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In Part 1 of this two-part series, Dr. Melissa Seibert sits down with Professor Bart Van Meerbeek, one of the most influential figures in adhesive dentistry worldwide. From dentin permeability to hybrid layer degradation, Professor Van Meerbeek's research has fundamentally shaped how clinicians understand the biological and mechanical realities of bonding. This conversation moves beyond product marketing and into the core science: what we truly know, what remains uncertain, and why durability in adhesion continues to require deliberate clinical judgment.

Together, they unpack the "adhesion degradation paradox," the hydrophilicity trade-off inherent in universal systems, and the persistent performance gap between simplified one-step adhesives and multi-step gold standards. The discussion explores film thickness, hydrophobic layering, stress distribution, and the biomechanical role of flowable composites as stress-relieving buffers. They also examine why 10-MDP concentration matters, why not all universal adhesives perform equivalently, and how bonding strategy should be tailored to substrate conditions—from young permeable dentin to sclerotic or amalgam-affected substrates.

This is not a discussion about shortcuts. It is a rigorous, clinically grounded examination of what evidence-based adhesive dentistry actually demands. If you are striving to practice with greater clarity, confidence, and scientific defensibility, this episode will recalibrate how you think about bonding protocols in everyday practice. Part 2 will continue the conversation, moving deeper into contamination management, clinical troubleshooting, and long-term durability.

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Dr. Dichter brings nearly 20 years of clinical, research and teaching experience — as a general practitioner and prosthodontist — to his position with Spear. He serves as an instructor in the Treating the Terminal Dentition and Fully Edentulous Patient seminar, in addition to multiple Spear Workshops.

Dr. Dichter has served as a guest lecturer and clinical instructor at Oregon Health and Science University School of Dentistry, teaching occlusion and esthetics. He has been a Spear faculty member since the company's inception, as well as a contributing author for Spear Digest. He is passionate about education and is involved with multiple study groups in the U.S. and Canada.

After earning his D.M.D. from OHSU in 1995, Dr. Dichter practiced general dentistry and eventually joined a startup practice in his hometown in coastal Oregon before moving to a practice in Portland. He brought 16 years of restorative dental experience into UCLA's world-renowned, full-time advanced prosthodontics residency, which he completed in 2014.

Join Elevated GP: www.theelevatedgp.com

Register for the live meeting: https://www.theelevatedgp.com/ElevationSummit

Download the Injection Molding Guide: https://www.theelevatedgp.com/IMpdf

In part two of this two-part conversation, Dr. Brian Vence moves from philosophy into execution, offering a clear, ethical, and highly practical framework for how comprehensive dentistry is diagnosed, discussed, and ultimately chosen by patients in a successful fee-for-service practice.

This episode is a deep dive into how dentists can guide patients through complex decisions without pressure, persuasion, or procedural selling. Dr. Vence outlines his structured yet flexible approach to patient intake, record gathering, diagnosis, and treatment planning—centered around what he calls the Pathway to Essential and Meaningful Treatment. Rather than dictating solutions, he emphasizes co-discovery: helping patients see, understand, and articulate their own problems before ever discussing procedures.

A central theme is risk reduction over procedures. Dr. Vence explains how he frames treatment options not as products to purchase, but as graduated ways to lower biological, structural, functional, and aesthetic risk over time. From stabilizing compromised teeth to sequencing orthodontics, restorative care, and provisional solutions, the focus remains on sustainability—not urgency.

You'll hear practical insight on:

• How to structure patient intake from the first phone call through diagnosis and case presentation

• Why allowing patients to ask for solutions is more powerful than proposing them

• How to use analogies and visual co-discovery to explain complex problems without overwhelm

• The difference between short-term stabilization and long-term structural correction

• Why timelines, pacing, and emotional safety matter more than closing treatment plans

Dr. Vence also addresses real-world concerns around fees, financing, and practice sustainability. He discusses why fee structures should reflect time, complexity, and overhead—not insurance schedules—and how this approach supports both clinical integrity and business stability. Importantly, he underscores that dentists cannot want treatment more than the patient does—a mindset shift that allows for clarity, calm, and long-term success.

The episode closes with a candid reflection on leadership, emotional resilience, and the inner work required to sustain a fee-for-service practice over decades. Dr. Vence shares why confidence doesn't come from certainty or volume, but from having a clear vision, strong values, and the ability to remain grounded as conditions change.

Together, parts one and two provide a comprehensive roadmap for dentists who want to practice at a higher level—clinically, ethically, and relationally—while building a practice that is both financially stable and deeply fulfilling.

This is not about faster dentistry.
It's about better decisions, made well, over time.