Dental Fuel Episode 9: Clinical Mistake with Dr. Shannon Johnson

Shannon Johnson is in the HOUSE, bringing the DENTAL heat!!

A true ROCKSTAR in the dental world and an AMAZING educator, she’s about to BLOW YOUR MIND in this week’s episode as she reveals her clinical mistake, the lessons learned, and how she turned it all around!

Shannon Johnson grew up in a small coal mining town in eastern Kentucky. She graduated from the University of Louisville School of Dentistry in 2002 and completed her Advanced Education in General Dentistry Certificate at the University of Florida in St. Petersburg in 2003.

Ever passionate about providing the very best care for her patients, Dr. Johnson is an avid continuous learner attending countless hours of continuing education each year from the profession’s best and brightest.

An educator at heart, Dr. Johnson has taught at both the University of Florida and the University of Louisville. She is an associate faculty member at the Dawson Academy where Dr. Johnson dedicates time to helping dentists around the world master the skills necessary to predictably restore simple to complex cases with outcomes that are both beautiful and functional.

She is the current President of the Dawson Association for Complete Dentistry and leads two Dawson Academy Study Clubs.

In her free time, Dr. Johnson enjoys spending time with her husband and daughter playing board games, visiting theme parks, attending various comic conventions, crafting, and scuba diving.

🎙️ Listen to Dental Fuel Episode 9 on Apple Podcasts

Dental Fuel Episode 9: Clinical Mistake Transcript

In Dental Fuel episode 9, Dr. Johnson shares a clinical mistake she has experienced in her career.

Dr. Tanya Sue Maestas

Shannon Johnson, welcome to Dental Fuel. How are you doing today?

Dr. Shannon Johnson

I’m doing fabulous. Thanks for having me.

Dr. Tanya Sue Maestas

I’m so happy to see you. I know the last time we spoke was via Instagram Live. Now we are in the flesh at our Ignite DDS retreat. I’m so happy to see you. How are you enjoying our retreat so far?

Dr. Shannon Johnson

Wow, the energy is great. It’s been fabulous to brainstorm with like all these energetic creative minds. So you know, I count myself as a very fortunate soul to be here. 

Dr. Tanya Sue Maestas

Oh, well, we feel fortunate to have you in our company as well too, Shannon I would love it if you would share with our listeners a little bit about yourself.

Dr. Shannon Johnson

All right, so Shannon Johnson from Kentucky, Louisville to be appropriately the right city.

A little bit about me – I graduated from dental school well over 20 years ago. In that timeframe, after I graduated from school, I did a one-year postgraduate training program down in Florida AEGD program and then I stayed and taught at that program for several years before I went into private practice had a small fee-for-service practice in Florida until I had to relocate back to Kentucky for some family reasons.

And then I’ve been back in Kentucky and I’ve taught at the University of Louisville and I’m back in private practice now.

Dr. Tanya Sue Maestas

Can you tell us a little bit about your private practice?

Dr. Shannon Johnson

So my practice is very interesting and unique.

I have a shared space with an older doctor, I use one operatory that I basically rent from him and I started it from scratch right at the pandemic.

So it’s been, you know, really interesting to watch that grow to a couple of hundred patients and it’s just me. So, quite a fascinating little practice, but definitely a different setup. It’s so interesting. That’s the beautiful thing about dentistry. You can do it. However, you want it. Yeah, if you can dream it you can make it.

Dr. Tanya Sue Maestas

I would love it if you would also share about your journey with Dawson and you’re a faculty member for them. Is that correct? 

Dr. Shannon Johnson

That is correct. So back in dental school, I had a couple of patients who really got me thinking that there had to be a better way.

So one of the first patients was a five-unit bridge that I was doing in my third year of school. And my faculty member said, you know, it’s not going to last.

And I’m like, well, why wouldn’t it last? Why am I going to do a five-unit Bridge, which was wisdom tooth to premolar like, why isn’t it going to last? Why would I do it?

And so anyway, that got me thinking and that got me searching. That’s how I stumbled upon to Pete Dawson concepts of Complete Dentistry in his book and so I’m like, okay, well, that’s kind of cool.

Well, then, fast forward to my senior year, I encountered a denture patient that I had to see over 20 times in dental school, like 20 times, I made multiple dentures with every faculty member and I’m like, alright, I’m getting ready to graduate dental school, and I don’t want to practice like that.

I need something predictable. And it just so happened that residency program was associated with the Dawson Academy and I learned about him so I’m like, I want to go down to the beach for a little bit. So I was fortunate enough to be accepted into that program. And then over time, establish a relationship with the academy. So that’s how I have been there. So predictability.

Dr. Tanya Sue Maestas

Yes. How in addition to predictability, how did the Dawson Academy transform the way that you practice?

Dr. Shannon Johnson

My favorite thing is that Pete Dawson would ask the question, “Who deserves an incomplete exam?”

And if you look at that, honestly and ethically, you realize every patient deserves the best and to know what’s going on. And to be able to have like, maintainably a really beautiful, healthy mouth, whatever that might look like for that patient, their economic level, that sort of thing.

And so I was able to learn how to really connect with patients, no matter the practice setting, and provide care at an elevated level meeting these requirements for like functional stability, aesthetic stability, and again, the patient can maintain it and so I find that those principles are timeless and they apply pretty much in any practice, and I’ve practiced a lot of different ways.

I get quite passionate about it.

Dr. Tanya Sue Maestas

Very cool. Now if a person can’t go out to Dawson, say it’s a new dentist coming out of school, really wants to start learning more, up their CE game, what would your recommendation be for them?

Dr. Shannon Johnson 

I think you have to really look at yourself to see where the return on investment is going to be initially, ike, what do I need to learn first?

And then I think you have to seek out the highest quality that you can pay for.

So depending on where you are regionally, there are so many amazing CE centers, and a lot of really great state meetings, or regional meetings that you can attend and hear speakers.

So you can go here, Dawson, Kois, and Spear faculty, Pankey faculty at some of those meetings and really challenge yourself.

But focus in on building a strong foundation of occlusal principles and then just start diving in if you want to do aesthetics, you know, make sure that you have a strong understanding of materials and then start there.

And then of course, you know, as a bias because you know, we’re on the podcast, we might want to talk a little bit about Ignite! Oh my gosh, come on, so affordable.

Dr. Tanya Sue Maestas

What a natural plug it wasn’t going in that direction.

Dr. Shannon Johnson 

But honestly here’s the thing you know, Ignite DDS is here to like, inspire, and help young dentists start to grow and to see what’s possible.

In a very, again, ethical way. So great content, reach out to everything that you can that’s free, find a mentor, you know, it doesn’t always have to cost an arm and a leg to be able to access really good quality people.

You just have to be passionate and you have to put in some legwork.

Dr. Tanya Sue Maestas

How did you get connected with Ignite?

Dr. Shannon Johnson 

So it was actually through the academy. So yeah, David came and spoke at a couple of our alumni retreat meetings and things like that.

And so then we started to meet and talk and then he asked me because I was running some other study clubs if I would be a study club mentor, and I was like “To go hang out with some of the like the most brilliant young dentist in like the country. Of course, I’m going to do that!”

So that’s how it started. 

Dr. Tanya Sue Maestas

Thank you for your kind words. I don’t consider myself that but I am learning for sure from people like yourself all along the journey.

For our listeners out there. You have so much to learn from Dr. Johnson here and if you’re curious to hear a little bit about what she’s teaching her methodology inspired by Dawson, the study club through Ignite DDS is a great way to get an introduction to what study clubs are to advancing your techniques and your skill in dentistry and to learning from brilliant minds like Shannon Johnson.

And you know, finding a mentor in them as well too, and somebody that you can throw questions back and forth.

So great when you have a case come in and you can you know shoot a quick question over and get a pretty quick response about a case that you may have in the chair.

So that I think for me that is just worth its weight in gold.

Dr. Shannon Johnson 

I think it’s amazing when you can build a community and you can just say, Hey, this is where I’m at, this is where I need help and it’s not a judgmental zone because we’ve all been there right?

I mean, we’re all learning, we’re all continuing to grow and you don’t know what you don’t know.

But the thing is, if you can learn to ask the questions, and you’re asking the right people, then you start learning and you can do great things. So yeah.

Dr. Tanya Sue Maestas

Well, Shannon, here at Dental Fuel, we are dedicated to learning from clinicians’, and team members’ mistakes.

So I would love it if you would share with myself and our listeners a little bit about a clinical mistake that you made, how you learned from it, and how you grew from that.

Dr. Shannon Johnson 

Yeah, so there have been many, sadly, we call it research. Glenda calls it research, not a mistake, right? But definitely some learning moments.

And I had a case and this is actually further along in my career. That you know, she had a lot of dentistry work done south of the border and had really thick base metal porcelain fused to metal bridgework like roundhouse bridges that were sharing and breaking and it was just a constant issue for her and it was plaque trap is just bad.

So it has to get replaced. So I went through all of our checklists at the time and I was restoring her, but she broke down.

She did great through the provisional phase, but then she broke like a canine. It came off and I’m like, my work doesn’t really do that very often, like what’s going on?

Like I said, this is later in my career, so we’re talking like 13 years out or something, I should have this pretty well under my belt.

What I had missed ultimately, was she was a significant airway case. And I had missed the impact that had for her because she was constantly moving, clenching, grinding, and she had been diagnosed with sleep apnea, and I made the mistake of just letting that be okay, well, you’re wearing a CPAP let’s just move on, right?

I checked that box, but I really hadn’t checked the box because she really wasn’t compliant and it wasn’t titrated well for her, and we still had to manage pair function on top of it.

So you know, the hard part with a failure like that is I lost her anterior guidance. I had to go back and reestablish all of that to manage the pair function, but really, you lose, like your patient’s confidence.

And so that’s hard, you know, and it’s hard to look back and see so, you know, I have to be careful because a lot of the mistakes that I’ll make it’s because I’ve jumped in like a checklist.

So the academy you know, we have like this checklists, which I love because if you follow it step by step by step, you don’t miss things. But you also have to really think about it and I think for that one, I just checked the box and my other mistakes just because I’m like, oh well I already know that I’ll skip it and it ends poorly.

So anyway, that was one of the most prominent ones that I could think of that really made me sad.

Dr. Tanya Sue Maestas

How did the case end?

Dr. Shannon Johnson 

We restored her, then I restored her one more time. So you know at that point I’m paying her for the case. Got her connected to a sleep physician in the area who really helped improve that area.

And she has to wear an appliance at night with her CPAP to help control the forces. She didn’t have a lot of posterior support, she wasn’t an implant candidate and she refused partials. Right?

I was like you still have to have protection. Otherwise you can overload even if you have everything dialed in, because if there’s that pair function component crossover component airway component in this particular case, you know it was harder, and I’d missed it.

Dr. Tanya Sue Maestas

Speaking of clinical stuff, and posterior support, I find it so interesting when we see non-curious cervical lesions when people are missing posterior teeth.

I mean, all that load is on those anterior teeth and I’m just waiting for these teeth to go and like fracture off.

Dr. Shannon Johnson 

Well and many start to, they start to get like stomas. They start to flare a little at a time. So if you’re not measuring that, you know, you can ask the patient maybe always have that space. 

But I do feel like as a clinician, if we start to see stomas we need to record them like this space.

That’s where intraoral scanners and digital photography that you can take and just hold on to you really will be able to see if overtime that those are getting more like bigger, bigger, bigger, and then fremitus you know as anything shaking and bouncing so you just take your fingernails and you put very gently like a little butterfly on the teeth and had the patient tap, tap, tap and grind all around and you shouldn’t feel the teeth moving.

And a lot of folks who’ve lost posterior support and things start to maybe close down you’ll start to find that they’re really bumping hard on their front teeth and all of those things will start to happen and they can get the noncarious cervical lesions.

And then you go in and you’re like, I’m going to put this beautiful little filling in, and then what happens to the filling out it comes right it’s like did it make it to the parking lot but like the first meal, not always right?

So then what do you do you come back in and while there wasn’t enough retention, you’re like scoring more into the tooth. So you have to learn to control all of those factors. And then yeah, hopefully, get them some back teeth as well.

Dr. Tanya Sue Maestas

Teeth are tricky. Such a beautiful system it really is.

Join us on our next episode where Dr. Johnson talks about a financial mistake she’s made.


Tanya Sue Maestas, DDS

Tanya Sue Maestas, DDS

Dr. Tanya Sue Maestas graduated from The University of Texas School of Dentistry at Houston in 2018. During her dental school career, she served as the national American Student Dental Association President and became involved in organized dentistry. After graduating, she completed an Advanced Education in General Dentistry Residency in 2019. Upon completion of her residency, she returned to the El Paso Borderland community where she serves as a Dental Director at La Clinica de Familia in Chaparral, New Mexico. She also serves as a faculty member at the Woody L Hunt School of Dental Medicine in El Paso, Texas. She remains involved in organized dentistry and holds various leadership roles in organizations including the American Dental Association, Texas Dental Association, Academy of General Dentistry, Texas Academy of General Dentistry, Hispanic Dental Association, and others. She currently serves on the ADA Council on Communications and previously completed the ADA Institute for Diversity in Leadership Program. She was recognized as an ADA 10 under 10 winner, Incisal Edge 40 under 40, and previously nominated as one of Texas New Dentists of the Year. She currently hosts New Dentists on the Block where she helps showcase the New Dentist story and build connections with new dentists around her and Dental Fuel a podcast dedicated to sharing and learning from industry leaders’ mistakes. She has a commitment to providing dental care to the Borderland community and hopes to encourage the next generation of dentists to give back to the community.