The amazing thing about practice management software today is it provides enough bells and whistles to power the Pentagon! Yet, most of the tools that generate valuable statistics are never touched and reports pile up, gathering dust on the dentist’s desk. So where is the disconnect?

Most dental teams do not realize their practice management system has a goldmine of data, that when properly analyzed, can drive major improvements in efficiency, productivity, and profitability. Here are some basic consulting principles that Pride Institute draws from to help increase desire and intention to fully use the resources your Dentrix practice management software offers.

Tip #1: Motivate your team to analyze reports.

Have a reason for you and your team to want to fully use the reports and tools available. If you don’t want analysis and strategic planning to be an “eat-your-spinach” moment then you have to dial into the old radio station – WII FM: (What’s in it for me?). I don’t mean in order to analyze these reports you need to promise everyone a cookie. What I do mean is that if you and your team fail to have clear, mutually agreed-upon goals, which can be supported by your software then no one will care what information is available. What are your goals for your collections and accounts receivable? How do these goals tie into the vision, values, and strategies of the team? Once you answer those questions…then pull the report (it will mean something).

Tip #2: Compare data to other data sources.

When you look at productivity, scheduling, or treatment acceptance reports, how do you know what the numbers are telling you? No one statistic means anything by itself. If a dentist says, “Hey, I produced $95,000 last month,” does that mean he is successful? How does this compare to credible, national-range norms? What are the costs associated with that production? What is the year-to-date trend? These are just some of the questions dentists must ask anytime they analyze data, so they can determine true successes or challenges.

Tip #3: Understand what is working well and why.

Do not use the information only to reveal weaknesses and failures. Too often, statistics and analysis become the rolled up newspaper used for puppy training! There is a natural tendency in dentistry to look at all challenges from the negative “cuphalf- empty” view. Why would anyone want to continuously reveal their weaknesses and vulnerabilities? How much time do you spend, analyzing your tools and reports for what’s going very right in the practice? It’s not just “nice” to look at what’s right—it is the ticket to sustaining positive growth.

Tip #4: Establish priorities.

There are a thousand different aspects to running a dental practice. If you attempt to analyze, reinforce, and action plan every aspect—you will get nowhere, fast. Between your scheduling reports, finance tools, continuing care lists, and treatment acceptance monitors you and your team could find an overwhelming amount of opportunities for growth. The trick is to focus on one thing at a time. A great question to ask yourself— before you pull a report is—What is the one thing the team can focus on that will reduce stress and /or increase efficiency and bring us one step closer to our vision and goals? With this answered, you can then focus on the tools that will support you the most.

A treasure of important information is buried in your Dentrix practice-management software. When you begin to use all the bells and whistles, and properly tie practice management principles to the data—watch your practice grow!

It is incredible to think how much dentistry has changed in the last 20 years. From a diagnostic standpoint, nothing can hide from us. Digital radiography, whether periapical or a 3D Cone Beam CT, gives us the ability to slice images, rotate images, colorize, increase the brightness or contrast, and see things in incredible detail. The way we take impressions is beginning to transition to a digital environment, and soon we will be utilizing virtual articulators if we choose.

As these areas of dentistry continue to evolve at a rapid rate, it is not surprising that some dentists are utilizing technology for routine dental procedures involving the teeth and surrounding tissues (gingiva and bone). The first procedure that utilized a laser intraorally was a CO2 laser used on soft tissue in 1977. It was not until 1987, however, that the CO2 laser received FDA clearance. Although this laser was specifically for soft tissue, the stage was set for research and further study to look at different wavelengths that could alter enamel, dentin, and bone. What has transpired is a revolution of interest that has some in dentistry utilizing this technology on virtually every procedure they do.

Understanding Laser Energy

Theodore H. Maimain was the first to develop a laser. He utilized a theory from Albert Einstein, where a crystal medium (Ruby) was stimulated with energy and radiant laser light was emitted from the crystal. Shortly after this discovery, the Neodymium laser was released (Nd:Yag laser). Early dental research focused on the Ruby laser, but it was soon found to be ineffective to cut the hard tissues inside the mouth. As a result, the Argon, Carbon Dioxide, and Nd:Yag lasers were utilized for soft-tissue procedures only in the early years.

In 1985, Dr. Terry Meyers and his brother William (an ophthalmologist) started using an ND:Yag laser to remove incipient caries. They founded American Dental Laser (acquired by Biolase in 2003) and created the first true dental laser system called the D-Lase 300. Many in the industry believe this was the beginning of the laser revolution, focusing the lens of interest on the topic of lasers. In 1997, Premier Laser received the first US FDA clearance for cutting enamel and dentin using the Eb:yag laser. Soon other companies utilized a similar crystal, furthering the R & D of the dental laser industry.

It is important to note that lasers have been used in virtually every other specialty in the medical field. It is also interesting that in medicine, specific wavelengths have been aligned with specific clinical applications. Although this thought process was carried over to dentistry for many years, we are fortunate that a single wavelength laser has emerged that can be used across the full range of oral tissues. Like other lasers they are named for the active medium that is charged with energy (the crystal) inside the laser. The YSGG laser receives its name from Yttrium, scandium, gallium, and garnet doped with erbium and chromium (Er, Cr:YSGG). The specific wavelength for this laser is 2780 nanometers, by comparison Erbium : Yag is 2940, Nd:Yag is 1064, many Diodes are at 980. Specific wavelengths will interact and be absorbed by the tissues in different ways. A diode is best absorbed by pigmented tissues, and is ideal for cutting and coagulating soft tissue. The YSGG laser, first called the Millenium laser, utilized a combination if the YSGG laser energy combined with water and air to effectively ablate enamel and dentin. It was soon found that with the water turned down or off, this same laser could be used for additional uses that involve the cutting and coagulating of soft tissue. By 2000 the FDA had cleared the use of this laser so that clinicians were able to work on oral tissues with one laser. In 2000 and 2004, Biolase released as second-and-third generations of the YSGG laser—the Waterlase and Waterlase MD, respectively. They provided a number of improvements never before seen in dentistry.

Clinical Procedures

Cutting Enamel & Dentin

Conserving the maximum amount of tooth structure during our restorative procedures is the goal of any standard of care. Magnification and quality radiography as well as improved materials and techniques all have made this a clinical reality. Utilizing a surgical microscope in conjunction with an appropriate dental laser is the ultimate in minimally invasive dental procedures.

When using a traditional high-speed handpiece at very high magnification, it is impossible to see to the depth of the cavity preparation as you prepare the tooth. This is because the water and debris have nowhere to go and thus cloud the operator’s field of vision. As clinicians, we learn to develop a tactile sense of enamel, dentin, restorative materials and even caries. Nothing, however, replaces the ability to see. Because the laser ablates the tissues, there is no debris. This allows the clinician to have an exquisite view of all areas of the cavity preparation, leading to more conservative results.

The laser has been cleared for Class I, II, III, IV, and IV cavity preparations since 1999. Additionally, the laser has been shown to reduce the smear layer (due to ablation), which can improve surface adhesion and ultimately the strength of our bonded restorations.

Osseous Surgery

The YSGG laser has been cleared for shaving and contouring bone since 2002. Shortly there after, in 2003, the device obtained its FDA clearance for osseous crown lengthening and the ultimate recreation of the biologic width. Some doctors are doing these procedures without laying a flap or suturing in certain indications. Combining certain restorative procedures in conjunction with laser-assisted surgery can add increased visualization, efficiency, and predictability with these procedures.

Soft-tissue surgery

Since the early soft-tissue work with lasers, the YSGG laser has been cleared for a multiple of uses for soft tissue. It is important to note that this is the only device cleared for use on both hard and soft tissues. Procedures such as the treatment of aphthous ulcers, herpetic lesions, frenectomy’s, gingivectomy, fibroma removal, and atraumatic troughing around crown preparations are some of the procedures that are routinely performed with this laser.

Cosmetic/esthetic dentistry has shined a light on the importance of the gingival frame as it relates to the backdrop of the esthetic restorations. Being able to properly manipulate the gingival tissues’ biologic width becomes an integral part of nearly every cosmetic case. Having the technology and skill to complete these procedures, increases the fun, efficiency, quality, and profitability of these cases.

Root Canal

The use of the dental laser has long been associated with the potential benefits of disinfection and sterilization. When the YSGG was cleared for use on hard tissues, this device was a natural for the shaping and cleaning of the root canal system. Similar benefits that are evident that exist when cutting enamel and dentin also exist inside a canal. Utilizing a laser decreases debris and eliminates the smear layer, which leads to dentinal tubules that are free and clear, ultimately improving obturation and sealing.

Efficiency & Productivity

Increasing the numbers of procedures that a dentist can offer his or her patients all goes to increasing the productivity of the practice. The expansion of periodontal procedures in the diseased-based realm as well as the increased esthetic possibilities adds to practice expansion. Restorative procedures also become more efficient, because the need for anesthetic is reduced and many times eliminated in operative care. As a result, the dentist can work in multiple quadrants at the same visit. This translates to fewer, well planned, longer visits. Not only is this great for the practice, but patients appreciate less time away from family and work, as well as leaving the office without being numb.

Conclusion

We are practicing in a very interesting time. Technology, materials, and new procedures are evolving at an unbelievable rate. At the same time, financial pressures exist that affect our own practices as well our patients. As clinicians, we have to make a decision about what we are going to get involved with and what specifically we want to master. We also have to be conscious of the message we are sending to our patient population and surrounding community. What do we want our practice to be known for? What are we doing to make our practice distinct in the community? How can we attract patients who value their oral health and want to continue to invest in better care.

Laser dentistry is not a panacea for everything in dentistry. It has evolved as a valuable tool to do numerous procedures within general and specialty practices with increased precision and efficiency. It is also a tool that will place your practice, in the eyes of your patients, right on the cutting edge.

Is this going to fit? How will it look? Is the occlusion going to be right? How much adjusting am I going to have to do? Are the contours right? What about those interproximal contacts?

These are the questions that drive dentists absolutely crazy! It seems to make our jobs less fun, less enjoyable, unpredictable, frustrating, maddening— okay, okay, I’ll stop there!

Whether you’ve been practicing for one day or for 30 years plus, when it comes time to seat that crown, veneer, onlay, or inlay, I know you hold your breath. (Be honest; nobody’s going to know if you’re not.) Our blood pressure elevates slightly, a small imperceptible bead of sweat pops out somewhere, and our pulse quickens slightly.

Is this going to fit? How will it look? Is the occlusion going to be right? How much adjusting am I going to have to do? Are the contours right? What about those interproximal contacts?

These are the questions that drive dentists absolutely crazy! It seems to make our jobs less fun, less enjoyable, unpredictable, frustrating, maddening— okay, okay, I’ll stop there!

After practicing—literally practicing —for about 15 years (I’ve been in practice 22 years), I finally got to the point with my lab that I was quite comfortable with their quirks, idiosyncrasies, and limitations—and mine, too. I respected their work, always “made” things work, and took the blame if something didn’t work out (just ask them!). I had remakes, and as you know, those remakes took all the profit out of doing that restoration. The lab did a great job making a crown to fit that model, but it was only as precise as the model, impression, casting, firing, etc., and a lot of it depended on me giving them something they could work with. I still work with and support them, but in different ways, and only because there is something better that solves many of the frustrations with crowns, onlays, inlays, and veneers (prep-less or prepped).

CAD/CAM technology is here to make your practice more predictable, more profitable, more fun and much more than this space allows. It is also here to stay! I chose the E4D Dentist System and it’s probably the largest and best investment I’ve ever made for my practice, my patients, and for my enjoyment of dentistry.

My Top Ten Important Points About the E4D Dentist System. You don’t have to wonder if your restoration made with the E4D will “fit.” Prep for clear margins, scan (without the need for powder), and design and mill your restoration. There’s no more holding your breath when you seat the restoration.

It’s time to start practicing in the digital age and stop being a blacksmith. The digital revolution is here, it’s not going away, and you couldn’t pick a better, more solid company than D4D Technologies (Richardson, TX; manufacturer of the E4D Dentist System). An investment in this level of technology flourishes when an incredibly close relationship exists between the owner (you), the manufacturer (D4D Technologies), and the distributor (Henry Schein Dental). Remember, you’re not buying a new composite to try out. The E4D is here to stay and D4D is constantly finding new ways to be innovative in the dental industry.

You’re now in the driver’s seat!
No more wasted time writing lab slips, taking impressions, communicating special needs, working with lab schedules, and such. You’ll be more profitable, provide a better service, excite your staff, enjoy your work more, fascinate your patients, and attract clients who have heard about the technology.

You’ll be providing solutions you could never have accomplished with a lab.
I cannot tell you how many times I’ve been a hero to a patient when something unexpected happened, and I was able to solve it—all because I had the E4D at my fingertips. If they weren’t my patients before, they are now (for life!)—and they’ll tell everyone how I saved their day, trip, wedding, etc. Very gratifying!

Scared of the computer? Don’t be. Training at E4D University is excellent, and you can decide on any number of ways to utilize the E4D in your office, whether you delegate its operation to the staff or do it yourself. I was like a kid in the candy store when I first got the E4D in my hands at a preview at the D4D campus, and again at my initial training there. I’ll bet you will be, too. (OK, I might be a closet computer geek, but it’s not a requirement or even a necessity.) Regardless, the training is a requirement for you and a staff member and all accommodations are included in the cost of the machine.

You’ll be ahead of the curve without being the “first one out.” Being on the cutting edge isn’t all it’s cracked up to be, but you won’t be on that edge anymore. This is solid territory. It’s proven, it works, it’s reliable, and it’s only going to get better. In the two years I’ve owned the E4D, I still get excited when a new update comes out!

Work on multiple units without having to seat one crown before going on to the rest. For you “heavy-hitters” out there, yes, you can do a full mouth “rehab” all at once, if you so choose. For those who enjoy making a batch of veneers, visualize the whole case at once—even have your patient preview it. Amazing. Patients getting veneers in one day used to be reserved only for those doctors who charged a fortune and had a lab tech on-site. Not anymore! You can offer this great service now, designing up to 16 units simultaneously with E4D’s intuitive DentaLogic™ software.

You can make world-class crowns, inlays, onlays, veneers, and “prep-less” veneers with the best materials available today. You can take your dentistry to a whole new level that you may never have achieved with your lab, because YOU control every element of the restoration. The IPS e.max CAD material (lithium disilicate) by Ivoclar Vivadent is the material of choice (just ask Gordon), but you have plenty of other choices to suit your needs as well from D4D’s partners, 3M ESPE and Ivoclar Vivadent, and reliable diamond burs exclusively from Premier Dental.

You’re never alone. Not only does D4D Technologies have their S.O.S. (Support-on-Sight) service if you get stuck, have a question, or need advice, they also have ongoing advanced training courses for those who have got to have it all. They’re available 7am to 7pm CST, Monday through Friday via a tollfree number, and soon by VOIS™ (Voice Over Internet Support via Bluetooth® technology; Q1 2010). My calls are handled within 10 seconds 95% of the time I’ve called them when faced with a challenge. That means when you’re working chairside with the patient and, perhaps, you have a brain lapse, they can even take over your system live over the Internet, talking with you at the same time and helping you get the job done without any loss of momentum. And, all E4D owners are welcome to be a part of their special online community just for ECO members (E4D Clinical Operators) where you can communicate with other users on the ECO forum and download useful resources.

No membership fees, no upgrade costs, great warranty. You never have to worry about your system working optimally (quarterly maintenance visits are part of the purchase price), software upgrades are free, and you can count on their support and commitment one hundred percent.

Take the time to do your “due diligence,” learn about the E4D (go ahead – compare it to the competitor!), and most importantly…get your hands on one! Then, be prepared to be able to do things you never dreamed you could do.

Don Deems, DDS, FAGD is known as The Dentist’s Coach®, and is a 22-year practicing dentist and professional life and business coach. Listed by Dentistry Today for the last 5 years as a Top Leader in Continuing Education, Dr. Deems speaks and lectures on a variety of topics highly valued by dentists and their teams. You can visit his Web site, www.drdondeems.com, for more information.

Dentists who own digital pans have already witnessed the role that their investment plays in their practice’s financial success. Dr. Roscoe Scott, who runs a private practice in Overland Park, Kansas and implemented a digital pan (Gendex Orthoralix®, 8500DDE) in 2007 comments,

“I would urge my fellow general dentists to consider adding digital panoramics to their practices. It is a way to increase valuable patient services and, secondarily, profits.”

Digital-imaging products, from intraoral sensors to pans and 3D Cone Beam, enhance the patient experience. A digitalimaging system is an educational experience for the patient. Due to the size and clarity of the images in the computer screen, patients can more readily comprehend their conditions, and better evaluate the dentist’s recommendations. Digital X-rays and scans build communication and trust between the patient and the doctor, resulting in increased case acceptance.

Digital imaging–clinically and financially enhancing the practice

Even better, satisfied patients discuss their positive experiences with family and friends, resulting in referrals. Dr. Richard Schmidt, of Skokie, Illinois, whose general practice welcomes patients ranging from children to seniors, notes, “Patient reaction to our digital images [Visualix eHD] is amazing. With traditional film X-rays, patients often did not understand or see their problem. However, when I optimize a digital image, the evidence of their infection, periodontal issues, or decay is as clear as day. Armed with this knowledge, they are more accepting of treatment.”

Besides happy patients, digital equipment from Gendex increases profitability for the practice. Dr. Terry Myers, who has incorporated both 2-D intraoral and 3-D radiographic imaging (Gendex GXCB-500™) into his practice notes that investments in innovative technology are imperative to dentists who want to remain profitable. Dr. Myers notes, “Technology has changed my business. In the recent tough financial times, it is important to keep investing in your practice. The addition of digital technology will allow dentists to better serve their existing patients, attract more patients, and be equipped to make better diagnoses for all.”

An investment in digital imaging benefits the dentist and the patient. Although it may mean dipping into the budget now, acquiring a Gendex imaging product will continue to clinically and financially enhance the dental practice for many years ahead. Don’t let the competition offer more complete dental care. In the New Year, resolve to evolve.

Simply “Plug-n-ray”

One unique feature of the DEXIS Platinum sensor is its direct USB digital technology that maximizes portability for use of a multiple-operatory setting. The capture and processing electronics are fully integrated into the sensor itself, enabling a direct connection to the computer, without any kind of adaptors, controllers, or docking stations. Additionally, durability is optimized with the first-ever gold plating on a sensor connector. “The company calls it ‘plug-n-ray,’ but we call it ‘easy’,” explains Dr. Terry Myers, of Belton, MO.

“It’s very portable—the whole sensor and cable fits in the palm of your hand, and with the direct connection, it can easily move from one treatment room to the other.”

Diagnose with PureImage™

PureImage allows clinicians and their patients to view the subtleties within an image with a high degree of clarity and detail. Accomplished behind the scenes, this complex process starts with a state-of-the-art scintillator that sends the X-ray beam to the high-resolution CMOS sensor surface, providing more than 20 visible line pairs for remarkably clear images. The next component maximizes active area at the pixel level to offer even the smallest details, followed up by a converter that generates 16,000 shades of gray that makes subtle variations in densities more visible. And what does this mean clinically? Dr. Jeff Dalin of St. Louis explains that the increased size of the display capability is integral to proper diagnosis. When a patient brings in traditional film X-rays, “I take one look at those 1 inch by 2 inch films and ask them if I can retake these using my digital technology. I explain that I can no longer look at something that small when I have an opportunity to view the image on a large computer monitor with great resolution.”

Expose less, see more

DEXIS Platinum’s enhanced quantum efficiency makes it highly receptive when capturing images across a dynamic range of radiation settings—meaning, the hardware and software work in harmony so that clinicians now have the ability to reduce the number of needed retakes related to under- and over-exposure while ultimately lowering radiation dosages. “We let patients know that their health concerns are a priority during every aspect of their dental visit, and we can prove this even more since we have started using Platinum,” says Dr. Cynthia Brattesani of San Francisco. “If we can decrease patients’ radiation exposure without sacrificing image clarity or detail, then we should definitely do that for them.” At 2.2 megapixels, images can be displayed at “ultra-large sizes”, providing zoom-in capabilities without forfeiting image quality. Dr. Brattesani notes that the resolution of the X-rays obtained by the new sensor is so sharp that “even when I enlarge the image to my heart’s content to direct the patient’s attention to a certain area, the images don’t lose quality.”

Position confidently, offer comfort

The PerfectSize™ sensor allows for vertical bitewings, horizontal bitewings, and all periapicals with a single sensor, eliminating both the cost and inconvenience of using multiple sensors of differing sizes. By enhancing DEXIS’ already highly ergonomic sensor housing, TrueComfort™ design optimizes both ease of use and patient comfort. Refined curves and a smooth, rounded casing ensure that there are no sharp edges to rub against the palate or any soft tissue, and a smaller angled dome facilitates precise placement even in tight areas. “Digital radiography has made the dental hygienist’s life easier and more efficient,” says Sherry Rice, RDH, hygienist at Dr. Dennis Grabowski’s practice in Lake Elmo, MN. “Our DEXIS sensor has rounded edges that make it comfortable. I can very quickly and efficiently position the sensor so I can avoid retakes—something my patients and I both appreciate.”

Work within the “Hub”

The easy-to-use DEXIS software, known for its one-click features and clinically meaningful tools, serves as an imaging hub that manages all digital images—including intra- and extra-oral radiographs and photographs—which are easily and quickly organized, stored, retrieved, printed, and shared with both patients and colleagues. DEXIS also integrates seamlessly with all major practice-management systems with its Integrator software to allow the clinician to preview thumbnails and diagnostic-sized images within the charting programs. Add the dynamic DEXIS Platinum sensor to the highly efficient and feature-rich DEXIS software, and one of the rewards is a 25-minute FMX procedure that can be reduced to 5 minutes with the “One-Click Full-Mouth Series.”

The benefits derived from Platinum technology touch on every aspect of the dental experience, from radiology to diagnosis and patient understanding. After implementing the Platinum sensor, Dr. Dalin, a long-time DEXIS owner, noted, “The superior results totally surprised me. DEXIS took something great and made it perfect.”

Two of the things in your control are practice speed and efficiency. I’m sure everyone would agree that mastery of these two areas benefit the practice immensely. Digital technology will be able to influence both of these on a daily basis to make your practice both professionally and financially successful. From the electronic chart to the digital X-ray, “speed is king.” I can’t imagine curing composite any longer than 3–5 second bursts.

An example of an overlooked area in a practice that I believe could be more organized in, is the treatment room. One of the biggest areas where time is lost each day is moving from room to room. I try to organize every treatment room as if it were my own private office and then duplicate that in every room. The rooms have an Internet connection, a printer, and E-mail access. This allows for easy communication between staff members in other treatment rooms. I want to be able to sit down and not get up until I’m finished working on the patient. I utilize my hygienists to anesthetize the patient if possible. I can then answer E-mails or read referral letters that I have received from my specialists while this process is carried out. After reading, I just copy and paste the E-mail and the attachments into my Dentrix Document Center. The key is to stop wasting paper and time. Receiving X-rays and letters by E-mail is a preferable choice. You can then eliminate the step of scanning.

I hope that everyone reading this article has or is planning to have a computer in every treatment room. You will see at least a 15 % increase in yearly production just from the timed saved. Henry Schein can help you design the most ergonomically efficient treatment rooms on the planet. Pelton & Crane has a solution for every situation, from new builds to the renovation of an old room. I just renovated two rooms and built a new hygiene room. They all have a massage feature built into the chair for patient comfort and the intraoral camera in the delivery unit for quick and easy access. The hygienists have the image up on the screen of the next area to work on when I walk in for the exam. I attribute much of our success to having an intraoral camera and DEXIS Platinum sensor in every room. This equipment and technology has increased our speed and efficiency for every appointment from hygiene to restorative. Anytime you share equipment between treatment rooms, you slow down. So equip your treatment rooms to have its own technology. You can turn your newfound speed and efficiency into extra time for more production. The new DEXIS Platinum sensor is unbelievable, in this regard. I have diagnosed at least 15% more treatment with the new sensors because they are so clear and accurate. You have to see them to believe it. Ask for an in-office demo or go to www.dexis.com for more information.

It is for this reason that I encourage you to switch from phosphor plates to the DEXIS sensors. There has not been one case that I have not been able to X-ray with the wired sensors. For the longest time I had both phosphor plates and sensors in the office, because I believed I would not be able to get every X-ray I needed. Well, after one year I sold my phosphor plate system on e-Bay. It saves me at least 10 minutes for every hygiene appointment, which adds up to 80 minutes a day that the hygienists use for patient education, fluoride treatments, oral cancer screenings, etc.

Another way to bring speed and efficiency to the treatment room is by changing your chairside monitors to touch screens. You can purchase them through Henry Schein OATS (800-288-7691). I recommend the Elo Intellitouch. It is glass and easily sterilized. All you have to do is take down your old monitor and hook up the new one. Your patients will be activating patient education on their own; you can draw on the monitor with a rubber tip stylus, and even discuss their treatment plan without having to use the mouse. The patient can even initial the treatment plan or presentation to make a record that they saw it. The new screen adds an interactive element to the treatment room.

Moving to perfecting the paperless office using the EDRElectronic Patient Record, is an ongoing goal in my office. I went paperless in 2001 and have never looked back. I do not miss my staff asking me what I did with “Mrs. Jones” chart. One of the most speedy and efficient additions toward that record has been the addition of the e-pad from interlink electronics. It is also available from Henry Schein OATS. It captures the patient’s signature for consent forms and treatment plans, and also allows you to sign your notes all in the Dentrix Chart. By far, the Dentrix practice-management system is the best. I have practiced for more than 20 years and have found none better. The pads are USB compatible and we have a 15-foot cable that easily sits on the counter and stretches to the patient chair.

Look for the upcoming Digital Dentistry Delivers Part 3; I will focus on the front office. The future is yours!

The thought of proactively marketing your practice often brings a negative connotation to mind. It was not that long ago that marketing was actually looked down on and the common thought was; I don’t want to be “one of those guys.” The reality is, whatever you’re doing, or not doing as far as marketing is concerned, effects the message you are sending to your patients, team, and community.

External marketing, including billboards, radio, and large signage is generally what most people think of when they think about marketing. However, on-going internal marketing is almost always a better vehicle and far less expensive. For example, 75%-80% of new patients come from patient referrals. So an effective internal marketing program designed to increase patient referrals should be your focus. You should really narrow that focus to your “ideal” patient. What does your ideal patient look like? What type of dentistry do you want to do more of—cosmetics, implants?

What do you think of this definition of an ideal patient; they arrive on time, readily accept your treatment plan, pay their bills, and refer their family and friends? We want to start with our ideal patient because like people tend to surround themselves and spend time with like people. The busier we all get and the less time we have, the fewer friends we tend to spend time with and those we do see are usually closer friends. So chances are if you get a referral from an “A” patient, you are likely to wind up with a new patient very similar to your referring patient. Therefore, when possible, you should focus on marketing and referral efforts to that ideal patient.

The following are some internal marketing tips to help you get started:

Set new patient goals

a. As the saying goes “if you don’t know where you are going any road will take you there.” How many new patients did you average per month last year? How many new patients would you like be seeing per month by the end of this year? If you and your team answer these questions, then begin to track and measure the results, you will increase your chances of hitting new targets.

Run on Time: The number one thing a dental office can do to market their practice is run on time.
a. Everyone is busy these days from the CEO to the “Soccer Mom.” People have become less tolerant of “their” time being disrespected. In addition, if your practice is running behind, the perception is you’re too busy and not even interested in new patients. So many of your current patient base and your number one source of new patients could actually refer away from you. “My dentist is pretty busy but there is a new guy that just opened up down the street.”

Have a Morning Huddle
A well run “Morning Huddle” is the single most important thing you can do to increase communication and productivity in your practice and will help your practice to stay focused and run on time. Fewer than 10% of dentists have a morning huddle. If you would like information on structuring a morning huddle please contact your Henry Schein Field Sales Consultant for help.

The Telephone: Answer the telephone before the 3rd ring
This is the first impression a new patient has of your practice. A pleasant, inviting voice that is willing to patiently take time to initiate a relationship with the new patient is critical to the new patient experience.

Stagger lunches and staffing on Friday’s to make sure that your phone is answered by a “live” person.

On-hold message
If you do have to put a patient on hold, a professional, recorded message is one of the best ways to introduce new procedures, techniques, and technology to your patients. In a recent survey, 80% of people said they had purchased a product they learned about while on hold with a business.

Reception Room
Your Reception Room should be your marketing area. The area should be neat and well lit and updated every 5 years.

• What do you want your patients to know about you? Patient’s testimonial letters with before and after photos provide a great visual for the client considering specialized treatments.
• What clinical services do you provide; implants, cosmetic dentistry, orthodontics?
• What technologies have you chosen to improve treatment options: Hard- and Soft- Tissue Lasers; Digital Technology, CAD/CAM?

Remove the competitors. Many doctors think they are in a competition with the dentist across the street when in reality you are competing for discretionary income. You presented veneers to “Mrs. Jones” but she mentally just spent that money on a Carnival Cruise she saw in People Magazine in your reception room. Patient Education in your reception room is a must. Replace the TV and all of the “bad” news your patients listen to with dental procedures that are available in your practice, as well as medical health and wellness channels.

Henry Schein offers GURU. GURU offers:

• Video and interactive animations
• GURU TV (waiting room DVD)
• Full Integration with HSPS (Dentrix, G3, G4, and Easy
• Dental 2008 – Bridge Available for Other Systems – COMING SOON)
• Flexible, customized
• Continued content development

Gifts: Don’t let your patients leave empty-handed. Small gifts are a nice touch and show appreciation.

• Bath oils, lotions, golf balls and/or tees, pens, pen lights—all with your name and logo
• Lottery ticket with a note that says, “Thanks a million for coming in today”

Generating Referrals

As we said, 75%-80% of new patients should come from patient referrals, yet many dental practices do not focus on their #1 resource—their current patient base. Many patients do not know that you are looking for new patients (especially if you frequently run behind schedule). The following are tips for asking for referrals. You could “roleplay” these ideas during an upcoming team meeting.

At the initial visit – A new patient who has a favorable impression is more likely to share this positive experience with others than even a long-time patient would. As a result, we suggest that you encourage all new patients to refer to you with a simple friendly closing to their first appointment. Thank the patient for choosing your practice and say “if you have friends or family that are as nice as you, we would love to have them as patients too!”

After their initial visit – You should consider sending patients a handwritten card after their initial visit to thank them for making your practice their choice for dentistry. Include a “P.S.” at the end stating, “We hope you’ll tell your friends and family about our office. We would love to have more patients just like you.”

When patients compliment your practice – This represents a natural time to ask for patient referrals. Respond to the compliment by saying, “We are glad that you had such a positive experience in our practice. We would love for your friends, family, co-workers, and relatives to have the same positive experience and would welcome them as new patients.”

At treatment completion – Asking for patient referrals is also natural when patients are near the end of a successful treatment. Asking the patient if they are pleased with the result and requesting the patient referral when they respond affirmatively, is an easy and natural lead in for many doctors.

Involve your team – Your staff may well know your current patient base better than you. In regular staff meetings, ask for patient referral suggestions that they would be comfortable implementing. Better yet, in the morning huddle, have the staff consider which patients to ask for referrals and make this part of your practice’s regular routine. During your morning huddle identify one “A” patient per day that you will ask for a referral and then decide who on the team will ask.

Marketing your practice does not need to be an overt act or very expensive. For most patients, the perception of value and level of care has very little to do with what the doctor sees as important. In fact, 67% of patients will leave a practice because of indifference and/or how they were treated. The following are results of a survey characterizing the differences in what the patient and doctor value when choosing dental care.

If you will get started with 2 or 3 internal marketing ideas this month and then add just one per month for the next 12 months, you will be amazed at the results you will see in increased patient flow. An on-going, continuous marketing program that the team embraces and participates in is the key to increasing referrals and new patient flow.

CR Dental Health Clinic’s 2,974-sq. foot; Provo, Utah-based facility resembles a private dental clinic: however, it works in conjunction with the nonprofit CR Foundation that publishes the Gordon J. Christensen - CLINICIANS REPORT ( formerly Clinical Research Associates) to identify products, techniques, and equipment used in dental care for efficacy and clinical usefulness. After testing all types of dental products, the results are disseminated to colleagues around the world, supporting dental healthcare providers with in-depth evaluations of new products that often lack testing aside from being used on patients in a random, uncontrolled manner.

“Our intentions were to communicate to our patients that they will get the most up-to-date techniques, care, and quality products while paying only a moderate cost.”

Photographed by Michael Moosman

Some examples of products studied at CR Dental Health Clinic are restorative materials, tooth-whitening systems, air abrasion units, caries detection devices, and a wide variety of dental equipment.

The newly renovated facility is within proximity to the CR Foundation, its labs, and teaching facilities. “We needed a new clinic where we could continue our clinical evaluations and research; teach dentists and lab technicians; and highlight those products and services that we have found to be faster, easier, better, or less expensive,” comments Dr. Paul L. Child Jr. “Our strong desire is to reach all dentists through continuing education and quality research that is unbiased and independent.”

After determining the goals of the Clinic with input from CR’s principals, Dr. Christensen and Child turned to Henry Schein’s regional and local specialists and other companies to get the project moving. Equipment Sales Specialist John Dickson comments, “CR Dental Health Clinic was structured to allow the CR Foundation to build a facility that would give us the ability to highlight recommended products of our choice that reflect the highest level of quality and demonstrate the highest degree of technology available. CR Foundation would then evaluate these products on a nonbiased basis.”

Photographed by Michael Moosman

CR Dental Health Clinic wanted to demonstrate that a highquality office could be constructed within space limitations. “Our intentions were to communicate to our patients that they will get the most up-to-date techniques, care, and quality products while paying only a moderate cost,” points out Dr. Child. “We desired to convey an image of excellence and elegance within reason.”

“Our strong desire is to reach all dentists through continuing education and quality research that is unbiased and independent.”

“We believe that the equipment installed represents the highest quality and best technology available to today’s dental practitioner,” comments John Dickson. “The unique aspect of this project is that our vendors are supplying the majority of the equipment on a consignment basis. As new products come out…products can be rotated…the doctors gain by having the opportunity to use the best products anywhere in the dental industry.”

Henry Schein’s specialists provided Pelton & Crane equipment, Midmark sterilization center, Dentrix practice-management systems, office equipment, i-CAT CBCT, and the water filtration system—plus hardware and software through our OATS group. OATS experts bring a full range of technology support and solutions to the dental office setting, offering full integration and maintenance that dental healthcare providers need for their highly specialized computing and practicemanagement needs.

“Our patients are at ease in our clinic knowing they will receive the highest quality service at a moderate cost,” notes Dr. Child. “Our staff and dentists are excited to use the new equipment and demonstrate to our patients and other dentists we are teaching how this has enhanced the overall dental experience.”

Referrals have increased at CR Dental Health Clinic with the best technologies on the market to support their continued success as they move forward in reaching their goals and their vision as dental healthcare professionals.

Forefront: Dr. Gordon Christensen, Senior Consultant of CR Foundation. Back row: (L to R): Dr. Paul L. Child, Jr., CEO of CR
Foundation, Joe Cavaretta, Zone General Manager; Derek Hein, COO of CR Foundation; Deb Grieve, Field Sales Consultant;
Jeff Harmon, Regional Manager; Patrick McGibbon, Technology Sales Specialist; Ryan Perez, Equipment Service Technician;
Mike Simmons, Project Coordinator; John Dickson, Equipment Sales Specialist; Corey Spray, Equipment Service Technician,
Toni Wengreen, Administrative Director of CR Foundation

Featured Equipment

• Pelton & Crane Center, Side, and 12 0′clock
• Renaissance Cabinets
• Pelton & Crane 3000 Delivery Unit
• KaVo Electric Handpieces, Intraoral Cameras, and Curing Lights
• Pelton & Crane 3003 Chairs and Stools
• Pelton & Crane Helios Track-Mounted lights and Monitors
• Sterilization Center With Midmark Integra Cabinets
• Sci-Can Instrument Washer and Statim 5000
• Midmark M-11 Sterilizer.
• Pelton & Crane Vista Pure and Vista Clear
• KaVo Customized Lab Workbench
• Dentrix Practice-management System
• DEXIS
• i-CAT CBCT

Even though this project that you are considering involves brick and mortar, it is actually an exercise in marketing. Yes, you will be practicing in the facility and treating patients, but the environment of the office will speak as loudly to the patients as you or any of your staff members. Patients, especially new ones, gauge or determine the level of care they receive by assessing the quality of the office environment. Don’t believe it?

Keep this concept in mind the next time you are a new patient to an unfamiliar doctor. Nonverbal communication is very powerful in new or unusual environments. Your office will speak to patients; you have a choice in the statement the office will make to them. Regardless of your clinical ability, your success does not depend on your diagnostic and treatment skills, but rather your perceived competence as viewed from your patients’ perspective.

There are two basic tenets advanced in the above paragraph. First, if you accept the concept that the office, among other things, is a communication tool, a giant billboard that all of your patients view each time they are treated, then it should be the personification of your “marketing” program.

In fact, it is the marketing program.

Second, success is dependent upon your patients’ perceptions. But what is success? Is it greater production, i.e., dollars, fewer direct patient care hours so that you can spend more time elsewhere, focus on a subspecialty requiring a certain environment, hiring an associate to alleviate the workload, or increasing your income while maintaining your direct patient care hours? These goals will dictate certain design objectives such as the number of operatories. Often, there exists a great disparity between what doctors believe they need in order to achieve their goals and what is actually required for them to accomplish these goals.

Communicating your goals and dreams How do you expect the office to assist in reaching your personal goals? Too many times, when questioned about why this new office project is being undertaken the response has been, “I need more chairs or operatories.” More operatories are a means to reach your ultimate goal. You must decide how you want your office to look. It is helpful to view your office from your patient’s perspective. Would you rather have a quaint, comfortable looking office or a more dramatic presentation that conveys the use of cutting-edge knowledge and technology? Know your goals because they will undoubtedly impact the manner in which your office is designed.

There are two basic office design criteria that should be foremost in your mind as you begin: office function and office image.

After stating your expectations or goals you will be able to gauge the amount of assistance you will require, the amount of work you will do on your own, the financial commitment you will make to the project, and how much time you are willing to commit to it. Doctors’ involvement can range from total immersion in the project to completely delegating the design of the office to a staff member, spouse, or more appropriately, the designer or architect. Delegation is ideal for a doctor who wants to devote minimal time and/or effort to the process, but remember that you are the one practicing in the facility for, on average, the next 20 years. Request that the designer or architect confer directly with you at the following key decision points in the design process: (1) your definition of the size and components of the office, which is expressed through the use of a design program questionnaire (supplied by the designer), (2) your final approval of the floor plan, (3) your characterization of the elements of the interior design and, (4) your acceptance of the final detailed design drawings. This sequence of events has the potential to satisfy your goals because modifications are almost always needed to meet individual needs and preferences. If accomplished in an orderly fashion by effective leadership of the designer/architect and yourself, this method of project development will decrease your design costs, reduce your construction costs, and result in the office that you “had in your head” as you began the process.

Figure 1

Defining the character of the office includes establishing a wish list of merchandise and equipment you want to employ and procedures and events that you want to hold in your facility. Make certain that this list is in writing and submitted to the architect. Many architects will typically refer to this document as a design program questionnaire, and some will even have one prepared for you to complete. Without the design program, an architect can always design “something,” but this “something” may not coincide with your goals and dreams. If the design program is written as opposed to verbally communicated to an architect or designer, the architect or designer will have a much clearer vision as to what is to be accomplished, and more importantly, they will have your goals and dreams. You and the designer or architect become committed to your ideas by intentionally enumerating your thoughts on paper. This step of (you or the architect) drafting your office design desires is vital to the uniform and daily progress of the project.

Form follows function…right?

There are two basic office design criteria that should be foremost in your mind as you begin: office function and office image. You are designing a dental office, before and above and above everything else, it must function effectively to provide quality treatment to patients while minimizing the physical and emotional stress to the staff. It sounds simple, but there are innumerable things that can impede you from treating patients properly. A very simple formula that is critical to your success is the equation that the functional dollars of the project plus the image dollars will equal the degree of success that you have in reaching your goals and building your practice. Focus and concentrate on the functional aspects of the office design and establish them, then layer the elements of image or aesthetics onto the functional aspects of the office design.

Figure 2

A common misconception is that a well appointed office costs a great deal more that a relatively plain, simple office. In fact, it is just plain costly to build any technologically driven diagnostic and therapeutic dental office. You are going to make an investment in your professional office, unlike your car or house, because you expect a return on the investment. If properly designed and constructed in an acceptable location, your office will probably yield greater financial return than any other investment made in your life. First of all, there are many rooms confined to a relatively small space. The rooms are smaller and, as a result, there is much more framing, sheet rock labor, technology cabling, vacuum, compressor, and medical gas lines, and many more electrical outlets. A typical fiveoperatory office has between 80 and 100 outlets whereas a 2500-square foot accounting office might have 20 outlets. This plethora of outlets begets a tremendous amount of electrical work and this, of course, is accompanied by extensive plumbing and the resulting stratospheric costs.

Before the appearance of the office is considered you have already invested a considerable amount in the aforementioned physical elements of the office. The remainder of your financial resources will then determine the office’s image. In order to create a minimally acceptable appearance for the office, it is necessary to invest $10 to $15 per square foot in “image expense” which, in a lease space, might represent between 10 and 15% of the actually building cost. However, if you were to invest $25-30 per square foot you will enjoy an office that emits a strong statement about the quality of care offered at the practice (Fig 1). Many believe that offices with this degree of investment in their image simply have sacrificed something pertaining to function, but this is simply false.

Do not succumb to this fallible reasoning and begin to make imprudent judgements such as “Oh I can’t have that, I don’t want that” or “People in my town won’t like that.”

Quality Counts

Why would you not want to make a statement of quality to patients from the instant they walk into your office (Fig. 2)? Marketing surveys have been conducted as to how patients assess the quality of healthcare they receive. In these surveys, patients in a number of facilities were asked to rate the quality of care they would expect to receive, based on a scale from one to ten, according to their observations in a particular healthcare facility. The highest rating any facility received was fifty percent. In other words, patients from a wide spectrum of income levels and facility experiences expected, at best, only mediocre care. It is tragic that people must walk into medical or dental offices and, because of what they see, expect mediocrity.

Patients base their expectations of care on those items they can judge: furniture, artwork, and posters. Message to all practices: Get rid of the posters! Nobody enjoys looking at posters, advertisements, and things lacking in visual appeal. Give the patients something aesthetically placating to view. The patients in these surveys also commented that the furniture in the offices appeared to come from a second hand store or a basement. Clutter was another condition for which the patients voiced disdain; it dramatically lowers the patient’s opinion regarding the level of care they receive. It is important to take notice of these items—because your patients most certainly will.

The key to success of the practice is congruency. You must be congruent in everything you do, say, and display to your patients. The function and esthetics (image) of your office must be consistent with the treatment you propose and deliver to your patients (Fig 3). In other words, your environment must reflect who you are as a practitioner.

Success will follow.

Therefore, posing the question whether your practice can support a new office is not the manner in which the project should be approached. Indeed, the question should be whether a new office will support your practice. The facility must support the practice in order for your life and professional goals to be achieved; it is a vehicle for success. The office must support the growth of the business, the practice, and you as a professional, or it is the wrong design. The office, as the marketing centerpiece, should facilitate the functioning of the practice with a significant increase in productivity.

Figure 3

Green Lights

Are you the type of person who needs all of the spotlights to be green before you will start out on a journey? If so, now is a rare time in which all of the economic green lights are on. Construction (labor and materials) costs are down from 15 to 20 percent on a national average, borrowing costs (interest rates) are at historic lows, and the economy is in its beginning stages of recovery. Remember the admonition, “Buy low, sell high”? It is a very simple strategy which is extremely difficult to execute, but now is the time to buy low. Hopefully, you will seize the opportunity to take your practice to the next level while earning more and feeling better at the end of the day.

Want to seek business success? The prescription “location, location, location” often comes to mind. And, although this approach has been used upfront repeatedly, there can also be circumstances that help one gain entree into new venues.

Such is the case in Jamestown, North Dakota when, as fate would have it, there was a need for another orthodontist in the area, opening up the opportunity for Dr. Alison Fallgatter to take the step up that would help to better define her professional goals by providing the option to create an office of her own. Previously, Dr. Fallgatter had worked in a private practice, but had a strong desire to start new and be her own boss. The timing was perfect. She would also be in a prime position to gain a strong customer base in Jamestown.

The decision to build The Dental Specialists of Jamestown opened up a world of possibilities for Dr. Fallgatter. A new endeavor of this sort has the built-in dynamics that are sure to bring about a great deal of optimism and excitement for those involved. The Doctor could now exercise her personalized design preferences and pursue her philosophy of patient care as well.

Her previous experience with Henry Schein Dental’s equipment specialists assured her that she would have a similar level of success in the upcoming transition to her own facility. Equipment Sales Specialist Mike Minor comments, “We held preliminary meetings and discussed equipment needs and what she was looking for in a dental office. I coordinated the activities through our National Design Group and the doctor’s architect to maximize the use of space. Dr. Fallgatter had a strong relationship with Field Sales Consultant John Lester. I handled equipment needs…and chose what would be required based on the specific needs of the orthodontist. The office’s customized cabinetry had to reflect high quality, low maintenance, and durability as well as being aesthetically correct.”

” We were able to meet all the doctor’s needs…and proud to be part of the team that worked to help this office become a reality.”

The office’s style is modern and open with clean lines and a contrasting color palette that brings a feeling of sophistication to the space. The inviting reception area expresses the minimalist approach with sleek, contemporary furnishings, a fireplace, and modern art that helps to set the mood. Glass walls around the consultation room add to its sense of overall spaciousness, as do the open-bay operatories.

The Dental Specialists of Jamestown has achieved its mission in creating an ideal environment that attracts patients and inspires them to refer the professional services it provides. It is also a comfortable and prosperously engineered facility, able to support the many daily activities performed by Doctors and adjunct staff members. Heightened efficiency, enhanced workflow capabilities, and the potential for increased profitability are ensured by the office’s winning design. “Everyone who walks in just raves about the new space,” remarks Doctor Fallgatter.

“The Doctor always had time to go over everything…this led to a smooth process,” adds Equipment Sales Specialist Mike Minor. “We were able to meet all the doctor’s needs…and proud to be part of the team that worked to help this office become a reality.”

Dr. Fallgatter looks forward to a future that will expand the oral surgery area. She also sees the potential for a pediatric dental practice, and is already planning equipment upgrades in radiography and the purchase of a soft-tissue laser.