As a leading dental group practice, we always strive for the best quality of care using the most innovative technology for our dental and medical care. In order to better accommodate many of our patients, we started to incorporate advanced endodontics (Complex Root Canal Treatment) in our office. We researched for various types of dental microscopes to improve our quality of care. One brand stood out above the rest: Zeiss, an internationally technology leader operating in the fields of optics and optoelectronics. Since it’s formation in 1846 in Germany, Zeiss has transformed into a large, research-oriented company that distributes a host of optical products across the world and is well known by almost every surgeon as the best of the best when it comes to optical accuracy. Early in 2019 we decided to add the Zeiss dental microscope to our office to join our growing list of advanced technology.
For over a century, we as dentists have used various different materials to take molds (impressions) of the hard and soft tissue in the oral cavity. Many patients had no choice but to put up with it, while others suffered through gagging or left with a snack – otherwise known as extra dental fluff in their mouth. Advances in dental technology came out with other ways of doing these impressions digitally- one of the first was Sirona CEREC. Some brave dentists immediately jumped on board thinking it was the greatest thing since sliced bread. These advanced machines were used to create dental restorations, such as crowns without the use of that dental “GOOP” abhorred by so many patients. I held back during that time, because I did not want to be the first to experiment with this technology without seeing a reliable track record. Not long after, a major flaw was soon discovered…These machines were not as accurate as the dental “GOOP” or standard PVS impression material, causing many patients to return to those dental offices with inadequate dental restorations, such as leaky margins or recurrent decay. Years passed by and the technology gradually improved to the point where certain companies were able to dramatically improve the accuracy. The American Dental Association recently published an unbiased study showing the following:
I realized why so many patient’s complained about having problems with other dental offices who do “Same Day Crowns” by Sirona CEREC in their own office. These Sirona CEREC machines used to take digital impressions and mill dental restorations such as crowns were faulty because their accuracy were the worst out of the six main intraoral scanners on the market. The accuracy of CEREC is even worse than than the best dental “GOOP” PVS impression, which has an accuracy of 10-20 µm (microns). After review of the ADA literature, obviously one digital scanner stood out: 3Shape TRIOS. Not one wanting to base my knowledge on just one study, I dived deeper and found that study after study the 3Shape always came out on top. A few months later, we purchased the 3Shape TRIOS Cart in August of 2017 and many patients were ecstatic. Having the most advanced/accurate digital scanner in the world, we try and use it for most of our dental and medical procedures today. However there are times when we have to go back to the standard dental “GOOP” material because of difficulty accessing the area and or distortions due to contaminants such as oral debris and bodily fluids.
Sunday, February 26, 2017
On Friday 2/24/2017 I volunteered for the ADA Give Kids a Smile Program at a preschool in Monrovia. Unfortunately I was the only non-staff volunteer dentist to participate. I know for a fact that they were doing mass emails to find other dentists to volunteer – I just feel an indescribable sadness because I was the only person to respond …
We provided oral examinations, oral hygiene instructions, and gift bags for over 72 kids from the ages of 2-5 years old. What I found interesting was that although a few number of kids needed proper oral hygiene instructions, I found no children with existing carious lesions. It was a far cry from 1999-2000 when I was volunteering at the USC Mobile Clinic; back then with those kids over 75% were in need of immediate dental work. Monrovia was obviously a much more affluent area than the cities that we visited with the USC Mobile Clinic. It’s days like these that remind me the stark differences in oral health between the impoverished areas and the more economically developed cities. While some of the reasons are a result of access to care, I believe the majority are the results of financial constraints.
February 3rd, 2017
Last night at around 8:00 pm, I sat at my desk in my group practice, looking at a pile of about 50 patient charts that I needed to finish up. I was thinking, how in the world was a going to write the closing eulogy for my dad’s funeral, taking place tomorrow? My thoughts were interrupted with the beeping of my cell phone. I looked down on my screen and saw that my sister, Serena, had sent me a text with a copy of her speech. My sister has always been the better writer in our family. Seeing how incredible her eulogy was made me feel proud, but at the same time, it made me apprehensive because I knew I would have to follow. Then as I scrolled further down my phone, I saw that Serena was trying to help me, by writing a rough draft of my closing eulogy. If Dad was with me last night; I could already imagine the look on his face – frowning down at me for trying to find the easy way out. That thought was all the encouragement I needed to throw out my sister’s draft and get to work.
Today, this morning on the day of the funeral, I was contemplating about what to say, while driving in the rain to a job site to pump and work on a feasibility plan to re-route or replace some septic tanks. It was ironic because when I was a kid, I remember my dad telling me, “You better work hard or you’ll be a garbage man.” I hope Dad would not be disappointed that this was one of those rare times that I proved him wrong. I was indeed working very hard … on preparing to oversee and design the septic system for a house. However technically since I was still working with sewage and garbage, I guess I could be misconstrued as a doctor who on his off days worked as a “garbage man.”
My dad’s relationship with me was not one of many words– he didn’t have to say a whole lot to get me going, just a simple look maybe a short statement and that would be enough. My father was a great man backed by an overwhelming number of accomplishments and yet he refused to accept his own greatness. To this day, I still remember the time he was helping me with my High School AP Physics class homework. He had come back from work late at night, had a small dinner and at around 11:00 PM, he was trying to teach me how to go about solving a complicated physics problem, without actually doing the work for me. I was frustrated and said something to the effect of, “I can’t do it on my own, I’m not smart like you.” There was an immediate pause as my dad lowered his head ever so slightly, looked directly up at me. Letting his glasses slide just barely down the bridge of his nose, he used those stern eyes to erase my last words. He then told me that he was not a very smart man, that he had above average intelligence and that he was only able to get by in life because he worked hard. As he said those very words, I looked up at the wall to see his PHD, various Masters degrees and other accolades. My dad had so many awards and patents that there was literally a pile of plaques stacked next to him because there was not enough wall space to hang everything. I think my dad was right; he was not a “smart man” … he was a genius.
In regards to that physics homework that he helped me with; well a problem similar to that appeared later when I attended college. I was sleeping and snoring obnoxiously loud in a chair during one my physics lecture at USC. This particular physics professor had a habit of embarrassing disruptive students. So he threw an eraser at me, to wake me up. The professor then told me to come up to the front and solve a difficult question on the board. So I got up, strode confidently to the front of the class and in my head I thanked my dad. I took that marker and with no hesitation, I solved that physics problem with ease. Afterwards, as I went to sit back down, most of the class went silent with astonishment – except of course for my friends, who were laughing and trying to high five me – they said something like, “Holy [blank], you are one smart [blank].” I just shook my head in denial and said, “I’m not smart, I just had a genius teacher.”
Fast forward to only a few weeks ago. I still remember when Dad was laying in his bed, fighting against all his ailments with more strength and courage than I could ever imagine. That day his mantra of telling me to work hard had changed. While by his bed side, he told me to not work as hard as him because life was short. Behind that simple statement, I knew he meant that he wished he could have spent more time with us as family, instead of always being out all day, working so hard to provide for us. In his final days at the hospital, the doctors were amazed that even though Dad looked deceivingly frail, he was incredibly strong and continued to fight, working hard for every breath … until the very end.
Dad would be extremely uncomfortable with all of us sharing these remarkable things about him. So, as we say goodbye to him, please remember the things we love so much about Dad. I know in his afterlife, he would be standing there with that great big smile and he would be so proud to see all the people here, who loved and admired him. I love you, Dad, and I’ll miss you more than any words can say.
Xie xie Fa Shi min, Hui Zhang Shao Yifu, Xiao Ai Yi,
gen Jin Zhong Shehui da hui renmen.
Xie xie dajai bang mang , hai you suoyou da qin qi gen pengyou. Xie Xie nimen lai.
On behalf of my family, I would like to thank everyone for being here today. We appreciate the Buddhist monks, the Amida Society president Uncle Jason Chen and Aunt BT Chen, Amida Society members, our relatives, and friends for spending the time to come out to honor our Dad. Burial services will be held this afternoon after 2:30 PM in my family’s burial grounds, at the Gardens of Contemplation. Thank you again.
Sunday, November 15, 2015
Recent advances in technology has allowed many dentists to apply 3D Cone Beam CT imaging to patient care in private practice. I took the plunge late in 2014, investing in one of the top rated 3D Cone Beam CT scanners in order to improve the quality of dental care for my patients. While most hospitals will charge around $1000 for a single scan, we charge only a small fraction of that cost. Less than one percent of the dentists in the world have this technology – in fact none of my current fellow cosmetic and general dental colleagues in my known network have one of these machines (as of November 2015). I’m sure most dentists may think it highly impractical to allocate such a large monetary sum towards technology that will not give an immediate return on investment. However in my humble opinion, the peace of mind that I am providing the best dental care for all my patients outweighs any monetary reward.
I have been very impressed with the accuracy of our imaging technology thus far. Below is a sample case of one of the methods of how we utilize our 3D Cone Beam CT in our practice. In these images we are maximizing both the length and diameter of each implant, thereby improving the retention and therefore the longevity of the implant. Please note the close proximity to the IA and mental nerve. Without this technology, many dentists may run the risk of damaging a nerve when placing implants of this size.
In February 2015, Dental Products Reports, one of the nation’s leading dental magazines interviewed our office to discuss our thoughts on this technology. More information can be found at
On April 27th, 2014, I had the rare chance to volunteer at a free dental clinic serving the volunteers that help run some of the medical/dental free outreach clinics. It’s rare when we receive the opportunity to help those that help others…I think we as humans get so involved with the donation of funds and services to others in need that we forget about helping those people who make it possible for us to do so. This was the very first free clinic geared towards helping the actual volunteers. To no surprise the oral health conditions of our fellow volunteers were excellent. The only services that I preformed that day were exams and cleanings. Nonetheless it felt great being able to give back to those who give…
Monday, August 26, 2013
After finally moving into our new facility, I compiled an inventory of dental supplies and equipment that I no longer needed. Estimated net worth of these items based off of comparative sales equates to over $4500.00. Once we were settled into our new office, I contacted Loma Linda School of Dentistry and arranged for a pick-up for my donation. For those other dentists, who do not realize, Loma Linda has international outreach missions of free clinics that are in dire need of dental equipment and supplies. Loma Linda runs these missions through NASDAD (National Association of Seventh-day Adventist Dentists) Should anyone wish to send in a donation please contact them at: 909-558-8187
The following month I was contacted by the director of the Tzu Chi Medical Foundation about their very first free medical and dental clinic in Orange County. This organization has been operating various mobile clinics throughout Southern California and Mexico for over a decade. I immediately made arrangements so that I would be able to volunteer and donate my services.
Upon arrival on 8/25/2013 in Santa Ana, I noticed that while there were a lot of patients in the waiting area, the numbers were not anywhere near what I am used to experiencing in the free clinics in San Bernardino and Mexico. Perhaps the population in Orange County were not as financially strapped and therefore did not need as many of these free services? I was immediately ushered into the mobile unit and assigned to perform surgical extractions and fillings.
What I felt was nice, was that they assigned 1-2 assistants to help me with my dental surgeries. Normally the doctors at free clinics receive 0 – 1 assistants – so this was a pleasant surprise. These assistants were also volunteers – the lady in the photo is a retired molecular biologist, while the gentleman was an engineer. Because this was Tzu Chi’s very first free clinic in Orange County, it took the organization almost an hour before we were able to see patients. Therefore we started around 10 am and ended at 2:30 pm. Even though the duration of this free clinic was shortened, I was still able to see about 12 patients, all with procedures such as scaling and root planning, fillings and surgical extractions. In general, I did notice that the oral health of patients here in Santa Ana were definitely in better condition than that of the patients in the San Bernardino and LA counties. However regardless of the conditions of their teeth, all these patients were in need of dental work, and all of them were very grateful that we provided them with our services.
Posted by Dr. Brien Hsu at 1:04 PM
Wednesday, May 23, 2012
Recently we had a break-in at our construction site for our new facility. The burglars basically stole some materials and cut out copper piping, medical gas piping and electrical wiring in the building. When we reported the crime to the Rancho Cucamonga Sheriffs Dept, we found out that these incidents have been very common especially during these times. It’s frustrating because the amount of money the thieves made from selling the copper and metal was nothing compared to the repairs we would have to do for our office. Luckily my partners and I have insurance and most of the damages should be covered… It just puts yet another delay on our anticipated move date.
FYI : for those patients who are not aware yet, we are moving to a new dental office in the same shopping center in the next few months.
It’s interesting, the theft occurred earlier in May and I thought to myself our economy most be getting worse … if people would go that far to make a buck. Yet last week-end, I went to volunteer at another free-clinic in San Bernardino and I was prepared for a long day with long lines of patients…
I was shocked the lines were short and the work needed by many of the patients were quite minor. I saw about 16 patients and was done early in the afternoon. When I left that day, I felt great – not only because I was able to help people who cannot afford dental care, but the place being less packed translated into what I believe is a sign that the economy is getting better…which means all my patients who have suffered losses the past few years may finally be seeing the light at the end of the dark financial tunnel!
In the month of October 2011, a colleague and I visited the American Dental Association Convention in Las Vegas at Mandalay Bay. It never ceases to amaze me as to how may dentists and auxiliary staff attend these annual sessions. Every year the ADA rotates the site for this convention – and this year it happens to land in Las Vegas. The typical set up of these large annual meetings are the first floor containing exhibits on new dental technology and materials and on the floors above, classes are held for dental related continuing education. This year there must have been over forty thousand attendees … perhaps many of them here because they wanted to gamble afterwards?
In total I spent 2 days at this convention – which I felt was not enough. Visiting the many booths help me upgrade all my necessary dental materials such as my dental composite materials and prepared me with a list of many other dental upgrades to come in our new office that was currently under construction. The classes I took up on the 2nd and 3rd floor, as always, were helpful in broadening and improving my knowledge on my dental surgery skills and education.
Posted by Dr. Brien Hsu at 9:13 PM