Timothy Finkler, DDS, MSD

Endodontics engineered with excellence

What can you tell us about your background?
I grew up in the then small town of Chester, Virginia. It was a great place for me to grow up. It is about 30 to 40 minutes from where I currently practice. I enjoy seeing people whom I grew up with and knew from around town. Seeing people whom I knew when I was younger will often bring up pleasant memories that otherwise are lost.

In 1990, I graduated from the Virginia Military Institute (VMI) in Lexington, Virginia, with a Bachelor of Science in Electrical Engineering. I choose electrical engineering because it was supposed to be one of the most difficult, and I wanted a challenge. I did not understand the pathway to becoming a dentist; plus, I was excited to finish college and enter the workforce. That was my plan. I was set.

After I graduated from VMI, I joined the Virginia Air National Guard as a traditional guardsman and also worked full time for the Department of the Navy in Norfolk, Virginia. I studied diligently and passed the test to become a registered professional engineer (PE) in the Commonwealth of Virginia. Having my professional engineering license gave me the opportunity to pursue other interests because I could always return easily to engineering if desired; it was a safety net.

I enjoyed being an electrical engineer but felt a desire to pursue a career that I thought would be more fulfilling. I was concerned that I was losing interest in that type of work. I was concerned that I would not be interested in engineering as a profession for the rest of my career. Adding to my concerns was an engineer who worked in the cubicle beside mine who would fall asleep during the day. I was afraid that was my future. While I was young, not married, and without children, this was my chance to make a change.

I actually made a list of my likes and dislikes about engineering. My first concern about engineering was that the business owners I knew seemed to work long days and weeks, which was a strain on their families. Design projects also lasted for months, which I found less than exciting. I also did not care for the relative isolation of a design engineer.

Dentistry seemed to be the opposite. My childhood dentist was Dr. William F. Callery. He was well respected in the community. He had favorable hours. He always seemed to enjoy his work, and it was obvious that he cared about his patients. Even more than caring, you could tell that the interaction with his patients was important to him. Remembering all those things, I felt that working in a field that helps people more directly would satisfy the personal interactions that I enjoy. So, I packed my bags.

I returned to the Richmond area and attended dental school at Virginia Commonwealth University (VCU). I found out that I had been accepted into dental school while deployed with the Air Force in Kuwait. That was a funny experience because I was excited to tell my friends back home, but they were all asleep.

I completed a 2-year general practice residency at the McGuire Veterans Administration Medical Center (VAMC) in Richmond following dental school in 2003. I stayed on as the interim director of the residency for a year as I transitioned into private practice.

Being the interim director of the program gave me a deeper appreciation for the rewards of teaching. I still love teaching at the VAMC and in the VCU Department of Endodontics.

When did you become a specialist, and why?
I received my certificate in endodontics from Virginia Commonwealth University School of Dentistry in 2011.

I enjoyed root canal therapy as a general dentist. I liked that I could focus on one treatment for a period of time instead of having several interruptions for hygiene checks. I liked that the procedures were always behind the rubber dam, which meant at the end of the day, I was not covered with saliva.
I found it fulfilling to diagnose and treat patients with acute needs. I liked helping patients with their pain while maintaining their teeth. It should sound foreign to have to rip a body part out of a patient’s month to replace it with metal as the first choice.

I felt an affinity toward the electronic apex locator because of my background as an electrical engineer. Electrically speaking, I understood why it can indicate a perforation, root end, and give various false readings as fundamental principles from my engineering background and not as something that that I had to memorize anew.

I enjoyed the series of steps to complete a root canal. It is more like a familiar engineering process to me. In general, I am most comfortable in a routine. Being a specialist, you see all the odd stuff frequently, so everything is relatively routine.

Being in the Virginia Air National Guard during our country’s heavy involvement with Iraq left me with insecurities about opening a general dentistry practice. Opening a practice was risky due to the probability of being deployed. I had heard stories of deployed dentists losing their practice as a result of being away for a significant period of time. Ironically, going back to a residency with three young children seemed a less risky choice in comparison and allowed me an opportunity to pursue my interest in endodontics. The endodontic residency gave me a feeling of growth instead of being in a holding pattern.

Is your practice limited solely to endodontics, or do you practice other types of dentistry?
I am in a group practice, Commonwealth Endodontics in Richmond, Virginia, with four great partners. Our practice is solely limited to saving teeth through endodontic procedures and microsurgery. I have been trained in IV conscious sedation, which is helpful to patients with dental anxiety, a strong gag reflex, and special needs patients. Being in a large group with a very large patient pool allows enough patients to keep my skills sharp. Treatment at our office can also be completed with a deep sedation/general anesthesia that is administered by a couple of great anesthesiologists who care for our patients.

Who are your partners?
My partners are Drs. Harold Martinez, Ron Vranas, Madelyn Gambrel, and Steven Barbieri. Initially, my plan was to start a solo practice; however, when this opportunity became available, I decided I would give it a try. Of course, my wife could not be any more excited about the prospect of keeping our children in the same schools, and she loves the Richmond area. Any hesitation on my part was only that I was pretty far into my plans for a solo practice. I thought highly of the partners at this practice and was excited that they would be interested in my joining. I knew most of them from their participation in the VCU Endodontic Residency. They were kind and always interested in sharing the knowledge and experiences.

I have benefited from being in a group practice in ways that I would not have appreciated prior to this experience. The benefit of working with a group of people who are open and sharing has helped mature my practice. Because they have a great collective experience, I have avoided some of the difficult learning experiences that a new endodontist might have to learn when first entering practice. My partners support me and want me to succeed. We have all served in the U.S. Armed Forces, which gives us a common frame of reference.

 

 Why did you decide to focus on endodontics?
I like saving teeth. My engineering background and interest blended with this field. As a general dentist, my plan was to do as many different procedures as I could; however, ultimately my comfort was found in performing one specialized set of procedures for which I had received in-depth training. I often felt as a generalist that I could do a wide variety of procedures but was lacking the knowledge of which treatment choice is the best. Studying one field gave me the knowledge base that I need to feel that I am treating and advising patients appropriately.

Do your patients come through referrals?
Most of our patients are referral based.

How long have you been practicing endodontics, and what systems do you use?
I have been practicing as an endodontist for 5 years. We use the Brasseler® Endo-Sequence file system. I was exposed to this system as a resident and have enjoyed its consistent function.
We have an ORTHOPHOS Sirona XG 3D for our cone beam computed tomography. Having a CBCT when indicated allows for better patient care. I do not want to imagine practicing without one.

Partners in Commonwealth Endodontics

Harold J. Martinez, DDS, was born and raised in San Juan, Puerto Rico. He attended Kansas State University and, in 1989, received dual Bachelor of Science degrees in Exercise Physiology and Foods and Nutrition. In 1995, he obtained his Doctor of Dental Science degree from the Baltimore College of Dental Surgery, University of Maryland Dental School.

He continued his dental education as a Dental Officer in the United States Air Force where he completed an Advanced Education in the general dentistry program in 1996 while stationed at Barksdale AFB in Louisiana. After serving 2 additional years as a general dentist in Tyndall AFB in Panama City, Florida, he came to Richmond, Virginia, to attend Virginia Commonwealth University School of Dentistry, where he earned his Certificate in Endodontics in 2000. Since graduating from the endodontic program, Dr. Martinez has been in private practice with Commonwealth Endodontics and serves as a part-time clinical instructor with the Endodontic Department at Virginia Commonwealth University School of Dentistry.

Dr. Martinez’s work and accomplishments have been recognized by his peers. He was honored as one of Richmond’s Top Dentists in the Richmond Magazine and Virginia Living magazine. He strongly believes in giving back to the local community by supporting different organizations and volunteering his services to the CrossOver Clinic and the Free Clinic of Goochland.

Dr. Martinez belongs to the American Dental Association, Virginia Dental Association, Richmond Dental Society, American Academy of Endodontists, Virginia Academy of Endodontists, Hispanic Dental Society, Pierre Fauchard Academy, and several local dental study clubs. He has been involved in organized dentistry as a Richmond Delegate for the Virginia Dental Association House of Delegates and as a member of the Richmond Dental Society Board of Directors. Dr. Martinez lives in Short Pump with his wife, Conchy, and their two children. He enjoys sports and nutrition, baseball, traveling, and spending quality time with his family and friends.

Ronald N. Vranas, DDS, was born and raised in Mesa, Arizona. He attended the University of Arizona and received a Bachelor of Science degree in Chemistry in 1990. In 1996, he obtained his Doctor of Dental Science degree from the Medical College of Virginia.

After completing dental school, Dr. Vranas joined the United States Navy as a dental officer and completed an Advanced Education in General Dentistry program in 1997 while stationed with the Marines at Parris Island in South Carolina. After serving 3 additional years as a Navy dentist at the Naval Air Facility, Atsugi, Japan, he returned to the Medical College of Virginia where he earned his Certificate in Endodontics in 2002.

Dr. Vranas has been with Commonwealth Endodontics since 2002. His affiliations include multiple local dental study clubs, the American Dental Association, the Virginia Dental Association, the Richmond Dental Society, the American Association of Endodontists, and the Virginia Academy of Endodontists.

As a way to serve others, Dr. Vranas has taken multiple trips to the Dominican Republic as a member of a medical/dental church mission team in order to provide needed dental services to the community of Hato Mayor and the surrounding bateys. Closer to home, he participates in the VDA’s Mission of Mercy projects, providing endodontic care to Virginia’s population that have limited or no access to dental care. Dr. Vranas also teaches part time as an adjunct professor in the Endodontic Department at the VCU School of Dentistry and provides free endodontic care for patients at the CrossOver Healthcare Ministry in Richmond.

Away from the office, Dr. Vranas enjoys spending time with his wife, Elizabeth, and their four children. He is an avid fan and supporter of CharacterWorks, a Richmond children’s theater that his family participates in. As the only Arizona Cardinals fan in Richmond (he has yet to meet another one), Dr. Vranas enjoys traveling to stadiums around the country to watch his beloved Cardinals.

Madelyn G. Gambrel, DDS, was born and raised in Bonham, Texas, a small town northeast of Dallas. Dr. Gambrel received a Bachelor of Arts degree in Spanish from Baylor University in 1993 and graduated from the University of Texas Health Science Center San Antonio Dental School in 1997. After receiving her Doctor of Dental Surgery degree, she joined the United States Navy and served as a dental officer in Rota, Spain, until 2001. She then attended Virginia Commonwealth University School of Dentistry, where she received her Certificate in Endodontics and Master’s degree in 2003. During her endodontic residency, Dr. Gambrel was an instructor for the dental school endodontic department from 2001-2003. She also completed research for her Master’s degree and has an article published in the Journal of Endodontics.

Upon graduation from endodontic residency, Dr. Gambrel moved to San Diego, where she completed her obligated service to the U.S. Navy in 2005. Dr. Gambrel then returned to Richmond, Virginia, in the fall of 2005 and joined Commonwealth Endodontics. She recently earned her Board Certification from the American Board of Endodontics. In order to obtain Diplomate status, Dr. Gambrel successfully completed a rigorous three-part examination that included a review of her education, knowledge, skills, and ability to apply new research and advances to the practice of endodontics, as well as her commitment to providing the highest quality of patient care. Becoming a board-certified Diplomate reflects Dr. Gambrel’s commitment to the specialty and is the highest status that an endodontist can achieve.

Dr. Gambrel strongly believes in giving back to her local community and serves through her church, teaching at VCU graduate endodontics clinic, and providing free endodontic care to patient’s referred from CrossOver Healthcare Ministry. She is active in many local dental study clubs and belongs to the American Dental Association, Virginia Dental Association, Richmond Dental Society, American Association of Endodontists, Virginia Academy of Endodontists, and Richmond Association of Women Dentists.

Dr. Gambrel enjoys spending her free time with her two young sons. Her hobbies include attending live music concerts, skiing, sailing, traveling, and interior decorating.

Steve Barbieri, DDS, was born and raised in Queens, New York. He attended Queens College and obtained a Bachelor of Arts degree in Biology with a minor in Philosophy in 1980. He received his Doctor of Dental Surgery degree from the Medical College of Virginia School of Dentistry in 1984. Upon graduation, Dr. Barbieri joined the United States Army as a dental officer. He completed a Dental General Practice Residency at Fort Bragg, North Carolina, in 1985. After serving 2 additional years as a dental officer at Camp Hialeah in Pusan, South Korea, and at Fort Stewart, Georgia, he returned to the Medical College of Virginia where he earned his Certificate in Endodontics in 1989.

Dr. Barbieri established a private practice limited to endodontics in Richmond, Virginia, in 1990. After 18 years in solo practice, Dr. Barbieri joined Commonwealth Endodontics in January 2009. He is a member of the American Dental Association, Virginia Dental Association, Richmond Dental Society, American Association of Endodontists, Virginia Academy of Endodontists, and the McKee-Dominion Dental Study Club. Dr. Barbieri is a past President of the Virginia Academy of Endodontists and has had the honor of being selected as one of Richmond Magazine’s Top Dentists. He volunteers his time, skills, and finances to the CrossOver Clinic.

Dr. Barbieri resides in Henrico, Virginia, with his wife, Shari, and their two children. He enjoys history, traveling, and spending time with family and friends.[/vc_column_text][/vc_column][/vc_row][vc_row][vc_column][vc_column_text]

What training have you undertaken?
I was initially trained for IV conscious sedation at the GPR. After I joined Commonwealth Endodontics, I took the IV conscious sedation program at the Mylan School of Pharmacy to update my skills. It was great to have the opportunity to retrain because it allows greater growth after having many clinical experiences.

Who has inspired you?
My parents first and foremost have always encouraged me to challenge myself. They did not push me in directions that I did not want to go. When I would approach them with what sounded like a crazy idea to me, they would always say ,“You’re young; do it.”

From an endodontic perspective, my inspirations were great. Possibly the busiest person in the world, Dr. Gary Hartwell, would always give me his time when he had none to give. Dr. Ellen Byrne has had a tremendous impact on my life. She has impressive accomplishments and great sense of humor. Dr. Richard Wood is a great general dentist who volunteered in the Endodontic Department. He also went to VMI, and I always enjoy our interactions and his great advice. He has always been a role model for me in the professional and respectful manners in which he treats his friends, colleagues, and patients alike. I could list another 20 people from dental school and my residency who have inspired me endodontically. I have been fortunate to know such a great group of people throughout my life.

What is the most satisfying aspect of your practice?
I love working in a big group. The staff, partners, and I have fun at work. I cannot believe that I considered practicing solo. One of the most satisfying aspects of our practice is undoubtedly our staff. We have the greatest staff on the planet. I am sorry if you thought you did until now! They do everything they can to empty our cup. Their support is nonstop and never appears to be tiring. We have empowered them in all aspects of our practice, and they have made our practice shine.

Professionally, what are you most proud of?
I am proud that our practice gives back to the community and helps those in need. As an example, Dr. Ron Vranas and I recently went to the Mission of Mercy (MOM) project with the Virginia Dental Association Foundation in Wise County, Virginia. Some of his and my children volunteered at this outreach program in age-appropriate ways. Our assistants also volunteered their time and expertise.
This is a great experience on many different levels. My children and I together had the opportunity to spend a weekend aiding others. For my children, it was also an opportunity to gain a more tangible idea that their dad performs a function when he leaves in the morning for work. For me, it is also rewarding to work with so many skilled dentists who would volunteer their time. It was rewarding to be able to complete a root canal, and half an hour later the patient would return excited that the black tooth in the front had been restored and looked brand-new again.

From the VCU Department of Endodontics were Drs. McKay Parker, Nic Schoeder, Riley Sturgill, and Syrous Ardalan. Dr. John Shamul also brought a team to help. He practices endodontics in Long Island, New York. The 3-day Wise Mission of Mercy 2015, treated 1,181 patients.

What do you think is unique about your practice?
Our practice size gives us opportunities to participate in projects that would be more difficult to accommodate in a solo practice. Our practice is comprehensive in the endodontic care that we provide to a diverse patient population. We have a great opportunity to care for patients with acute pain quickly. We can support charitable organizations like the CrossOver Healthcare Ministries (https://www.crossoverministry.org/), treating their patients’ endodontic needs in our office.

What has been your biggest challenge?
My biggest challenge is balancing home and work. My wife, Kim, is a licensed pediatrician. We both have chosen careers that do not easily allow us to miss work, which is so often needed when you have children. Kim stays home with our children, and I am grateful for her sacrifice. It is so comforting to know they are cared for by her. With our youngest entering kindergarten, I am hopeful that Kim will be able to find something rewarding for herself outside of the home as she desires.

What would you have been if you had not become a dentist?
This is an interesting question because dentistry is what I chose over engineering. I had at one point considered medicine. Fortunately, I stuck with the dental track. Dentistry stood out as being the clear choice at the end. Had I not gone into dentistry, I probably would not be here today. I would likely have been on a military airplane that crashed carrying many of my fellow members of the 203rd Red Horse. Sometimes we can forget how delicate life is and how fortunate we are to live it for as long as we do.

What is the future of endodontics and dentistry?
The future of endodontics is bright. Natural teeth are still the first option. People in general value their teeth and other natural body parts. Endodontists are performing only 20% of the root canals; therefore, there is plenty of room for growth.

I am always surprised when someone asks if they should just extract an otherwise restorable tooth and replace it with an implant. Nowhere in medicine do we do that. Do knees get replaced at age 60 without symptoms? Of course not! And that is because the knees you were born with are always the first option when possible.

Patients are becoming more aware of the specialist’s role in the health professions in general. Patients also generally want to be treated by the person who has had the most training doing their needed procedure. As other treatment options become available, endodontists will expand their procedures. I just cannot see a time when there are a bunch of endodontists in a room fighting to do the last root canal. In my experience, endo-dontists are too bright, resourceful, and innovative to find themselves without a function.

What are your top tips for maintaining a successful specialty practice?
As a practice, we are constantly trying to improve. Our staff is highly involved in that process. It includes everything from improving patient interactions to infrastructure. Being in a group practice, the effects of problems are magnified due to practice size; and as a consequence, when improvements are made, the benefits are dramatic.

We are currently working with the Culture Company. They are helping document our processes and develop procedures to become better organized. We are also learning how to better communicate with each other, which is something that can be applied to many relationships in life. I believe it is imperative to understand that no matter how good you are, it is important to continue to be coached. This can come from outside companies and colleagues. If you question this importance, ask how many professional athletes do not currently and regularly have coaches that hone different aspects of their game.

What advice would you give to budding endodontists?
Do good work. Treat people with respect. Get patients in quickly. Take care of your referring dentists.

What are your hobbies, and what do you do in your spare time?
I have four children from the ages of 5 to 11. The hobbies that I focus mostly on today involve my children. I enjoy coaching soccer. I love taking the kids fishing. I am trying to get them into fly-fishing, but it may be too early. They love exploring the James River or any other body of water we are around. LEGO® night is always fun.