Choose Wisely

Choose Wisely

The Editors:

When a member of the Publications Committee nominated Dr. Edgar Ziegler as a profile subject, the first thing we were told was, “He is a teacher.” Indeed. Northwest Dentistry has since spent some very instructive time with this highly honored and well loved pillar of the Operative Division of the Department of Restorative Dentistry at the University of Minnesota School of Dentistry. We were engaged by a man whose perspective includes a literal professional lifetime of varied experience that bridges “then” and “now” and teaches by example that being prepared for whatever the future may bring is a key to making a continuing contribution and a fulfilling life.
The Editors

NWD: We always begin with some personal background: where you were born and raised, education, often service following graduation, and finally how you chose dentistry as a career.

Dr. Ziegler: I was born February 17, 1930, in Perham in west central Minnesota, and I grew up there. My mother died in 1933, and after a short time with grandparents in Detroit Lakes, I returned to Perham when my father remarried. A German immigrant, my father was a barber, but he did a lot of women’s styling like marcelling. I had several powerful influences on me as a child. I had a wonderful stepmother who was to me my second mother. My teacher/principal in grade school gave us an ethical world view, and our “small town” pastor taught us comparative religions! Sports was a big thing for me, and our coach was a great teacher about life: Always play to win, even though you won’t always win.

It was the Depression, but there was some money around, and in 1937 my dad had saved enough silver dollars from tourists* to take us to Germany to see his parents. What an experience for a seven-year-old! I spoke German before I spoke English, so I could talk to my grandparents. They were thrilled. And in September, I got to see the entire hierarchy of the Third Reich at the big partei tag parade in Nuremberg. The route was lined with the elite SS guard in their dress black uniforms. I remember hearing a whistle, then saw every other one turn, and they all locked hands to create a barrier that could scan the crowd and the street. I was getting tired, and one of them said, “Rest your chin on our hands.” That was how I watched the parade. Hitler, Goering, Goebbels, all of them went by. I will never forget any of it.

It was our local dentist, Dr. Russell Johnson, who suggested I pursue a career in dentistry. Graduating from high school in 1948, I went to the University of Minnesota to pursue a dental career, and to play football for the legendary Bernie Bierman. I did my pre-dental education in two years, which was an option then. We had not only GI bill students but the first of the second-career students in our class of 104, from which we graduated 78 in 1954. I finally made the football team in 1950, losing two central incisors to an elbow in the process! And in high contrast to today, I graduated with no debt, thanks to my mother’s father and an uncle.

In 1954 I graduated, got married, took my boards, and by July 1 was in the Army and on my way to Germany. The military experience was a great General Practice Residency for me, and almost like running an independent practice. I came home in June of 1956, and I bought a one-chair, one-operatory practice in Chaska for $4,000. I could stand by the chair, open the window, reach my instruments, write in my appointment book, and open the door to the waiting room from the same spot! In 1959, we moved from there into the building we helped build.

NWD: Which came first, participation in organized dentistry or starting to teach at the School of Dentistry?

Dr. Ziegler: The two are inseparable. I immediately started attending Minneapolis District meetings, more as a learner. But you know if you show up often enough, they’ll ask you to do something. In 1956, Dr. Bill Braasch was my mentor. Whatever I have accomplished in dentistry I owe to him. He officed with Dr. James Jensen, and it was Jim who offered me my first teaching position. In 1962 I went part-time in operative one day a week. I loved the challenge and opportunity of working with students. Then Bill encouraged me to take my interest in intraoral photography to presenting table clinics. I was juggling all this when MDA president Don Johnson asked me to join the officer ladder. From 1979 to 1983 I was intimately involved at the MDA, and was privileged to host the Association’s centennial celebration. The two big issues that year were “busyness” and the subsequent “Word of Mouth” campaign, and direct reimbursement. As for practice and teaching, clinical procedures had been pretty stable from 1954 to 1980, but then the world changed, and we were confronted with a veritable explosion of treatment options for our patients, which continue to this day.

I taught from 1962 to 1987, then took a five-year hiatus to manage changes in my practice. I returned to teaching in ’92, retired from practice in ’94, and in ’95 began teaching full time four days a week. It was a love that had kept calling to me, but also, and I have to stress this, this second career has been an important piece of my retirement puzzle.

I was mayor of Chaska from 1968 to 1975, and I have participated in many levels of involvement with both my church and the MDA (1968-1983, when my term as MDA president ended).

My current five-year contract at the School is up in 2010. I was among the first to be honored with a full professorship as a part-timer, but now I’m an Associate Clinical Dental Specialist. The teaching is 100% hands-on. I do clinical instruction and three lectures a year on case studies of lifetime patients from my former practice in Chaska. I stress that “lifetime” with students, that we must strive for the best quality we can possibly attain with our procedures, and if we do that, the longevity of dentistry is absolutely phenomenal, a potential lifetime service.

NWD: What are the opportunities the School offers you as a teacher?

Dr. Ziegler: You try to make every student and his or her patient encounter an optimal learning experience, and that never changes. The patient always has to come first. In doing that, you hope the student grows in competence and professionalism. The latter is very hard to define. It should mean establish trust with the patient; gain his or her confidence, and communicate that our recommendations are the best possible solutions for their circumstances. Some graduates do struggle with that last piece.

NWD: Tell us about students, then and now.

Dr. Ziegler: This is a whole different world from my time as a student. My class had four women in it, and that was unusual for that time. Now we are approximately 60/40 (40% female). As well, average age of students has increased dramatically because almost all have baccalaureate degrees, and we are also impacted by second-career students. There is actually an issue with distribution in that two individuals who meet here and marry leave as one practice. Older students also have family demands that have to be factored in.

Today’s students are all eager to learn, but times have changed. There was in my time an almost deliberate attempt to get rid of 20% of the class, due to inadequate pre-dental training elsewhere, and to A.B. Hall’s ideas about preparing dentists to practice. Not true now. Therefore the pressures then do not exist now, and today’s students lack the intensity that went with that time. It does change your teaching. I talk all the time about context for a specific procedure we’re doing, its ramifications, to make it a total learning experience.

NWD: Taking the long view, what are some of the watersheds you think are significant as you look back over your professional journey?

Dr. Ziegler: The dentists of the 40s, 50s, and early 60s changed the public’s attitude from “dentures are inevitable” to “I can keep my teeth for a lifetime.” I am very proud of that. It had a huge impact on the acceptance of orthodontics in particular.

NWD: Let’s talk a little politics. You were mayor of Chaska from 1968 to 1975. That’s about as literal a “community leader” as it can get. How did that occur?

Dr. Ziegler: My interest goes back to my father, who grew up under Kaiser Wilhelm. He never wore a uniform, but he learned his trade shaving the German war wounded, and it profoundly affected his thinking. The father of my best friend in high school was another role model for community service. Being mayor of Chaska was a great experience, from the “new town” of Jonathan to meeting state leaders to the challenge of several years of flooding. It taught me that there a lot of ways to serve. Just look around.

NWD: Discussing dental practice in the long view, what’s working, what’s changing, and what do you think needs to change?

Dr. Ziegler: Solo practice is not nearly as prominent as it used to be, driven by operating costs. Number of days working has changed, and I’m a bit envious of that. There is much greater utilization of specialists today. Scope of practice and spectrum of services is now so broad one individual cannot present 100% competence in everything.
We need to foster strong dentist/patient relationships. A dentist needs to have a sense of ownership and responsibility for the long-term oral health of the person who has entrusted his or her care to him. We are not dispensing a commodity, but an oral health service.

As for access to care, I believe the main problem is cost. Dentistry has become expensive for a lot of people. I believe there is a “borderline MA” segment of our society for whom dentistry does not show value for dollars. We certainly have access issues here in the Metro and outstate. Solutions I see include:

1. Good quality care to reduce reappointments and to open time for new dental treatment.
2. I believe there is absolutely no reason for the bulk of our patients to be seen every six months, the reason being advances in the understanding of how fluoride works — i.e., the topical advantage. That can be lost with vigorous prophy work. Changing the six-month schedule would create an insurance, and thus health care, benefit by getting more dentistry done for the same amount of money. Fluoridated, and tartar control toothpastes or dentifrice in particular, have convinced me this is a valid viewpoint.
3. To my profession, and my students in particular, I would say I believe there needs to be a more diligent interjection of preventive measures for the patient on the part of the dentist. We need to customize the home care procedures with more due diligence.

NWD: What do you do to relax and have fun? What are your plans for the future?

Dr. Ziegler: This is where I must first express my complete and lifelong appreciation of the sacrifices my wife Ruth and our sons Michael and Robert have made so that I could be as involved in politics, church, and the School as I have been. Very simply, they made it possible.

Free time? What there was, then and now, is family time, including time out of the office to go to their activities. [laughs] No golf! Ruth and I have six grandchildren. We also enjoy our cabin on Little Pine Lake, back home near Perham. We have done some traveling: the Holy Land, Turkey, Germany. When I retire, she and I will hang up our traveling shoes and find a selection of service activites here.

NWD: You have shown us what has added up to make you who you are: a general practitioner, an organized dentistry activist, a teacher, an involved community member. How has your personal philosophy supported you in all this? How did you, in effect, “find your place”?

Dr. Ziegler: I have mentioned my family, and very strong for all of us is our faith life, in a sense living a worry-free life with no fear of the afterlife because of what Christ did for us. I subscribe to the Judeo-Christian Code of Ethics. I have never imposed my religion or my values with my patients, but I have viewed each of them as one of God’s creatures, and I believe that my responsibility to them is the same as my responsibility to myself to stay a productive, contributing member of society. My teaching philosophy has been that I practiced what I taught, and I taught what I practiced. I would encourage all my colleagues in strong family relationships. Make them first in your life, and strive every day to understand how that works.