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Interview with Ernie Ward III, July 4, 2005 | UNCW Archives and Special Collections Online Database

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Interview with Ernie Ward III, July 4, 2005
July 4, 2005
Dr. Ernie Ward III, a second-generation dentist, discusses his dental education and training in personal detail. He also touches on changes and advances in dental techniques, the computerization of the dental office, and the growing, media-influenced popularity of "glamour dentistry."
Phys. Desc:

Interviewee: Ward III, Ernie Interviewer: Zarbock, Paul Date of Interview: 7/4/2005 Series: SENC Health Services (Dentistry) Length 50:27

Zarbock: Good afternoon. My name is Paul Zarbock. Today is the 4th of July in the year 2005. And we're recording in Whiteville, North Carolina. This videotape is part of the collection used in the Healthcare Delivery System and the professional personnel who people that space. Today's interviewee is Ernie Ward III. Ernie Ward III is a doctor of dental surgery, practicing in private practice here in Whiteville. There may be somewhat random noises in the back. It is the 4th of July. And this is a family activity. And I'm very grateful to Dr. Ward for taking the time to make this tape. Good afternoon, sir and how are you?

Ernie Ward III: Good afternoon, you. Doing well, thank you.

Zarbock: Tell me what event or series of events or individual or series of individuals led you into the selection of dentistry as a profession?

Ernie Ward III: Well, I'd have to say, probably, number one is my father, who is also a dentist. Of course, growing up, seeing him practice and being around the profession, I think, has certainly put that in the back of my mind. I always knew I kind of wanted to- to be in some type of health profession. Uhm.. and growing up-- and in high school, we had a- a, kind of, a senior workweek, where I visited some professionals and worked with them. Uhm.. I worked with an optometrist for a while. Uh.. but it wasn't until about, I guess, my sophomore year in college before I realized I- I decided I wanted to- or I needed to make a decision to go do something besides play soccer. Which is what, kind of, took me towards the college ranks to start with. Uhm.. so I talked to Dad a little bit and uh.. decided that I think- thought I wanted to go towards dentistry. And he never really pushed me one way or the other. He was always very supportive of me in any decision I made. But I started taking the science courses and the prerequisites and uh.. it just, kind of, evolved from that.

Zarbock: Let me probe that a little bit. Your father was in private practice--

Ernie Ward III: That's right.

Zarbock: In Columbus County; is that correct?

Ernie Ward III: Right.

Zarbock: And he worked--

Ernie Ward III: I'm sorry.

Zarbock: I'm sorry. He provided patient care in what town?

Ernie Ward III: Whiteville.

Zarbock: In Whiteville?

Ernie Ward III: Yeah, started out in Chadbourn, actually, about seven miles away. And then, he was--

Zarbock: You mean, the metropolitan center, isn't it?

Ernie Ward III: That's right. That's right. And then, he uh.. he went to the Korean War. And when he came back, somebody had uh.. moved in this area, a dentist, so he--that's what brought him to White.

Zarbock: For the record, would the transcriber please note that there is a videotape of Father available on tape. So you went to college and you got interested in science? By the way--

Ernie Ward III: Yes.

Zarbock: Did you make model airplanes and model trains?

Ernie Ward III: I did not. I was not much of a- a of- of a model person. Uh.. I did do a lot of things with my hands. Uhm.. I was more into playing ball than anything. And I think that's eventually what uh.. got me to the college that I attended was- was actually playing soccer. So I- I didn't- didn't have a whole lot of aca- academics on my mind when I first went to college. But I realized I couldn't play professional soccer. So I realized I needed to, kind of, buckle down and start- start studying a little bit, about my second year or so. That's when I started deciding that I needed to decide what I wanted to do and start working towards it.

Zarbock: Okay. Of course, dentistry is a graduate program. So when did you finish your undergraduate degree?

Ernie Ward III: I finished the undergraduate degree in- in 1986. Uh.. attended a small Liberal Arts college. It was called Atlantic Christian College and now, it's called Barton College, in Wilson, North Carolina. And then, graduated from- from there and then, attended dental school from 1986 to 1990.

Zarbock: Why did you attend the small-- it was a Liberal Arts college?

Ernie Ward III: Yeah, uh.. there again, it was uh.. to play- to play soccer.

Zarbock: Okay.

Ernie Ward III: Yeah, it was a small school. I wasn't good enough to play at the big schools. So I uh.. talked to the coach there and uh.. he offered me a walk on position, you know, so I could walk on, try out. I made the team, uh.. started playing soccer. I played for three years. And then, my last year, decided I'd better just focus on the books and- and did not play my last year, and just, kind of, started preparing for the entrance exams to dental school. And- and that type of thing.

Zarbock: What courses did you enjoy, Doctor?

Ernie Ward III: Well, uh.. I- I--

Zarbock: And maybe, enjoy is too strong a word.

Ernie Ward III: Yeah, I- I enjoyed most of the science courses. Uhm.. I started off with Botany and- and uh.. that was- that was one eye opening experience. Uhm.. welcome to college, made a- made a "D" in that course and decided that was, kind of, a wake up call. And uh.. that was one of the times, you know, I realized I needed to start studying a little bit more. Yeah, so uh.. I- I retook that and uh.. and made an "A" in it, and decided, Okay. Well, I'd better start getting a little bit more serious about this thing.

Zarbock: Now, you're an older man of what, maybe, 19 or 20?

Ernie Ward III: At the time, yeah- yeah, about 19.

Zarbock: Okay.

Ernie Ward III: Um-hum.

Zarbock: So the wake up call came relatively early in your life.

Ernie Ward III: Early on. Yeah, that first- that first year really uhm.. this is not high school anymore. You'd better start studying, son.

Zarbock: Did your father, as a dentist, did he say, "Shape up or ship out," or anything like that?

Ernie Ward III: Well, no, he didn't. He- he never was that- that type of parent. He was, you know, thankfully, he was always very supportive. And uh.. you know, I- I remember when I was in dental school, talking to him on the phone and, you know, complaining about how hard it was. And- and, you know, uh.. how tough it was. And he was- he was saying-- he- he wrote me a letter one time. And he- he told me just to stick in there. You know, uh.. "You'll do fine." Sometimes when I'm-- he- he was s- saying to me, "Sometimes when I'm- when I'm talking to you, it's almost like I'm reliving this experience through myself." You know, which is very interesting to me. "It's almost like I'm doing it all over again." 'Cause he struggled just like I did. You know, we- I- I think we both were the type that didn't really grasp things quickly and, you know, read it one time and get it. You know, I think we both had to work very hard to- to get where we are and to get- get through school. So I- I thought that was always, kind of, special--

Zarbock: Okay.

Ernie Ward III: --when he- when he told me that.

Zarbock: So you graduated, probably, age 21, 22?

Ernie Ward III: Yeah, somewhere thereabout. Yeah.

Zarbock: Okay. And you had made application where?

Ernie Ward III: Uh.. applied to- to dental school?

Zarbock: Yes.

Ernie Ward III: Yeah, uhm.. applied to- I think I only applied to University of South Carolina and University of North Carolina. Uhm.. and grade- my grades weren't that great at that time. And thank- thank the Lord, it wasn't as tough as it is now. You know, I'll tell you what, you have to be top 3 percent, I think, practically, in your class, now. And you have to have the aptitude test and, you know, top notch. So- but uhm.. luckily, in those days, the competition w- wasn't as- as tough. Uh.. but I- I was accepted into the University of South Carolina. At the last minute, uhm.. I think, I was practically packing my bags to go to South Carolina, and the University of North Carolina, uh.. let me know that I was accepted there. So I decided to stay in state. And uh.. that's- that's really where I w- wanted to go. So it worked out.

Zarbock: There was a time in dental education, during the application process, that the applicant was given a piece of chalk or some other material and told to carve, either a tooth or some sort of geometric or some sort of object. Was that part of your application?

Ernie Ward III: No. Thank God, it was not. Uh.. I understand Dad had to do that. He had to carve a tooth out of a, basically, a block of chalk or- or some material. Uhm.. we had to do that after we were in dental school. You know, uh.. we had to carve uh.. different structures. We had to wax up different uhm.. teeth forms--

Zarbock: I'm sorry. What do you mean wax up?

Ernie Ward III: Wax up is if you've ever had a crown uh.. fabricated, made uh.. in your mouth, they take an impression after they prepare the tooth for the crown, after they use uh.. the drill. They take an impression and they pour that up in a dental plaster. They send that to a lab. And the lab will, actually, put wax on that form and make it look like a tooth. And then, they use a lost wax technique to actually fabricate a- a crown casted out of a metal. You can use, you know, like, a cast gold crown or that- that metal can be cast. And then, porcelain can be baked on top of that for a white crown. So if you've been to the dentist and you've had an impression for a crown or a bridge that's part of the process. Uhm.. so, you know, in the early days of dental school, we had to wax up different teeth and we were graded on the shape, the form, uh.. the function and how it looked and so forth, the anatomy. Uh.. but I did not have to carve one out of a rock, like Dad did, as part of the uh.. entrance process, is- is what I understand, used to be. But--

Zarbock: One of the things I've learned, during the series of interviews that I've conducted with dentists, is enormous change in dentistry in the last 25, 40, 50 years. Well, when this videotape is shown 45, 50 years from now, that which you're saying is going to be, I think, historically relevant. "Wow. Is that what they did then?" So here we go. You're now a first year dental student; is that correct?

Ernie Ward III: Um-hum.

Zarbock: And you show up at dental school. And did they give you a white coat or anything like that?

Ernie Ward III: We did- we did get a white coat; lab--

Zarbock: And what did you do the first year in dental school?

Ernie Ward III: First year?

Zarbock: Yeah.

Ernie Ward III: Part of it was the waxing. You know, the waxing of the teeth. Uhm..

Zarbock: So you were involved in clinical activity?

Ernie Ward III: Yeah, somewhat. I think, we actually- they gave us some uh.. a few extracted teeth to practice drilling on. And uh.. dentists around the state will donate teeth that they've extracted to the dental school. And they- they collect these teeth. And uh.. one of the first- the first time I ever drilled on a tooth, it was an- an extracted tooth. You know, just a simple drilling and filling procedure. Uh.. but they, also, use-- they had people, I think, they were second and third year students, or they may even have been earlier students, uh.. would actually take all these extracted teeth and they'd put them in an artificial gum. And they would put it in a mannequin. And that's how we practiced dentistry, on this mannequin, on real teeth and artificial gum. And that- that's how we learned how to- how to drill on teeth. Uhm.. so I- y- you know, it was great- it was great that we had real teeth, uh.. real teeth to work on. And uh.. you know, it's- we also trained with gloves. And uh.. you know, I don't know exactly when they started using gloves. But uh.. of course, Dad had to-- the interesting thing about him, he practiced 30 years before he had to start using gloves. And can you imagine the tactile sensitivity, you know, of using your fingers that long without anything on them and then, having to switch?

Zarbock: And suddenly diminish that.

Ernie Ward III: Right. Then you- your tactile--

Zarbock: Sensitive.

Ernie Ward III: Sensitivity diminishes; right. Uhm.. so he had to make that transition, which, you know, that had to be tough. So I'm thankful that I was trained with gloves and did not have to make that- that transition.

Zarbock: Gloves, yes. But mask, no?

Ernie Ward III: We did- we did train with masks, as well.

Zarbock: You did?

Ernie Ward III: Right. Uhm.. you know, the smoke from the- from the teeth when you're drilling on them.

Zarbock: Yeah.

Ernie Ward III: Uhm.. we used those so we wouldn't have to inhale the- the dust and so forth, you know. Uh.. so that's- that's, kind of, what we did the first few years. I think, maybe, our second year, uh.. the first year, I think, we, maybe, cleaned some teeth towards the second part of the year, started cleaning some teeth. But uh.. we didn't actually drill a tooth. _______--

Zarbock: But there are classroom activities?

Ernie Ward III: Oh, yeah- yeah. We started classroom activities that first year.

Zarbock: What did they consist of? You've had your basic Chemistry, Physiology..

Ernie Ward III: We- we took Physiology. We took uh.. Anatomy, uh.. Chemistry, uhm.. Cell Biology. You know, that- that type of thing. Uhm..

Zarbock: Did you have to dissect a head?

Ernie Ward III: We did- we did. Uh.. just a neck up. We didn't have to do the entire body. And I don't know, you know, if- if uh.. Dad may- he may have had to do more than that. I understand years back that- that they may have had to do the whole entire body. But we just had to do the neck- the neck up.

Zarbock: What was that like?

Ernie Ward III: Uh..

Zarbock: How was it done? I mean, you show up some place and somebody gives you a head in a box?

Ernie Ward III: That's right. Uh.. we pull up--

Zarbock: It's not some sort of styrofoam thing?

Ernie Ward III: They bring- well, they bring out uh.. cadavers. And uh.. you know, everybody's trying to find a skinny one so that the musculature can be seen real well and d- it's- it's very defined. You know, and- and I- it- I got a- I got a chubby one. So uh.. we didn't get a good selection. But if you- if you don't have the fat tissues, you know, you can see all the anatomy real well. Uhm.. and that's part of the learning experience, learning the anatomy, all the features, the nerves, the muscles, the bones. Uhm.. so uh.. that was interesting, you know, when you're-- I remember specifically one time when we had to- we had to section the skull, you know, right down the middle. And we had to do that with a saw. And I just thought that this is- it was, kind of, cool at the same time, but it was really, kind of, weird, too, as well, kind of strange.

Zarbock: It was a handsaw, not--

Ernie Ward III: Yeah.

Zarbock: Not electric saw?

Ernie Ward III: Yeah, it was a handsaw. Uhm.. if I remember correctly. Yeah, it wasn't a- it wasn't an electric one. But we had to do that so that we could see the internal structures uh.. you know, with that certain slice. Uh.. but that was- it's, kind of, neat. You know, it was, uh.. but a little- little strange, too, uh.. sawing on someone who used to be, you know, among us, you know.

Zarbock: But events like that, doesn't it contribute to the notion that, "I'm really entering a very specific field," you know, "I'm entitled to do- This is a learning experience for me to do something very unusual."

Ernie Ward III: Yes.

Zarbock: Would that contribute?

Ernie Ward III: Yes. And I think uh.. you know, I felt, I guess, the word could be honored. Uh.. it was very special to be able to do that. Uhm.. and I- I felt very fortunate that the resources were there that we could do that. You know, and I'm- I'm assuming they still do that. Uhm.. they spend, what, 15 years.

Zarbock: I like the word "honored." Because if you did it and you weren't in that position, you'd be called a murderer.

Ernie Ward III: Yeah- yeah, that's true. (laughs) Or a little uh.. strange. But uhm..

Zarbock: Now, this is year number two when you're still in training. And this--

Ernie Ward III: I think that was year number one. And I think that was because we were taking Anatomy, uhm.. you know, along with this. Uh.. so I think that was the first- that was the first year. So that was one of our first experiences. Uh.. we jumped right into that anatomy.

Zarbock: How many students were in your class?

Ernie Ward III: Uh.. I think there were about 85 in my class.

Zarbock: How many women?

Ernie Ward III: Oh, that's a good question. Uhm.. I want to say, maybe, one uhm.. maybe, one-fourth were women at that time.

Zarbock: How many ended up three years later, of the 85?

Ernie Ward III: Uhm..

Zarbock: What was the drop out rate?

Ernie Ward III: Maybe, five dropped out. I don't think there were a lot that dropped out. Uhm.. it wasn't a large number, if I remember correctly. I think most of them __________--

Zarbock: So if you get in the gate--

Ernie Ward III: Yeah.

Zarbock: At the professional gate, there really is a commitment?

Ernie Ward III: Yeah, and I- I think, you- you really have to just not like what you're doing uh.. terribly to- to- or just be miserable or really, it's, kind of, hard not to stay in it. You know--

Zarbock: Before I get to your third year, let me quiz you about the faculty. Were they helpful? Were they less than helpful? Were they punitive? Were they all of the above, none of the above?

Ernie Ward III: Mostly, helpful. But- but all of the above. Uhm.. I had some- some just some wonderful professors and teachers uhm.. that I think truly cared about teaching and were very dedicated to what- what they did. Uh.. I had a- had a few that were from the old school, I guess. And we heard about them before we ever got there. Uh.. you know, legends, uhm.. the guys that you always uhm.. were scared to see their name beside yours when clinic time came. And you knew you were going to be checking to them, uh.. you started shaking in your boots and sweating, you know, heart rate go- going up.

Zarbock: Because why? They were so punitive?

Ernie Ward III: Yeah, and they were just uh.. they were- it- it was almost like they were there just to make you miserable, instead of teach you something. Uhm.. and I think, you know, I think they- they truly wanted to teach, but they just didn't know how to communicate. Uhm.. but I remember specifically, one time, this- one of these gentlemen that we just dreaded uh.. I walked to the clinic. And I saw his name beside mine. I knew I had to fill this tooth, and I was gonna be checking to him. Uhm.. so I was not feeling really perky at that point. And uh.. proceeded to treat the patient. And he uh.. he told me to do something to the edge of the tooth and uh.. not very clear about how he wanted me to do that. So I proceeded to do what I thought he told me to do to the edge of this tooth. Uhm.. and after I did that he came up and, basically, just started giving me a hard time.

Zarbock: In front of the patient?

Ernie Ward III: Yes, absolutely, in front of the patient. Uhm.. about what I had just done and walked off. So, you know, I proceeded to follow him, asking him, "Well, what did you want me to do?" And trying to, you know, trying to communicate with him. "Well, tell me what- tell me what you want me to do." So that's- that's some of the uh.. some of the- the not so enjoyable experiences of dental school. Uhm.. but those guys, I think, most of those are gone, now. But uh.. you just dreaded seeing these guys. And they were- they were definitely the minority, no doubt. But you, uh.. that was not a fun part of- of the educational experience. They just made life, kind of, miserable, and you dreaded seeing them come and uh.. I think it was communication, basically. They just didn't know how to communicate and just wanted to- as- it- we felt like they just wanted to make us miserable. And they did a pretty good job of it, too. (laughs)

Zarbock: Let me bump you into the third year of dental school. Here you are, experienced. Is the length of the coat, in dental school, an index of your status?

Ernie Ward III: No- no.

Zarbock: For example, you know, in medical school, the longer your coat, the more advanced you are.

Ernie Ward III: It didn't- length had nothing to do with it. Uh.. we had coats--

Zarbock: But there you are in the third year of dental school.

Ernie Ward III: Right.

Zarbock: Okay.

Ernie Ward III: Uhm.. well, we start, obviously, getting into more of the clinical treatment areas uhm..

Zarbock: People are taking you seriously, now.

Ernie Ward III: Yeah, we- we we're starting to think, you know, we're- we're somebody now. Uhm.. treating more patients. And we still have our uh.. our classes, our- our other subjects that we continue to take. Uhm.. but we're starting to get into more of the- the requi- prerequisites to get out of dental school, the requirements, I should say. Uhm.. we have to do so many crowns and so many bridges, so many silver fillings, so many white fillings. Uhm.. so many--

Zarbock: I'm sorry. What is a white filling?

Ernie Ward III: White filling is a- it's a filling made out of a, basically, a plastic material, composite resin material. And that's what uh.. we used in the front of the teeth so that we don't have to put a silver- dark silver filling in the front. And that- that material has advanced over the years. When Dad, you know, used to place those fillings in the '50's and the '60's, uhm.. it was an acrylic material that they used. And uh.. then, uh..

Zarbock: I'm sorry. Acrylic is what?

Ernie Ward III: It's a- it's another white material that they used uhm.. to fill front teeth. But now, they just a- they just advanced the materials to be more durable, more aesthetic, more polishable. As time goes on they just get better and better, better. They start uh.. the- the particles in there, they change the shape of the particles so they're more polishable so that they transmit light easier, uhm.. look more natural, more translucent, like real enamel on a tooth. So that- that just every year there's a new material coming out. Uhm..

Zarbock: But back to your third year of dental school. I led you astray. Sorry.

Ernie Ward III: Yeah, we uhm.. so we started doing more clinical procedures, uh.. started working on our- our requirements. Uhm.. and, you know, this day and age, too, there are less cavities than there used to be. So it was a little hard finding patients that had a certain type of cavity so that we could meet our requirements.

Zarbock: I'm sorry. There are different kinds of cavities?

Ernie Ward III: Yes. Like, there's- there's cavities on the chewing surfaces. There's a cavity, uh.. and we classify them, Class 1, 2, 3, 4, 5. There's cavities at the gum line. There's cavities between the teeth, which is what we call flossing cavities, like, where the floss snaps between the teeth. Well, we had to have- we had to do so many of each type of cavity to get our requirements. Uhm.. but there aren't as many cavities out there as there used to be. You know, with- with fluoride in the city water, now, uhm.. and dentistry progressing, uhm.. it's not as- not as easy to find decay as it used to be, especially, in a University town. You know, so-- but there's still some country folks out there and- that uh.. don't take such good care of their teeth. So there's still some cavities out there. Uhm.. but it's- it's not like it used to be. They--

Zarbock: Doctor, did you have to go recruit these patients?

Ernie Ward III: Well--

Zarbock: Or did the school provide you with--

Ernie Ward III: They provided--

Zarbock: --a number of 1, 2, 3, 4 and 5?

Ernie Ward III: They provided- they provided patients for us. But, you know, if- if those patients didn't have, in their mouths, what we needed, then, we had to go searching. Uhm.. we had to talk to other classmates and see if they had patients that- that had these types of uh.. needs that could meet our requirements. Uhm.. and then--

Zarbock: Now, this is in your third year of- of dental school.

Ernie Ward III: That's right.

Zarbock: And you're really looking for dental cadavers?

Ernie Ward III: That's right. If- if your patients didn't-- you just kept getting new patients, if you had to, uh.. to get what you need. And sometimes, that was a little bit of a challenge to find uh.. what you needed. You might get a new patient and they might not need- they might not need that Class 5 cavity that you need, you know, your last one to- as far as a requirement. So uhm.. it gets a little touchy there at the end. Uhm.. but it's all about getting those requirements done. And uh.. that's- that was part of the pressure. That- that was part of the really tough part for me is just getting that-- getting those requirements done. You know, you're in that third and fourth year just- just getting those things done so that you could graduate on time. And uh.. that was-that was kind of tough.

Zarbock: Now, theoretically, if you didn't have the correct number of patients per anomaly, am I correct, the possibility exists that you would not have graduated?

Ernie Ward III: That's- that's correct. That's correct. You know, I think everybody helped you do- everybody did everything they could to make sure you got those patients. There's no doubt about that. Uhm..

Zarbock: Despite the fact that you may have to go far afield to get them?

Ernie Ward III: That's- that's right. Uhm.. usually you could get them. Uhm.. but if it took you a- an extra week or so to find a patient or to get in some new patients and examine them to see if they needed that, you know, that's another week you spent. And if you're not real good at time management, and I was not, uh.. you know, your time starts running out on you. Uh.. so I think time management was one of the- one of the larger challenges for me.

Zarbock: Doctor, who paid for the dental care of a patient that you needed in order to graduate?

Ernie Ward III: They- they paid. Uhm..

Zarbock: They who?

Ernie Ward III: The patient paid. It was on a uh.. it was on a- a scale for- I- I don't know if it was the same as- as the low income Medicaid type patient would pay. But it was probably pretty close to that.

Zarbock: But there was a sliding scale, then?

Ernie Ward III: Yes- yes.

Zarbock: Okay.

Ernie Ward III: Yes. So they- they got- they got good quality care for a good price.

Zarbock: Well, okay. So you're in your third year of dental. Is there a fourth year?

Ernie Ward III: Yes- yes. And four- fourth year, kind of, more of the same.

Zarbock: Well, by this time, you're, sort of, the cliché, "The cock of the walk."

Ernie Ward III: That's right- that's right. You see the light at the end of the tunnel, you think. Uh..

Zarbock: And what was the emphasis in the fourth year?

Ernie Ward III: Well, it really- it really became time to get those requirements done, then. Uh.. you know, that's- that's when you had to get your final bridge done. You knew everybody was looking for a bridge to do. (laughs) Uh.. yeah, that's right. Uhm.. or your final inlay or onlay or crown. Uhm.. but we still- we still had some- some classwork to do, as well. But it- the main emphasis was--

Zarbock: Clinical.

Ernie Ward III: Clinical. Yeah, and uh.. getting your patients in, examining them, making sure you had all your- all your- your classifications of cavities to be done, your bridges, your crowns, your partials, your dentures. Uhm.. making sure you got it all done before May whatever it was, you know.

Zarbock: But this is drill and fill. What about oral cancer and gum disease and that type of thing?

Ernie Ward III: Yeah- yeah.

Zarbock: Was that cramped into it, too?

Ernie Ward III: Yes, it was. We had uhm.. we had periodonics, gum disease, we had to go into those clinics and- and spend time there. And we had to find patients that had the same thing as far as gum disease, Type 1, 2, and 3, 4 periodontal disease. And we had to treat patients with all types of that gum disease uh.. to- in order to graduate. Uhm..

Zarbock: What about care of the tongue?

Ernie Ward III: Part of oral pathology, uhm.. we had to spend time in the oral diagnostic area in the emergency clinic. And we had to- we had to examine patients and do an intraoral and extraoral exam. And uh.. that was a- another one of the gentlemen that was dreaded, you know, was the oral pathologist. He was famous for being very, very good, very thorough, very tough. Uh.. and what a- what a great place for a man to be tough, as far as an area where you might find cancer, for example. I mean, I- I'm thankful that the man took his job very seriously. And I'm glad that he was tough on us there. Uhm.. so pathology was another- another very challenging subject for me.

Zarbock: Well, there's a difference between being tough and being brutal.

Ernie Ward III: That's true- that's true. And he--

Zarbock: Are we entering into the world of brutality or was this just--

Ernie Ward III: Well, th- this gentleman--

Zarbock: Rigidly demanding?

Ernie Ward III: That's a good- good way to put it. And uh.. he was not brutal, and he was not disrespectful as some of the other gentlemen were. And there weren't many. But uh.. he would not drill you uh.. in front of a patient, you know, and- and he was respectful. But he demanded excellence.

Zarbock: It seems to me one of the most humiliating things that could be done would be for somebody who is the proctor to chastise the student in front of the patient.

Ernie Ward III: Um-hum. Uh..

Zarbock: I mean, you know, confidence just crashes down.

Ernie Ward III: Um-hum. You're- you're there and you're- you're learning. So you're nervous anyway, in front of the patients. You're trying to learn how to be confident and treat these people and- and uh.. try to instill confidence in these patients. And they know you're- you're learning. So they're a little bit tentative, I'm sure. But uh.. and then, you're trying to treat them and you have somebody come up and just tell you everything you're doing wrong in front of them. (laughs) You know, it doesn't make either one of you feel very good.

Zarbock: Kick the milk stool up.

Ernie Ward III: Right.

Zarbock: By the way, how much was spent in your professional training on developing confidence? Let me make that more broadly defined. How much was spent on the psychological aspects of patient care?

Ernie Ward III: That's a good question. A- a little bit. Uhm.. we had- we had some classes on- on psychology, uhm.. interaction with patients, uh.. personality types, you know, that type of thing. Uhm.. I think we could've used some more of that. You know, after being in practice now for a few years. Uh.. so im- so important to- to learn how other people react to- to certain things and how they communicate. Uh.. it's extremely important.

Zarbock: This is too important to lose this string of conversation. I'll come back to something else later.

Ernie Ward III: Um-hum.

Zarbock: Okay. How are patients approached by you? And by the way, have you ever heard of a dentist joke?

Ernie Ward III: (laughs) Well, how I approach patients. I, basically, approach every patient as if they're- and most of them, uh.. well, a right good many of them are- are pretty fearful, I think. And uh.. they don't exactly want to be there realistically. And uhm.. so I just try and approach every one of them by trying to put them at ease, uh.. making them feel comfortable.

Zarbock: How do you do that?

Ernie Ward III: Well, I try to-- I kind of learned this from Dad. I- I always try to put a hand on their shoulder and say, "How you doing?" First of all, and look them in the eye. And uh..

Zarbock: So there's body contact.

Ernie Ward III: Yeah, I th- I try to do that to start with. And smile and just uh.. ask them how they're doing. Start off with that and then, just try to- try and talk to them like a normal person in a normal setting. Which is, for them, is- is certainly harder when they're sitting in a chair and looking up at you and thinking about what you're gonna do and so forth. I just try to put them uh.. put them at ease and just try to talk normally to them, I think, like you would- like you'd talk to- to you or anybody else.

Zarbock: Curiously enough, I was attended by a dentist this week. And the first thing he asked me was, "Why are you here?" And I thought, what a great question.

Ernie Ward III: Yeah, it is.

Zarbock: I've never had a dentist ever ask me why am I here.

Ernie Ward III: That is a great question. Es- especially if it's your first visit--

Zarbock: Correct.

Ernie Ward III: With that particular dentist. Uh.. 'cause you're trying to- that's- you're trying to figure out what- what they're thinking, what's their chief complaint. Yeah, that's a great question. Why are you here? What do you want from this? Uh.. great question. I think more people need to do that. I need to do that more.

Zarbock: Let me shuffle you back to, there you are, your final year of dental school. And the day arises and you are, "ta-dah," D.D.S. And what year was that?

Ernie Ward III: That was 1990.

Zarbock: And how old were you?

Ernie Ward III: Oh, let's see. I was 25- 25 years old.

Zarbock: Married, single, what?

Ernie Ward III: Single. I was single.

Zarbock: And you leave the school of dentistry and where do you go?

Ernie Ward III: I go back to the big city of Whiteville, North Carolina, and join my practice with my dad. Uhm..

Zarbock: You- you and your father joined the same practice?

Ernie Ward III: Um-hum. Yeah, we uhm.. I was very fortunate to uh.. have a place to go, a building and equipment there and a patient base, you know, that he- he shared with me. So I was extremely fortunate to be able to do that and just practically start working immediately.

Zarbock: One of the things that dentists who graduated early said, "I didn't know how to run a business."

Ernie Ward III: Um-hum.

Zarbock: "I know how to drill and fill. I know how the anesthetics and all (inaudible). But, you know, somebody has to tell me the business. I don't understand the business. I had a very quick crash course." Am I correct that Dad had a business support system--

Ernie Ward III: Um-hum.

Zarbock: And so you didn't have to stumble through that?

Ernie Ward III: I did not have to stumble through that like a lot of folks have to do. And that- that is a--

Zarbock: And by the way, that's not a criticism.

Ernie Ward III: Oh, I know. Yeah.

Zarbock: Professional schools are oriented towards providing the best clinical education they can provide.

Ernie Ward III: Absolutely.

Zarbock: Not business administration.

Ernie Ward III: Yeah, I- I think, if you were to ask me what- what could they have added in the curriculum, it would certainly be more business and more psychology like we talked about earlier. I think both of those would be- I think it would be- it'd be great to have an extra year, you know, in dental school. I was talking to a colleague the- recently about that. Uhm.. I- I think it's needed.

Zarbock: You mean, a fifth year of dental--

Ernie Ward III: Yeah, I do. Uhm.. just to- you know, you just can't practice enough. And- and I think the business aspect of it and the psychology involved uhm.. I think that would be a good thing. But uh.. that was 15 years ago and they still haven't done that. (laughs) So I don't think they're gonna add another year. But uhm.. I didn't have to struggle through that business aspect. I had a business already set up and had staff there that knew the business end of it. So--

Zarbock: And a professional reputation.

Ernie Ward III: Absolutely. Um..

Zarbock: Okay. So how long have you been in practice?

Ernie Ward III: Fifteen years.

Zarbock: How have things changed when it comes to the technical aspects of the machinery, and the pharmaceuticals and the legal aspects of your profession, in the 15 years?

Ernie Ward III: I think uhm.. technique-wise, there's been a tendency to go more computerized, obviously, this day and age. Uhm.. when- when I joined practice with Dad, there was no computer in the office, at all. And uh.. we practiced together about four years, until about 1994, and there still isn't a computer in the office. But a- a couple of years after he retired, we started introducing computers in the practice, from a business management standpoint. And then, I guess, about four years ago, introduced them into the clinical area. We started doing our charting on the computer. Uh.. so it- it started as a business thing only. Uh.. accounts receivables and so forth and now, it's- it's gone back into the clinical area. And that's where everything's going. It's going towards uh.. charting and even- even making appointments in the back, in the clinical area, before they go out to the front. So a lot of offices are now going towards, handle it all in the back and just go up to the front and pay the bill and leave. You know, that- that's the way a lot of practices are going. Uhm.. and of course, everything's, kind of, eventually going towards paperless, now. So uhm.. I think-- and I have not gotten into a lot of the computerized dental procedures uh.. these days. But now- nowadays, folks are starting to use computerized dentistry to- to make crowns, to sit down and take an impression like we talked earlier about and send it to the lab. Well, you make the crown right there, take a digital photograph of the tooth. And- and the computer, basically, generates a crown out of a block of porcelain. Kind of, like, Dad had to used- used to have to generate a tooth out of a block of porcelain to get in dental school. So it's- it's computerized. Uhm.. and I ha- I have not gotten into a lot of that, yet. But it's coming, that and lasers. Uhm.. it's exciting, there's- there's so many changes coming on. It's- it really k- helps keep the pro- profession--

Zarbock: How about anesthetics? Again, your father told a wonderful story about anesthetics. How about you? Have anesthetics changed in the period of time of your practice?

Ernie Ward III: Uhm.. not a lot the anesthetic solution, itself. Uhm.. we've just been introduced, recently, to a- a different type of anesthetic solution that we're starting to use- some of us are starting use. It's- it's a little- seems to be a little stronger, works a little faster. And some folks that are hard to numb uh.. we'll use this anesthetic.

Zarbock: I'm sorry. Let me pick up on that phrase. Some people are harder to numb?

Ernie Ward III: That's correct. Uh.. some- some folks--

Zarbock: But you interpret that?

Ernie Ward III: If, for example, you have a patient in, you give a normal injection, like, you would every day to numb a certain area. Uh.. usually it's a lower molar. Uhm.. give them the injection and you wait the certain standard amount of time. You go back. Uh.. you start working on a tooth and they can feel it. That happens from time to time. So you give them some more. Sometimes, it takes two or three injections to get them numb. And uh.. I think it has to do with a number of factors- factors, the density of the bone, the certain anatomy, anatomical features of this patient. And I think sometimes it's a- I think there may be a factor involved, just a fear factor, just how pumped up they are, you know. Uhm.. so there are some anesthetic solutions to that, that are- that seem to work a little bit better, a little bit stronger, a little bit faster. Uh.. and the other thing that's different is the- the delivery system of those anesthetic solutions. Nowadays, we do have some different anesthetics.

Zarbock: You know, there's an awful lot of dentistry being practiced, now, about glamour dentistry.

Ernie Ward III: Um-hum.

Zarbock: You know, the whitest of teeth and the most perfect of teeth. I remember talking to some people from England, United Kingdom. They said, "We can always tell a Yank. Their teeth are so perfect. That seems to be important."

Ernie Ward III: Um-hum.

Zarbock: Well, why are teeth so important and what is this glamorous dentistry business? This is the year 2005.

Ernie Ward III: Um-hum.

Zarbock: Glamour Dentistry.

Ernie Ward III: It- it seems to be the big thing. Uh.. the Extreme Makeover show you see on television, now. Uh.. Hollywood dentists making people look-- uh.. it's- it's all about y- looking younger, looking better, looking more youthful. Uh.. from plastic surgery to teeth to- to breasts to stomach tummy tucks, you know. It's- that- that seems to be what everybody wants, now. And uh.. I think the profession is just having to- we're having to provide them with what they want, whiter teeth and more youthful looking teeth.

Zarbock: Does it diminish the professionalism of the profession?

Ernie Ward III: Well, I think, uh.. it can. It can. I think, uh.. there's a fine line there between what truly is what's best for the patient and making them look good. And there's a little ethical decision there, I think, a lot of dentists have to make. And- and I struggle with it a little bit. Because I have people that come in, and they've seen the shows on TV, and ask me about putting veneers on their teeth. Veneers are, like, it's just a surface, like, a Lee press on fingernail goes on the fingernail. You know, you- you prepare the tooth surface slightly, and you- you put a- just a veneer on the front surface of the tooth to make it look whiter and shape it differently and make it look better. Uhm.. but you have to alter that tooth to do that. You have to prepare that tooth a little bit with your drill to do that a little bit. Uhm.. certain teeth, you have to prepare it more. And so you have to ask- ask yourself, "Is that what's best for the patient?" Then, you have to-- it looks so easy on TV. You know, it- it's so easy. They show them before and they show them after. And they don't show what goes on between, necessarily. Uhm.. you gotta numb those teeth up. You know, you have to prepare those teeth. You have to take impressions. You have to-- uh.. it's a two or three week procedure, normally, uh.. to get it all done. So--

Zarbock: Numbing needs an anesthetic; is that correct?

Ernie Ward III: That's right- that's right. Local anesthetic--

Zarbock: There is a possibility of death as a result of anesthesiology. Remote--

Ernie Ward III: Yeah, remote, yeah, especially with local anesthesia.

Zarbock: Yeah.

Ernie Ward III: Uh.. just injecting around the teeth is- is very remote. But uhm.. in most instances, you do need to do that. Now, some instances, you don't have to use local anesthetic to do some of these cosmetic procedures. Uhm.. but I always like to start out conservative and conserve as much tooth surgery as you can. And just, uh.. as far as treatment playing, uh.. try to treat them playing conservatively. And then, kind of, go from there. Uh.. some of these extreme makeover shows, I think, some of the treatment is- is extreme, you know, in my opinion. Uhm.. I just try to educate the patient and tell them what- what are the advantages and the disadvantages of- of doing those procedures. But it is fun to make people look better. You know, a lot of the things we do in the back, if you have a cavity way back here. We take an x-ray. We see a cavity. We tell you, you need to have it done. We fill the tooth. You know, what does a- what does a patient get out of that other than the fact they know their cavity's gone. But they can't see it. You know, they- they can't experience- it doesn't make them look any better, especially. So uh.. cosmetic dentistry, it is uh.. something that's rewarding when you make somebody look better and they feel better about themselves. That's always- it makes you feel good.

Zarbock: Doctor, you have children?

Ernie Ward III: Yes, twin girls, 12 years old.

Zarbock: Would you be interested if they decided to go into dentistry?

Ernie Ward III: That's a good question. Uhm.. I- I think, I would support them in that decision. I think, it's extremely hard now, right now, to get into professional schools, uh.. medical school, dental school, uh.. all the schools. It's- it's just very competitive. The test scores have to be really high. The grade point averages have to be really high. You have to do a lot of-- I mean, it's not only schoolwork these days. They're looking for a lot of uhm.. extracurricular activities, community work.

Zarbock: Yes.

Ernie Ward III: Uhm.. and it's uh.. it's not easy to get into a professional school these days. So I- I would encourage them if they wanted to do that. Uhm.. that's- that's a great question. It's uh.. I guess, I would tell them to not be as stressed out as I am about it, you know what I mean? (laughs)

Zarbock: Well, what about women in dentistry?

Ernie Ward III: Um-hum.

Zarbock: You know, I've had some really astonishing positive remarks about women in dentistry. What is your opinion of women in dentistry?

Ernie Ward III: I think- I think it's great. Uhm.. I think, women generally do a good job in any profession, you know, they take on. And--

Zarbock: How about clinical skills, as good as, better than?

Ernie Ward III: Well, the ones that I have had experience with in dental school, most of them had excellent clinical skills, uhm.. very good hands and, I think, very gentle. Uhm.. and I think women tend to be a little bit more nurturing than men, as far as clinical chair side uh.. activities. So I think, generally, they seem to just be more caretaking, I guess, and- for patients than- than the- than the males do. They just seem to uhm.. be m- more mother-like, I guess, and more gentle. Uh.. but uh.. most of- most of the ones that I've dealt with have- have been very- very good, clinical skills and- and otherwise.

Zarbock: We're just about at the end. First of all, let me thank you. Number two, let me tell you how much I've enjoyed interviewing you and connecting your interview with your father's. And here we go. You're gonna look right into the camera and say your wish for the profession of dentistry would be what?

Ernie Ward III: I think it would be to continue serving people and continue striving for excellence in the- in the profession. And to continue to- continue to be educated about the profession, learn more about it, uh.. continue to provide better and better care for patients, less- less stressful on patients. Hopefully, make these patients feel uh.. less fearful, I think. And continue to educate. I would- I would hope that a professional would continue to educate the patient so that they would uh.. be more likely to come in to the dental office and- and get treatment done.

Zarbock: Dr. Ward, thank you.

Ernie Ward III: Thank you.

Zarbock: Well done.

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