The Resilient Dr. Sarah Morris

By Dr. Glenn Vo

Several years ago, Dr. Sarah J. Morris was living her dreams. Sixteen years prior, Sarah took a leap and became a practice owner after finishing dental school. She poured her blood, sweat, and tears into steadily building up her new practice—Sarah J. Morris and Associates—and it blossomed into everything she once envisioned. She was working with a loyal patient base and a hard-working team committed to the same mission.

But things suddenly changed. Sarah dealt with an active draining ear infection nearly every month. It became debilitating— she couldn’t perform in the operatory like she used to. Her clarity and balance were compromised, and she missed days of work at a time. On the days she came in, Sarah pushed through and acted as if everything was fine. But, as soon as she left the room or stood up, she needed to grasp a wall to stay upright. There were many days Sarah didn’t feel it would be safe to practice, so she was forced to stay home and pray for healing.

This Wasn’t Sarah’s First Rodeo.

Sarah had her first surgery on her ears when she was only three years old. At the time of this article being written, Sarah has had her ears operated on a whopping 12 times.

In 2020, Sarah decided to do another surgery after realizing the effect her hearing challenges were having on herself, her family, and her ability to socialize. It was scheduled for March 27th, 2020, right as the world descended into utter chaos with the emergence of the Covid-19 pandemic. After some delays, Sarah got her surgery but, unfortunately, she received a defective cochlear device. Reluctantly, she decided to go back and get a replacement surgery.

After running into the aforementioned draining ear infection, a new doctor helped resolve the issue, but Sarah was left with permanent hearing loss. Now, due to chronic infections and burst eardrums, her ear bones are no longer functional on one side. And the “good” side has a perforated tympanic membrane to this day.

Any Challenge is What You Make of It.

As detrimental as this seems, Sarah believes this physical condition has brought her closer to her patients. They offered her sympathy and showed emotional support. It led to conversations which strengthened their connection by creating deeper understanding of one another —especially for those patients with hearing challenges themselves. And while Sarah must work extra hard to understand their needs, she believes the added effort makes her patients feel more valued and heard.

All in all, Sarah believes her disability reminds her to slow down, stop, and be in the moment. She’s grateful that so many avenues of communication are available, and resources abound for the hearing impaired. On that note, gratitude is something Sarah is passionate about. Whenever disappointment and frustration creep up, she takes a step back and realizes we all have our challenges. She focuses on her many blessings, and that helps change her perspective from negative to thankful.

Sarah reminds herself daily to keep pushing and always makes the conscious habit of expressing appreciation for things big and small.

Maybe it’s her perseverance, willpower, and admirable mindset that keep Sarah’s practice as strong as it ever was. She’s still living the dream and sees it as a privilege to provide exemplary, innovative, and effective dental care in a compassionate and comfortable environment. But Sarah couldn’t do it without her hard-working team, who aspire to promote a culture of inspiration, motivation, and love to all those they serve.

For Sarah, Family Matters the Most.

While Sarah finds dentistry extremely fulfilling, she has made a point to dial the hustle back and pour into her family more. Being the best mom she can be has filled her heart “unlike anything she ever expected.” Even better, she has the best partner in crime she could ask for: her college sweetheart and husband, Matthew.

Their two daughters, Lillian, 12, and Hannah, 9, are the light of their lives. They keep Sarah and Matthew busy with their activities, sports, and silliness—for Sarah, “each day is a new day.” She has found herself at more school events, particularly those related to volleyball. Sarah and Matthew opened a volleyball club and helped open a volleyball gym in their hometown of Aledo in April 2022.

When Sarah isn’t practicing in the office, bringing her children to sports, coaching volleyball games, or going to church and community events, she’s an avid continuing education supporter. This year, Sarah acquired her Master in the Academy of General Dentistry and is currently pursuing her Lifelong Learning and Service Recognition award.

Some Sage Advice From Sarah.

Last but not least, Sarah has some advice for dentists: for one, dental practices are loud places, and it wouldn’t hurt to invest in some filtration ear pieces to help salvage your hearing. But, on a more emotional level, Sarah urges her fellow dental professionals to never give up nor feel alone. She believes there is power behind joining a community of dentistry, and seeking fellowship with your peers or finding a mentor can go a long way.

In Sarah’s words: “The accountability, support, and challenges will grow you beyond what you could ever expect. It takes being meek and understanding that you don’t have to have all the answers all the time. Relying on others in the dental community is crucial when you feel like you are on an island and struggling. There are phenomenal resources to help affirm and carry you through your struggles.”

Dual cure resin cements are making it easier for me to feel like a good dentist.

CE courses are annoying.

The person up there on stage always seems to have it better than me. Their composite restorations somehow never result in sensitivity, their extractions never result in infection or dry socket, and their crowns all have beautiful margins, occlusal anatomy, and never come off.

Returning home to my practice, with my mediocre clinical skills, when patients would agree to treatment of any kind, there was always a small voice in the back of my head, reminding me of that one patient, a few weeks ago, who can’t chew on that new crown, and that other patient from a few months ago, who shreds their floss around that new class II restoration that I worked so hard on.

I truly wanted to be the best possible dentist, but reality was annoyingly standing in the way.

Zirconia crowns have created a revolution in general dentistry. They are so strong, so durable, and often, quite beautiful. When I first became a dentist in the early 2000s, my material choices for long term indirect restorations all seemed to have limitations. Many of those have been eliminated with the incredible growth in the advent of zirconia. There was only one problem: While they wouldn’t break, they would come off more often than the PFMs that they replaced. Patients would quickly forget about the fact that their new crown didn’t have a dark line near the gingiva, or that their new crown could be hit with a hammer without breaking, or that I didn’t need to hyper-reduce the occlusal surface of my prep, or that the anatomy was so pretty.

They would remember, however, how this is the second time that the new crown has come off in less than a year. A big reason for this was because I was using traditional cementation techniques from dental school, and hadn’t yet heard of the incredibly beneficial long-term features of dual cure adhesive resin cements, like the Visalys CemCore products from Kettenbach.

It was time to reach out to those annoying dentists. The ones who did full arch cases on a daily basis. The ones who owned those really expensive cameras and actually used them. The same annoying CE dentists who took pictures of their amazing houses and beautiful families and their six-pack abs and somehow interwove their superiority in dentistry and life into the content of their lecture slides. It was time for me to ask them, in no un-certain terms, what they were doing that I wasn’t.

Here is a very limited list of everything they said:

• Selective etch

• Use bioactive composites

• Rubber dam everything, every time, as much as possible

• Use the Gow-Gates method to anesthetize the mandible

• Drill less, air abrade more

• Use your intra-oral camera for greater magnification and to identify areas you might have missed

• Quit being so whiney

Ok, ok, but what about my zirconia crowns that come off, especially 18 and 31, where I really can’t prep more retentive walls without violating biologic width? (Here is where I would add a photo of a very short prep)

The answer, while not simple, was consistent, and it wasn’t at all what I was already doing. Utilizing a dual-cure adhesive resin, like the Visalys CemCore from Kettenbach, creates a system to consistently do the following:

1. Try on the crown and do whatever adjustments and polish are needed

2. Air-abrade/sand-blast the inside of the crown

3. Use a crown detergent like IvoClean or BisClean to remove impurities and residual sand from the inside of the crown. Make sure to scrub it in as recommended, and rinse it off well

4. Dry the inside of the crown

5. Dry the tooth

6. (Optional, but I do this especially if the tooth has been endodontically treated) - etch the tooth, especially any enamel at the margins

7. Apply Visalys restorative primer to the inside of the Zirconia crown, scrub it in, and dry

8. Apply Visalys tooth primer to the tooth, scrub it in, air dry, and cure

9. Then (finally), mix the Visalys dual-cure resin cement, CemCore, apply to the inside of the crown, and seat it

10. Cure for a couple seconds

11. Remove the excess cement (this is very easy and quite satisfying with this type of cement)

12. Fully cure

Is this necessary for all cementation? No. Often, ideal prep’s retentive design require no crafty highly evolved cementation technique and technology. However, as you know, dentistry is messy, and rarely ideal.

After using this technique for a while, I noticed another wonderful quality of certain dual cure resin cements. The fact that CemCore is made with resin particles means that their cured chemical make-up closely resembles that of a core buildup. This has provided benefit in two key ways. First, when removing the temporary crown, either a bit of the original core buildup or a piece of the tooth sometimes comes with it. Knowing that the CemCore will fill in that gap provides me with a lot more reassurance. Second, there are times in which we determine that the tooth requires endodontic therapy after it has been prepped for a crown and a final impression or scan has been done. This leaves us with a finished crown from the lab, but a rather large void inside the original scanned build-up where the endodontic access was prepped. Using CemCore by Kettenbach allows me to fill in the gap without feeling like I am taking some sort of short cut.

Dentistry continues to provide difficult, messy, and unpredictable clinical episodes, but happily, crowns needing re-cementation no longer are a part of that list. Now if only I can figure out how to eliminate all the others. . .