Gables at Dr. Hamilton’s urging.)
- L.D. worked night and day, patching teeth, making a few small bridges, and removing teeth. A large percent of his practice was making full dentures and “hooked partials.”
- L.D. met Anna Pearce, whom he later married.
- His practice thrived, but he was unhappy. Patients only wanted extractions and dentures. He tried to diagnose and sell them on a treatment plan, but they didn’t want it. People with money went to Louisville for their dental care.
- Dr. Hamilton wrote to Dr. Pankey several times encouraging him to relocate to Coral Gables, Florida where many people were wealthy.
A Letter Sparks a New Vision for His Practice
- A letter from his mother changed Dr. Pankey’s life forever. She wrote, “I am happy that you are doing so well in your practice but I hope you are not doing to your patients what has been done to me. I have had all my teeth out and now have dentures. This has been the unhappiest experience of my life.” She was 42 years old.
- In his book with Dr. Bill Davis, Dr. Pankey wrote, “She had lost the four things that I have spent the rest of my life trying to learn, use, and teach dentists to give to their patients: Comfort, Function, Health, and Esthetics.” It opened the door to a vision that the goal should be to save patients’ teeth for a lifetime — if at all possible. (If he had not pulled so many teeth and made so many dentures he may not have felt the guilt that he was creating the same unhappiness that his mother was experiencing. His commitment to “never pull another tooth” became his “brand” and life purpose.)
- L.D. informed Dr. Hamilton of his decision to leave New Castle.
- After 18 months in New Castle, Dr. Pankey had paid his school debt of $3,300 and the practice loan of $5,000. He had $800 to buy a Nash coupe and $1,000 in reserve for his trip to Florida.
- He left New Castle on a Monday in December of 1925, at 2:00 p.m., after extracting 81 teeth for 12 patients at $1.00 per tooth.
- He wrote that on the very next day, “I made a commitment to myself. I would never take out another tooth as long as I lived. I had promised myself that I would devote the rest of my life to learning how to save people’s teeth. Some way, somehow, I was going to learn to communicate to my patients the importance of saving their teeth. At that moment, a peace came over me that I have never experienced before or since, as though I was having a religious experience. I came to peace with myself; a weight was lifted from my conscience. I did not know how I was going to do it, but I had decided to dedicate my life to saving people’s teeth.”
L.D. Moves to Coral Gables… the 4th Turning Point
- Upon arriving in Florida, he passed the Florida dental boards and rented space in a building under construction.
- In Coral Gables, his patients were from a higher social-economic class but their dental IQ was similar to his patients in New Castle.
- In September of 1926, a hurricane blew the top off of his office building, and he could not work for three months. He returned to New Castle to marry Anna Pearce. When he returned to Coral Gables, the real estate boom was over in South Florida.
- The building manager had a toothache and wanted the tooth extracted. Dr. Pankey said he didn’t extract teeth; however, he would take an x-ray and if the tooth could be saved, he would save it. If the tooth could not be saved, the building manager could go to the exodontist in Miami to have it removed.
- The x-ray showed the tooth had deep decay. Dr. Pankey offered to place ZOE and amalgam temporary filling. He told the man he wouldn’t charge him if the tooth was not comfortable. The man still wanted the tooth out. Dr. Pankey said, “Okay, but don’t come back until you want to save your teeth.” (Dr. Pankey felt he had to affirm his commitment to his purpose, no matter what relationship he had with the patient.)
- The owner of the building came in to see Dr. Pankey when the office manager reported,
“Dr. Pankey kicked me out.” After Dr. Pankey explained his commitment about extractions and what really happened with the manager, the owner, his wife and children became patients. They became good missionaries for the practice. Dr. Pankey said, “What has come to be known as the Philosophy started in that office in Coral Gables.”
- In 1928, he learned to use the Munson articulator to produce the Curve of Spee and the Curve of Wilson. Every case was restored to a 4-inch curve. Dr. Pankey completed five cases in a few months. He considered all of them to be failures because he didn’t understand occlusion. He started back doing “patch-work” maintenance dentistry, which later he called a “holding program.”
1930, Enter Mrs. Blanchard… the 5th Turning Point
- Mrs. Blanchard, a 65-year-old, widow of a wealthy New Englander was referred to “the dentist who did not believe in pulling teeth” by her neighbor in Coral Gables. (What is your “brand” — your “why” by which people refer patients to you?)
- Mrs. Blanchard was born and raised on Beacon Hill in Boston and graduated from the Sorbonne in Paris. She spent winters in Coral Gables and summers in Maine.
- She walked in the office without an appointment and wanted to speak personally with
Dr. Pankey. She would not sit in the reception room. She related that two dentists in Boston and Maine had said she needed all her teeth extracted and full dentures made.
- She was in pain and agreed to a complete examination. Dr. Pankey advised her to have two teeth removed by a Miami exodontist. He made a treatment plan and quoted a $1,000 fee. She accepted.
- He did operative procedures on the upper anteriors and restored the lower posteriors using the Munson articulator carving the cusps compatible with incisal guidance by the cuspids.
- He built the upper posteriors using the “chewing in” technique (FGP) that Dr. Taggart described in 1912. He used a copper band impression of prepared teeth with modeling compound. He made an amalgam die on which a wax pattern was made. He heated the occlusal with a hot spatula to do a chew-in, carve, and cast.
- She enjoyed her teeth until she died at 81and never lost another tooth.
- Mrs. Blanchard always waited in Dr. Pankey’s private office before her appointment. One day she read the ADAJ in his office and asked him if he was going to Paris for the International Dental Conference.
- He said, “I haven’t given it much thought. Why do you ask?”
- Her reply was “I think you should go. You will meet the outstanding dentists in the world and learn the new techniques.”
- The next time she was in the office, she asked him again if he had given thought to attending the Dental Conference. He asked why she was interested in him going.
- “You could learn something there. I really think you have great potential.”
- “Frankly, I can’t afford to go. I have a new practice and a young child.”
- She insisted, saying, “I want you to go, and I want you to travel first class. I would like to pay all your travel expenses, as well as compensate you for the time you will lose from your practice while you’re gone. Now will you go?”
- He replied, “That certainly will put a different complexion on it.” She also wanted him to travel to London, Florence, Rome, Vienna and Heidelberg. (The power of trusting relationships has great rewards. This philosophy is built on honesty, sincerity and truth, as well as treating each patient appropriately, according to their need and ability to pay a fair fee.)
Enter Dr. Frank Davis… the 6th Turning Point
- A few weeks before L.D. left for Europe, Dr. Frank Davis of Chicago, creator of the Davis Crown, entered L.D.’s office to have new upper and lower dentures made. Dr. Davis had recently retired in Coral Gables.
- During one of his visits, Dr. Davis said he knew L.D. was going to Paris and suggested that he should look-up a dentist who had been his lab clean-up boy while the boy was going to dental school at Northwestern. Dr. Davis reported that he had heard his former clean-up boy now had the most outstanding dental practice in the world. His name was Daniel Hally-Smith.
- Dr. Davis sent a letter introducing Dr. Pankey to Dr. Hally-Smith. (If Dr. Davis had not retired in Coral Gables; he would have not met Dr. Pankey and encouraged him to meet Dr. Hally-Smith in Paris.)
- Dr. F.R. Broderick wrote a textbook on dental medicine, and Dr. Pankey’s study group used this book to study nutrition.
- Dr. Pankey spent one week studying with Dr. Broderick in London, and then together, they traveled to Paris to attend the convention.
- Dr. Pankey spent two days seeing the sights of Paris.
- Dr. Pankey had difficulty finding Dr. Hally-Smith’s office in the Place Vendome. He wrote, “His only sign was a gold plaque about the size of my two thumbnails with D.H-S engraved on it. The door was locked. I pulled the tassel at the end of a long rope by the door. The door was opened by a gentleman wearing a cut-away coat and striped trousers and holding a silver platter asking for my card.” He didn’t have a card so he provided the slip of paper on which Dr. Davis had written Dr. Hally-Smith’s name and address.
- Dr. Hally-Smith greeted him warmly and gave a personal tour of the office. He had five dental technicians and three associates.
- The two men spent much time together following the meeting. Dr. Pankey learned about hydrocolloid impression material and gave the first clinic on its usage at the Florida West Coast Dental Society meeting in October 1931.
- They talked about patient communications and Dr. Hally-Smith asked, “So you took the Bosworth course? Isn’t that the dental supply man who suggests we offer one price for a good job, another price for a halfway job, or I’ll louse it up for you at a very reasonable price?”
- L.D. asked, “What am I going to do for those people who come to me and say they can’t afford me?” Dr. Hally-Smith said, “You should tell them the optimum way their dentistry should be done, and then what they do is their own decision. If you’re going to make a compromise with them, then compromise on the basis of their knowledge, not because you have prejudged them. You should tell every patient what optimum dental care would do for them. If they decide to go elsewhere, leave the door open for them to come back later.” (Dr. Hally-Smith’s lifestyle and words of wisdom were an inspiration for Dr. Pankey’s vision and philosophy.)
- Dr. Hally-Smith told Dr. Pankey he needed to know more about examination, diagnosis and periodontal disease. He suggested that he attend Northwestern to learn more. He gave
Dr. Pankey a paper with a handwritten verse, The Power of Thought, by James Allen. He said, “Read it every week of your life.” Dr. Pankey kept that paper under the glass on his desk and read it every week until it faded and became unreadable.
As you think, you travel; and as you love you attract. You are today where your thoughts take you, you cannot escape the results of your thoughts, but you can endure and learn; can except and be glad.
You will realize the vision (not the idle wish) of your heart, be it base or beautiful, or a mixture of both, for you will always gravitate toward that which you secretly most love.
Into your hands will be placed the exact results of your thoughts; you will receive that which you earn—no more, no less. Whatever your present environment may be, you will fall, remain or rise with your thoughts, your vision, your ideals; you will become as small as your controlling desire, as great as your dominant aspiration.
Switzerland – Italy – Austria
- Dr. Pankey traveled with two other men to Lucerne and then to Zurich, where they met: – Dr. Alfred Geysi, Dean of the Zurich Dental School and inventor of the Geysi articulator,
— Dr. Weston Price, author of Nutrition and Physical Degeneration, and
— Dr. Carl Gustav Jung, world-renowned psychiatrist.
- The trio went to Lake Como, Italy and the Villa d’Este to find a dentist to treat Dr. Pankey’s travelling partner’s toothache. After this, they went to Salzburg, Innsbruck, and finally Vienna, Austria.
- In Vienna, at the American Express Office, a cablegram was waiting. It informed Dr. Pankey of his wife’s death in an automobile accident. Dr. Pankey left immediately for the three-week trip to the United States. His friend Jimmy Klock accompanied him.
Return to Coral Gables….study at Northwestern……the 7th Turning Point
- Dr. Roy Bovard joined Dr. Pankey’s practice in Coral Gables, and L.D.’s sister came from Chicago to care for his daughter, Kitty, which enabled Dr. Pankey to take Dr. Hally-Smith’s advice for postgraduate education.
- L.D. signed up for the three-month summer courses at Northwestern University, during the summer of 1932. The courses included Diagnosis-Treatment Planning and Patient Interviews. He also took a course in Psychology with Dr. George Crane who stressed the “Cross of Life” and the need to balance work, play, love and worship for a truly fulfilling life.
- In the psychology course, he studied the work of Carl Jung, learning about personality types: introvert, extrovert, and ambivert. He also studied the Binet – Simon scale developed in 1905 to determine the intellectual capacity of children. This gave him the idea for his “Dental I.Q.” concept, as well as the patient’s intellectual, sociological and economic classification.
- Dr. Crane’s course gave Dr. Pankey the knowledge and communications skill needed for his practice and the basic elements of his “A Philosophy of the Practice of Dentistry.”
- L.D. first heard the word “occlusion” in the summer of 1931 while at NUDS. He asked the librarian for all the papers on occlusion. There was only one by Dr. Clyde Schuyler, reprinted from the 1926 New York Dental Journal.
- After speaking with Dr. Schuyler, L.D. began to understand the principles. He used these principles for 20 years without saying anything about it to anyone. (If Dr. Pankey had not gone to Northwestern for postgraduate courses that summer, many elements of his philosophy and the technical expertise he became known for would not have fallen into place in 1931. It was there that he learned the principles of occlusion from Dr. Schuyler, the Cross of Life, a system of diagnosis-treatment planning and patient interviews, and the psychology concepts leading to his Dental I.Q.)
- In 1933 property values were such he was able to buy land in Coral Gables for the price of 50% of the unpaid taxes. On this land, he built his 22-room “dental bungalow” in October of 1934.
1947, Enter Dr. Arvin W. Mann… the 8th Turning Point Dr. Mann moved to Ft. Lauderdale and came to Dr. Pankey to learn his technique of occlusal rehabilitation, diagnosis-treatment planning and how to use the Philosophy to get to know the patient and educate the patient to accept treatment.
- He would bring models and x-rays of patients to L.D.’s office, and they would diagnose the case together. Dr. Pankey would present the case to Dr. Mann as if he were the patient.
- Dr. Mann convinced Dr. Pankey to present the information to the dental profession. They wrote the Pankey-Mann Technique Manual.
- Having made presentations before countless local, state, national and international dental groups, L.D. was best known for his seminars on “A Philosophy of the Practice of Dentistry.” In 1956, his Philosophy lectures were organized into three-day seminars.
- Drs. Pankey and Mann selected 11 dentists from various parts of the country who had taken the Philosophy course at least three times. They met with these dentists and formed the Occlusal Rehabilitation Seminars (ORS). (Dr. Pankey practiced his philosophy and restorative technique for 20 years without sharing the information. If Dr. Mann had not persuaded him to go public, there might not be a Pankey Institute today.)
1958, Enter Drs. Loren Miller and John Anderson
- Four years after first learning Dr. Pankey’s Philosophy and technique, John and Loren began to dream of working together in dental education. They had become best friends as they learned the Philosophy and ORS techniques from Dr. Pankey.
- John was on the short list to become Dean at Northwestern, and Loren was on the short list to be Dean at Baylor. John encouraged Loren to join him in Chicago if he became Dean at NUDS. Loren said, “No way could I live in Chicago.” They decided regular academia was not the best venue to learn the new techniques. It must be a different approach.
1959, Enter Dr. Clyde Schuyler
- Pankey and Mann had difficulty teaching occlusion from a lecture format. They persuaded
Dr. Clyde Schuyler to join them in teaching occlusion.
- In 1959, they began giving the Pankey-Mann-Schuyler Seminars, attracting dentists from throughout the United States and many other nations. Their occlusal rehabilitation procedures became known as the Pankey-Mann-Schuyler Technique (PMS). Dr. Pankey’s secretary, Rose Quick, was the coordinator of the seminars.
- L.D. was acknowledged by the dental profession for this work by being elected President of the American Prosthodontic Society.
The Conception of the L.D. Pankey Dental Foundation
- At the 1969 Florida Academy of Dental Practice Administration Meeting, Jack Wilkens, Jim Cosper, and Billy Anderson discussed a gift or gesture to show their appreciation to Dr. Pankey for his contribution to their lives and to dentistry. After much discussion, Rose Quick suggested, “Why don’t you start a foundation in his name? Surprise him in this manner and allow him to be a part of the decisions relative to the use of the money raised.”
- Many ideas were discussed:
— Should they endow a chair at a dental school?
— Should they be part of a dental school or a medical school?
— Should they be a separate post-graduate school not like academia?
- After much discussion and advice from dental leaders around the country, the decision was made to create an Institute with a new and radical departure from conventional academia.
- Dr. Harold Wirth, Dr. Pankey’s close friend from New Orleans, was asked to chair a new group – the planning committee, composed of Jack Wilkins, Billy Anderson, Bob Barkley, Peter Dawson, Jim Cosper, John Anderson, and Loren Miller.
- Dr. Pankey told the committee that if they could raise one million dollars he believed they would be successful.
- The committee pledged $200,000 among themselves. They called on the many study clubs and former students for donations. After all sources were exhausted they were $40,000 short.
- Billy Anderson excused himself from the meeting and called Hal Pearson, president of
Den-Tal-Ez Company. Mr. Pearson had praised John Anderson for helping design the dental chair for which his company was named. He was pleased to pledge the $40,000.
- Formation of the L.D. Pankey Dental Foundation was announced at the 1970 Florida State Dental Meeting. (Without the inspiration of Dr. Pankey’s Philosophy and the gratitude and appreciation of the many recipients, The Pankey Institute would not have come into being.)
- In his book about the beginning of the Institute, Dr. Loren Miller aptly wrote, “The Dream Had Become Reality.”
1970, In the Bahamas… the 9th Turning Point
- In November of 1970, the ORS faculty met on a large schooner in the Bahamas.
- Loren Miller and Harold Wirth had discussed the possibility of Loren devoting full time to the project of The Pankey Institute. Loren agreed only if Dr. Pankey would be pleased, and Dr. Pankey was very pleased.
- While at anchor, Harold made the announcement that Loren will be Executive Director.
- John Anderson said, “If Loren will do this, so will I,” which was met with great applause.
- Loren served as Executive Director; John was Director of Education.
(Can you imagine that at 50 years of age, giving up your lucrative practice to follow a dream of creating a teaching institute with a radically new curriculum that had never been tried before — and asking your wife to leave her home and friends to move to a condo in Miami? These two men risked everything and dedicated their lives and fortunes to create a meaningful life for others… and changed Dentistry forever.)
- The first class of the Pankey Institute was held in September 1972.
The Significance of It All
This story is significant because we learn the importance of the “Power of Purpose” that changes lives and leaves a lasting legacy that can better life for generations to come.
First, make a firm Commitment (not a hope or wish).
Second, the daily Discipline
to become a continual learner,
Total Patient Care
Third, Dedication to apply the principles of what you learned,
Persistence to stay on the path of mastery to achieve your vision and purpose.
Set your goals high and continue your journey with a passion.
You can “Create a Life That Matters.”
- Personal communication with Dr. L. D. Pankey, Dr. John Anderson, and Dr. Loren Miller.
- A Philosophy of the Practice of Dentistry, Dr. L.D. Pankey and Dr. W. J. Davis (1985).
- The L.D. Pankey Institute: How It Was Conceived, Believed and Achieved, Dr. H. Loren Miller (1993).
The Exceptional Dental Practice, Why Good Enough Isn’t Good Enough, Dr. M. William Lockard (2007)