By Lou Shuman
DMD, CAGS

As the president of the Pride Institute, I have consistently encouraged the use of technology in the dental office.

Our research indicates that 81 percent of Americans between the ages of 30 and 49 are online daily. Patients have become educated consumers for their daily purchases as well as in choosing their practitioners; researching treatment options; obtaining patient feedback; and browsing practice Websites to increase their chances for a better dental experience. From the practitioner’s viewpoint, digital radiography is a superior technology over film that improves clinical assessment and greatly enhances treatment presentation.

When faced with implementing new technology, dentists often express budgetary concerns. In the current
highly competitive and tight economic environment, although the initial outlay for an investment in digital radiography seems like the higher cost, practitioners should explore the true costs of staying with film—including what is spent on film, chemicals, and labor on an
ongoing basis.

Since research is the cornerstone of my business, and also my passion, I recommend that you do some research
on your own business’ traditional film

X-ray-related costs. Using your practice-management software, run a report on how many X-rays—including single PAs and bitewings, and all types of series—your practice generated in the last 3, 6, or 12 months to derive an average daily amount. Next, review your invoices for the same period to calculate the cost of film, mounts, processor chemicals (including cleaners), and your quarterly disposal fee. This will give you a better picture of what you are spending on these consumables.

To save time, DEXIS has an online calculator that allows you to plug in the average number of X-rays taken each day, which can be derived from your overall practice-management statistics. The tracker factors in the price for film, chemicals, and waste disposal and automatically calculates your monthly film cost. It then compares this total to a monthly rate for a digital radiography solution. Keep in mind that the calculation does not include labor, duplication costs, and postage for mailing film to insurance companies or referring dentists. I think you will be surprised to learn how much traditional film actually costs you to maintain, and in that light, how a digital X-ray system will comfortably fit into the budget—and be more economical over the course of your system ownership—especially if you already have computers in
your operatory.

The return-on-investment in a digital system extends beyond the money saved on supplies. With digital radiography, besides the opportunity for better diagnosis, the dentist can explain that diagnosis more concisely. The result of increased patient communication is treatment acceptance. When patients are happy, they will tell their friends, most likely on Facebook, who may have otherwise just resorted to a Google search of dentists in the area, thus increasing your potential for referrals.

I urge you to take my digital challenge today at www.dexis.com/DigitalSavings. Compare the cost of film to the investment in digital-imaging technology. Once you look at the whole picture, the image of your future will be much clearer.

Dr. Shuman is not employed by Dexis. He does not act as a consultant for them nor does he have any financial interests in the company.

Dr. Michael Wing

That’s my boy!

And, that’s who I want to be with, along with the rest of my family when I am not with my patients. The incorporation of technology into my practice has given me more time for what matters and more money for what doesn’t matter as much.

I practice in Eagle, Colorado. It’s a small town in the mountains, which can present its own set of challenges but it can also present incredible opportunities when you can separate yourself from the rest. Differentiation provides market advantages regardless of city size—large or small—different is noticed. I pride myself on running a high-tech dental office that produces high-quality dentistry. I know and understand that my patients want quality, convenience, and efficiency when they come to see me. I also want my time to be lucrative because, let’s face it, this life is not getting any cheaper. I find that I can save time and money for both my patients and my practice by providing single-visit restorations using the latest in digital technology.

Figure 1. My pot of gold! This is a bag of blocks I milled with my E4D. I save the mandrels as a reminder of the number of teeth we have restored.

It seems everyone is talking about digital impression systems and the term CAD/CAM is commonplace in dentistry (but not in the operatory). Although all of the talk about digital-impression systems seems to offer some convenience (no impression material, eliminate gagging, etc.)

Figure 2. Scan of missing tooth and implant site number 20.

Practice and Life Changing
Four years ago I purchased an E4D and after milling and seating over 3,000 restorations, I’m here to tell you this thing works and it works well. So let’s do the math: 3,000 times an average fee of $950 (my C&B fee) equals $2,850,000 dollars. I can say that this is a conservative number for what my E4D has produced in revenue for me; in fact I am sure it is well over $3,000,000 when you count all the other procedures and new patients just having an E4D has provided (Figure 1). And, the opportunities never stop; the mill doesn’t quit or need vacation and maintenance visits are done quarterly—right in the office. It just doesn’t matter whether I do one restoration a day or six. Believe me, this technology provides you more revenue without compromise—I’ve seen no compromise in my quality of care or restorations (form, fit, function, esthetics) and certainly no compromise in the bottom line, in fact, the E4D allows me to expand my capabilities like no other—and my technology capabilities continue to expand.

Figure 3. Digital restoration of number 20.

Figure 4. All on one screen: shown here as the final plan for tooth 20.

Phase Two
Now I am moving into phase two of that technology and integrating the use of cone beam technology with my CAD/CAM technology—all thanks again to E4D. Using my i-CAT® (Next Generation 3D cone beam system) combined with the E4D Dentist system, I can now present a solution to my patients for their edentulous area using the E4D Compass software right on my cart (chairside).

i-CAT Next Generation 3D cone beam system

The i-CAT was my most recent acquisition, and I can tell you that the patients who are interested in implants are not leaving my office looking for another provider to place their implants for them after I am able to graphically present all that I’m planning with them. With the E4D system, I can scan the edentulous area (Figure 2), design the ideal restoration (Figure 3) then combine that information with the cone beam data in E4D Compass. From there, I can detail with the patient what implant size I plan on using, the implant’s location, abutment height, and angle and, of course, the look and size of the final restoration. Now my patients can see all of this on one screen. I can map the nerve for them and then demonstrate quality and quantity of bone. I can show my patients the location of the implant as it relates the to the rest of their anatomy (Figure 4). This is not a plastic model, make-believe situation, or cartoon, it’s their anatomy right in front of their very own eyes, showing both above the tissue (E4D scan) and below the tissue (i-CAT scan).

After showing them the plan and telling them how this will provide us a preview of what to expect, I am able to capture their confidence and get them to book that implant placement right away. After receiving an okay from the patient, I simply order up a surgical guide using the data directly from the i-CAT and a conventional impression and we are on our way to highly predictable implant treatment. E4D Compass sells more cases and better yet, it involves the educated patient in the process. I am now able to provide a whole new world of service to my small town patient population and not send them on a two-hour drive through the often-stormy mountains of Colorado. My patients are continually thanking me for this technology and believe it or not, implant placement does not have to be a stressful unplanned event if you have the right tools! It reminds me of a movie from the 1980s—Fast Times At Ridgemont High— when Spicoli tells his buddies not to worry about fixing the car he just wrecked because his dad has an awesome set of tools he can use to fix it. Technology in dentistry has equipped us with an awesome set of tools (E4D Dentist, i-CAT) to fix the issues. Now with the treatment planning visuals, the E4D Compass software, you can treatment plan the implant or collaborate with your surgical team so that you can actually restore that implant based upon the plan.

My buddy says you can’t score if you don’t shoot–if we want a productive practice we must plant seeds that will bear new fruit and continue to grow professionally so that we will attract and retain our patients. “He who wants to be the greatest will find a way to serve the many”…why not allow technology help you serve others? Our greatest task is serving our patients well and giving them something great to take home. Let E4D expand your services and professional opportunities by implementing CAD/CAM technology and together with cone beam technology— allow you to serve the many more efficiently and effectively and that is true return on investment.

For more information how technology can fly your practice, contact Dr. Michael Wing at dr.wing@yahoo.com or contact your Henry Schein Dental Sales Consultant.

By Dr. Mark Tholen

Clothes Makes the Man—or Woman
How superficial. Clothes make the man; the saying implies that image is very important. Although the phrase may not be completely true, first impressions are very important. In fact, psychologists have found that an individual will assess a new acquaintance or environment within 30 seconds to one minute (revealed in the book, Blink), and an overwhelming amount of contradictory information is required to change the originally-formed opinion.

What is your patients’ perception of your practice? You might be surprised to learn their actual assessment because we judge ourselves based on our intentions, but others (that is, patients) judge us on our performance. And since not many of your patients are dentists(!), they judge your clinical skills on the condition of your office and the sophistication of your equipment and technology. Worn out dental equipment and outdated technology yields a perception of compromised quality of care—and this perception becomes reality in the mind of the patient.

The Moment of Truth
The state of your technology is especially evident to the patient in the case presentation. For example, are you using current radiographic technology such as Cone Beam Computed Tomography (CBCT) in your implant case presentations? Are you conducting your case presentations in a consult room or the operatory? Utilizing state-of-the-art technology in a nonthreatening consult room (yes, the operatory is threatening to the patient) allows your patient to hear you, focus on the quality of the technology being presented, and most importantly, trust you. In order for your patients to accept the care you are proposing to them, they must first trust you. Ergo, you must give them a reason to trust. And since they don’t understand the clinical aspects of the case presentation, you must speak to them in a language they understand: the sophistication of your employed technology such as CBCT and the room in which you present the case. The design and elegance of the consultation room must match the level of care you are presenting to the patient (Fig.1).  If you observe this design principle, your case acceptance rate will soar. The average case acceptance rate in the US is approximately 45%, but offices with technology and consultation environments consistent with the level of care proposed have acceptance rates greater than 80%. The reason is simple; patients have been given a reason to trust the doctor.

In order for your patients to accept the care you are proposing to them, they must first trust you.

Figure 1. Modern consultation room

Figure 2. Elegant, calming consultation area with monitor showing i-CAT® Quick Scan in Tx STUDIO®

A Picture Is Worth a Thousand Words
Working with a three-dimensional radiograph (CBCT) of the patient’s maxilla, mandible, or dentition in a case presentation delivers a clear message to the patient that you use state-of-the-art diagnostics and deliver a high standard of care (Fig. 2). They don’t need to understand anything about dentistry to receive that message loud and clear. You are allowing the patient to trust you—and accept the treatment plan.

The Clinical Benefits of CBCT and i-CAT Are Well-Known
The quantum leap in diagnostic and treatment planning value of CBCT makes the purchase of the technology a true value proposition. The added data points create a three-dimensional image, thus making your mental interpolation of multiple two-dimensional views unnecessary, and the analytical software used to examine the radiograph will reveal pathology that even the most trained radiologist will not be able to discern with conventional radiography (Fig 3). The radiograph is composed of 256 shades of gray from absolute white to black, but the human eye is capable of detecting only 12 to 14 shades of gray. A tremendous amount of information is present but not detected by the human eye. Diagnostic software can shift the gray scale range of the entire image and also stretch the gray scale of the image on the monitor so that the pathology “enters” the gray scale range of the human eye. The course of hair-line fractures, root and canal anatomy, quantitative determination of a structure’s density, metabolic disorders manifested in hard tissue, and many other diagnostic functions can be employed. i-CAT goes beyond that with color 3D renderings. The point is that CBCT and i-CAT transform radiography from a diagnostic aid to a pathopneumonic diagnostic tool. That said, you do need CBCT technology that best serves and supports your practice. The i-CAT suits the needs of general and specialty practices that offer orthodontic, TMJ, airway, implant, and other surgical procedures.

Figure 3. i-CAT® Precise™ scan in Tx STUDIO showing radiographic grayscale details as well as 3D rendering

Figure 4. CBCT system neatly incorporated within the office floor plan

Office Design Considerations With i-CAT
If you are planning a new office, I would urge you to plan on adding space for CBCT and i-CAT even if you are not initially installing the unit in the new construction. As CBCT trends toward the standard of care, you may want to incorporate i-CAT in the practice in the future. Of course, it will be necessary to comply with your state’s radiation safety board code, but generally the i-CAT has the same foot print as a pan machine (Fig.4). The alcove should be located in the clinical zone, i.e., grouped with the operatories, lab, and sterilization (Fig.5). However, rather than occupying your time with these details, request that your Henry Schein Equipment Specialist partner with the i-CAT certified pro-physicist to conduct a site analysis to determine the specific radiographic and space requirements for your existing or new office.

Also, when considering which CBCT to employ, remember that your equipment selection must be able to adapt to future advances in hardware and software applications. The average practice will occupy a facility for 17.5 years, so the CBCT unit must be expandable and adaptable as technology races forward; i-CAT is particularly suited to upgrades.

Feature i-CAT as a Practice-Building Element Without Saying a Word
Illuminate your i-CAT (Fig. 6) in the alcove in which it is housed! This will draw the patient’s eye to the technology and speak volumes to them about the quality of the practice. Lighting in an office delivers the biggest bang for the design dollar as it truly delivers the “wow” factor, and you can capitalize  on your “cutting- edge technology” image with purposeful illumination of your i-CAT.

The Economic Advantage of Moving Now
There have been some tectonic economic shifts in the past few years, and we need to be positioned to take advantage of the movement created by these shifts: inflation, depressed construction costs, and depreciation schedules. The answer to inflation (It is occurring, no matter what the Fed says. Gasoline is up by 83% and food by 21% over the past several years.) is taking on debt and repaying the debt with inflated dollars. As dentists, we have an almost unique opportunity of (1) investing in an asset (office and equipment) that (2) earns money that (3) we use and manage. This combination allows us to maximize the return on our investment and keep pace with inflation.

Depressed construction costs are seemingly paradoxical when describing an inflationary environment. But because the housing industry is in the doldrums, labor costs are down about 15% compared to 4 years ago.

Finally, there is a significant tax advantage to building a new office and buying new equipment such as the i-CAT. Section 179 of the tax code continues to allow accelerated depreciation of dental equipment; in 2011, the maximum amount that can be depreciated 100% in the year the equipment is placed in service is $500,000. I would urge you to speak with your Henry Schein Sales Consultant to obtain the details and other tips in navigating the funding process.

Every journey begins with the first step, so take the step of contacting your Henry Schein Sales Consultant and investigating the clinical and financial opportunities of adding CBCT and i-CAT to your new or existing office.

Figure 5. Henry Schein National Design Group – 3D Design

Figure 6. Modern design for i-CAT alcove

By Martin F. Van Vliet, DMD

Three years ago, I implemented two i-CAT® Next Generation 3D cone beam systems for my orthodontic practices.

At that time, I believed that this technology would enhance my diagnostic skills and orthodontic treatment planning. However, I did not realize that this versatile imaging modality would lead to a complete metamorphosis in the evaluation and treatment of my orthodontic patients.

Three-dimensional imaging and CBCT provide me with accurate pictures without any distortions of the teeth, including roots, structures of the jaws and skull, sinuses, upper respiratory airway, and temporomandibular joints (TMJ). I am able to view the exact locations of unerupted teeth, supernumerary and impacted teeth, as well as abnormalities and pathology.

It is well documented in the literature that a limited upper respiratory airways has a tremendous effect on the growth and development of a child’s face. Before visualizing upper respiratory airways with 3-D imaging, many children with restrictive airway disease (RAD) and pediatric sleep apnea (PSA) went undiagnosed, potentially affecting the development and growth of their faces, as well as the effectiveness of their orthodontic treatment. In adults, RAD can affect their dental health in addition to the quality and longevity of their life. Viewing the CBCT scan in 3-D software, such as Tx STUDIO® or Dolphin 3D, airways can be evaluated from all angles, and the airway volume can be measured in detail. Appropriate medical referrals and adjustments in orthodontic treatment can be made.

An exciting and enhanced world lies ahead for orthodontists who implement 3-D imaging.

In the late 1990s, the first generation of 3-D orthodontics was introduced with Invisalign® orthodontic treatment. I began to see the importance of treatment planning and projecting orthodontic treatment prior to implementation. SureSmile® 3D treatment then became available with the use of traditional braces and customized robotic wires. I could now obtain superior orthodontic results with less office visits and decreased treatment times of 30%–50%. Initially, I used a white light intraoral scanner to obtain images of only the crowns of the teeth. However, when the i-CAT system was approved for SureSmile treatment, I immediately incorporated this technology to obtain clearer 3-D images of the entire dentition including the roots, as well as using the scans for diagnosis.
Orthodontic treatment is also affected by the capacity for bone visualization. With the use of i-Cat 3-D imaging and new enhanced tools such as SureSmile 6.0’s Bone Modeling, I am able to see how the roots of the teeth are positioned within the limits of the alveolar bone. With this feature, the bone measurement is accurate to consider 0.2 mm on average. In addition, I can visualize the final position of the roots at the end of orthodontic treatment, making outcomes more predictable and accurate.

An exciting and enhanced world lies ahead for orthodontists who implement 3-D imaging. All of these innovations stand at the center of this new world, allowing us to treat orthodontic patients more quickly and effectively than ever before. Once you live in the 3-D world, you will never return to a world without this new dimension.

Drs. Michael Danahay &
Matthew Hanfland

Designed to Succeed

Superior ergonomics, enhanced functionality, and industry-leading technologies have made Dental Innovations an office that is destined for success. Early on, Doctors Danahay and Hanfland combined their vision to create a clinical environment that would bring their patients the latest in treatment options and a touch of home-like comfort as well. Both Doctors had individually spoken to Henry Schein Dental Field Sales Consultant Brandon Stewart about developing a plan for a new office—and both wanted to partner to accomplish this goal. After the three had had several meetings, it seemed clear that the Doctors shared similar ideas, goals, and values when it came to opening a new dental office.

“I was an associate dentist at a private practice here in Omaha and decided that I wanted to do my own thing,” notes Dr. Danahay. “I enjoyed being an associate but desired to have my own practice and plan it from start to completion. Dr. Hanfland had a private practice he owned in Omaha but was looking for a new space to expand his practice and wanted a partner in the endeavor.”

The Doctors agreed that the ideal location to open our new dental office was a new, two-story professional building with large, eastward-facing windows across the entire second floor and an amazing view of West Omaha. “We knew that our patients would enjoy the light, the spaciousness, and the great view,” adds Dr. Danahay.

“The new office has had a tremendously positive impact on the entire dental team,” notes Dr. Danahay.

A comfortable and welcoming reception area reflects the practice’s philosophy of patient care.

“After the location was secured, we met with each of the companies that submitted a design and plans; went through an interview process; and ended up choosing Henry Schein Dental because of the layout; their team approach to installation; and the software and programs that would be used,” comments
Dr. Hanfland. “Henry Schein’s plan best utilized the existing space and showed a great understanding of the ‘flow for production’ that we wanted. Their team worked really well with the general contractors and architects. The build-out went very smoothly and the installation of the dental equipment, nitrous system, sterilization area, and operatory cabinets went off without a hitch.”

Equipped with: Pelton & Crane Cabinetry, Chairs and Delivery Units; Midmark Track light and Monitor; KaVo Electric Handpieces and Gendex Intraoral X-ray.

Dental Innovations’ contemporary, yet comfortable look is evident as soon as you enter the facility. Neutral colors are used on carpets and the walls. The artwork and decorations chosen reflect the overall contemporary theme. Mirrors are positioned throughout the office so that patients can checkout their re-vamped or naturally beautiful smile! A stonewall in the reception area with a waterfall feature provides soothing background noise. Furniture includes bucket chairs in a soft leather finish that matches the dental operatory chair finish. Black-speckled, solid surface quartz has been placed on all of the hard surface countertops throughout the office and flows with the color scheme. A large-screen television and coffee/
beverage bar in the reception area make each patient feel a little more at home.

Consultation room for reviewing patient’s treatment plans and explaining procedures. Equipped with DEXIS Software.

Custom, contemporary art is utilized to give the office a
comfortable, home like feel.

Equipment and technology choices include Pelton & Crane, Midmark, Gendex, Dexis, Dentrix, and Camlog products. “We needed a digital panoramic X-ray; computers in all operatories for patient education and entertainment while in treatment; and the Camlog implant system, as our office has added dental implants to its treatment options list,” points out Dr. Hanfland. “Digital X-rays mean no more dark room and instant viewing of radiographs and our centralized sterilization makes processing instruments much more efficient.”

A digital Panoramic X-ray is utilized for diagnosing and addressing patient’s specific needs. Equipped with Gendex 8500 Digital Panoramic X-ray.

The main hallway is designed for efficient patient care. Decorative mirrors allow patients to check out their beautiful new smiles before leaving.

Both Doctors agree that the practice has grown by leaps and bounds since the completion of the new office. With ample space for a more streamlined workflow, production has increased greatly and additional staff has been hired to meet this growth. “The new office has had a tremendously positive impact on the entire dental team,” notes Dr. Danahay. “The layout has allowed us to incorporate many more appointments to fit our clients’ busy lifestyles. Referrals are burgeoning because of wide variety of treatment choices and the enhanced level of patient satisfaction. Our team’s renewed motivation and enthusiasm is felt by our patients as we work to restore and maintain their oral health.”

Doctors Danahay and Hanfland advise you take your time in designing and building a new office. “Get to know the people you plan on working with,” comments Dr. Danahay. “It was comforting to know that Henry Schein Dental as a company encompassed all the aspects needed to complete the project. The staff and Sales Consultants were always helpful and knowledgeable and quick to answer our questions and resolve any issues that arose. Make the process a learning experience and enjoy it as it unfolds. Don’t forget to stop and reflect on how you got to where you are now—and what the future
will bring.”

The spacious, hands-free sterilization area has been configured at the center of the office layout. Equipped with Pelton & Crane Solaris and Autoclave, SciCan Statim Sterilizer and Statmatic, Handpiece Maintenance, and Coltene Whaledent Ultrasonic Cleaner.

Left to right: Dan Matthews, Equipment Service Technician; Ryan Lingenfelter, Equipment Sales Specialist; Eric Nuss, Regional Manager; Dr. Matthew Hanfland; Dr. Michael Danahay; Brandon Stewart, Field Sales Consultant.

Designed By: Kory Schneider, Henry Schein National Design Group

Dr. Charles Blair

It is no fun to write a narrative.

It takes an extensive knowledge of the procedure and what the plan is looking for as justification for the treatment provided. It also takes time, and time is one commodity that the typical dentist has little to spare. This article will take a close look at the construction of narratives. It will identify some of the challenges to writing a narrative. Finally, the article will provide information that will allow the dentist to prepare a narrative in such a way that the claim is paid or pre-determination is approved on first submission.

Here is a list that contains some frequent concerns, followed by recommended solutions.

Concern #1—It takes too long to write
Keep in mind that if a narrative takes too long to write, it also takes too long to read. Those who review claims for dental insurance carriers have been confronted by office personnel who indicate that their boss didn’t have time to write a three-page letter explaining why the patient needed a crown. The dental consultant reviewing the claim can certainly appreciate that. In fact, he or she doesn’t have the desire or time to read a three-page letter either. The dental consultant just needs to know the pertinent details regarding the proposed service. The first thing to understand about narratives is that they should be concise and to the point.

You can be brief when writing the narrative, because it is another dentist who will be reading it. Since you both speak “dental,” you can write your narrative using the dental abbreviations that all dentists understand.

Concern #2—The Provider is not sure what the dental consultant needs to know
The dentist reviewing your claim needs to know the specific diagnosis or condition for which the treatment is being performed. In the case of a crown or an onlay, issues that need to be addressed in a narrative include the following: Is there decay and if so, how much? Is there an existing restoration? If so, which surfaces are involved, and what is the condition of the restoration? Is any part of the tooth or restoration fractured off? How much healthy tooth structure is left? Is any cusp missing or undermined?

Given this list of questions, you are probably wondering how writing a short concise narrative in a reasonable amount of time is possible. In most cases, the doctor has performed a visual exam, a radiographic exam, a periodontal exam, and determined the need for pulp vitality tests of the tooth in question; however, the dental consultant doesn’t need all of the information you have gathered about the patient—just the part that explains why you determined the tooth should be restored with a crown or onlay (the criteria for benefit plan payment is generally the same for either of these procedures).

But how exactly do you relay this information in a narrative in a reasonable amount of time? Think about the last patient for whom you recommended a crown. After you gathered the clinical information about the patient, how long did it take you to decide the patient would be best served by placing a crown or an onlay? Based on my own experience and conversations with other dentists, I would estimate that it takes less than a minute.

You can be brief when writing the narrative, because it is another dentist who will be reading the narrative, and since you both speak “dental,” you can write your narrative using the dental abbreviations that all dentists understand.

After all of our years of training, dentists make those decisions so quickly and for the most part so easily. We barely realize how many pieces of information we evaluate to come to that decision. To create a narrative for a single crown or onlay, a dentist must separate out those particular pieces of information that are integral to making that recommendation and put those facts in a brief narrative.

For example: A patient comes in with the chief complaint that “part of his tooth fell off.” During the oral evaluation you review the patient’s health history and note that #30 has an MOD amalgam, and the ML and DL cusps have fractured off at the gum line. You order and evaluate the necessary radiographs. You perform six-point periodontal probing and other periodontal evaluations as necessary to determine the periodontal status of the tooth. You confirm the endodontic status of the tooth. You determine that a crown is necessary on #30 and that #30 is periodontally and endodontically sound, and that the patient’s general health is such that he can withstand the procedure. You recommend the crown to the patient, and the patient agrees to proceed with treatment.

Now, to write the narrative:
You have gathered the necessary information. Now, what do you include in your narrative? You include the information that made you decide to recommend a crown. Just by looking at the radiograph, could you have determined the need for the crown? No. The amalgam would obscure the fact that the ML and DL cusps were missing. If you can’t see the problem in the radiograph, neither can the dental consultant. So, your narrative only needs to communicate what cannot be seen in the radiograph. Your complete narrative would read, “ML and DL cusp fractured off at gum line.” Sending clinical photos of the tooth (along with your narrative) may also be helpful and is highly recommended.

Do you need to tell the dental consultant about the periodontal and endodontic status of the tooth? If the periapical radiograph you send shows that the tooth is periodontally and endodontically sound, you do not need to state this in your narrative; however, if there is significant bone loss then you need to explain what periodontal treatment has been completed or is planned. If there is an apical lucency or if the existing root canal is short, overextended, etc., a brief explanation of the existing symptom and endodontic status of the tooth is also necessary.
The treating dentist has the luxury of seeing the patient, hearing his/her story, examining his/her mouth, and reviewing the radiographs and any clinical photos before making a decision. With just a radiograph it is impossible for the dental consultant to know as much about the tooth as the treating dentist does. Writing a brief narrative allows the treating dentist to tell and/or show the dentist reviewing the claim what could be appreciated clinically that may not be obvious on the radiograph. If you, as the treating dentist do not see the information needed to make the treatment recommendation, unless a photo and explanation is provided the dental consultant, the dental consultant can’t appreciate what you heard or saw during the evaluation.

Finally, the clinical record should always mirror the information provided to the payer in the narrative.

When writing your next narrative for a single crown or onlay, remember it best to remember the KISS rule, “keep it simple stupid.” What details did you see that were pertinent were pertinent in the treatment decision-making process? Always ask yourself, what information is not clearly evident in the images used to make your treatment decision? Compare your answer with the information you are sending with the claim. When submitting the claim or pre-determination, include a periapical radiograph and a photo. Add to the radiograph and photo any additional information you appreciated that helped you diagnose the pathology, determine the appropriate treatment and make the treatment recommendation to the patient. When you routinely include this information in your narratives in a complete and concise way, you will be able to generate a narrative that will result in prompt and easy payment from the carrier.

Dr. Charles Blair is the publisher of the Coding With Confidence Manual, Insurance Solutions Newsletter, and PracticeBooster Website.
Order these breakthrough products through your Henry Schein Sales Consultant.
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PracticeBooster SKU# 377-0006
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Dr. Lesley Rudolph

Realizing that you have outgrown a process or environment
can be difficult for some, but for Dr. Lesley Rudolph it was an energizing moment that set her professional career onto a new path. “After a year of practicing in a general dentist’s office, the dentist who owned the business…told me I had outgrown her space,” recalls Dr. Rudolph. “It was time to take another large step toward fulfilling my own professional goals and being able to offer the services that I felt were so important to the pediatric patient.”

Gaining the freedom to pursue new goals and fulfill everything on your wish list is cause for excitement—and securing a plan to get there is vital to getting the project moving. “I began looking for space to lease or buy,” notes the Doctor. “Unfortunately, I was unable to find a suitable building with adequate parking. So, I searched for property to build a new office. I then turned to (Henry Schein Equipment Sales Specialist) Pat Tarrant to assist me in designing the new space. We attended dental meetings where I was able to see the type of equipment and technology that was currently on the market. Pat also took me to see several pediatric offices in the area that he had helped to equip. This gave me the opportunity to determine what I preferred for my new office.”

“Dr. Rudolph’s new facility has the very latest in dental technology. The high-end,
high-efficiency, digital products will keep her office ahead of the curve for quite a while.”

Dr. Rudolph’s free-standing building houses South Tampa Pediatric Dentistry’s beautiful new 2,700-sq.-ft office. There are 3 operatories and additional 4-chair units set up in an open-bay style. The Doctor has made good use of her last name in creating a playful reference to the popular book and movie character, Rudolph the Red-Nosed Reindeer. There are quite a few “Rudolphs” to be found around the office. “Everyone loves the reindeer theme,” comments the Doctor. “There are several in the lobby…the kids love to line them up as if they were leading Santa’s sleigh or place them in a circle around them as if observing while they are playing video games.”

The “reindeer” theme is found throughout the practice as well as on the building’s sign

The contemporary freestanding building is ideal for the practice’s goals.

The kid-pleasing office is warm and welcoming to the patients and their parents. Wide-plank flooring in the reception area is nicely offset by creamy ecru walls and ceilings and a pop of red on the reception desk. The adjacent children’s reception area has games, toys, and a flat-screen TV to relax the kids while they await treatment. And, of course, there are all those fun Rudolphs hanging around! The operatories are beautifully done—chocolate wood cabinets and ultramodern chairs are set off perfectly by the mellow neutral wall tones.

“This office is very impressive and will help to ensure that the Doctor can look forward to heightened productivity, reduced work-related stress, and continuous future growth for her business.”

State-of-the-art equipment choices include technologies from Pelton & Crane, Midmark, and KaVo. “Dr. Rudolph’s new facility has the very latest in dental technology. The high-end, high-efficiency, digital products will keep her office ahead of the curve for quite a while,” notes Equipment Sales Specialist Pat Tarrant.

The office uses all digital radiography allowing Dr. Rudolph to obtain quality diagnostic images while also minimizing the radiation exposure to her patients. Equipped with Sirona XG3 and Progeny Preva DC

Welcoming reception space with activity area for children.

Equipped with Royal Chairs, Biotec Cabinetry

The office can now accommodate more simultaneous appointments and still has the ability to give uninterrupted attention to each patient. “Everything has grown tremendously in only one year,” points out Dr. Rudolph. “Our referrals have accelerated and our total number of patients has doubled. We have hired additional staff (from 3 to 7) to keep up with our scheduling needs. Patients and their parents love the new office.”

“Dr. Rudolph now has her dream office right in the heart of South Tampa—where she grew up,” notes Pat Tarrant. “This office is very impressive and will help to ensure that the Doctor can look forward to heightened productivity, reduced work-related stress, and continuous future growth for her business.”

Quartz countertops and a stainless steel back splash give the sterilization center a clean look. Equipped with Midmark Sterilizers and KaVo QUATTROcare

The consultation room provides a private setting for Dr. Rudolph and her staff to review X-rays and treatment plans with parents.

Dr. Rudolph and team along with Pat Tarrant, Equipment Sales Specialist and Patty Call, Field Sales Consultant.

Designed by Jennifer Rhode, Henry Schein National Design Group

Dental implants are an increasingly valuable part of modern dentistry.

Although they’ve been available for more than a quarter of a century, it is only in the last decade, since the technology has advanced, allowing them to be considered the optimal way to replace missing teeth. Instead of endless rounds of heroic attempts to save a failing tooth, it’s increasingly simpler, less invasive, and more cost-effective over the long haul to replace the failing tooth with a dental implant. Besides, patients are increasingly reluctant to let good teeth be cut down to support bridgework.

If relatively little remaining tooth structure is left supra gingival, or if there’s an incipient furcation involvement, then conventional therapy may be tedious, time-consuming, and short-lived. If root caries is rampant or periodontal disease
is aggressive—or if the systemic health is in decline then aggressive therapy to
save a failing dentition may be as counterproductive as it is contraindicated. Interceptive implant therapy should
be considered. It’s no wonder that implantology is fast becoming an essential component of any modern dental practice.

These days, most dental implants can be placed in simple one-stage surgical procedures. Their long-term survival rates have been steadily improving, even for smokers, and the restorative processes are now simplified and far more reliable. With modern “deep-engagement” connection systems the days of failing screws and damaged implant interfaces are over. Modern systems increasingly permit implant platforms to be placed at “bone-level” and the deeper “emergence profile.” This allows for a more natural “tooth-like” emergence. The abutments providing these emergences are trending to be custom formed of zirconia attached to CAD/CAM bases. These biocompatible, aesthetic, and functional abutments, contrast with those formed by traditional cast-based technology, which we now know fail to develop any adhesion to the peri-implant gingival tissues. This allows infection down to the abutment-implant platform interface.

JOIN FREE at www.camlogconnect.com

So how can dentists come up to speed with the fast-moving developments in implantology? How can they incorporate implantology into their practice? There are many advanced-level education programs available to help dentists get started, but many dentists falter when they get back to their practices and look for suitable cases. Some find their investments in implants and surgical kits staying stuck on the shelf. What a waste!

A new approach is to have access to
Web-based education. Unfortunately, this is often of variable quality and can get
to be quite expensive. A new site, www.camlogconnect.com, takes a different approach. Yes, it relates to Camlog implants, part of Henry Schein. Camlog is in the top tier of dental implant companies and is rapidly getting more popular around the world. The CamlogConnect Web site is free, no charge to join or access. The content is generated “By Camlog Users: For Camlog Users.” You can get detailed technical help with using Camlog systems and you can see cases done by colleagues around the world. You can ask questions, get support, and talk about treatment plans. You can see how to get around all sorts of problems. You can use the site as much or as little as you like. You can contribute. It’s like a virtual “Study Club.”

CamlogConnect.com came online at the start of the year and is starting to build up rapidly. It’s founder and editor is Dr. Peter Hunt,
who is based in Philadelphia. You can
contact him at Editor@CamlogConnect.com. Make this your site for dental implant information and education. Use it to help incorporate implantology into your practice. Use it to help take your practice to the
next level.

Jason Werner
Henry Schein TechCentral

Every morning the dental team at Porter and Singley Family Dental gathers together for its morning huddle and discusses the day ahead. In the past, the meeting would have involved paper-based schedules with handwritten notes.
Now they review Dentrix schedules and patient information in real time on the staff lounge big screen TV, making notes as needed. This is just one of the additions made in 2010 when Dr. Steven Porter and Dr. Patrick Singley decided to expand the office and update their dental technology and computer systems. Out of space in their Columbus, Mississippi, practice, which had been built out in 2000, the doctors decided to gut, renovate, and expand the existing office to meet the needs of the busy practice. The demolition opened up more than the walls—it also opened up the opportunity to install a reliable, high-speed network to support new, state-of-the-art dental technology. The doctors knew that properly integrated technology would have a positive impact on every aspect of their business. Knowing how important it would be to get the undertaking right, they turned to Henry Schein’s TechCentral computer solution and Henry Schein’s team of technology experts.

Over a ten-day period, Porter and Singley Family Dental was transformed. The TechCentral solution experts worked up to 18 hours a day laying the groundwork for the technology, including running computer cables for the waiting area, nine operatories, and the staff lounge. Amazingly, this was all accomplished while the practice maintained regular business hours and scheduling timetable!

After construction was complete, the team installed 16 new computers and a dedicated server. The office also switched to digital radiography, with a new DEXIS sensor added to their existing Scan-X. All images are centrally stored, shared and backed up.

“Henry Schein TechCentral has been great,” notes Dr. Porter. “Of our entire remodel, the most seamless part was the computer installation.” Porter and Singley is the first practice in a 60-mile radius to purchase the E4D Dentist for same-day crowns. The E4D system connects to the practice network via a new, secure Wi-Fi from TechCentral, and is used wirelessly throughout the office. Patients can walk out with permanent crowns in the time it takes to watch a few TV shows or run errands!

Ceiling-mounted computer monitors are now in the operatories and patients can view digital X-rays, intraoral camera views, Guru videos, and even Netflix movies! “With the monitor in front of them, they can see what’s going on,” says Dr. Singley. “An educated patient is more accepting of treatment.”

By upgrading and networking all of the computers in the office, the staff is able to more fully maximize the capabilities of Dentrix as well as other software, including DemandForce, an appointment reminder and confirmation program that uses text messaging and E-mail.

“Our goal as a family practice is to set ourselves apart and change the concept of people hating dentist visits by making it more comfortable for them,” said Dr. Porter. “We already had some technology in place. But it wasn’t uniform or properly integrated. When we decided to remodel, we knew we wanted to standardize everything in the office and incorporate technology that would give our patients a much better treatment experience.”

Standardization is one of the key benefits to choosing TechCentral solutions over local providers. All Henry Schein IT professionals are trained using the proven best practices that TechCentral developed from thousands of network installations each year.

Front: Dr. Steven Porter and Dr. Patrick Singley. Back Row: left to right–Andy Garrison, Field Sales Consultant; James Kinney, Digital Technology Consultant; Warren Torrey, Equipment Service Technician/CADCAM/CIT/Software; Bobby Manual, Equipment Sales Specialist; Todd Carter, Regional Manager.

Dr. Steven Porter scans, designs, and seats same-day crowns with E4D
software while assistant Julie Gillis schedules and accesses Dentrix in this
paperless operatory.

“All TechCentral installations are done using proven recipe for success,” explains James Kinney, Digital Technology Specialist. “So, if something comes up, the TechCentral support team can remotely log in, see what’s going on, and in 90% of cases, locate and fix the problem over the phone without an on-site visit. We’re a one-stop IT resource.”

“When we decided to remodel, we knew we wanted to standardize everything in the office and incorporate technology that would give our patients a much better treatment experience,”
said Dr. Porter.

In addition, TechCentral services continually run in the background to protect the practice valuable patient and financial data from viruses, new Internet threats, unauthorized access, natural disasters, and network issues.
The practice also turns to TechCentral computer support experts when they have questions or need help.

“TechCentral has been great. We actually had a problem with backups on our server and we didn’t know it. They alerted us; logged in remotely; and fixed the problem,” notes Dr. Porter. “Of our entire remodel, the most seamless part was the computer installation.”

Dr. Patrick Singley explains a treatment plan to a patient in the operatory, while assistant Brandy Shelton is able to access digital radiography with DEXIS, and make clinical notes in Dentrix.

Dr. Patrick Singley talks with Warren Torrey, Equipment Service Technician/CADCAM/CIT/ Software, in the treatment planning room about software and hardware integration.

Service technician Warren Torrey has worked closely with the practice as well, maintaining and repairing equipment and troubleshooting other issues by consulting with support teams to deliver solutions. “For solving big problems,” recalls Dr. Porter, “we found we relied on Henry Schein Dental and DEXIS personnel to get it right, so why not let them do it all?”

Making such a leap into technology is a big decision, but Dr. Porter and Dr. Singley will attest to the contribution it has made to superior patient care, employee morale, and to the bottom line.

“Anytime an office functions better, I think morale is going to be better,” said Dr. Singley. “There’s a lot less wasted time and we are definitely more efficient. I think we all enjoy our job a lot more.”

Porter and Singley Family Dental has also seen a dramatic increase in the number of new patients it sees each month and says the E4D Dentist, and the quick turnaround of crowns, in particular, instantly made an impact.
“We’re averaging from 70 to 100 new patients each month,” said Dr. Porter. “Word of mouth is our biggest way of getting new patients. Patients are coming in and enjoying their experience and referring our services to their family and friends.”

With Henry Schein technology experts and TechCentral solutions behind their practice, Porter and Singley Family Dental not only remodeled their office space, they reshaped their business.

Dr. Michael Koceja

In dentistry, we are constantly being bombarded with new products and new ways to make providing care to our patients easier.

Technology continues to change how we practice, and although many of the basic concepts dentists have learned while in dental school are still relevant, the dental office of today is unrecognizable from 25 years ago. Composites were in their infancy, gold was still being pounded into teeth, curing lights, lasers, and implants were almost unheard of. Radiographs were taken and developed by traveling through a machine full of developer and fixer. No one would deny that dentistry has changed dramatically and technology has made patient care easier, faster, and more predictable.

One technology that has become integral to the modern dental office is laser technology, especially soft tissue or diode laser technology. Most dentists wish to incorporate soft-tissue lasers into their practices. We know that lasers are kinder and more technologically advanced than other methods of cutting or contouring tissue, but purchasing the right laser that has all the capabilities needed and learning to use the instrument are realistic concerns. Dentists love technology, but they fear change. Dental school did a great job teaching us how to create a level of comfort during patient care; however, it is sometimes difficult to change old habits—no matter how innovative the technology is. Because of the popularity of soft-tissue lasers, you have numerous companies selling and promoting their laser as the best. How do you decide which one to get? What about price? How does a doctor new to technology decide which laser to choose? It is almost like going to an electronics store showing row upon row of TVs—all with different sizes, prices, and features. Many times we walk away more confused than when we started our search.

So although many companies have introduced soft-tissue lasers, it is a challenge to determine which products are innovative, simple to use, and a fair value. We’re not talking about reinventing the wheel; we are talking about a soft-tissue laser. We want something that delivers power, is simple to use, and won’t break the bank.

Post Ortho Gingival Hyperplasia, if left untreated, can
lead to decalcification, caries, and esthetic concerns.

Immediate post-laser treatment: Exposure of clinical crowns will allow proper oral hygiene and prevent further decalcification.

I believe that laser is the Precise LTM. The Precise LTM is made by the CAO group in Salt Lake City, Utah (That’s a good start; it’s made in America!). It combines 5 watts of power in a reliable, easy-to-use laser that is cost effective. So before we go over the attributes of the Precise LTM, let’s spend a minute discussing why someone should incorporate a soft-tissue laser into the practice.

First time users should look at the areas of the practice that could benefit from a soft-tissue laser. The most common procedures that come to mind are:

• crown & bridge impressions
• class V and subgingival restorations
• cosmetic and gingival recontouring

There are numerous other procedures that can be done with a soft-tissue laser. I am a true believer that lasers can be used on almost every patient, but for the first-time laser user, I think you should concentrate on the everyday benefits of a laser. Soft-tissue lasers are crucial for tissue shaping and troughing prior to taking impressions. You will get better impressions. Utilizing soft-tissue lasers for exposing subgingival decay or class V lesions is another reason to incorporate a laser. How many times, when placing restorations, does tissue or heme get in the way of creating a sealed, smooth gingival margin? Soft-tissue lasers will recontour tissue to expose decay and stop bleeding, allowing proper placement of restorative materials. Then there is gingival recontouring. Whether it is an uneven #8 and #9 or hyperplasia from ortho treatment, soft-tissue laser is a great tool to have.

There are numerous other uses for a laser—from periodontal applications to soft-tissue surgery to pulpotomies, but remember—the more you utilize a laser the more it will become an integral part of your office. So what should you look for in a soft-tissue laser—and why is the Precise LTM a great laser to help change the way you practice? Different lasers have different features, and I believe this laser has what you need without overloading you with excess useless features.

The Precise LTM is a powerful laser (5 watts) that has all the features you will need to easily incorporate laser technology into your office, but most of all, the precise laser is a concept. The concept is to change the way you approach laser technology—the Precise is a “soft-tissue handpiece.” It is meant to be an instrument, just like a high-speed, slow-speed, or cavitron that the doctor incorporates and can easily reach for, feels comfortable with, and uses multiple times a day. This is accomplished by creating a laser that is well made, easy to use, and cost effective. The characteristics of the Precise that make this possible are 5 watts of power for maximum cutting and higher pulsed power. Because it is an 810-nm wavelength laser, the Precise delivers predictable cutting ability and hemostasis. The laser’s fiber system is easy to use and cost effective. The fiber comes in 21-ft. long, easily-replaceable cartridges—almost double in length compared to most other diode lasers with fibers, which avoids costly disposable tips. The Precise has an easy-to-use wireless foot pedal, a two-year warranty, 4 presets (probably more than you need), and a training course. This laser has been developed for daily use. It’s reliability is unmatched and it is backed by a name you trust in dentistry—Henry Schein.

Another useful feature of the Precise LTM is its fiber storage system. It allows you to extend or retract the fiber, which keeps it in place and helps prevent accidental damage. You won’t have to wind or unwind the fiber every time you use it like you do with most diode laser systems. Another innovative feature is a magnetic handpiece holder. This keeps the handpiece easily accessible and ready to use. So if you are looking to purchase your first laser or thinking of adding another laser system to your office, the Precise LTM is a great choice– Here are the basic tenets of laser use:

1. Slow down when using your laser. The slower you move, the faster the laser cuts.
2. Use your laser for a variety of procedures. Be innovative in your thinking. Lasers can really benefit you in those difficult situations that arise everyday while practicing dentistry.
3. The monetary benefits in utilizing lasers are multi-fold. You can add new or different procedures and bill for these procedures—and lasers will save you time and help to get better results (better impressions, better cosmetic results, and easier restoration placement) thereby increasing your ability to treat more patients.
4. Choose technology that is reliable and backed by a company that will be around in the future, a company that partners with you to provide the highest level of care and helps to grow your practice.

Technology will continue to change the way we practice dentistry. Sometimes a product is available that makes a huge difference for the practice and the patient. The Precise LTM has been designed with features we can use every day and the ability to take our treatment options to a new level. Perfect!

El Dorado Hills, CA

Dr. Jason A. STRAW

Dr. Jason A. Straw opened his new oral and maxillofacial office in 2011, fulfilling his goal to offer his patients highly specialized services in an environment that reflects his commitment to excellence in care with the very best in equipment and technology to support that ideal.

El Dorado Oral & Maxillofacial Surgery is located in El Dorado Hills, California and is the Doctor’s second office. The new location was also influenced by the fact that there are no oral surgeons nearby, an advantage in of itself for a business. The practice provides a full range of OMS services to patients and gives the staff of eight a spacious 2,424-sq.-ft. area to work in.

Dr. Straw contacted Equipment Sales Specialist Adam Jones to move the project forward. Henry Schein Dental’s perspective is one of partnership with its customers. By supporting their professional goals and delivering the products and services that will keep them competitive and profitable in the industry, our specialists help to ensure that their customers’ businesses cost-effectively achieve the level of success they envision. From design and equipment to supply purchasing, every aspect of the oral health care provider is of concern. Each office is an entirely unique endeavor and requires full focus and a dynamic and proactive attitude to bring the plan to fruition.

The overall efficiency of the facility’s layout has provided the ergonomics to get the job done while reducing stress and increasing production capabilities.Industry-leading, well-integrated technologies make it possible for El Dorado Oral & Maxillofacial Surgery to deliver high-level care to patients and confidently expand their services.

“We are now much more productive and the level of efficiency is greatly increased, bringing our business to a whole new
level of success and increased potential for
the future.”

Designed to help patients feel at ease by providing an environment that feels like home. With warm colors, inset sealing, fire place, and a rug all help to bring home to the office. Being comfortable and
relaxed helps settle the nerves especially to those who are
particularly anxious before surgery.

i-CAT – Cutting edge diagnostics

The patient base is continuously rising, recently coming in at around 80 new clients per month since the new technologies were incorporated. The right equipment and technology can enhance, improve, and streamline the patient experience from start to finish. Some of the winning tech products chosen by Dr. Straw were the iCAT Miele, Dexis digital sensors, and the Porter O2 system. “Our digital and chartless office is a major positive change for us,” notes the Doctor. “We are now much more productive and the level of efficiency is greatly increased, bringing our business to a whole new level of success and increased potential for the future.”

Steri Center–Spacious, easy flowing sterilization area. Allows for fast and efficient productivity by facilitating several people to work in one area. Equipped with Midmark Sterilization equipment

Spacious, fully equipped operatory. We chose the finest equipment in our operatories to maximize both patient and staff comfort. Equipped with Midmark, Boyd, Aribex Dexis, Accutron and KaVo

El Dorado O&M Surgery gets high scores in the design department with an aura of relaxed simplicity. Its “good looks” create the perfect mood for staff and patients, and make busy workdays a pleasant experience. The motif in the office is modern traditional with contrasting dark woods, carpeting in hallways, finished wood planks in the consult rooms, and an eye-catching tray ceiling in the reception area. “People are amazed at how nice the office looks,” comments Dr. Straw. “Many remark that it feels like a really nice ‘house’ until they pass into the operatory space, which is what I aimed for when the facility was designed.”

Left to right: Tony Hazen, Equipment Service Technician; Adam Jones, Equipment Sales Specialist; Dr. Jason Straw, Frank Solomon, Field Sales Consultant; Mark Lowery, Regional Manager

With all the elements for success in place, the new facility is poised to fulfill its philosophy on patient care and look forward to continuing to energize its productivity and profitability. “We now have the ability to expand into different markets and to acquire patients from referring Doctors,” points out Dr. Straw. “Our goal is to grow and build our niche as excellent providers of high-quality specialized dental services.”

Midmark procedure light

Miele Professional Dishwasher Disinfectant

Dr. Straw and Staff

Check out – Separate area helps give privacy for checking out.

Designed by Henry Schein National Design Group

Always looking for ways to improve my service to patients, I attended an implant course given by Dr. Mark Hunt in Raleigh, NC.

Always looking for ways to improve my service to patients, I attended an implant course given by Dr. Mark Hunt in Raleigh, NC.

My practice aspirations are to provide more dental options for my patients. This practice, operated by my wife
Dr. Laura Davila and me, needs the most up-to-date technology to be able to offer treatment such as implants and orthodontics. At the implant course, I met John Kuzman with Gendex, and discussed their new pan-ceph-3D unit and how it fits with my practice goals.

“Besides the benefits that I gain from 3D imaging, my patients benefit from increased understanding of their individual dental issues and my treatment plan.”

Why does a general practice need 3D imaging? Three-dimensional imaging takes away many variables in the dental equation. Laura and I want the confidence of seeing the various anatomical structures, relationships between adjacent teeth, location of nerves, the angulation of roots, and the amount of available bone before starting implant or orthodontic processes. With the surgical view that I gain by having 3D scans, my procedures are less invasive, and in some cases, I can avoid additional surgeries. Before I had the knowledge that comes with CBCT, I would tell my patients, “I am going to try to do your implants today, but we need to find enough bone.” Then, I would open a flap, and only at that point know if the patient actually had enough bone to support the implant. If not, we would have to graft that day instead of placing the implant. This would be a disappointment to both me and the patient. CBCT gives me this information ahead of time.

Besides the benefits that I gain from 3D imaging, my patients benefit from increased understanding of their individual dental issues and my treatment plan. The patients are amazed that they are looking at a 3D model of their mouth and that I can capture such a data-filled scan in just a matter of seconds.

With all of the complex technology that it probably took to develop a CBCT, it is surprisingly simple to learn and operate. My Henry Schein Sales Consultant, David Johnson, has been an incredible help getting the machine in place. We have a great relationship with our sales consultants. Training was seamless— 11⁄2 days, and the staff learned quickly how to use the system to take both pans and 3D scans. My office staff also learned how easily they can position the patient, and change from the 2D panoramic mode to the 3D mode. The touchscreen is easy to understand, which makes choosing imaging selections quick and easy. They were particularly impressed with the 3D preview screen that ensures the scan will capture the area of interest that I want.

Another benefit of my new system is that we were able to eliminate our panoramic film, so we do not need to use chemicals to process those types of images. This is one more step toward achieving full digital radiography. We hope to add the ceph to our unit in the near future. Since
I also already have an E4D milling machine, I also plan to integrate it
with my CBCT for even further progress with implant procedures.

For an office like mine that wants to offer more to patients, having a 3D system is a most valuable tool. Choosing a system that also includes a 2D pan is even more practical. For detailed data, flexibility, and versatility, I am very happy to be one of the first dentists to have the opportunity to use the GXDP-700. I now feel better prepared to face the challenges of implant procedures without facing the “unknown challenges” after the patient is already in treatment.

In addition to reduced donations, many organizations are also facing severe cuts in government funding as well. When Henry Schein discovered that Dental Lifeline Network (formerly the National Foundation for Dentistry for the Handicapped) was facing that very situation, the Company made an immediate decision to act. Well-recognized for their dedication to social responsibility, Henry Schein doubled its 2012 commitment to the DentaCheques program—a major source of revenue for Dental Lifeline Network.

Year after year, Dental Lifeline Network has worked to provide comprehensive dentistry for society’s most vulnerable individuals; those with disabilities or who are elderly or medically fragile and have no other way to get help. The money raised through the sale of DentaCheques books and other donations generated 23.6 million dollars worth of dental care last year. With a waiting list of 17,000 patients in need, it is imperative that everyone find a way to support the work of Dental Lifeline Network, either by purchasing a book or even volunteering your time and resources.

• Each year approximately 9,000 dental offices purchase a DentaCheques book, a tax-deductible charitable contribution. DentaCheques enables dentists to save hundreds, and even thousands, of dollars on purchases of equipment and supplies for their dental practices while providing dental services to vulnerable people who are desperately in need of care. This year’s edition offers $120 in invoice discounts from Henry Schein, over $700 in free products and potentially thousands of dollars of savings. Great gifts for your dental peers, there is no limit on the number of books that can be purchased.
• Each year 15,000 dentists and 3,200 dental laboratories volunteer their time and resources providing dental services on behalf of Dental Lifeline Network. Volunteering is easy with Dental Lifeline Network coordinating all arrangements with the patient in advance. The dentist simply reviews the patient profile prior to appointment, with the ability to decline the case for any reason, and then sees the patient in his/her own office to determine the treatment plan. Dental Lifeline Network will arrange for specialists and donated lab work as needed.
• Each year hundreds of companies and individuals make donations to Dental Lifeline Network. Although the revenue from the sale of DentaCheques books supplies a major source of funding for the organization, additional donations are still a critical component to the success of Dental Lifeline Network. For every $1 in general operating support, the Dental Lifeline Network provides $9 in charitable treatment and other direct-care program services. This would not be possible without the support of the dental professionals, the dental industry, and dental laboratories who donate.

“Forget “minimal invasive” or “minimal intervention” dentistry. We do not want to do the minimal amount. We do not want to “watch and wait”. We need to properly diagnose, assess risk, and proactively intervene before the situation requires more extensive treatment. Welcome to the concept of Proactive Intervention Dentistry,” Faye Goldstep, DDS, FACD, FADFE.

Most charitable organizations have struggled with funding the last few years. Donations have been down while the number of people in need has gone up.

Assistant Sue, Patient Lew, Dr. Robert Humphreys, Assistants Stephanie and Shawna (Colorado)

Harold and Dr. Greta Richter (New York)

The culture of social responsibility at Henry Schein reflects the charitable spirit witnessed in dental offices every day. Please continue to support Dental Lifeline Network and help them move patients off of the waiting list for care and back on the road to health. For more information about donating your time or resources, visit www.DentalLifelineNetwork.org.

Treating the people currently in need with the help of the Dental Lifeline Network is the vital first step. Next is looking at how to reduce the number of people who reach this critical state of need in the future. With education, prevention, and early intervention, we can improve patient health and reduce the number of patients in need of urgent dental treatment. Using a wellness program in the dental practice, such as Total Health™ Beyond the Mouth, educates patients on the oral systemic health connection while reinforcing the importance of regular oral care. Patients who understand the impact oral health has on their overall health are motivated to maintain a regular schedule of dental visits and accept recommended treatment when needed, reducing the number of patients who require advanced dental care. To learn more about Total Health and how you can improve the health of your patients visit www.facebook.com/HenryScheinTotalHealth.

Jason Werner, Henry Schein TechCentral

PC and network security are hot topics, thanks to ever-evolving Internet threats. Here are 10 rules to live by (even if you’re not a computer geek).

PC and network security are hot topics, thanks to ever-evolving Internet threats. Here are 10 rules to live by (even if you’re not a computer geek).

Just locking your practice’s front door at night doesn’t mean your practice is totally protected from intrusion or threats. I bet you lock the back door, windows, and employee entrance as well. But what about that thin, little wire that brings you the Internet. In today’s ultra-connected world with Internet access on everything from PCs to phones, you must take computer security precautions seriously or put your practice at risk.

Protecting your practice requires you to make network and data security a priority, especially now that more of your records, business transactions, and data are digitized and accessible over the Internet.

Not a computer security expert? Here are 10 things you can do to reduce your risk and better protect your practice. Volumes of information have been written on computer security, and this list is certainly not a complete list of all the security safeguards available to you. However, these quick tips go a long way toward protecting you from the nastiness (and costs, time loss and stress) that await the unprotected.

The basic concepts, best practices and technologies below are things you should be familiar with and use in your network operations to keep things safe.

Operating systems and applications, especially browsers, must be patched continually to protect
against new threats.

1) Your password is your friend. I’m amazed at the number of offices I come across that don’t have passwords for their systems or have a standard password for everything. You must require a password on every computer, all the time. Don’t let users share their passwords. Don’t write them on a little yellow piece of paper and tape them to your computers for all to see.

2) Your name is a bad password. As a rule, mix numbers, words, symbols, and capitalization in your passwords. A good example is “G8D3nti5t!” (Think “Great Dentist!”). However, you can’t use that one now that I’ve told the whole world. See Rule #1 above. Create a variation of an easy-to-remember word or words, like your first car, pet’s name, or favorite hobby. Many Internet sites already require passwords containing a mix of characters today, so why shouldn’t your practice’s security policy. Can’t remember all your passwords? Neither can I. Get a reputable password manager for your smartphone. They keep all your passwords close at hand, security encrypted—and you can back them up somewhere safe in case you lose your device. It is worth the $.99 to $5.99 investment. And yes… you’ll need a password for password manager as well.

3) Keep up to keep safe. Operating systems and applications, especially browsers, must be patched continually to protect against new threats. Keep up to date with updates for the software you rely on most.

4) Protect yourself from viruses your autoclave can’t kill. Well, that might not be true. However, super-heating your hard drive until it melts will destroy a computer virus, but that will get expensive. Antivirus software on every computer is a must, and each computer must have regular updates to its antivirus software. A quick check of your antivirus software will tell when the last time your protection was updated and when the last full scan was completed. Been a while for either one? Turn on your software’s automatic update feature
and adjust the automatic scan schedule.

5) Wireless good! Unsecured wireless bad! We all love free Internet access while we wait for coffee, our dinner, or an oil changes. And yes, your patients will love you for it, too. However, leaving your Wi-Fi open for all to use puts you at risk. Configuring your wireless router so it doesn’t openly broadcast your Wi-Fi network for all to see will require a little work on your part. Plus, you will have to provide patients with the exact Wi-Fi network name and password you’ve chosen. That, however, is a small price to pay to keep lurkers in the parking lot and the next-door businesses from stealing your wireless network and slowing your Internet access speed to a crawl.

6) Speaking of Wi-Fi…Wi-Fi for you, Wi-Fi for them. If your practice is thinking of deploying wireless networking for your patients and your business use, guess what? You need two Wi-Fi networks—one for your patients’ use and a separate, isolated, and secured Wi-Fi network for your business data. Don’t mix them or you could open the door to unauthorized access of your business systems. You can configure most quality wireless routers to create two networks to keep business and patient wireless traffic completely separated.

7) A firewall around your practice won’t burn patients. Just the opposite—you’ll protect the sensitive information they’ve entrusted you with. A network firewall will act as a flaming drawbridge to your practice’s network, letting in the good and keeping your network out of reach from Internet “nasties.” But it has to be configured correctly. Don’t have a firewall? Get one ASAP. Otherwise, your network could become the next playground for hackers and malicious software.

Filter your water and the Internet. Most firewalls provide some level of Internet content filtering. That puts you in control of what your patients and staff can access while on the Net. X-rated photos and videos are not the sort of things you want your network used for. There have been cases where unsecured networks have been used to access illegal content and the networks’ owners were blamed. Internet filtering will also block malware (think robotic software that scurries around your network letting in hackers and doing damage) and questionable websites that are known to contain dangerous software. Internet filtering, just like antivirus software, is continually updated to protect from ever-evolving threats.

9) E-mail. You’ve got risk! Be suspicious and only open E-mails from sources you trust. You would not open your door to a questionable stranger. Don’t open E-mails, click on links, or open attachments from sources you’re not comfortable with. One simple click can open your PC and network up to malware (remember
these?) attacks.

10) Data never dies. Are you ready to donate that old PC or sell it on eBay? Are you sure you aren’t handing a stranger your patients’ sensitive data, credit card information, and your financials? It is amazing what can be recovered from a hard drive because (newsflash!) deleting a file does not make the data vanish completely. With a little know-how, files and data can be recovered from discarded or repurposed drives. Use a reputable disposal and recycling service that will electronically, or physically, shred your hard drives.

Learn more practical security tips. Listen to the Henry Schein TechCentral Protected Practice Webinar available on www.henryscheintechcentral.com/security

Check out the Henry Schein TechCentral Protected Practice solution on our website. Henry Schein TechCentral also offers secure computer equipment recycling and environmentally friendly disposal to keep our customers safe and green.

See how Dr. Steven Johnson transformed his practice in order to fullfil all of his specialized service needs!

In designing and building a new office, the ultimate mark of success is revealed a year after completion with the owners’ comment that they would not change any element of the design.

Fear is an emotion, and an emotion should not drive a financial decision; numerical facts should drive your decision to build a new office.

Every Journey Starts With the First Step Have you been thinking about a new office…for years? What is keeping you from moving forward with the desire to improve your facility and practice? Many of us will cite circumstances that are seemingly beyond our control (insert your favorite reason here), but after thousands of conversations with doctors over many years, I would suggest two reasons for inaction: fear and inertia.

Fear is a four letter word.

There is fear of the unknown in that you don’t know where to start, how to proceed, and that you will lose control. We are in total control (most of the time) in our office, but when we embark on designing and building a new office, we don’t even know what we don’t know. Now, that is frightening.

Losing control of the cost of the project is a big fear because it leads to an even bigger fear: financial failure. What if we could eliminate this fear and risk to zero?

Well, now you are talking!

Fear is an emotion, and an emotion should not drive a financial decision; numerical facts should drive your decision to build a new office. EXACTLY, what will the project cost? Incidentally, Pelton & Crane is able to assist with this calculation (project cost, cash flow analysis, and risk assessment) with their new project management tool called inView and their analysis is spot on.

Your project cost can be calculated in the following manner. First, after understanding your vision of your dream office, the architect should make an estimate of building cost. Second, that estimate must be used by an accountant to calculate the impact on your cash flow to determine if you can fund the project and still meet all of your current financial obligations.

Third, the calculated increase in cash flow should be divided by your current production to assess the risk in undertaking the project. For example, if the cash flow analysis results in a production increase requirement of $5,000/month and you are currently collecting $50,000/month, then you would have a 10% production increase requirement. This value of 10%, by itself, is meaningless. But when compared to the thousands of projects with which I have been involved over the past decades, we found that projects that required less than a 20% increase in production had virtually no risk of failure, i.e., being able to cash flow the project during their (critical) first year in the new office. However, this metric applies only to those new offices that employ the principles of dental office design described in my book, A Guide to Designing the Elegant Dental or Medical Office: The Largest Marketing Tool of Your Career.

If the production increase requirement is greater than 20%, your risk increases. Now the possibility of failure is real. So, you either scale back the project and repeat the calculations, or you attempt to increase your current production and thereby decrease the quotient which is the production increase required.

Do You Have Tired Blood?

The second reason I cited for not moving forward with a new office is inertia. We have so many professional and personal demands on our time that it seems we never get to anything that is not essential.

And therein is the answer.

IF YOU EVER WANT TO HAVE A NEW OFFICE, IT MUST BE TOP PRIORITY.

It is hard to have a sense of urgency if you don’t know what you are missing. If you have always been swimming upstream, you have no idea how easy it is to swim with the current. To put this metaphor in tangible terms, doctors who incorporate the principles of dental office design into their new facilities actually work 2.5 hours less each week in direct patient care going from 31 hours/week to 28.5 hours/week, and their production increases by an average of 38%. These results have been achieved in over 3,000 offices across the country spanning two and a half decades.

Time dulls our memories of the effort we expended to obtain our dental degree. Perhaps refreshing our memories would motivate us to capitalize on our education with an office that 1) makes our daily efforts easier and less stressful, and 2) drives our production by physically communicating the quality of care we are providing to our patients. We, and our practices, will be successful when the office environment is consistent and congruent with the care we are proposing to our patients.

Go West, Young Man

So, what is the first step? How do you decide whether to build from the ground up, finish out a lease space, buy a condominium, or remodel?

First, determine the number of operatories you will need in the new office. This should be carefully discussed with your Henry Schein Equipment Sales Specialist and/ or practice management consultant, but I will offer the observation that doctors characteristically and almost universally underestimate the number of operatories needed. Remember that the incremental cost of an additional operatory is dwarfed by the opportunity cost of lost revenue in an office that has an insufficient number of operatories. Pelton & Crane’s inView program includes a financial calculator that is used to compare the bottom line impact of choosing to add an additional operatory.

Second, determine the size of the office (space) and the size of the lot needed to support the practice. The metric I use is that we need approximately 500 usable square feet of office space per operatory, so a 5 operatory office would need about 2,500 useable square feet (space inside the walls). Next, the size of the lot needed is generally six times the size of the office, so 6 X 2,500 square feet= 15,000 sq. ft.

Third, define the search area for the new location. As a general rule, you can move up to seven miles from your previous location and not lose patients as long as you don’t cross any psychological boundaries such as bridges going from one side of town (good) to another (bad). Also, you want to be in a class A building if leasing or purchasing a condo; commercial real estate ranks properties as class A, B, or C with C being a warehouse. Finally, you want to be in an area or neighborhood that is consistent with the level of care you are providing and the type of patient you are attempting to attract.

Fourth, ask your Henry Schein Equipment Sales Specialist (ESS) to help find a good commercial real estate person and ask them to find all of the opportunities that fit the above criteria. Then review the results with your ESS and select the top three candidates based on the above criteria and your knowledge of the local area.

Fifth, with your architect and ESS, determine the cost of the project for each of the three selected options. Then using the financial calculator available in inView—calculate the impact on the practice’s cash flow and determine the level of risk associated with each option.

Sixth, select the single best option that will yield the most optimal floor plan result (The optimal floor plan will incorporate the tangible principles of dental office design. These are enumerated in my book.) and financial result, that is, the total production increase requirement is less than 20%.

Now you have the beginnings of a great office, one that can generate substantially higher revenues and produce less physical stress. But it is only the beginning because now you must engage an architect to design the office and to control cost, build the office on paper. There are literally thousands of decision points during the construction process and they must have answers or the contractor will make a decision on the spot that will affect the price of the project. Cost over runs occur because many of the construction decision points were not addressed in the architectural drawings, so insist that your architectural drawings are complete with all necessary schedules and plans.

Getting There From Here

At this point, we are feeling pretty good. We have selected a location, we know the cost of the project, the impact on cash flow, the financial risk associated with the project, and we have a floor plan. We know we need an architectural plan that builds the office on paper to control costs, and a good general contractor who understands how to build dental offices. Note: Here is another decision in which your Henry Schein ESS can be of great assistance in securing a knowledgeable contractor. Dental offices are very different from other buildings in that they are much more complicated with all of the electrical, mechanical, medical gases, plumbing, and technology issues that must be correctly addressed. Employing an uninformed contractor will delay the project’s completion, yield a poorer result, and will increase construction costs.

There are still many issues to address. I have put them on a timeline rather than attempt to chronicle them. If you feel somewhat overwhelmed, that is natural and expected. I suggest that my clients create an inView account. Pelton & Crane has compiled years of office design expertise into a project management portal to help your project stay on task and on budget.

inView includes more than a robust financial analysis, it serves as a guide throughout each step of the dental office design process. Members of your project team can collaborate, track the progress of your project and share documents in one secure location. THIS IS CRITICAL BECAUSE IT IS IMPORTANT THAT EVERYONE KNOWS WHAT EVERYONE ELSE IS DOING in a project that has hundreds of moving parts.

You can register for a free inView account at: www.yourfutureinview.com. Thousands of doctors have successfully completed beautiful and functional offices—you can too. The key is to surround yourself with an experienced team and take advantage of the tools that will help you succeed.

In designing and building a new office, the ultimate mark of success is revealed a year after completion with the owners’ comment that they would not change any element of the design. When you stand in your new office and make this statement, you will have the office of your dreams.

About the Author
Dr. Mark Tholen graduated from the University of Texas Dental School and U.T. Graduate School of Business with an MBA. He served in the U.S. Air Force and was engaged in practice before turning his attention to industry. He is the former CEO of T.H.E. Design, a dental and medical office design firm and author of the book, A Guide to Designing the Elegant Dental Office…The Largest Marketing Tool of Your Career. He can be reached at marktholen2000@yahoo.com or 972-365-6151. Dr. Tholen lectures throughout the US and Canada frequently and is engaged in the active design of dental offices with Fazio Architects of Austin, Texas.

Dr. Mash Ameri

Sophisticated and contemporary, the reception and waiting area has spa-like impact. Equipped with Dentrix and eServices Practice Management Software.

Dr. Ameri’s newest office focuses on cosmetic and implant dentistry and represents the doctor’s vision of an ideal setting to provide his patients with the latest in smile-enhancing procedures.

In preparation, Dr. Ameri attended seminars sponsored by Henry Schein, Inc. and presented by Dr. Mark Tholen, a specialist in the field of dental office design principals. The seminars also featured equipment and technology options that would help to increase practice efficiency and productivity. Equipment Sales Specialist Michael Konesheck, Field Sales Consultant Josh Toppass, Digital Technology Specialist Steven Castaneda, and National Design Group’s Genevieve Cicero combined their expertise in effectively managing the many phases and specifications of the project. Henry Schein Dental’s specialists strive to advise and mentor their customers by listening to their concerns and offering the products and services that work to help them accomplish their individualized business goals.

Unique art is presented throughout the facility.

The customized and efficient sterilization center is equipped with Pelton & Crane Solaris, Delta Q, and KaVo QUATROcare.

“Through attending the seminars and experiencing a hands-on approach to the equipment ad technology I was interested in, I gained the insights necessary to make choices that would benefit my overall vision for the new office,” comments Dr. Ameri. “The Henry Schein team was integral in the planning, design, and successful completion of the project while staying within my budget.”

“The type of equipment…decided upon was the best in each respective category,” notes Equipment Sales Specialist Michael Konesheck. “From a technology standpoint, the integration of Dentrix and DEXIS products with the computers creates a streamlined and efficient operating system for the office. With this level of equipment and technology in place, there is more time to treat patients and less stress.”

“The Henry Schein team was integral in the planning, design, and successful completion of the project while staying within my budget.”

The office design perfectly captures the fresh and simple elements of contemporary style. At the entrance, an 8-foot water feature embedded with the practice’s logo creates instant impact. Twenty-foot ceilings, large windows, sleek oversized furniture, and a custom-made 240-gallon aquarium bid patients welcome in the reception area. Art niches in the main hallway, unique suspended lighting, and attention-getting wall art add drama and complete the sophisticated backdrop that mimics the mood of a luxury spa.

“My staff loves the new office,” comments Dr. Ameri. “New patients who come through the door say ‘WOW’ as they walk in. Patient flow and productivity have improved greatly because of the design, equipment, and technologies. The practice is building clientele quickly. New patient count is up—about 100 per month now—and we’ve seen a 30% increase overall since we opened. We have a beautiful space to enjoy as we deliver excellent care to our patients every day.”

Digital Imaging is provided by the Instrumentarium OP300 and DEXIS.

Check out your beautiful smile in this elegant “goodbye” mirror. Located on your way out next to the lobby.

Dedicated space for personal treatment planning.

Dr. Mash Ameri and Staff.

Dramatic customized lighting.

Dedicated space for personal treatment planning.

The 8-ft. water wall is an eye-catching feature at the office’s entry.

This state-of-the art operatory is equipped with Pelton & Crane 3000 Chairs, Stools, Helios 3000 Lights, Renaissance rear and side cabinetry, a 2500 Delivery System, and the KaVo Comfort Drive Handpiece.

Left to right: Michael Konesheck, Equipment Sales Specialist; Mark Lowery, Regional
Manager; Dr. Mash Ameri, DDS; Joshua Toppass, Filed Sales Consultant; Steven Castaneda,
Digital Technology Specialist

Designed by: Genevieve Cicero, Henry Schein National Design Group

The E4D Dentist system has changed the way I practice—for the better.

Dr. Curtis Jansen, DDS
Monterey, California

I’m a prosthodontist practicing out of Monterey, California. I’ve got a progressive and successful practice with a great team assisting me in providing patients with excellence in dentistry every step of the way. I’ve had the E4D Dentist system for over three years now and it has provided my patients with a unique dental experience every time I’ve used it; digital impressions, restorations in one appointment, and quicker turnarounds with larger cases. All without compromise in form, fit, function, and esthetics. I’ve involved my whole team from Irma, my chairside assistant, who has become a CAD/CAM Dental Designer (CDD), and a Clinical Integration Specialist (CIS) to Frank, a dental technician with over 30 years bench experience—who is now “gaga” over what he can do with a mouse rather than a hot waxing instrument. I do it all—inlays, onlays, and crowns and veneers from single tooth to extensive cases. All are better when you have the E4D Dentist system by your side. Take my word for it— if you haven’t looked at this type of system in the last couple of years, you haven’t looked at all. And don’t believe what you’ve heard or seen before—this technology works!

Figure 1

But now it’s gotten even better and in a way that is most passionate to my interests in dentistry—implants. More specifically it provides all dental professionals a more predictable way to communicate with patients, specialists, and laboratories. It’s a way to get exactly what you’ve planned for—restorative-driven implant therapy—with E4D Compass

Your Henry Schein Dental Sales Consultant can help you decide which one is right for you. Then get ready for E4D Compass—putting you and your surgeon on the same page!

In the implant world, we’ve always talked a good game and have extensive preoperative plans with the laboratory, the surgeon, and the patient. Mocking up diagnostic plans, getting surgical stents and then hoping for the best as you send your patient along the implant placement trail. But, and you’ve all had it happen, something goes awry—the surgical stent doesn’t make it into the placement procedure or the surgeon puts the implant “where the bone is” and not necessarily where the restoration needs to be…then what? These surprise events in the continuum of implant therapy can set the final treatment plan back and dramatically increase the cost of treatment for the patient and the restorative dentist—let alone throw us all into a state of recovery and embarrassment.

Digital dentistry is coming to the rescue! With E4D Compass you’re able to combine cone beam data for the 3-D “internal” view of the patient along with intraoral data from E4D scans. Only the E4D Compass combines the data chairside from multiple sources and provides the clinician an intuitive planning process. E4D Compass works with leading dental cone beam manufacturers such as Imaging Sciences International, Gendex, Instrumentarium Dental, and SOREDEX for a complete solution.

Although other manufacturers have used a closed loop to simply export a static file into implant planning software, only D4D Technologies and the related cone beam systems have worked together to revolutionize the entire restorative/implant planning with E4D Compass. I don’t want to learn new surgical software—I’ve already invested time and effort learning my restorative software. Wouldn’t it be great if I could have all the data on my restorative cart – and be able to play, adjust, and design both the restoration and the implant placement all on the same screen? Well, that’s what we can do with E4D Compass—anything we want—at any stage of the game or plan. I can now draw a nerve the same way (using similar tools) as I draw a margin on a preparation. The interface is made for dentistry…for restorative dentistry.

Flexibility is the key! I know that the implant is not always going to be able to be placed exactly where I want it to be. Factors including bone density, dimensions, and nerve location all can dictate the final placement. But wouldn’t it be nice to know beforehand as you are designing the restoration? With E4D Compass, I can be flexible with my restoration design and implant placement all on the same screen and adjust both parameters (restoration and implant) rather than try to heroically save a situation with angled abutments, extensions and other compromises only on the restorative end. Optimize, don’t compromise.

I’ve been lucky enough to be involved and see the development of this exciting software program. It makes everyone’s “wish list” come true. I can draw the nerve(s), view the data from any angle, design the restoration that is right for the edentulous area, then choose one of a myriad of implants to place into the space using just a click and drag of a mouse. Nothing is this easy in dentistry. Then I can line up the implant with the ideal restorative placement, check the density of the bone, even the angulation of a proposed abutment—incredible. [See screenshots at the end of article.] This flexibility also allows for efficient and effective communication between the surgeon and the restorative dentist, and the laboratory if needed.

Figure 2

Figure 3

So what’s your next step? First, if you are a restorative dentist—get E4D Dentist system into your office (Figure 2): no powder, easy to use, makes any office more profitable by being able to complete same day dentistry or fabricate nearly all your single unit restorations. Get going with that system, and start scoping out the myriad of excellent cone beam systems listed above or locate a scanning center using one of those brands
(Figure 3). Why be tied into just one option? And, more importantly, why be tied into a closed system of the same manufacturer’s CAD/ CAM system and cone beam system? Be able to choose the best of both worlds and what is right for you.

Your Henry Schein Dental Sales Consultant can help you decide which one is right for you. Then get ready for E4D Compass—putting you and your surgeon on the same page! The more you grasp technology and use its capabilities to guide you to the ideal, the more efficient and effective you will become.

So here is your future dialogue with patients missing a tooth who come to see you for restorative therapy. Note: patients don’t come to you with the request for “an implant” they come to you to fill a missing space—it is up to you to offer the ideal restorative plan to fill that space first, then decide how you are going to put the restorative plan in place (bridge, implant; orthodontia). So let’s do that—design the ideal restoration then plan the mechanism to hold it in.

Okay Mrs. Smith, it is very important for you to replace that missing tooth with a “tooth” that will maintain the health of your mouth and will provide you function for chewing. We have several options to complete that goal, but let’s first scan the area with an advanced 3-D laser scanner so we can plan accordingly.

Take the E4D Scanner and capture a true 3-D image of the area—all soft and hard tissue. Note: No powder or contrast agent is placed. Think about it. This patient had just had the tooth extracted and there was still an open or healing wound. The last thing you’d want to do is spray titanium oxide under pressure into an open or healing wound. (So don’t go the powder route.)

Okay, so here is the 3-D virtual model

Figure 4

Figure 5

Figure 6

We can get a better idea of what the ideal restorative solution would be. The computer will assist us in previewing what would be the best functional and maintainable solution for your individual case. Here is the ideal proposal, which we can optimize for your individual situation prior to doing any treatment

It looks like one solution we should consider is a single-tooth implant that would hold the restoration in place and also provide you the most natural feeling and looking solution possible. But first we’ll need to look under your tissue to see if an implant is possible in that location.

Take them over to the i-CAT (or other compatible cone beam system) and complete a cone beam scan. Or if you’ve taken one before on any of the compatible systems, just grab the DICOM data.

So now we can see the bone available below your tissue. I’m going to combine this data right on this screen and show you what is possible. Here is the implant solution I would recommend and you can see I’ll place this directly under the restoration we’ve designed and see if you have the type and amount of bone ideal for this procedure (Figure 6).
We’ll identify the location of the nerve that runs down your lower jaw and certainly avoid that. With this software you and I can get a great view of the overall process before any treatment is started. So yes, it looks like this would be an ideal treatment. If we decide to go with this I have all the information I need. I can be ready when you are and in fact, I can prepare a temporary restoration and have it ready to place in that space the same day the implant is placed so you’ll never feel that open space again and your tissues will heal in the ideal form so when you’re ready the final restoration will be that much more natural and beautiful. Let’s get started!

E4D Compass will guide you in the right direction. Share your passion.

Screenshots

With so many products vying for individuality these days, it is refreshing to find one that strives for compatibility as well.

i-CAT® provides both—a reputation for flexibility in clinical control for individual cases and also compatibility with a variety of other tools to help dentists achieve great results more easily and more precisely.
Distinguished from other cone beam systems, Tx Studio™ software was developed exclusively for i-CAT systems. This powerful software package allows doctors to create complete treatment plans for implants (with abutments and restorations), surgical procedures, endodontics, orthodontics, TMD, and airway assessment in minutes. Plus, doctors can build onto the program with a host of special tools. The clinician can guide each case efficiently, from plan to completion, with enhanced surgical predictability. Visuals in the software facilitate patient education and lead to greater understanding of their condition and reasons for treatment plan.

With i-CAT, dentists can also take advantage of the benefits of other programs and technologies that are compatible with i-CAT data, such as the E4D®. The new E4D Compass™software integrates 3D data from i-CAT® Next Generation™and i-CAT® Precise™with E4D scan data to assist in the designing the optimal restorative plan and ideal implant positioning. Using i-CAT and Compass, dentists can efficiently plan and place implants and use CAD/CAM to restore them with a single software program.

i-CAT data in E4D Compass

i-CAT data in SureSmile

Implant planning with i-CAT
Precise data in Tx Studio

Besides implants, i-CAT also is compatible with orthodontic-related programs. SureSmile® technology transforms cone beam scans into 3D computer models for orthodontic planning and treatment. Orthodontists can use the data from i-CAT scans of the patient’s mouth, face, and jaw, for control of treatment through virtual diagnostic simulations, instant quality grading tools, prescriptive planning capabilities, and robotic arch-wire customization.

Time-saving i-CAT software includes quick launch integration with 3D planning software, including Dolphin® 3D. i-CAT scans used in conjunction with various types of 3D imaging software, provide an opportunity for planning in a program that is specifically geared toward specialty and procedure-based practices.

Compatibility with different software applications is just one facet of i-CAT flexibility. This dynamic CBCT system also offers a variety of scan sizes and dose. The ability for collimation allows the practitioner to focus on a particular area of interest, limiting radiation exposure for the needs of the individual procedure and patient.

i-CAT imaging systems’ individuality, compatibility, and flexibility offers dentists more choices and more control over their patients’ treatment, from diagnosis to implementation.

Dr. Michael Koceja breaks down laser technology and how it works within a dental practice.

You have heard all about lasers in dentistry—all the different applications in your everyday delivery of dental care and the ways they can make your practice grow and grow.

Your patients like the idea of laser dentistry, and you want to modernize your office. All of this sounds great, but you are still a little hesitant. So, “What Now” laser companies are springing up faster than tulips in April in Wisconsin. You have to have lived there to know what I mean.

Every laser company is promising you the world and telling you their product is the best, the latest, the greatest. A whole new generation of dental speakers want you to attend their courses…to learn how to use lasers from them…to grow your practice…to make millions. We have all heard it all before.

So let’s all take a deep breath and float back down to reality and let a guy (I’m just a dentist.) give you a little down to earth advice on the laser revolution.

Let’s talk a little about how lasers work, what they are really good for, and how to utilize them to their fullest potential. We will also touch on what type of training is needed to make a laser work in the “real world” we face every day as dental professionals. So many lasers, so many different wavelengths, disposable tips, cleavable fibers…which laser is really the one that you need? Do you really need a laser?

Choose a trusted partner in purchasing technology.

I had the opportunity to attend a lecture by one of the most knowledgeable laser specialists in the US, Donald Coluzzi, at the ADA meeting. The first question that came from the audience was—which laser should I buy? Dr. Coluzzi had the best answer I have ever heard—buy the laser that you will use. Simple, yet so true—no technology is worth a dime if it sits in the corner. Decide what you want to use a laser for and then buy a laser from a trusted source, a person or company you deal with on a regular basis. We have all purchased equipment from a company or salesperson that went away after the sale. It’s no different with numerous companies popping up to sell lasers. Choose a trusted partner in purchasing technology.

Figure 1

Figure 2

Figure 3

Figure 4

What are you going to use your laser for? As many applications as possible—the more you use new technology, the more it becomes indispensible. A great everyday use is in restorative procedures (Figures 1 & 2). Trying to restore teeth with subgingival decay can become a nightmare. The laser can expose the sugingival decay, control hemostasis, and can be used to also contour tissues to blend with the adjacent teeth. How long should this procedure take? It should take a minute or two—max.

Another great everyday use is gingival recontouring to create an even esthetic gingival contour in the maxillary anterior region (Figures 3 & 4). Both these cases were basically soft-tissue procedures. The first case required a soft- tissue diode laser (Precise 810 nm, CAO company). The second case required an all-tissue laser (MD 2780 nm, Biolase Waterlase) because once the soft tissue was recontoured the attachment level and osseous level had to be modified. So remember to think-out your procedure prior to carrying it out clinically. This determination of what each type of laser can accomplish will play an important part in the decision you make.

Will you need a soft-tissue laser or an all-tissue laser? This brings up the concept of hard-tissue cutting. Can lasers cut tooth as fast as a high-speed handpiece? To me, this is an unimportant comparison. It’s not how fast you can accomplish a procedure—it’s the end result. Isn’t this the whole concept of incorporating technology into our offices? Lasers can cut hard tissue and they can cut efficiently. I have done hundreds of cavity preparations with lasers and time isn’t a factor. Let’s get back to the concept of utilizing lasers. It boils down to getting a better result with an efficient instrument. Lasers come in different wavelengths. Diode lasers are available in 810 nm, 940 nm, 980 nm, and 1060 nm wavelengths. Which is best? Again, I quote Dr. Coluzzi, “The best laser is the one you use.” Hard-tissue lasers come in 2780 nm and 2940 nm wavelengths. There are differences such as ease of use, touch screens, simplicity in understanding the technology into your practice. After 4 years of college, 4 years of Dental School, a residency program, and a postgraduate fellowship,

I still live by the—keep it simple rule. Lasers should be easy to use and training is important. Does the company you purchased your laser from offer training, DVD, online, live training, and support? Can you contact laser users to answer your questions? These are important aspects of learning lasers. You should be open to continuing to learn. Remember if you don’t get the result you expect when utilizing your laser, don’t blame the laser—it’s usually the operator. You would not use your high speed without water—so if you’re learning to use a laser and it’s not accomplishing the result you want, think of how to change your approach to get that result.

Take the time to learn to use your laser and you will get predictable results. Most lasers that are sitting in the back corner of the operatory not being used, are there because the doctor did not take the time to learn the technology. So training is paramount. What does training entail? How long does it take? What is the best type of training? That depends on you. Do you like to attend training with other dentists, prefer online training, or like in-office training with your staff?

I believe training should be simple and should concentrate on how the laser you purchased interacts with the tissue you want to change. Setting sheets are a great starting point (every laser company will give you one) but concentrate on the laser-tissue interaction. Then make adjustments to the settings to get the result you want. Remember, new concepts are sometimes difficult for a dentist who has practiced for 10, 20, or 30 years. Give yourself a little extra time to learn. Numerous times when training a new laser user, I hear that it takes longer than a high speed or scalpel. My response is usually to inquire how long they have been using a laser. If their response is… “This is my first time,” I encourage them to try a few more times. After a few more tries, the concept comes together and the procedure is done. I then look at the doctor and say, “Wow after only 5 minutes of training, look what you were able to do.” The results suddenly seem so much easier and better.

Spend a little time researching new technology and jump in. Lasers are here to stay, the cost is very reasonable and you will provide better care for your patients. Contact your dental supplier and discuss the advantages and disadvantages, cost, and abilities of the lasers on the market. Spend a little time learning to use your laser and most of all—have a little fun with technology. I bet you really will enjoy the benefits of laser technology. What are you waiting for?

For Dr. Natalie Carr, moving forward to reach her professional goals also meant moving back to her hometown of Riverview, Florida.

“I had grown up in this area and wanted to move back to open my own practice,” notes Dr. Carr. “After 12 years of working as an associate there were many things I liked about each office…as well as many things that I would have changed. These experiences allowed me to focus on determining choices that I would eventually incorporate into my new practice.”

The use of a “car” as a branding logo for the business reflects the Doctor’s name and adds an element of whimsy for pediatric patients.

The wall color was chosen in order to promote a soothing and relaxing environment. Equipped with Belmont Clesta lights Summit Dental chairs and stools

After the Doctor purchased the building she moved forward to plan out the design and equipment needs. “I had known Henry Schein Dental Equipment Sales Specialist Pat Tarrant for over 10 years,” comments Dr. Carr. “When I finally made the decision to create my own business, I contacted Pat. He was always honest, hardworking, and knowledgeable. I knew he could offer the guidance and support required for the project.”

“We have come a long way and will continue to improve, providing great service to our clients. I love my office. It projects a clean, fun, and professional image.”

The new consultation area provides a comfortable and private space for reviewing treatment options.

The X-ray unit is situated to promote efficient workflow. Equipped with Sirona XG3 and Progeny Preva DC

Fresh and bright, the reception area creates a great first impression. The stainless steel and glass tiles were used on the reception desk for easy cleanup.

The office’s bright colors and clean contemporary look make it a place where children can feel comfortable and relaxed. The smaller waiting area has been purposely proportioned to be “kid-size.” “It is a tiny triangular room with a TV, children’s chairs and toys,” points out the Doctor. “It is positioned to be away from the main traffic zone to maintain a clutter-free environment. There is also a video game area for older children to enjoy while awaiting treatment.”

Dr. Carr is also an active participant in community activities that support dental health. Referrals from local pediatricians and dentists have steadily increased at her new office. “We have come a long way and will continue to improve, providing great service to our clients. I love my office. It projects a clean, fun, and professional image. My patients look forward to coming to visit and their parents can be assured of high-quality care for their children.”

Left to right: Andrew Guenther, Field Sales Consultant; Dr. Natalie Carr; Pat Tarrant, Equipment Sales Specialist.

Quartz countertops make for easy upkeep in the Sterilization Rooms. Tall cabinets provide for increased storage space. Equipped with the SciCan Statim 2000 and KaVo QUATTROcare

Dr. Carr and her team.

Designed by Jennifer Rhode, Henry Schein National Design Group

The wall color was chosen in order to promote a soothing and relaxing environment. Equipped with Belmont Clesta lights Summit Dental chairs and stools

Dr. Gary Kaye describes an analytic tool that he uses in his practice to predictably assess when the technology is right for him.Making decisions on when to add a particular technology to the practice has become a task that confronts dental practitioners more and more frequently. The technology is often expensive and how we make those evaluations is varied and often irrational.

My experience in almost 20 years of private practice has taught me many things, one of which is that the impulsive reasons for acquiring the technology often end up being expensive mistakes (both in time and money). The same can be said about deciding not to buy something because of an irrational reason (which, incidentally, can be more costly in the missed opportunity, benefit to patients, or any number of other factors).

We are taught many skills in our education but few of us have received any formal training in general decision making. In clinical dentistry the decisions we make are driven by very rigid guidelines on when to treat or when not to treat, then what and how to treat. These are evidence-based and grounded on sound scientific principles. It would be inconceivable and downright unethical to make a clinical judgment—a decision—based on some irrational motive. However, we live in a world where technology is moving at a rapid pace and the benefits of technology are all around us. There is often a “wow” factor associated with new technology that is so utterly compelling that it drives our decision to buy it. Dentists, have become very good at jumping on the “wow” factor of technology, buying something, and ending up with a piece of equipment that gathers dust in a corner somewhere in our offices. Most of the technology utilized in our private practice in New York City has helped put us into the top 1% of solo practices nationwide, driven efficiency, and given the team phenomenal tools to perform at the highest level but, most importantly, is that it has provided our patients with benefits they would otherwise not have received. Our patients are the heart of our practice, so if they benefit from a particular technology, then it will weigh positively on whether that technology should be adopted.

The Kaye Technology Decision Scorecard can be used in any practice setting to determine if the time is right to implement CAD/CAM

Figure 1. We have developed many systems in all areas of our practice that help us achieve our goals. For technology acquisition decisions, we developed the Kaye Technology Acquisition Scorecard (KTAS; Figure 1), a list of all the conceivable variables or factors that have to be considered in the decision with a score for each one.

Figure 2. Summary of the Kaye Technology Acquisition Scorecard.

We end up with an overall score, a number, rather than a hunch about whether to go ahead with the technology or not. We tested the scorecard and looked back at decisions we had made in the past and it has been remarkably accurate and reliable as to how those decisions turned out. For example, a number of years ago we bought an air abrasion system and stopped using it long before we came close to amortizing the equipment. Had we used the technology scorecard, we would have come up with an overall score of 375 against it and only 210 in support of the decision. The scorecard is very practice-specific so two different practices using it for the same technology could arrive at different scores and hence different decisions whether to adopt a technology or not. On the other hand, in 2001 we added digital impressions and CAD/CAM into the practice. Unlike air abrasion, it worked out very well. The retroactive scorecard of instituting CAD/CAM would have been 335 to 246 in favor of CAD/CAM. By 2009, CAD/CAM had become an integral part of our practice. At that time, the technology had advanced and we faced the decision of whether to upgrade to a newer version of the same system, but there was now a competitive CAD/CAM system available in the E4D Dentist™ system by D4D Technologies in Dallas, Texas. The Kaye Technology Decision Scorecard is also very useful when comparing different products, and based on the overall scores, 335 for E4D and 246 for the upgrading our existing system, we decided to purchase the E4D Dentist system.

Why CAD/CAM?

The Kaye Technology Decision Scorecard can be used in any practice setting to determine if the time is right to implement CAD/CAM. Based upon all the benefits of the technology and the success of more than 10,000 practices that have adopted CAD/CAM, the technology scorecard will usually come up with a positive result, indicating that the benefit of acquiring CAD/CAM exceeds that of not acquiring it. The next step is to determine which product or company to go with. It is here that the KTDS excels. By using the scorecard, a true side-by-side comparison can be made. Another way of looking at the KTDS is as a series of 30 questions that should always be answered when selecting a technology product. The scorecard has the flexibility to accommodate additional variables should the clinician deem them to be significant as well as ignore variables that are not considered important for a particular decision.

How the Kaye Technology Acquisition Scorecard works

The KTAS looks at numerous factors and divides them into four broad categories: clinical use, product features, service, and support plus a variety of business issues that relate to the practice management. Each of these categories is divided into subcategories that are assigned an importance value of 1, 2, or 3 to the subcategory as it pertains to a particular decision. For example, if we are looking at a piece of technology that we will depend upon for critical functions in our treatment, then the service response time if it malfunctions takes on a higher level of importance in our decision so we assign an importance value of 1 to the subcategory of response time. Then for each subcategory we assign a “positivity” score between 0 and 10, with 10 representing the highest positivity for that subcategory. For example if the distributor of the technology has a good track record, then for quality of who handles it under service and support we assign either 7 or 10.

The spreadsheet is set up to calculate weighted scores for each category and two overall scores, and then a graph displays the results (Fig. 2). We use the difference in the two overall scores to drive our decision. The larger the difference between the two overall scores, the more compelling the decision in favor (or against) the technology becomes. If the scores are very close then that will obviously be indicative that there is not much of an overall benefit or detriment to acquiring the technology.

Good for your patients. Good for your practice.

We hear about it a lot these days—dental practices getting squeezed by lower consumer spending. The result is less treatment acceptance and lower revenues—and no practice is immune. Economists have even coined a phrase for this belt-tightening and credit-crunching …“the new normal.”

But, as any dentist will tell you, patients electing not to get the treatments they need because of financial concerns is far from what they’d like to see as “normal.” Luckily, there are some innovative payment options out there for dentists who want to help their patients, keep money coming into their practice, and avoid becoming debt collectors themselves.

Here are a few of our favorite tips for what to look for in a patient-financing program.

Your outside financing partner should be as flexible as you. You always have your eye on individual solutions for your patients—from the routine to the cutting edge. And, we all know that “one size fits all” rarely fits anyone. So you should expect the same kind of flexibility from from your financing partner. Look for a payment option like the Citi Health Card that offers several no-interest plans as well as budget plans and regular revolving options. The more options your financing partner can provide, the more likely you’ll find the one that works best for your practice and your patients.

A good partner lets you focus on your patients, instead of whether you’ll get paid. Almost nothing is as frustrating or drains productivity more than out-of-control accounts receivable. Who wants the hassle of tracking down past due payments? Keep your focus on care, and let a third party handle the payment process. Just make sure they offer fast payments in 2–3 days.

You shouldn’t be held hostage to high merchant fees. One of the main benefits of patient financing is cash flow management. But be careful. A lot of partners will make you pay a big price for this convenience on the back end. Keep a close eye on the merchant fee rate for each financing option you select. The Citi Health Card has the lowest No Interest and Budget Payment Plan Merchant Discount Rates in the dental industry and providers can save up to 41% compared to other products.*

Peace of mind matters to you and your patients. No one wants to wonder how they’re going to afford a procedure they need. That’s why the best financing partners provide your practice with all the materials your patients need to understand their financing options right from the start. And they also provide reliable support to your staff so they can answer patient’s questions. That way, your patients know exactly how they can pay, and you know exactly when you’ll get paid. Taking the payment out of the relationship lets everyone focus on care.

You have enough equipment in your office already. Do you really want to deal with another payment terminal, snarl of wires, and who knows what else? Working with a financing partner who can accommodate your existing payment processing equipment just makes everything that much easier. For example, the Citi Health Card can be processed through a standard credit card terminal, a touch-tone phone, or via the convenient and easy-to-use online processing method.

Fast payments make for a healthy practice. We can’t stress this enough. Knowing that you’ll be paid consistently and on time lets you manage your expenses, budget for equipment upgrades, and keep your finances in order. Plus, offering a trusted payment option like the Citi Health Card can help you increase treatment acceptance and patient loyalty at your practice. Sounds like a good deal to us—less hassle, more savings, better treatment rates, fast payments, and full customer support.

For more information on the Henry Schein Financial Services Patient Financing program, please call 800-443-2756, Option 1 or e-mail hsfs@henryschein.com.

*Merchant Discount Rate is the cost to your practice and is calculated as a percentage of the total sale. Savings is based on No Interest and Budget Payment Plan rates charged by a major or national competitor.

My stance has always been that we are not in the dentistry profession working with people but rather working with people providing dentistry. Therefore, “connecting” with patients is key—day in and day out.

How do we connect? We ask insightful questions, provide clear explanations, and relate with sincerity. Patients don’t remember necessarily what you said but rather how you make them feel. This creates loyalty as we are developing relationships, and from that, deep mutual trust and respect develops. As a result, patients will follow and accept your treatment advice. This to me is the highest of priorities.
—Dr. Cynthia Brattesani

It might seem contrary that technology, which is often derided as something that keeps us from genuine face-to-face interactions with others, can help doctors connect with patients. But it’s true.

Smart devices, and in particular the iPad, are allowing dental teams to share information with patients in a more user-friendly, engaging way. From the three-year-old who’s entertained on the plane to the business executive presenting in the boardroom, the iPad and its endless supply of apps have changed the way we play, and it can change the way we work. It’s called a “smart” device for a reason.It will optimize care and streamline the workflow in every room of your dental practice.

Taking the steps to integrate devices like the iPad into your practice can provide productivity improvements, improved patient engagement, and an edge on your competition.

~Reception Area
Patients cultivate their opinion of your practice in the reception area. Use of an iPad can enhance every part of their experience here from the check-in and required paperwork completion to their entertainment and comfort during any waiting time.

• At check-in: Replace “old school” paper and clipboard and have patients complete forms on the iPad, which are imported into DENTRIX from the practice Web site or iPad, with a few clicks.
  Apps Needed: Dentrix Kiosk 
• Self-service consent forms: Forms can be set with required fields that expire after a pre-determined amount of time, ensuring that data is current.
  Apps Needed: DENTRIX Kiosk 

• Check-in alerts operatory staff: The appointment status in the DENTRIX Appointment Book is automatically updated to indicate that the patient has completed the forms and is readyfor the operatory.
  Apps Needed: DENTRIX Kiosk 
• As patients wait: Provide wi-fi, branded to your practice. Give patients an iPad loaded with digital magazines and newspapers, games, videos, social networking apps like Facebook and Foursquare, where they can “check in.” Dental care videos can also be provided as a service to patients through Guru.
  Apps Needed: Flipboard, Foursquare, Facebook, NetFlix, Guru

~Treatment Rooms/Consultation Room
Pictures are worth a thousand words, and are an excellent catalyst for conversation between doctor and patient. This“co-discovery” opens up conversation ata whole different level, sealing the message and fulfilling expectations for doctor and patient.

• Display 3-D videos and interactive demos: Explain diagnoses and treatment plans and give patients a superior level of understanding.
  Apps Needed: Guru 
• Put digital X-rays into patients’ hands: Enlarge or zoom in to images while sharing your diagnosis with patients as they hold an iPad in their laps. Choose from several iPad apps that can remotely access the computer that houses the DENTRIX image software.
  Apps Needed: Splashtop, iTeleport, or Jump Desktop  
• Patient file photos: Use the iPad or another digital camera for non-clinical patient photos. Patients find it fun and intriguing—and it’s less intimidating for some. Several iPad apps allow you to upload photos that can be viewed on all Apple devices in the office.
  Apps Needed – Apple IOS 5 / iCloud or Dropbox

~Practice Administration
Behind the Scenes – Staff Meetings
The iPad brings a powerful tool into your daily meetings, giving you the opportunity to present practice updates and patient information to the team, while also collaborating with them on patient care.

• Daily Huddle Reports: Exported from DENTRIX to a PDF. Using iAnnotate, review and make notes on the iPad with the entire dental team to show progress made toward monthly goals and maintain a focus on improving patient care.
  Apps Needed: Dropbox, iAnnotate 
• Practice Advisor Reports: Export from DENTRIX to a PDF and display on an iPad to give management team or entire office a glimpse of the financial health of the practice and overall performance data.
  Apps Needed: Dropbox, iAnnotate 
• Create a survey to answer questions about that day’s patient load in the huddle then store the document in the cloud for easy access by the entire team.
  Apps needed: Dentrix Kiosk

Potential questions to address in huddle:

• Who is coming in? New patient or existing?
• Who referred them? (Helps to remember who they are.)
• Any recent referrals to thank themfor today?
• Any medical history alerts?
• What will we perform as treatment today?
• What treatment is pending?
• Did we receive correspondence form/report from a specialist?
• Do we have any personal photos/announcements (new baby, marriage, announcement of new job, postcardfrom travel)?
• Eligible for FMX X-rays?
• Any pending balances or billing issues?
• Any specific notes about today’s appointments?

~Appointment Management
DENTRIX Mobile streamlines many processes for practice staff in scheduling appointments and keeping in touch with patients. Reminders and frequent contact with patients keep your office top of mind and provide them with a convenient service as well.

The Dentrix Appointment Book can be viewed, appointments confirmed, and notes added. Confirmations and notes are updated automatically in Dentrix.

• Postcards are automatically generated, reminding patients of a scheduled appointment. It includes a QR code so patients can use a smart phone or iPad to see appointment details, confirm the appointment, add the appointment to a calendar, and even get directions. Requires eCentral Communication Manager.
• Research drugs listed in patient medical history and drug interactions with dental treatment (www.Lexipro.com). Create an app for the Lexipro website on the iPad home screen by opening the Web site, clicking on the icon with the arrow in the top right and selecting, “Add to Home Screen.”
• Search for insurance codes and for narratives to submit insurance claims (www. practicebooster.com).
  Apps Needed: DENTRIX Kiosk

~Access on the Go
Even away from the practice, DENTRIX Mobile allows doctors or on-call team members to view appointment and patient information and add notes and updates remotely using a mobile device.

• Appointment schedules: View remotely to plan for the following day or call patients if appointments need to be rescheduled.
• Patient notes: Add remotely to the DENTRIX Appointment Book specific to a certain day or appointment using an iPad or Xoom tablet.
• Appointment confirmations: Update remotely using an iPad or Xoom by teams calling patients after hours or outside of the practice. The confirmations are automatically updated in DENTRIX. Requires eCentral Communication Manager.
• Patient prescription history: Ensure the doctor or on-call team member has the correct information if the patient calls requesting a new prescription.
• Patient eligibility status: Update or verify eligibility remotely. Requires eCentral Insurance Manager
  Apps Needed: DENTRIX mobile

~Getting Started
Basic Apps You’ll Want
Two of the iPad’s most powerful benefits are its ability to share information in the cloud and with other mobile devices seamlessly and the 90,000+ iPad-specific apps available in the Apple App Store! With so many to choose from, it’s difficult to know where to begin. Here are a few apps you should load to get started.

~App Store Apps

• Guru for iPad provides educational tools that can be used to connect with patients. High-definition videos, animations, and diagrams can be used to help to explain procedures. Guru is available to download for free and connects to the Guru Server products.
• iTeleport: VNC or Jump Desktop (Remote Desktop) – Access a stand-alone computer in your practice remotely and display its information on an iPad in another part of the practice. iTeleport works with VNC and requires that VNC be configured on the computer that you are connecting to. Jump Desktop will allow you to connect to Remote Desktop, the built-in Windows remote-connection software.
• Facebook for iPad: Install the native Facebook app on your iPad to allow users to connect directly to Facebook. If multiple team members access the app, encourage each user to log out when they are done.
• Penultimate: Are you using your iPad to take notes at your practice? The iPad equivalent of a pad of paper is Penultimate. If you don’t have a stylus, Penultimate provides a great reason to try one out.
• iAnnotate: iAnnotate provides the ability to annotate PDF documents with notes and comments, which allows for team collaboration and sharing. To view and read PDFs only, download Adobe Reader.
• iWork: Pages, Numbers, Keynote: If you have a Mac in your practice and use Apple’s iWork suite of apps, Pages, Numbers, and Keynote are all available as native apps on the iPad.
• Documents To Go – Office Suite: If you use Microsoft Word and Excel, Documents To Go provides a subset of the editing capabilities for the iPad. Open and edit Office documents right on your iPad and get some work done.
• iBooks: Apple’s eBook reader and store are not installed by default on the iPad, but can be downloaded for free fromthe App Store.
• Netflix: Does your practice have a Netflix streaming account? Install the Netflix app and allow patients to watch movies and TV shows on demand as they wait.
• Dragon Dictation: Dictate a note using the popular Dragon Dictation app and copyand paste the resulting text into an email or other apps. In the future, we may see Siri Personal Assistant, the voice recognition software debuted on the iPhone 4s, available on the iPad. For now, third-party dictation apps accomplish simple dictation.
• The Daily: Looking for news on the iPad? The Daily is a news app created specifically for iPad. It’s an immersive news experience similar to news magazines but with more interaction.
• Evernote: Another note-taking app that allows you to store videos, links, reminders and more in easy-to organize notes. Take notes on any device and view and edit them on another. Evernote provides cloud-based note management.
• GoodReader for iPad: Connect to a server location via FTP, Dropbox, or several other cloud-based services and open and view items right on your iPad.
• Dropbox: Share files and collaborate practice information over the cloud, a particular strength of the iPad. If you want to easily move files between devices, move them into your Dropbox location and view them on your other devices.
• Google: This shortcut to all things Google allows you to access Gmail, Google Docs, photo sharing, YouTube, and more.

~Web Apps
DENTRIX Mobile – Giving you the power of DENTRIX on mobile devices Dentrix customers can access the powerful benefits of their practice-management software while they’re away from the office with Dentrix Mobile. Available for devices like iPhone, iPad, Palm Pre, Android and select BlackBerry models, Dentrix Mobile is part of regular customer service plans, and maximizes your time in and out of the office. Some of the most common tasks that can be done while on–the-go include:

• Access patient data, contact information, appointment history, and more, 24/7
• Verify patient prescriptions while out of the office
• View upcoming appointments for you and your providers
• Deliver real-time updates for on-call teams
• Search by patient or provider with extremely simple but powerful search and navigation functions

Taking the steps to integrate devices like the iPad into your practice can provide productivity improvements, improved patient engagement, and an edge on your competition. It would be a daunting taskif you had to figure it out on your own, but you don’t. Contact your Henry Schein Technology Representative to help you take the first step toward introducing mobile devices into your practice.

Article Contributors:
Dr. Cynthia Brattesani
William Weldes, Centare Group
John A. DeToro, Techteriors.

See why Jason Barth, DDS, decided to switch from using a film-based system to digital radiography.

It is a wonderful feeling to make a decision and have absolutely no regrets.

Switching from a film-based system to digital radiography was a good choice. Digital is more environmentally friendly than film-based systems that require chemical processing, and images are immediate with no time wasted waiting for developing. It was one of our steps on the path to a paperless office. We did find out, though, that not all digital sensors provide the same quality of images or the same patient comfort. Over the years, I had the opportunity to use several brands of digital sensors. Our recent trade-in to the DEXIS system has changed our view of digital radiography, improved patient comfort, and eased staff workflow.

Some years ago, we chose another system that was compatible with our EagleSoft software. We immediately noticed more difficulty taking all of our shots with those sensors, causing us to have to rely on a Phosphor Plate system for some people, especially our younger patients, in conjunction with our digital X-rays in order to capture all of our needed images. This was frustrating. It was like relying on traditional films all over again, with the only advantage being that we did not have to use chemicals. All of the other benefits related to digital sensors could not be utilized. We also noticed many more patients complaining about discomfort, requiring us to use more pads on the edges of the sensor, which equated to more time and more expense.

Trading up: One dentist’s view of digital radiography

In our fourth year of use with our previous system, the problems started to escalate. I had already decided on changing to DENTRIX software, and knew that would lead to a change in sensors. Then, within a matter of weeks, all three of my other sensors became completely unusable. We used our PSP plates temporarily until I decided what to do.

The sensors carried a warranty, and I could have replaced them at a reduced price. However, I had already made up my mind to change. When I called my Henry Schein Sales Consultant, Charlie Lonberger, and told him of my decision to go to the DEXIS system, he told me about the trade-in program. I was happy to be able to acquire the sensors that I really wanted. The very first day that our new sensors were in use, my staff was amazed at the images. They were so well designed for ease of placement in the patients’ mouths. We could take a full-mouth series in nearly half the time that we did before, and they were so comfortable we were able to throw out our edge pads. The assistants remarked how convenient and efficient it was to only need one size sensor for every type of image. Since we switched, I can’t think of a single time that we have had to resort to our PSPs in order to get an image, even on kids! One of my team members, Erin Burch, shared her thoughts, “Now, taking X-rays is definitely easier. The angled corners are more comfortable for our patients, and the single-size is so convenient. We don’t have to worry about what size to grab—they’re very portable and just travel around the office.”

The really important aspect of any X-ray is the image itself. Everyone in the office is impressed by the clarity of the images. Our local DEXIS rep, Joel Martino, along with Charlie, made the transition seamless—we didn’t miss a beat. It is great to make the right decision the first time, and the trade-up program gives dentists the chance to rethink and replace their sensors for more durability, comfort, and image quality. Actually, even if there were no such program, I would have switched sensors anyway. The trade-in program just made the switch more enticing—and more of a no-brainer.

Time To Grow

See how Dr. Steven Johnson transformed his practice in order to fullfil all of his specialized service needs!

Johnson Family Dental’s continuously strong growth had propelled it toward full capacity at its former facility. The time had come to evaluate future needs and develop a plan for keeping up with its diverse activities and specialized services.

The availability of retail space at reduced rates because of the recent economic downturn proved beneficial for building a new facility. The focus was on design ergonomics that would enable the maximum use of space while saving footsteps during the day. Better integration and standardization of equipment and technologies was also a prime consideration. With constantly accelerating growth, a well-organized and efficient setup for delivering care was a necessity. “In the old office, small hallways, a patchwork of different equipment and chairs worked against our productivity,” comments Dr. Johnson.

“Patients and employees love the feel and openness of the new office — and often remark that they would like to work here,” comments Dr. Johnson.

Johnson Family Dental can now work confidently toward achieving its practice goals in a 5,390-sq.-ft. space that houses 18 operatories (11 doctor; 7 hygiene). There is ample room for patient treatment, a welcoming reception area, a large employee lounge that doubles as a center for employee meetings, and equipment and technology upgrades that are vital to its many specialized services.

“Henry Schein Dental’s team accommodated our every need,” points out Doctor Johnson. “We have built a good trust relationship with them. Our sterilization, laboratory, and operatory equipment are through Henry Schein Dental. We also chose Dentrix practice-management software through the Privileges program; and use TechCentral support for computer integration and maintenance.”

Comfortable chairs and a patient beverage station make the waiting room an inviting space.

Mellow earth tones are prevalent throughout the new facility. The main focus of the reception space is a 9-foot wall made of stacked stone that is native to the area. Its characteristic colors blend beautifully with the décor and make an outstanding accent statement in the room. A stylized, barrel-shaped ceiling in the main hallway adds additional architectural detail.

A dedicated lab provides a clean and quiet room for the E4D mill and other lab equipment. Equipped with E4D Dentist Mill

“Patients and employees love the feel and openness of the new office—and often remark that they would like to work here,” comments Dr. Johnson.

A dedicated lab provides a clean and quiet room for the E4D mill and other lab equipment. Equipped with E4D Dentist Mill

Soffits, arches, and unique lighting break up a long hallway.

Rear delivery, track lights, and an efficient
cabinetry design allow extensive technology in the operatory without feeling cluttered.

Equipped with DCI track lights, Marus Chairs and Stools, E4D Dentist, KaVo DIAGNOdent, Gendex Expert DC X-ray.

A galley-style sterilization setup
increases efficiency and allows a
single sterilization area to handle all
18 treatment rooms.

Equipped with Midmark 11 Ultraclaves

“Patients and employees love the feel and openness of the new office—and often remark that they would like to work here,” comments Dr. Johnson. “Employees feel they can better serve the patients in the efficient workspace. New patients have doubled and we have already experienced a 20% increase in reappointments; referrals continue to rise—we are now at 40%–50%. The renovation has allowed us to offer endo treatment—we have a specialist coming in weekly—and we hold an implant seminar monthly. Our equipment upgrades included the E4D Dentist system, which gives us the ability to provide same-day crowns and our i-CAT cone beam X-ray makes a wide range of diagnostics possible. And, we are looking forward to starting a dental assistant training school in 2012!”

Left to right: Hugh Hall, Field Sales Consultant;
Mike Mathews, Equipment Service Technician;
Matt Scott, Equipment Sales Specialist;
Gary Rzepka, Digital Technology Specialist;
Dr. Steven G. Johnson; Maritza Alford, Regional Manager; Frank Hovey, Office Manager

Johnson Family Dental 2D Design Plan

Just as a healthy, thriving dental practice begins with a healthy hygiene department, a healthy body begins with a healthy mouth. Improving patients’ understanding of the oral-systemic connection is the first step in boosting the profitability of your hygiene department. Imagine if every dental patient knew that periodontal disease doubles the chance of dying from a heart attack and every woman knew that periodontal disease can affect fertility and contribute to low-birth-weight babies. Oral systemic information has the power to motivate compliance with oral care routines and treatment recommendations, when communicated properly.

By setting clinical standards of care for soft-tissue management and determining office protocols to adhere to them, you can directly affect the health of your patients.

A healthy body begins with a healthy mouth. Find out how you can improve your patients’ understanding of the oral systemic connection. This is the first step to boosting the profitability of your hygiene department.

A wellness program provides a standard process for educating patients on the oral-systemic health connection and preparing them for a health discussion with the dental team. Wellness education teaches patients that regular visits to the dentist do not simply maintain oral health, but may help prevent serious health conditions and maintain optimal overall well-being.

What should a wellness program address? According to the American Academy of Oral Systemic Health, the foundation of any dental wellness program is periodontal disease. By setting clinical standards of care for soft-tissue management and determining office protocols to adhere to them, you can directly affect the health of your patients. Using wellness education to highlight the links between periodontal disease and heart disease, stroke, diabetes, pancreatic cancer, and osteoporosis will reinforce the importance of periodontal health for patients and drive treatment acceptance.

Using a wellness program to collect basic data on patients’ sleep patterns, you can uncover undiagnosed sleep disorders in your patient base, vastly improving patients’ quality of life and improving their health.

When diagnosing and treating periodontal disease, there are other health conditions that can impact a treatment plan. According to the American Heart Association, patients with periodontal disease are almost twice as likely to suffer from coronary artery disease as those without, and periodontal disease can exacerbate existing heart conditions. Using a wellness program that asks patients to report current heart conditions or risk factors for heart disease will allow dental professionals to target comprehensive periodontal exams, assess every patient’s risk of heart disease and make referrals for care accordingly.

Much like heart disease, we know that diabetes is also closely connected to periodontal disease. Since severe periodontal disease can put the patient at a higher risk for diabetes, dentists may refer these patients to a physician for testing or use a finger-stick test to check for diabetes in the dental office. Using information provided through a wellness program, both patients currently diagnosed with diabetes and those who report diabetes risk factors could receive a comprehensive periodontal evaluation, immediate periodontal treatment if necessary, and referral to a physician as needed. Research shows periodontal disease treatment can improve management of diabetes and improve the overall health of the patient.

In a 2007 survey, only 15% of patients who went to the dentist reported receiving an oral cancer exam. Although most dentists and hygienists are careful to do oral cancer examinations as part of both their initial patient examination and recall examinations, they might not be telling patients that they are looking for oral cancer. Patient education regarding this deadly disease ensures patients understand that the oral cancer exam they receive in the dental office is just one more crucial reason to keep their scheduled dental appointment! Early detection is the key to surviving oral cancer and using wellness education to reinforce this for patients will increase their commitment to dental care.

Sleep is one of the most important components of health, yet the Institute of Medicine reports that 50 to 70 million Americans suffer from chronic sleep disorders. Despite dangerous associations with high blood pressure, heart attack and stroke, depression/anxiety, memory and concentration problems, and driving accidents, 80 to 90 percent of sleep disorders remain undiagnosed. Using a wellness program to collect basic data on patients’ sleep patterns, you can uncover undiagnosed sleep disorders in your patient base, vastly improving patients’ quality of life and improving their health.

Henry Schein introduced their new wellness program, Total Health, to assist dental practices in communicating wellness information to patients with the goal of decreasing cancellations, increasing patient compliance, and ultimately improving the overall health of patients. By converting your current recare program to a wellness program, you can do what’s best for your patient and what’s best for your practice. To learn more about Henry Schein’s Total Health Program, visit the Wellness page on www.HenryScheinWeDoThat.com or contact your local Henry Schein Sales Consultant.

If you’re puzzled at the name of Dr. Ellen Brodsky’s new practice, Art & Dentistry, you only have to take it literally. This stunning office, which is located in Bethesda, Maryland, has captured a vision that is unique and inviting with a lineup of advanced technologies that deliver personalized, comfortable treatment options to its patients in an interior created to give maximum productivity—with the look and feel of an art gallery.

As a passionate lover of art, Dr. Brodsky has found an exciting way to be surrounded by inspired artists and their works through showcasing different collections in the office every few months. Patients and visitors can browse and enjoy the art, which is perfectly set off by the facility’s strikingly sophisticated architectural design.

Properly sized operatories with equipment and technology upgrades allow Dr. Brodsky and team to provide her patients with the specialized care they need and want. Workdays at Art & Dentistry are more productive and just more fun for both patients and team members.

Sleek and ultramodern in style, the office’s trendy mood captures one’s attention immediately. The office may look SoHo New York City, but make no mistake—the ergonomic environment was created and envisioned to allow all team members to deliver the finest dental health care throughout the day with heightened efficiency and productivity.

The 7 operatories use state-of-the-art equipment from leading manufacturers. “I purchased this practice over 13 years ago when digital technology was just about nonexistent,” notes Dr. Brodsky. ” We were in 1200 sq. ft. space that was outdated and limiting. We needed more and larger operatories along with private areas to discuss and present treatment plans and payment options.” I met with our Henry Schein Dental Field Sales Consultant Matt Rice and Equipment Sales Specialist Bob Middledorf to begin the process of creating my dream dental practice.”

“We all spent a long weekend in Charlotte North Carolina.” While there we participated in the Driven to Excellence program hosted by Dr. Mark Tholen on office design and ergonomics. The properly sized operatories with equipment and technology upgrades allow Dr. Brodsky and team to provide her patients with the specialized care they need and want. Workdays at Art & Dentistry are more productive and just more fun for both patients and team members.”

“We now have almost 4,500 active patients,” adds Dr. Brodsky. “The office setup is ideal for us—exceptional lighting, a The 7 operatories use state-of-the-art equipment from leading manufacturers. “I purchased this practice over 13 years ago when digital technology was just about nonexistent,” notes Dr. Brodsky. ” We were in 1200 sq. ft. space that was outdated and limiting. We needed more and larger operatories along with private areas to discuss and present treatment plans and payment options.” I met with our Henry Schein Dental Field Sales Consultant Matt Rice and Equipment Sales Specialist Bob Middledorf to begin the process of creating my dream dental practice.”

“We all spent a long weekend in Charlotte North Carolina.” While there we participated in the Driven to Excellence program hosted by Dr. Mark Tholen on office design and ergonomics. The properly sized operatories with equipment and technology upgrades allow Dr. Brodsky and team to provide her patients with the specialized care they need and want. Workdays at Art & Dentistry are more productive and just more fun for both patients and team members.”

“We now have almost 4,500 active patients,” adds Dr. Brodsky. “The office setup is ideal for us—exceptional lighting, a gorgeous new consult room, private offices for Doctor and practice administrator, and a large conference room with kitchen for meetings and continuing education. We have made it a priority to integrate modern technologies into the business. The right equipment gives us flexibility in patient treatments and makes a positive difference in the oral health of our patients. We are able to offer full service dentistry including; sedation dentistry, implants, orthodontics and even Botox and dermal fillers. We continue to see more and more patients for elective and cosmetic procedures.”

Dr. Brodsky and her team are now able to see more patients per day and to easily accommodate their requests and scheduling needs. The entire team is committed to each patient’s “best smile” and has the delight and pleasure of doing so in a spectacular environment that merges the science of dentistry with the art and cultural enrichment of talented local artists’ all with a like minded philosophy of esthetics and function.

Left to right: Tonya Faison, Equipment Service Technician; Bob Middledorf, Equipment Sales Specialist; Dr. Ellen Brodsky; Matt Rice, Field Sales Consultant

Featured Equipment and Technology

Dentrix Practice Management Software
DEXIS X-ray Digital Sensors
Guru Patient Education
Pelton & Crane Cabinetry
Pelton & Crane Chairs and Units
Pelton & Crane Helios 3000 Lights
Pelton & Crane Solaris Sterilization Center

The Cloud

Since the advent of the Internet, the term “cloud computing” has been used to refer to a variety of capabilities: online data storage; instantaneous file sharing across multiple users and wide geographies; and universal access to information that keeps businesses running.

It’s important to note that many cloud services have been around for a while, including now-ubiquitous products like Citrix®, Google Docs™, and iTunes™. Even basic services we all use every day, such as cell phones and ATMs, make use of cloud technology. Newer companies like Dropbox® are distilling the almighty power of the Internet down to amazingly simple, low-cost offerings that speed up the basic ways we share information. So, while not a new concept, running a business “in the cloud” has many exciting implications for the dental industry that are just now being realized with stable Internet bandwidth and operating platforms.

“The advantages of universal access and easier file sharing fit naturally into what dental labs [and practices] do every day. Communication with a clinician can help avoid frustrations and, with the cloud in play, collaborating with outsource partners, dentists, surgeons and suppliers can be accomplished in a variety of simple ways.” – Noah Levine, Senior Editor, www.dlpmagazine.com

Henry Schein DDX
At Henry Schein, more of our products and services are cloud-ready than ever before. In particular, Henry Schein DDX offers an extremely exciting network for dentists and labs to submit and receive new prescriptions, share lab case information, collaborate on case design, and manage account details like payments and statements—all integrated with technologies dentists use every day, like D4D, Dental Wings, and 3Shape. DDX is built and delivered online with no software installation necessary, and mobile access is planned for 2012 release. For added efficiency, DDX has been embedded into all of Henry Schein’s practice-management platforms, giving 47,000 practices the ability to create lab cases with just one click and without ever leaving their practice-management software. It’s also accessible via the Web, so any practice can use it—though practices with Henry Schein software will enjoy the maximum level of integration. Any lab can access DDX via the Web as well, so all labs can accept cases with DDX through a simple online set-up process.

The best part? DDX is completely, 100% free for dentists.

As the health care environment evolves and national legislation for basic care enters the horizon, we at Henry Schein see many dentists view the cloud as an elusive goal, a distant utopian future that some may think, like a truly paperless practice, requires sizable investments in software and equipment to implement. For many, distrust of security, questions of HIPAA compliance and perceived productivity loss due to staff training will slow adoption of cloud technologies in the short term.

Fortunately, cloud services like DDX are designed to be low-cost, secure, surprisingly easy to use and, for most, complementary to your existing software. They must, or where’s their value? The tumult of an Internet boom in its infancy is thankfully stabilizing into a recognizable adolescent landscape of minimum thresholds for dentistry: EHR, digital imaging, design and milling, Web-enabled front desks that schedule and notify patients electronically, etc. For the dental practice, an industry-standard practice-management system like Dentrix or Easy Dental provides the foundational software within the practice walls—patient scheduling, charts, financials, and records databases. Then, with a single click from the patient’s chart, DDX instantly populates a digital lab slip that can be sent to any lab, anywhere, with imaging files of any size attached: the perfect launchpad for liftoff.

DDX and the Cloud
In the cloud, of course, the lab prescription is just the beginning. Once a dentist takes a few seconds to submit the prescription, the chosen lab receives an automatic alert that the case is coming (or an automatic pickup request, if the practice chooses). Practices can more accurately schedule the patient’s follow-up appointment right in the chair, since DDX instantly generates an accurate turnaround date based on the lab’s production calendar.

With just a few clicks, the lab case and all its related info is in the cloud—secure, trackable, transparent, with all necessary files attached—and viewable by both the dentist and the lab, anytime, anywhere, forever.

There are more than 35 million lab cases in the U.S. annually. Given an aggregate caseload of 15–25 cases per month, per dentist, and hundreds or thousands of cases per month, per lab, this means DDX puts a critical aspect of the patient experience under greater oversight and provides an atmosphere of collaboration for both dentist and lab. At the same time, significantly reducing phone calls, lost staff time running down cases and costly rescheduling can virtually eliminate familiar hassles in today’s lab/dental environment—hassles that currently slow patient flow and lab production. Given that many practices work with multiple labs, and most labs work with multiple practices, the dental team can now log in and view a centralized case record, with no lost reporting time to patients, lab managers, or doctors. In January 2011, a survey of DDX-enabled labs reported that most saw around a 30% reduction in staff phone time after implementing DDX—time those employees can now dedicate to important tasks such as improving customer service or making outbound marketing calls to generate new business.

“This revolution has resulted in true increases in efficiency, security, accessibility, immediacy, and simplicity, since running software in the “cloud” (i.e., online) frees the user to no longer be concerned about the complexities of obtaining, installing, and maintaining software and hardware and focus instead on exploiting anywhere, anytime access to one’s programs and data.”– Bruce Lieberthal, VP Emerging Technologies, Henry Schein Inc.

How It’s Going So Far
In the short time DDX has been available, DDX-enabled practices say it has helped them improve:

• Efficiency—67% of DDX-enabled practices say DDX makes their practice more efficient
• Competitive edge—58% of practices increased the volume of cases they submit to their DDX-enabled lab
• Profitability—35% of practices credit DDX for reducing patient rebookings

With the program’s responsive, flexible, and customizable platform, dentists and labs can agree on the criteria required for a case and then standardize that criteria so incomplete prescriptions can never be submitted. Zero incomplete prescriptions! In the words of DentalOne Partners, a large dental practice-management service provider, “We partner with Henry Schein on the enhancement of the lab slip, the graphics, and the reporting enterprise and have been able to share ideas. Henry Schein has supported our training of the product and has taken on lab enrollment.” – Susan Huff, General Manager, DentalOne Partners

Put DDX and the Cloud to Work for You Today
For practices exploring the wisdom or efficacy of a sea change like totally paperless practice management, a smaller step that harnesses the power of cloud computing can deliver needed changes quickly, inexpensively and with measurable results. DDX provides dentists and labs with a universal network to communicate using technologies they already have, speeding adoption of ever more powerful solutions that just keep getting easier to implement and leverage for growth. Visit www.DDXDental.com to learn more today.

¹Integrated practice management software includes: Dentrix, Dentrix Enterprise, Easy Dental, OMSVision, EndoVision, PerioVision, DentalVision and DentalVision Enterprise.

Dr. Justin Moody believes “the future is in technology” and it definitely shows in his brand new practice in Crawford, Nebraska!

Dr. Justin Moody returned to his hometown in Crawford, Nebraska in 1997, to share and eventually take over the practice of his family dentist. In 2006, he began to think about how new technologies might benefit the business and the decision was made to implement DEXIS® 2-D intraoral digital X-rays. Using the system improved the imaging process and was instrumental in creating dynamics that would change the Doctor’s approach to patient care and the way he practiced dentistry in general.

“The future is in the technology…especially in digital impressions and milling,” points out Dr. Moody. “i-CAT® 3-D scans are invaluable in treatment planning and the CAD/CAM products E4DTM and E4D DentistTM allow me to generate restorations in my office.”

One year later, plans were made to increase the facility’s space and focus its services on comprehensive and implant dentistry. Horizon West Dental’s renovation added an additional 8,600-sq. feet to the existing premises, giving a total of 10,000-sq. feet for the new office. “In order to provide an optimal level of care and to attract high-quality professionals to rural Nebraska, we needed to make a commitment to the facility, the equipment, and technology,” points out Dr. Moody. “I worked with my Henry Schein Dental Equipment Sales Specialist Ryan Lingenfelter and the company’s design team to coordinate the project. I needed technologies that would help us to achieve our clinical goals and go forward with our projected future growth. We used many of Henry Schein Dental’s services to get the desired outcome for our business.”

Horizon West Dental’s 8 operatories contain industry-leading equipment and technologies that made it possible to offer expanded treatment choices that include a core of dental implant placement and restoration options, no-prep and conventional veneers, same-day crowns, soft-tissue procedures, and in-house tooth whitening. “The future is in the technology…especially in digital impressions and milling,” points out Dr. Moody. “i-CAT®3-D scans are invaluable in treatment planning, and the CAD/CAM products E4DTM and E4D DentistTM allow me to generate restorations in my office. The linking of these two high-tech products for surgical implant guides is very exciting. Having the proper dental imaging makes results more predictable, saves time for everyone involved, and also lets me fit more patients into my daily schedule.”

“Our new space tells the story of how you can have the very best in state-of-the-art dental care in a small, rural community. The total experience has been beyond our wildest dreams.”

The office’s ergonomically superior layout streamlines the practice’s daily activities and reduces workplace stress. There are a number of “firsts” for the office, including a surgical suite for dental implants, an in-house laboratory, and a spacious continuing education center. Five of the eight operatories overlook the 8th hole of an adjacent golf course and offer refreshing views of the rustic natural surroundings. Clean, contemporary furnishings and elements such as concrete countertops, suspended ceilings, and vessel sinks throughout the facility give it great style impact.

Horizon West Dental now enjoys increased production and the ability to offer patients a variety of treatment options in a comfortable and supportive environment. “Dr. Moody has an office that lets him express his standards of patient care,” notes Equipment Sales Specialist Ryan Lingenfelter. “Our entire team: Field Sales Consultant Gabe Olson, Equipment Service Technician Mark Junek, Regional Manager Eric Nuss, Equipment Sales Specialist Jim Farrell, and Office Designer Jennifer Rhode contributed their individual talents and skills to bring this project to fruition and ensure that the Doctor could successfully meet all of his business goals.”

“The flow of the office is very efficient,” comments Dr. Moody. “There is seamless integration of equipment and technology. Our new space tells the story of how you can have the very best in state-of-the-art dental care in a small, rural community. The total experience has been beyond our wildest dreams. We have nearly double the new patients, and we have many local dentists who refer their dental implant patients to us. I always want to do the best for my patients. We must never forget that it is all about the patient.”

From left to right: Mike Minor, Special Markets ESS; Ryan Lingenfelter, Equipment Sales Specialist; Dr. Mark Griffiths, DDS;
Eric Nuss, Regional Manager; Dr. Justin Moody, DDS; Dr. Kaylene Harms, DDS; Dr. Travis R. Dickey, DDS; Casey Silvas, Regional Manager Special Markets; Gabe Olson, Field Sales Consultant

Featured Equipment & Technology
Biolase ezlase soft-tissue laser
Dentrix Practice Management
DEXIS Digital Sensors
E4D Dentist

i-CAT Conebeam CT
Pelton & Crane Chairs and Units
Pelton & Crane Helios 3000 Lights
Pelton & Crane Cabinetry

The crown jewel of the bus is the new GXDP-700, which begins as a robust pan that can be upgraded in the field to add cephalometrics or 3-D Cone Beam CT, or both. The 3-D component, with two scan-size options and a low-dose PerfectScout™ location tool, complements diagnosis and planning for targeted areas of interest in applications such as impactions, root investigation, and implants. General dentist, Dr. Mohammad Khandaqji, of San Ramon, California is an excited new owner. He comments, “We are trying to offer a broad variety of dental options, such as implants, and surgical procedures. For a more successful outcome and to avoid complications, I need to know everything that I can about the patient’s sensitive dental anatomy.” He notes he will also be able to offer more endodontic procedures, with his added ability to view the root canal anatomy in 3D, especially for retreatment.” Dr. Khandaqji is a long-term Gendex and Henry Schein customer. “I have been working with Henry Schein since I started in 2000. I feel that both of my Sales Consultants care about my success. They know that if I grow, they grow.”

The Experience Gendex mobile showroom.

The bus interior with operatory-style setting

The new GXDP-300 panoramic was the perfect choice for general and cosmetic dentist, Dr. Richard Reath, who has used Gendex products for almost three decades. “I was looking at pans at the last Chicago Midwinter Meeting and my Henry Schein Sales Consultant suggested Gendex,” he said. After deliberations, Dr. Reath decided on the new DP-300. At recent hands-on training session, he was impressed by the projection technology of the unit, the comfortable patient positioning, and the overall design. “I particularly like that the tube head is designed to be angled, so that even people with short necks or big shoulders clear the unit better than with other pans.” Dr. Reath’s investment in a DP-300 also allowed him to eliminate his film pan. “I will be happy to get rid of the chemicals and the processing errors,” he noted.

Both doctors read about the Experience Gendex bus on Facebook™. Much to their delight, the bus team scheduled visits Dr. Reath’s office in August, and then, on the way to the California Dental Association meeting, to Dr. Khandaqji’s Mona Lisa Smiles office. Anyone can track the bus, see scheduled visits, and even suggest a stop by going to www.expereiencegendex.com. These new launches and the Experience Gendex mobile showroom show that Gendex really means business when it comes to “driving innovation.”

By John C. Cranham DDS

It is hard to imagine now that when I left dental school in the spring of 1988, the vast majority of dental practices did not have a computer on the premises. At the time, the public Internet did not yet exist and a single E-mail had yet to be sent or received. In dental practices the front desk routinely used a ldquo;peg board” to manage the patients’ accounts. All the clinical information, X-rays, and clinical photography were kept safely in the patients’ charts. That was a short 23 years ago.

In the fall of 1990, my practice bought our first office computer. I remember bragging to a colleague that it had a
20-megabyte hard drive. Amazing when we consider that even the most simple software options available to us today take up more space then what we had available on the entire
hard drive of our first computer.

As computer power has exponentially evolved, software companies have responded and provide us with a myriad of options. Now, practice-management software allows us to precisely manage the business aspects of the practice (We use Dentrix®.). Utilizing the scheduling option, we can focus on increasing the quality, efficiency, and profitability of the care
we provide. Treatment plans are created, sequenced, and customized on the fly, as well as closely followed over time so patients do not fall between the cracks. Utilizing the reports and practice analysis features has allowed us to run our businesses like any seasoned CEO.

By the new millennium, digital clinical applications were being developed that would forever change how we practice dentistry. When hardware prices came down, computers found their way into the clinical environment. At this point the paperless office, something that we couldn’t even imagine in the early 1980s, became a reality. Today technologies are being developed so fast that, for many dentists, it is difficult to know which will be right for their practice. Additionally, with the downturn in the economy, justifying any capital expenditure needs to be carefully considered.
The goal of this article is to review the return on investment of four key digital technologies, with the hope that it will help other professionals with today’s great question: ldquo;When and which technology should I become involved with?”

In our practice, potential technologies are evaluated to see if it will have:

1. A positive effect on the predictability and efficiency of our clinical procedures. Will it make us better?
2. Allow us to expand the professional services we are offering.
3. Provide the practice with cost savings through the utilization of the technology.

If a potential technology is viewed to have a positive effect on the practice, then the cost of the technology (over time) can be evaluated to see if the return on investment (ROI) makes sense. Your CPA as well as your Henry Schein Dental Equipment Sales Specialist should be involved in these computations.

Digital Radiography
As dental teams integrate computers into the chairside clinical environment, the ability to take and analyze digital X-rays is an ideal first digital technology (Our office uses Dexis®.)
At first glance, the cost may not justify what dentistry has been able to do with traditional film for over a century. However, the ROI comes from the combination of increasing efficiency and decreasing expenses over time.

Not having to wait for dental X-rays during an endodontic procedure or an implant surgery is a tremendous benefit. Trial files and master cones can be evaluated without waiting. Films can be taken momentarily to verify precise angulation during implant surgeries. A full-mouth series or a bitewing series can be taken and ready for viewing in a quarter of the time. Increased efficiency translates to increased profitability.

Lastly, digital X-rays are simply better. Having the ability to easily retake films that are not optimal, as well as adjust for brightness, contrast, and numerous other parameters dramatically increase our diagnostic capabilities. This is an excellent entry level digital technology that I would not want to practice without.

Digital photography
There is not a single thing a dental team can do that will improve the quality of their dentistry faster than routinely taking quality digital photographs. At The Dawson Academy, we teach a 21-photo series as part of the new patient examination. Photos are taken for shade communication with the dental laboratory, communication with specialists, case presentation, and documentation of our clinical skill.

Take the time to get your office trained, and take pictures every day, the same way every time. You won’t regret it.

The ROI on this technology comes from expanding the scope of the procedures you are doing. The dental team will diagnose more comprehensive dentistry, as well as be able to communicate better with patients.

Chairside CAD/CAM
Dental practices that are doing even a moderate amount of crown & bridge will benefit from having the ability to fabricate chairside CAD/CAM restorations. Although workflow issues have to be worked through to maximize the efficiency of this process, the ROI comes from the savings recuperated when decreasing your outside laboratory expenses. It is important to realize that it will not completely eliminate the relationship with the dental lab.

In our practice, we utilize our E4D machine for inlays, onlays, and crowns (1-4 units at a time), primarily in the posterior. Larger cases we work traditionally and mount on a semi-adjustable articulator. A good way to see if this technology is for you is to keep track of the number of units per month that you would be comfortable keeping in-house. Multiply this number by the average dollar cost per unit you currently pay. Simply compare this number to your monthly payment for this technology. Most offices are surprised by the savings.

Computerized Cone Beam Tomography (CBCT) Having the capacity to look at mandible and maxilla three dimensionally has dramatically increased our diagnostic capabilities. Boney pathologies, changes in the TM joints, and potential implant surgical sites can all be viewed without dimensional change and in incredible detail. In our office we utilize the Sirona Galileos. Although our reason for purchase was to increase the diagnostic capabilities of our TMJ patients, it has dramatically improved our diagnosis in the other areas already mentioned. The ROI in this technology lies in the scan itself, combined with the expansion of services we were currently providing. CBCT allows us to recognize the straight forward implant cases and provide the surgical service in house. For advanced cases, we provide the surgeon with the surgical and prosthetic plan in order to control the case.

The future of digital technology looks extremely bright. Hardware and software will continue to evolve, and the architecture between the various technologies will open.

The Future
The future of digital technology looks extremely bright. Hardware and software will continue to evolve, and the architecture between the various technologies will open. As the various technologies learn to speak to one another, our ability to evaluate, treatment plan and provide dental services will only improve. Soon cone beam computerized tomography will integrate with digital models in a way that precise virtual articulation (4D and 5D modeling) will be a reality. The opportunity to utilize one of the intraoral digital impression systems and have a choice between sending the information to a dental laboratory or to a chairside mill will also be possible.

My suggestion is to devote a small percentage of your time to stay up-to-date on current technologies, as well as the ones that are on the horizon. Apply the three principles we have in our practice to see which one will be best in your practice. Do your homework with regards to which technology will make you better, as well as positively affect your bottom line. If you do, your practice will evolve in a financially healthy manor, while providing optimum care for your patients.

Doctors have come to trust Imaging Sciences because of their reputation for knowing precisely what dentists need to improve clinical control and workflow. In contemporary dental practices, both general dentists and specialists are increasingly adding implants and other surgical procedures. 3D imaging is a tool that boosts the efficiency and success of the process. The new i-CAT® Precise™ was specifically designed for implant and oral surgery procedures with the award-winning i-CAT® technology.

Powerful Treatment Tools
This new dynamic system is equipped with tools for treatment planning and implementation, as well as patient education. With the exclusive Tx Studio™ treatment planning solution, dentists can feel confident in accurately planning the entire implant process, including single and multiple implant placement and the restorative treatment for these implants. The high resolution, volumetric images give the clinician the data to analyze and measure exact bone structure, discern buccolingual dimensions, concavities, bone height, and view tooth orientation in the planning stage. From the surgical placement of the implant to the final restoration, the scope of information obtained from i-CAT Precise provides dentists with a concise map of the entire course of treatment. The new i-CAT Precise also helps dentists to incorporate the latest dental techniques without the stress of guessing. Steven A. Guttenberg, DDS, MD, elaborates on the value of 3D imaging for implants. “CBCT offers me the data to evaluate potential implant sites, and develop a treatment plan. I can place implants exactly, avoiding anatomical structures, such as the sinuses and nerves, and I can establish precise angles to fit the implant properly in the available bone. With CBCT, my patients’ confidence grows and so does as my confidence to treat them properly and safely.”

Precise view into your patient’s anatomy and tools to plan their care.

Faster 3D Workflow
With all of the details to keep track of during an implant or surgical process, having a method of increasing efficiency and accuracy is comforting to the doctor and the patient. The scan is captured, reconstructed, and ready for planning in less than 30 seconds. Even complex treatment plans can be completed in a few minutes with the Tx Studio software and immediately discussed either chairside or in consultation rooms. With the opportunity to view rich, engaging 3D visual images, patients will quickly understand reasons for treatment and be eager to start the process.

More Clinical Control
Practices strive to make patients feel special in many ways, so why not also with imaging? Because patients are not “one-scan-fits-all,” i-CAT Precise gives the clinician control over image size and radiation dose—each scan can be designed for the individual needs of each patient. Capture a single arch to full dentition plus the TMJ complex with 3D scans of 8cm or 14cm diameters and heights ranging from 8cm to 2cm and everything in between. With Precise, dentists and staff can proudly tell the patient that the system was chosen with an eye for the lowest radiation exposure while still obtaining the necessary amount of information. And, for those times when a pan is indicated, the i-PAN™ option captures traditional 2D panoramic images without having to invest in two separate sensors or machines. Learn more about the new i-CAT Precise at http://www.imagingsciences.com/products/i-cat-precise/

By Jason Lipscomb

Social media has taken off in dentistry! Dentists all over the country are starting to learn the benefits of social media and the new marketing opportunity it presents. This is not a phenomena restricted only to dentists. Fortune 500 companies and small businesses alike are finding the benefits of social media. So is it all hype or is it a real opportunity? Just like any other marketing effort, some will have great success while others will flounder. Let’s talk about some successful dental cases and what they are doing right.

Web video can also be shared across many formats. Video is great to share on sites like Facebook and Twitter. Videos can also be embedded on Web sites and blogs, making them nice showpiece for these sites.

First of all, lets start with one of the most basic rules of social media. Personalize your office. Social Media marketing is never a hard sales pitch. Social media allows us the opportunity to present our office as a group of real people. Potential patients like real people! A potential patient will feel more comfortable coming into your office if they feel that they already know you. One office that has taken this to heart is Omega Dental Care, the office of Annelle Soberay, D.D.S. They have embraced the “fun” aspect of social media, and it has paid off. Fritz Soberay, who manages their Facebook page, relayed to me that they have gained several new patients from their page. They also have a photographer take a new set of practice photos every month. These photos are then used on their Facebook page,
and they make Omega Dental Care look like a very fun place to visit!

They have a good time with their pictures and it shows. Not only do these photos highlight the human part of dentistry, they also make for great Facebook fodder. Building a catalog of practice photos like these can be used in several aspects of social media. They can obviously be shared on Facebook all at once, but a gradual release of photos over time will give the average dentist something to post for weeks at a time. A photo session of 20 photos should be released 3 or 4 at a time. Dentists often ask how long it takes to manage social media. I tell them: “A slow release of a photo set will give you material for quite a while.” These photos can also be used on Twitter and photo sharing sites like Flickr. Photos posted to Flickr allow for great text descriptions that can be indexed by search engines and also in geotagging. Geotagging allows you to tell the search engines exactly where the pictures where taken. This activity will let the search engines know that your spot on the map is an active Internet presence. A similar service from Google named Panoramio.com is also a great place to share photos. This service will actually place your photos on a layer of Google maps. Once again, this will show Google that your blip on the map is an active spot.

Start taking your own photos now. Take as many as possible of your staff, your office, your work, and your dog. (Patients love dogs!) Building a great library of practice photos will give easy and effective material to post on social media sites. The second success story is an expansion of the first; the transition from pictures to videos. If a picture tells a thousand words, then video has to be a million! The invention of portable and easily accessible video can be a boon for any practice. Patient education has always been a big part of any successful practice and the use of online video extends the reach of any doctor’s patient education efforts. We recently worked with Dr. Don Deems of Cantrell West Dental in Little Rock, Arkansas. He was looking for a little more online visibility. We discovered that he had a knack for videos, but needed some slight improvement. He had great video content, but he was not using the power of YouTube and Google to its fullest. Many people fail to realize that Google owns YouTube, and they love to present video in search results when it is available. For instance, suppose someone searches on Google for the phrase “Gum Disease.” Google will present many Web site results, but at some point it will present a video result if it is available.

One of the biggest new fads in marketing is the QR code. These bar codes can be scanned by most smartphones and often contain a link to a Web site, a phone number, or Facebook. A simple scan from a smartphone can lead someone to your Web site in seconds.

Web video can also be shared across many formats. Video is great to share on sites like Facebook and Twitter. Videos can also be embedded on Web sites and blogs, making them a nice showpiece for these sites. Facebook has also begun to filter how your posts are shown to your followers. A simple text post may be filtered out and never seen whereas a video post will be considered more important by Facebook and seen by more eyes. Using all of YouTube’s tools when creating these videos will make their use more effective when they are employed.

Dr. Deems videos were nice, but they needed some simple changes. One of which was optimizing the titles and the descriptions of his video. The simple use of a few keywords like “Little Rock dentist” and his proper business name “Cantrell West Dental” used in natural speech patterns, helped boost the page positions of his videos in search. We all know by now that having a nice position on a Google search page pays for itself. We also started to add annotations to Dr. Deems’ videos. These annotations give the viewer visual links to your Web site and your branding. They remind the user where to find you through the length of the video. At the end of any video should also be a written transcript of the video. Sure, it is nice to talk about your dental implant procedures, but Google can’t index the audio from your video. A text version of the video will ensure that Google picks up on each time you mention “Dental Implants.”

Dr. Deems’ YouTube efforts are also successful because they help unify his library of videos. When someone completes watching one of his videos, they are quickly prompted to view the next one. We like to call this his “web of influence.” He is setting up his material so that the viewer will be inclined to watch one video after another. Thus the viewer is trapped in his web of influence by listening to his messages. Now Dr. Deems’ videos are often about real-world topics. He talks about the questions that many patients have. He also finds dental news reports and relays them in his own words, with his own spin. He doesn’t need to come up with the topics; he just needs to offer a professional opinion. This is something that every dentist can do.

I will give a few words of advice about recording your own videos. 1. Smile! Even if it hurts! 2. Watch your lighting. Many mobile devices don’t do well with light, so always keep the brightest light in front of you. Don’t record in front of windows during daytime. 3. Be brief! Try to keep your videos short if possible. YouTube likes it when someone watches a video the whole way through. We don’t want people to jump ship because they get bored!

The third example I am presenting is the blog of Albert Mendez from Pittsburg, Kansas. Blogs are often overlooked as requiring too much time and effort and not getting any results. The truly wise among us realize that all the efforts we put into social media and adding content to the Internet will be a synergistic experience. Blog posts may not seem like they are individually successful, but they are a very important piece of the Internet marketing puzzle.

Dr. Mendez of Mendez Family Dental recognizes that a blog is very important to social media marketing. He also realizes two important factors. Blogs can be fun and they don’t have to be tedious pieces of prose. They can also be informative while being fun. For those of you who don’t know what a blog is, I won’t bore you with a long description. It is an online journal of sorts. More importantly, it is a Web site to which you can add content all the time. Many of us don’t know how to create or change a Web site at all. A blog can easily solve that dilemma and allow a normal dentist to create great Web site content without a lot of technical know-how.

Why is this so important? Google is always looking for good text information on the Internet to populate its search results. A formal Web site can only showcase so much text before it starts to look like a page out of a phonebook. You have to find that fine balance of just the right amount of optimized text for your Web site. Your blog, on the other hand, could house the library of congress and still be a great resource. Even better, Google can index all that text. A nice blog could have hundreds of mentions of “Dental Implants,” “Sedation Dentistry”, or any other set of keywords. This large footprint of work will often be rewarded by Google.

Dr. Mendez does a good job of recognizing the need for a great story, plus adding the foundations needed to get a blog indexed by Google. Blog titles should be eye catching, but also include keywords that will help Google rankings. Want to have more visibility in a Google search of dental implants or sedation? Write a blog about it. Want to show up on Google for sleep dentistry in your area? Write a blog about it. Blogs are Web sites! Building a nice catalog of blog posts about a certain topic will power your appearance on Google.

By now, many of you are saying, “I don’t want to write a blog!” or “I don’t have time to write a blog.” Contrary to popular belief, blogs don’t have to be big productions. Think of 10 questions that your patients ask you every week: e.g., What are implants? Will bleaching hurt my teeth? Do composite fillings last longer than amalgam? These are all topics that you could answer in your sleep. Use these ideas to write a blog post. These blog posts don’t have to be very long and can be completed with only a few paragraphs. Don’t feel like writing? Record a video and embed it in your blog. Don’t have your own video? Find a video in the news, embed it, and write a commentary about it. All of these Web sites that host videos provide embed codes because they want you to share them! The key is to get started now. Building a great online footprint has to start somewhere.

Finally, one of the biggest new fads in marketing is the QR code. These bar codes can be scanned by most smartphones and often contain a link to a Web site, a phone number, or Facebook. A simple scan from a smartphone can lead someone to your Web site in seconds. I even posted one in the window of my office. They present a great way to easily give your information to the consumer with little effort. Many docs are starting to use them on businesses cards, T-shirts, and throughout the office. When considering using QR codes, consider the device that scans them. Your QR code should lead to something that is easily used or viewed on a mobile device. You should use a QR code to lead to your Facebook page, your telephone number, a text message, or your contact information. These bits of information are optimized for mobile devices and will have the most impact. You wouldn’t want to create a QR code to your blog or your wordy Web site. The person scanning will probably not read a blog on their phone. Only create a QR code for your Web site if it is optimized for mobile viewing. No one will read a tiny Web site on a smartphone.

As you can see, real dentists can find success by using social media. The possibilities for creative marketing are endless. Give it a try today and see what opportunities await your practice!

So how does this affect the dental technology market? This can be split into the three main areas through which technology today impacts the practice.

Accessing Information – The access to patient information as it relates to insurance coverage, past procedures, clinical notes, existing conditions, and other details that are kept in an electronic format are getting to the point where the expectations of the patient is for you to have all of the needed information at your fingertips. With most systems today this is possible.

Capturing Information – The ability to quickly capture and store information whether an X-ray, photo, patient questionnaire, or procedure notes has developed by leaps and bounds. The automation and ease of the process has been the largest area of improvement.

Sharing Information – This is the key focus for technology today. This is the heart of the cloud movement. The ability for the information that is collected to intelligently interact with related information to make decision-making faster and speed the business of dentistry.

These things have led to a major change in the world of dental technology. The ability to purchase individual parts of your technology from multiple partners is getting harder and harder. This is due to the real success of technology in the practice being based on the integration, not the individual parts themselves. The solution that allows all of the information and interactions that are collected act together in one seamless solution is the best option for most any practice.

So what is Henry Schein’s role in this ever-changing environment and world? We see our role as three-fold. We first need to find and partner with the best software and hardware vendors in the industry. Second, we need to create a complete and integrated solution so you receive the best converged offering for today and also to prepare you for the future. Third, we need to implement and support the right solution for your practice end to end. At Henry Schein we feel we have the best total solution for your practice today and are working diligently to improve it so we can continue to be the best partner for you.

Please contact any of our expert Sales Consultants or service technicians to hear more about what we can do for your practice.

“No Strings Attached,” what an interesting phrase. We hear it all the time; a pitch on a TV commercial or a special deal at a sales event—and usually it gets us in trouble. We are promised something and usually don’t get what we were promised and end up with “strings attached.” In dentistry, no strings attached has numerous implications, because dentistry like other professions continues to go wireless. More and more of the technologies we have implemented into our everyday delivery of dental care have become smaller and wireless—“No Strings Attached.” Wireless remote controls, wireless intraoral cameras, and even wireless digital X-ray sensors have all become common in the modern dental office.

So is wireless always better? Does it always improve the delivery of care? Well, fewer cords in an already cluttered dental operatory seem to be a great idea. I believe in most cases—yes, wireless is better, even though I have heard of a few stories of technology becoming too small and inadvertently ending up in the trash.

In the case of dental lasers, I believe smaller is definitely better, and some lasers have become wireless. The first dental lasers were extremely big and nicknamed “coffee tables.” They were bulky, difficult to maneuver, and inefficient. Over the years, laser technology has evolved. Lasers have become smaller, more efficient, and more user friendly. Some have also become wireless. Diode lasers are quickly becoming standard equipment in the modern dental office. I believe these smaller diode lasers and the wireless handheld diode lasers make laser technology easier to incorporate into our dental practices. We already have enough foot pedals, wired devices, handpieces, and suction hoses. Sometimes it is a small feat just to position ourselves to provide care to our patients. So adding another useful tool that doesn’t clog up our operatory can be a perfect way to introduce laser technology into the dental practice.

The ilase diode laser (Biolase) is a great example of laser technology that has “no strings attached.” Weighing in at about 1/5 of a pound and 7.2 inches in length, the ilase can literally fit into your shirt pocket. This small size makes it a perfect addition to the modern dental practice.

So what advantages does a wireless handheld diode laser have over its tabletop counterparts? What features should a dentist look for in a diode laser besides size when thinking about incorporating a diode laser into their practice?

Number one is always “ease of use” when adding new technology. If it is easy to use—we will use it. Often dentists overcomplicate technology and this creates a barrier to incorporation. Remember, diode lasers are easy to use and have numerous applications in our everyday delivery of dental care. Many procedures can benefit from lasers. This helps to make our day more productive—from troughing around crown preps (also great at helping with homeostasis) to exposing subgingival decay to soft-tissue surgical procedures (gingivectomy, fibroma removal, frenectomy) and periodontal applications, the ilase can improve the level of care we provide. Because we encounter these procedures every day, a handheld wireless laser can be convenient and quickly gives us numerous advantages over tools we used in the past (scalpel, electro surge) or, in the case of crown and bridge, can greatly improve the quality of the impressions we take.

Other factors that contribute to adding a wireless laser technology to your practice should include:

1. Size–Small diameter handheld lasers are easy to hold and operate. Because they are lightweight, they don’t create a lot of hand fatigue. They also take up very little space on the counter or in the tray setup
2. Rechargeable battery–In the case of ilase, the battery quickly attaches directly to the body of the laser. The battery can last long enough for even the most demanding procedures and can be easily changed out. Since the ilase has 2 lithium batteries you always have a standby available.
3. Adequate power–Handheld wireless diode lasers are useless without the power to perform a wide variety of procedures. The ilase has 3 watts of continuous power and the ability to provide pulsed power.
4. Easy manipulated with LED screen–The laser should be easy to use. The display should be simple, yet provide the ability to change mode, power level, and access presets in easy steps.
5. Disposable tips–Handheld diode lasers have disposable tips. These tips are easily placed on the laser—prestripped, premeasured, and ready to go. They can be easily changed, and specific tips for specific procedures are available.

When all these features come together, today’s techno-savvy dentist has the advantage of an efficient and easy-to-use tool.

Handheld wireless diode lasers can also be a great addition to your hygiene department. Diode lasers can be easily incorporated into soft-tissue management programs and can be utilized in the non-surgical aspect of treating periodontal disease. Because of their smaller size and ease of use, hygienists find the handheld diode lasers less intimidating than the larger tabletop or floor models. There is less hand fatigue, virtually no set-up time and they can add another treatment mode to the hygienist’s approach, thus helping to improve the oral health of patients. (Always check state guidelines as far as requirements for laser use by hygienists as they may vary from state to state. Certain certifications or training may be required prior to use.)

Diode lasers are quickly becoming standard equipment in the modern dental office. I believe these smaller diode lasers and the wireless handheld diode lasers make laser technology easier to incorporate into our dental practices.

A diode laser can be an efficient, easy-to-incorporate tool that any dentist or hygienist can utilize everyday to improve the level of care for their patients. By providing a wide range of applications and because of its smaller size, the ilase should become part of your tray setup for operative, crown & bridge, periodontal and, of course, soft-tissue surgical procedures.

As dental technologies continue to advance, and more of our everyday tools become smaller and wireless, our operatories will become less cluttered, our care more streamlined, and the term “No strings attached” could take on a whole new meaning in dentistry.

After completing his degree, Dr. Brandon Allen purchased the practice of a dentist who had done business in Athens, Texas for over thirty years. The two professionals worked together for 6 months until the retirement of the previous owner. The business flourished, and growth accelerated to the point where Dr. Allen began to strategize about his practice’s needs. Each month the patient count had increased and this reality was driving him toward moving forward with a clearly defined game plan.

“I knew I wanted to build for the future. If I was going to take the step of building a new office, I wanted to
get it right from the start.”

An Eye to the Future–“Toward the end of our time in the old office, we had turned the existing small private office into a pano room…and used another small space as our lab, staff lounge, and my office,” notes Dr. Allen. “We needed much more room. Being a relatively young doctor, I knew I wanted
to build for the future. If I was going to take the step of building a new office, I wanted to get it right from the start.
I only wanted to do it once in my career if I could help it!”

While engaging in talks for financing, the office design and layout plans were being firmed up with Henry Schein Dental. “I had originally found my practice through my local Henry Schein Dental Field Sales Consultant Jay Knight,” comments the Doctor. “I always had a good working relationship with the company, and I trusted the expertise and advice of their specialists. We have had Dentrix running since to 1997 in the old office and use the Privileges program for discounts and special offers, including earning Rewards Points for purchases. The flat-screen TV in our lounge room was earned with Rewards Points from the program.”

Perfect Form and Function–The new, freestanding office building is also located in Athens, Texas. Its first floor encompasses a 5,000-sq. foot area; the second floor adds 1,500-sq. feet to the overall plan. Crestway Park Dental’s exterior has the modern, organic feel of the Bauhaus-style architecture with strong cubic lines, minimalist sensibility, and a perfect blend of the functional and aesthetic. Mixed elements such as stone and metal, landscaping that adds softness, and a soothing water fountain at the entry give this office strong curb appeal. Inside, the well-thought-out design perspective continues. The use of wood, stone, and water in the reception and waiting areas echo the exterior design motifs and enhance the impact of the office’s clean, contemporary mood. The granite-topped, curved reception desk; warm wood floors; water wall; and an abundance of natural light invite the patient into a relaxed and welcoming space. 3form panels can be found incorporated into walls adjacent to the sterilization and consultation rooms. The translucent panels add decorative flair and allow ambient light to flow between rooms. Dr. Allen’s wife, Brittany, is responsible for all of the professional creative insights into the office’s design.

“The new office building gives added credibility to what we are doing. I am most proud of the overall look and feel of the office…very relaxing and the better location gives us greater visibility.”

Technology Leads the Way–Equipment Sales Specialist Scott Beech provided guidance with the layout and technology products that would support successful project completion. “When we began…I met with Dr. Allen to find out what his practice goals were in developing this new office,” notes Scott. “The Doctor needed more operatories. He also needed the ability to accommodate visiting specialists without sacrificing chair time and better handle his patient base without being space constricted. Since he already had two new Pelton & Crane (P&C) chairs, I took the Doctor and his wife to the P&C showrooms to show him the many equipment options available today. Equipment and technologies that were chosen included P&C chairs, P&C Helios 3000 LED lights, P&C Renaissance 12 o’clock cabinetry, KaVo handpieces and quattrocare system, and the Biolase ezlase soft-tissue laser. These products are ideal for the office’s customized needs and will offer outstanding patient comfort, better doctor accessability in the operatories, and a smoother daily workflow.”

Left to right: Jay Knight, Field Sales Consultant; Randall Mclemore, Regional Manager; Scott Beech, Equipment Sales Specialist; Mark Welch, Equipment Service Technician; Dr. Brandon Allen

Dr. Brandon Allen and team

The added space has allowed the Doctor to bring in an orthodontist and a periodontist one day per month. “My patients now receive the highest quality care from the best specialists—right here in Athens!” adds Dr. Allen. “The new environment makes it possible for us to practice high-quality, comprehensive restorative and cosmetic dentistry. We easily accommodate about 30 new patients per month and our production has increased by 10%-20% despite the current economic climate of the last few years. Referrals have also increased. We are looking forward to bringing in an associate and equipping more of our operatories.”

“Doctor Allen will have peace of mind knowing that his equipment will hold its value and give him a ROI that will far exceed his original investment,” points out Jay Knight. “The design and aesthetics of the new premises, inside and out, conveys ‘big city sophistication’ in the small town of Athens, which is 90 miles from Dallas, Texas. The staff at Crestway Park Dental now enjoys all the benefits of working with
state-of-the-art equipment and technology with plenty of room to grow. The office is a great marketing tool for the business and a great place to come to work every day.” Positioned for Success–With the ability to offer enhanced treatment options through industry-leading technologies and
a design plan that hit all the right markers, Dr. Allen’s dream office is a true reflection of his dedication to excellence in patient care. “The new office building gives added credibility to what we are doing. I am most proud of the overall look and feel of the office. It is very relaxing and the better location gives us greater visibility. Finally, our surroundings portray the quality of dentistry we work to achieve.”

Featured Equipment & Technology
Biolase ezlase
Pelton & Crane Chairs
Pelton & Crane Helios 3000 Lights
Pelton & Crane Renaissance 12 o’clock cabinetry
KaVo handpieces
KaVo Quattrocare

By Mary Verardi, DDS

Bringing an out-of-date practice into the 21st century can be challenging, costly, and take years. Therefore, when the opportunity presents itself to establish a new practice from the ground up, it simultaneously offers unique possibilities for incorporating state-of-the-art technologies as opposed to buying an existing practice and renovating it.

As a dentist, my objective always has been to remain on the cutting edge, but I was determined to do it right. So, when building my new practice in Orlando, Florida, I invested in state-of-the-art technologies, including Mediadent imaging software, voice activated software, and digital radiographs rather than traditional X-rays. As a result, from the start we’ve maintained a paperless, fully digital 3,000-square feet, seven operatory, high-tech practice in which we can deliver optimal care to our nearly 4,000 patients.

Although I’ve been in this location for almost six years, I continue to explore new ways to improve my patients’ dental experiences. Having already conquered the goal of going digital and paperless, our most recent addition was the E4D Dentist System, an innovative and advanced chairside CAD/CAM technology.

Choosing the Most Advanced Technology
What ultimately made E4D the right decision for my practice was the genius of the technology and the superior quality of the end result. In my practice, I’ve continuously raised the bar for myself and my staff when it comes to patient treatments and procedures. What was good five years ago isn’t necessarily the best today, and I had been waiting for the ability to fabricate a restoration on par with my standards. I was hoping for better margins and more durable porcelain. The E4D delivers both and more. Restorations fabricated with the E4D Dentist System provide a better fit, better function, better aesthetics and, to top it off, can be completed in one visit.

Ensuring Thorough Training & Support
A natural concern, however, is being left on your own once you’ve invested in the equipment. That’s not the case with D4D Technologies, the company that developed and stands behind every E4D Dentist System. Personally, I’ve never experienced better training and support they offer. Their comprehensive training program was wonderful. System integration into the office involved an E4D Clinical Integration Specialist spending a day with us in our office, during which we were able to complete four crowns in five hours.

But the training and support don’t end there. With the Support-on-Sight (SOS), if an issue should occur at any time—even during a restorative procedure—the Support team can actually take over the reins in real-time to provide the assistance and support you need, or they can talk you through it, explaining each step.

Ease of Use & Integration
Sized for in-office use, the design center is housed in a mobile unit, and the milling unit is kept in the office, which eliminates the need to send restorations to an outside laboratory. Knowing that you can provide a quality service and that your patients are gratified is extremely rewarding and has re-energized my entire staff.

For example, my assistant, a certified CAD CAM Dental Designer, has developed the skills to actually design my restorations. If I begin an E4D restoration design and am called away, she can take over, and vice versa. This represents a huge benefit, since her training enables her to participate in the process, from scanning to staining and glazing.

Elevated Care & Patient Acceptance
E4D’s DentaLogic™ software enables you to scan, design, and fabricate veneers, inlays, onlays, and full-contour crowns in one day, and the process represents the ultimate in convenience.
It’s as easy as waving the Intraoral Digitizer laser scanner (IOD). The software is so revolutionary there’s no need for messy contrasting agents or sprays. Patients don’t have to wait two weeks for their restorations, which eliminates the need for temporaries and return visits. So, the amount of convenience it offers is unbelievable.

Patients are excited, and they marvel at the convenience of one-day restorations and are ultimately relieved by the comfort and ease of the procedure. After scanning and completing the design, we walk them to the in-office lab- where they watch in amazement as their restoration is being milled.

Conclusion
The standard of care that the E4D Dentist System allows us to provide is unprecedented. It was unheard of to provide a custom porcelain restoration of the quality I was looking for in one visit until E4D. After all is said and done, the most satisfying aspect of investing in the E4D is that once our patients witness the technology and convenience firsthand, they are no longer afraid to come to the dentist. The ability to provide state-of-the-art treatments and the highest standard of care has redefined what we do, and that, in turn has improved the dynamics of my practice tremendously.

We have seen an increasing number of deferred transitions over the last several years. Whether you are recruiting an associate to become a partner or want to find a candidate to purchase your practice in one to two years, the question always asked by the Associate or Owner is “When does the practice get valued?”

For many associates who intend to make a financial commitment, they need to know what their potential investment might be. Therefore, determining a value at the outset or within the first year of employment is not unreasonable. We’ve often heard complaints from associates who have worked at a practice for several years who are offered a partnership opportunity, but at what price? If no valuation had been prepared at the outset, does the associate want his/her contributed production to be included in the valuation calculations? The answer is a resounding NO! If you want to value your practice prior to a partnership formation or deferred sale and the price is too high in the associate’s mind, they might walk away! Therefore, in order to avoid this problem and to prevent delay in achieving your transition plans, we recommend establishing a baseline early in the relationship, usually within the first year of employment.

Since many owners offer guaranteed salaries for the first three to six months of employment, it is fair to wait for the completion of the first year to conduct this baseline valuation. If you do the math, most valuations include a three-to-four year historical average, so the inclusion of the associate’s first-year collections should not skew the numbers too much for them. By establishing a baseline valuation when it is time for the partnership or sale to commence, you must update the numbers to reflect current economic conditions as well as any additional assets that might have been purchased during the Associate’s employment phase.

Using this approach minimizes any disincentive for your associate to work hard and help your practice grow without being penalized for their efforts. In our experience, if done properly, associate profit margins should be 30% to 35%. If not, there is something wrong with your economic equation. Perhaps overhead is too high or there aren’t enough patients to share. Good economics assure that the owner receives a good profit margin during this employment phase.

We recommend a baseline valuation for solo practitioners who plan to offer their associate a partnership opportunity within a two to three year period after the associate joins the practice.

There is one major exception to this rule. In situations where the owner feels that hiring a Management Consultant at the outset will not only enhance the success of the associate’s integration into the practice, but also increase the potential for the practice to grow, the valuation for buy in or sale should precede the event. The rationale here is simple. If the owner invests from $25,000 to $40,000 for a reputable consultant to improve the practice’s gross revenue, increase new patient flow, fix patient retention, and increase profitability, the new partner or owner will benefit from these changes and be buying into or purchasing a stronger asset! In fact, we have seen instances where the associate’s ability to earn income is enhanced during the employment phase. So everyone wins!

At the time of partnership formation, the valuation is updated in the following way:

As we have discussed in prior articles, all practice valuations consist of two classes of assets—Tangible Assets and Intangible Assets. Intangible Assets include goodwill, restrictive covenant, telephone numbers, namely all things you can’t see, feel, or touch. Tangible Assets include dental equipment, supplies, instruments, sometimes leasehold improvements, and technology. Once the baseline valuation is determined, you can segregate the value into these two asset categories. From our database, we have found that Intangible Assets values, on average, are about 76% of a practice’s value; the remaining 24% represent Tangible Assets. When it’s time to update your valuation, you’ll adjust the Intangible Assets by the CPI over the period of time from the baseline valuation to the current period. For example, if the buy in occurred in 2009, and the baseline valuation was prepared in 2007, adjust the former value of the Intangible Asset Value by referring to the Bureau of Labor Statistics, “Inflation Calculator” to update that number. Tangible Assets are then reappraised to take into account the additional “wear and tear” that has occurred. We assumed some new equipment or technology was purchased during this period, so you add these assets to the mix. Here are examples of how the calculations might work:

Summary
In this case, with the various adjustments made to both asset classes, the revised value would be $621,800. This way, by setting a baseline value, you demonstrate that you are trying to create a “win/win” situation for your partner.

Establishing a baseline valuation lets your potential partner or purchaser know you want things to be fair. In my many years of transition consulting, the root cause of most partnership failures has been over money. So start your relationship the right way by putting your economic cards on the table and create a win-win relationship.

Dr. Tom Snyder, consultant, lecturer, and author has consulted with dental practices nationwide in creating “win-win” practice transitions. He is the Director of The Snyder Group, a division of Henry Schein. Dr. Snyder is a graduate of the University of Pennsylvania School of Dental Medicine and
has an MBA from the Wharton School of Business of the University of Pennsylvania. His practical approach to the complex and personalized area
of dental practice transitions has been well received.

For Henry Schein Professional Practice Transitions, call:
1-800-730-8883

With Dentrix practice-management software, patient records, scheduling, insurance processing, charting, and digital progress notes are organized and easy to access. “We build the electronic dental record first, including information on insurance, contact information, and e-mail addresses,” says Dr. Busch. The patients have secure access to their files with their user name and password through Dentrix. Once logged on, they can see treatment they have received, possible future treatments, X-rays, intraoral photos, their balance, payment plan, and any other information relating to their relationship with the practice. To encourage “co-diagnosis,” a system of red, yellow, and green folders in their Dentrix file offers patients access to a gamut of possibilities for immediate, eventual, and optimal treatment planning. Also with Dentrix, patients can access their accounts and even pay their bill online. The program’s credit card system saves the information and allows for recurring payments in the system, with debit card information posted right into the ledger.

“The best part is that the patients and I can see their teeth up close with a noticeably improved level of clarity in images generated by the DEXIS Platinum sensor,” says Dr. Busch.

The practice-management application is fully integrated with the award-winning DEXIS digital imaging for a smooth digital workflow. The clear, crisp DEXIS digital images can be enlarged and enhanced in a variety of ways for better diagnostic capabilities and improved patient communication. “The best part is that the patients and I can see their teeth up close with a noticeably improved level of clarity in images generated by the DEXIS Platinum sensor,” says Dr. Busch. “Clear, well-defined images are easier to examine. Digital technology already has so many benefits over traditional film, and DEXIS’ sensor technology makes it even better.” Dr. Busch notes that the DEXIS system improves workflow and office efficiency. “An FMX can be reduced from 25 minutes to five minutes from start to finish. That’s an extra 20 minutes of time per appointment, meaning not only can each patient receive extra attention, but more patients can fit on the schedule for any given day.”

Dentrix practice management offers highly useful functions
for both the practice and the patient.

Dentrix and DEXIS integration provides greater efficiency.

Clear images are quickly captured and enhanced for diagnosis and communication.

Video animations demonstrate the exact steps to take the mystery out of the procedures.

Annotate videos, add your voice notes, and then send to patients via e-mail.

Guru lets the dentist create presentations with the patient’s own DEXIS digital images and information, and also with the option for 200 original 3D images and animations. With “the power of Guru,” notes Dr. Busch, “I can put together a full upper and lower arch of their own teeth in 180 degrees, and show them an image like looking in the mirror.” He continues, “You can create a story board or personalized presentation and then e-mail it to the patients so they can show friends and family. Dentists even have the option of incorporating their own recorded voices explaining the presentation.”

Guru also contains descriptions that can be edited for personal preference. “When the patients see procedure code 2392, surface posterior resin, that doesn’t mean much to them,” says Dr. Busch. “Guru describes the procedure in a more patient-friendly way—life-like tooth-colored filling that restores form and function to your tooth—that makes it easier for them to understand.”

Whether sitting together chairside or reviewing the dentist’s recommendations at their home computer, Dentrix, DEXIS, and Guru make dental care decisions easier. “Ninety percent of the patients don’t need a separate formal treatment planning visit—and don’t have the time to come back for one,” says Dr. Busch. “These three systems help your patients ‘get to yes’ more quickly, and Guru speaks to many different patient personality types.”

“Everything is ‘smart’ today,” says Dr. Busch. “We have smartphones, smart credit card machines, smart TVs. The combination of Dentrix, DEXIS, and Guru results in a seamless integration of diagnostic, treatment, patient education, and practice-management options.” Dr. Busch notes that sometimes if he leaves the room with the Guru presentation up on his touch screen, the patient continues to click on the various choices. “Nothing makes me happier than to hear the patient clicking away, educating himself with all of the personalized information. This really shows that as a doctor and business owner you have the freedom and ingenuity to create a smart practice for yourself.”

Get the whole story. Watch Tom’s videos at www.meandmydexis.com

Taking DEXIS digital radiographs is simple. When the sensor detects radiation, the image is automatically saved, dated, tooth numbered, and correctly oriented with one mouse click. My staff members are glad that they don’t ever have to mount a full series of X-rays again. One employee, whose job it was to change the chemicals in the film processor, would come into the office on a Saturday and proceed to perform a ritual where she took apart the processor and spread all of the parts out on the counter. The three days before the processor was cleaned and the three days after, we had to put up with less than optimal X-ray images. With all of the moving parts involved, the processor was our dental repairman’s best friend. Digital radiographs are immediate, clear, detailed and able to be enlarged to fill the size of my monitor, if necessary.

DEXIS digital sensors are very portable. The direct USB connection allows them to be transported between operatories without docking stations or other equipment that can get lost or broken. One of the greatest testaments to their durability is the fact that a DEXIS digital sensor has accompanied me on my humanitarian aid trips to Haiti. We set up portable dental clinics in towns, using a few tables and chairs in facilities with no electricity. Thank goodness we had a portable X-ray unit and the DEXIS digital system.

The sensor was rugged and durable, surviving its trip in a suitcase bouncing over bumpy roads and in very hot working conditions. There was no way that we could have maintained X-ray chemicals at a proper temperature or stored film correctly. DEXIS allowed us to move quickly and to gain the necessary diagnostics when working in those harsh conditions, treating hundreds of people who spoke a different language.

We stored the X-rays on a computer and downloaded the information to a thumb drive so when we come back for our next trip, we will have electronic records available. For towns with no electricity, that is amazing. Besides assisting us in the field, DEXIS donated a sensor to the Haiti Dental School, which has allowed me to teach their aspiring dentists about this important standard of care in dentistry that is not only achievable in America.

As a long-term DEXIS customer, digital X-rays have helped improve my diagnostic capabilities and to provide educational opportunities for my patients in the United States as well. Taking the DEXIS sensor with me to Haiti was like traveling with a good friend—reliable, and durable, and always ready to help.

By Kristen Esler, RDH

Today, most dental treatment providers clearly understand the importance of periodontal disease and its ramifications on patients’ health.So why are fewer than 5% of patients receiving the treatment this disease requires? There are several factors required to create a successful Periodontal Program. First, there must be an office protocol for perio diagnosis that reflects the vision of the practice. Second is the commitment to change from the dental team. The entire team must agree on the protocol and work together to execute it, including providing patient education and motivation. Third, scheduling must allow enough time for the hygienist to provide treatment and operatory capacity to support that treatment. Finally, perio coding must be done properly to ensure appropriate insurance reimbursement and patient compliance. Proper coding provides a means for helping patients achieve ideal oral health and proper insurance coverage.

The entire team must agree on the protocol and work together to execute it, including providing patient education and motivation.

Sadly, even though science and technology related to diagnosis and treatment of periodontal disease have significantly changed over the past 30 years, many dental practices are stuck in a “business as usual” mindset. Despite the prevalence and persistent nature of periodontal infections, more than 70% of dental offices do not perform full-mouth probing and charting on a regular basis. The popular “adult prophylaxis” procedure is being offered to patients who have all the clinical evidence of an active periodontal infection. We must start by informing patients of their current disease status and making recommendations for their treatment. The next step is to use the proper CDT 2011-2012 codes for billing and help the patient understand what these codes mean and why they are being used. Periodontal Program Goals should be customized for each individual, practice but the following are recommended:

Periodontal Program Goals

1. Use education to motivate the patient to accept the necessary recommended care.
2. Increase the patient’s level of periodontal health.
3. Help the patient receive maximum insurance benefits.
4. Make sure the hygienist is paid for the procedures she/he
   is actually providing*
5. Increase the practice profitability by using the correct periodontal codes.

*It’s important to understand that many hygienists are already doing the work, and should be paid accordingly. The use and documentation of proper billing codes will ensure the offices are paid for the proper periodontal treatments.

1. Diagnosing Periodontal Disease
The Periodontal Examination–Everything begins with the gathering of the clinical data necessary for the diagnosis of periodontal disease. Full Periodontal Probing Charting and
X-rays generally need to be sent to the insurance company to demonstrate presence of periodontal disease. They will not allow the patient coverage without these. Full Perio Charting involves 4 or 6 measurement points of pocket depth on each tooth. Notation of tooth mobilities, furcation involvements, occlusal trauma, and tissue attachment abnormalities, bleeding points on probing, etc. must also be included. All of this supporting documentation demonstrates active disease and some evidence of bone loss and allows you to use proper, periodontal insurance coding. Be prepared with scheduling; it will take extra time to probe and chart and can be done manually with the help of an assistant, voice recorder, automated probes or computer recorders, etc. Computer voice recorders can be extremely effective and can be done without the help of an assistant.

2. Explaining the Diagnosis to the Patient
During the exam, give the patient a mirror and show them at least one bleeding area. Use an intraoral camera. If patient is complaining about bad breath let them know it will clear up after treatment. Touch the patient’s hand with the probe and discuss pain and bleeding associated with touch. Explain that any probing reading over “3” is not good. It is important that the patient hear the numbers and recognize the importance of the probing depths. Call out the Pocket Depths during the exam—this gives a patient a warning so they are prepared to accept the news.

3. Confirm the Diagnosis With X-rays
Periodontal X-rays–Full Series X-rays are appropriate for both perio and non-perio patients. Full series X-rays show bone levels of perio patients better than routine bitewing X-rays.
A full series should generally be taken on new patients rather than vertical bitewings.

Codes for Periodontal X-rays

• Full Series X-rays (D0210) are appropriate for both perio
  and non-perio patients. Full series X-rays show bone levels
  of perio patients better than routine bitewing X-rays. A full series should generally be taken on new patients (D0210) rather than vertical bitewings. Full series X-rays are payable every 3–5 years depending on the plan.
• 7-8 Vertical Bitewings (D0277) show bone levels/loss better than regular (horizontal) bitewings (D0274). Some use (D0277) for annual checkups instead of four bitewings (D0274). D0277 is in reimbursement “no man’s land.” Some insurance companies “downgrade” and pay as four bitewings (D0274). Some insurance companies “up code” D0277 to a full series (D0210), if available at the D0277 fee, and then refuse to pay for the full series (D0210) when taken. Some insurance companies will accept a panorex (D0330) and vertical bitewings together but all companies will accept a full-mouth series.

4. Achieve Treatment Plan Acceptance From Patient
After the doctor reviews the pocket depth readings, bleeding-on-probing (BOP) readings, the Clinical Attachment Levels (CAL), and the full-series X-rays for bone levels and for extent of bone loss, he/she confirms the diagnosis of periodontitis and prescribes a Treatment Plan. Each level of periodontal disease requires a different treatment plan and uses different coding, sequences, treatments, and appointment lengths. The hygienist then discusses the prescribed treatment plan with the patient. This should be presented so that it’s clear the patient is involved in lowering/improving their pockets depths; it will be a joint effort between the patient and the dental team. Print out the perio chart and send it home with patient. Explain that pocket depths will be compared to track the progress during the next appointment. Help patients understand that treatment now may help them avoid Periodontal Surgery down the road. After the patient understands and accepts the treatment plan, transfer to the Financial Coordinator for financial arrangements and appointment scheduling.

Kristen Esler is a Registered Dental Hygienist and Regional Manager for Henry Schein Dental. She teaches Henry Schein Sales Consultants how to help dental offices implement and properly code for Periodontal Management programs. For help with your perio program, please visit www.henryscheinwedothat.com or contact your local
Henry Schein Sales Consultant.

Every day brings new challenges to the Dentist who embraces the role of “Physician of the Masticatory System.” Fortunately, new advances in diagnostic imaging, such as Digital Cone Beam 3-D Technology, make it virtually impossible for pathology to escape diagnosis. To illustrate, let’s explore a challenging case to diagnose, beautifully exposed by digital CBCT technology.

A 62-year-old Caucasian female presented with a chief complaint of progressive bite changes. Previously, all her teeth touched uniformly, but over the past 18 months this had gradually changed. The result was an open bite that extended from teeth #2–13, and a facial asymmetry with the mandibular plane of occlusion visibly canted significantly downward on the right side. She reported no pain; the left TM Joint felt normal but the right TM Joint felt restricted, as if something was in the way of normal movement. Her previous dentist had told her that she would need restorative dentistry to correct the new malocclusion; but was concerned as to why these changes had occurred. We also discussed the possibility that changes were still progressing.

(Figure 1.)

Clinical evaluation revealed an absence of masticatory muscle tenderness. Mandibular range of movement was limited to a maximum opening of 29 mm (normal 40–50 mm) with a marked deviation toward the right side. Right excursion was 7 mm, left excursion was 2 mm, and protrusive movement was 4 mm with a noticeable deviation toward the right (normal for each 7–13 mm). Palpation of the left and right TM Joint capsules and ligaments were negative for reported tenderness. Orthopedic load testing of the TM Joints via Dawson’s bimanual manipulation was negative bilaterally.

Doppler auscultation was negative for clicking or boney crepitus bilaterally. Joint Vibration Analysis-JVA (Bioresearch Associates technology) revealed no indications of joint clicking or condylar breakdown bilaterally. Occlusal evaluation, using articulating ribbon and TScan computerized bite analysis revealed the only teeth that touched with seated TM Joints were the left side first and second molars. The occlusion was increasingly open from left to right with the right molars open by 4–5 mm. Swallowing did not reveal a notable tongue thrust between the teeth that were out of contact. Movement of the mandible in lateral and protrusive excursions with the teeth in contact revealed exclusive contact on the left molars.

The first impression upon observing our patient’s facial asymmetry and open bite was the probability of an internal derangement in the left TM Joint; but the reported history did not fit that diagnosis. When observing the range of mandibular movement, it became evident that the right TM Joint was not translating normally. Joint assessment did not imply any obvious discal displacement or internal derangement in the left TM Joint. The concern shifted toward the right TM Joint region. To develop the bite changes observed would require an enlargement of tissues in the right TM Joint. Specifically, the concern became focused on the probability of some type of expanding pathosis. Due to the absence of pain and the inability to properly translate on opening, we became suspicious of extra capsular hard-tissue expansion.

The history, chief complaint, and clinical evaluation leave unanswered questions, which must be clarified. Now what? Should we correct the occlusion? Should we empirically try an occlusal splint first and see what happens? Where do we start? Answer: Always diagnose first, then treat. We needed a complete diagnosis. We needed to know exactly what was going on in the right joint. A cone beam CT scan provided an accurate 3-D image of the total joint region.

The CT scan of the right TM Joint produced a startling revelation. A large boney projection extended from the anterior condylar neck of the mandible superiorly, like a tree trunk, and mushroomed up to the opposing articular eminence. A 3-D projection showed the growth wrapped from posterior, to beneath, and even anterior to the articular eminence. This explained the inability to translate upon opening. A panoramic view also clearly showed the hard tissue pathological projection, which extended vertically beyond the height of the mandibular condyle, thus producing a resulting right side open bite. The diagnosis was quickly clarified through CBCT technology.

(Figure 2.)

(Figure 3.)

(Figure 4.)

The patient was referred to a Maxillofacial Surgeon. Surgical removal of the mass was performed and the pathology report came back “Benign Homoplastic Osteoma” (benign bone tumor growing on bone). The cause of osteomata is uncertain, but is commonly associated with embryologic, traumatic, or infectious sources.

Following surgical intervention the dental occlusion returned to its original Class I relationship, with all the teeth touching. We did not perform any dental procedures. The appropriate plan for treatment was developed primarily from the invaluable information obtained from the digital CBCT Scan.

DeWitt C. Wilkerson D.M.D. has a private practice in St. Petersburg, Florida, which focuses on Restorative Dentistry and Occlusal Treatment for TM Joint Disorders. He is the Immediate Past President of the American Equilibration Society; Adjunct Professor in the Graduate Program, University of Florida College of Dentistry; and Senior Lecturer at the Dawson Academy for Advanced Dental Study. He lectures extensively internationally and may be contacted at dwilkerson@dupontwilkerson.com.

by Dr. Robert Stanton, DMD

“Space … the final frontier,” those were the words written by Gene Roddenberry and spoken by Captain James T. Kirk in 1966 that sparked imaginations everywhere as to what might be discovered during the travels of the USS Enterprise. Some 45 years later, space may be the final frontier for the human race but as far as restorative dentists are concerned, the final frontier might be 100% utilization of in office CAD/CAM technology for indirect restoration fabrication, especially anteriors. My first exposure to CAD/CAM technology in 2001 with another system left me less than impressed with the practicality and flexibility of the technology. Most users at that time were using it mainly for posterior PCRs (Partial Coverage Restorations) because the deficiencies in strength and esthetics of CAD materials paired with a lack of utility in the design software and intraoral scanner at that time contraindicated its use with large anterior cases.

Over the next few years, advances were made in the scanner, design software, and materials quality and selection. Up to this point, all CAD blocks were monochromatic and somewhat opaque, which created obvious challenges when trying to create restorations with variable translucency, shading, and characterization. Manufacturers created polychromatic blocks with variable opacity layered within the block and the design software allowed for selection of the desired area within the block in order to create a milled restoration that had inherent transitions from cervical to incisal translucency, thereby negating the need for cutback and layering in typical cases. At that time, I decided that the technology was capable of meeting my standards of quality, efficiency, and practicality and I decided to incorporate it into my practice. I fabricated my first anterior crown during my second week of usage and although it took over three hours, I was immediately inspired to push the envelope of what was possible.

43 year old female patient presented with a chief complaint of “I haven’t been to the dentist in years. My teeth hurt and I never smile anymore.” Her anterior treatment plan consisted of eight restorations from #5 to #12 with necessary endodontic treatment.

Completed design. I used the Clone design technique to mimic the patient’s approved provisionals thereby guaranteeing
proper esthetics and occlusion. All interproximal contacts
can also be verified simultaneously.

Eight restorations delivered. Substrate used was Empress CAD Multi A2 (Ivoclar Vivadent) with incisal and cervical stain.

Secondary and tertiary anatomy added post milling very easily and predictably using the principles taught at E4D University.

I’ve improved the image of my practice, myself as a clinician, and made my patients and staff more satisfied—all due to the excellent results that the E4D delivers.

I started performing larger and larger anterior cases until I felt comfortable performing full/dual arch cases. Although I was satisfied with the results I was achieving, I was always frustrated with the design process. Every lab technician who performs a multiunit anterior case goes through a certain sequence of design steps. These steps revolve around the principles of golden proportion and smile design. Symmetry, proportion, length/width ratio, contact placement, and embrasures are just some of the factors that go into proper smile design and attention needs to paid to all of these during the design process. My frustrations arose from the fact that the other design software did not allow for confirmation of any of the aforementioned factors and so I decided at that time to investigate the E4D system since its design software did allow for confirmation of all of these factors.

I discovered that the E4D system provided three distinct advantages over any available and, as a result, I decided to incorporate the E4D in my practice:
1. I find the E4D Clone mode to generate a closer reproduction than the other system’s Correlation mode and this is my preferred design method for anteriors.
2. E4D’s software starts with a more accurate design and then offers a very wide range of tools to create whatever global and delicate changes are required to finalize the design in much less time.
3. The E4D software allows for the simultaneous design and finalization of as many units as the operator needs. From a smile design standpoint, any clinician would think that this would be a requirement and vital component of any software involved in the design of a multiunit anterior case. The ability to modify, finalize, and verify all aforementioned smile design factors simultaneously for all units involved not only greatly reduces the need for any post-milling correction, whether additive or reductive, but also guarantees that esthetics and function that were verified in the wax-up/provisional are properly and accurately transferred to the final restorations.

As a cosmetic dentist who is not only passionate about my profession but also deeply compassionate toward my patients, my goal is to put them at ease, keep them comfortable, and do things right the first time. That’s why the E4D is the perfect in-office CAD/CAM system for me. Because my goals are to perform better dentistry and make my patients’ lives less stressful, I have embraced the E4D technology and implemented it to its fullest potential. My patients love it, and I love it because my patients are happy.

For me, it is an honor to make a difference in people’s lives. Making my staff and my patients happy and providing state-of-the-art treatments is among my most prized accomplishments. I’ve improved the image of my practice, myself as a clinician, and made my patients and staff more satisfied—all due to the excellent results that the E4D delivers.

The E4D allows me to do all my own anteriors and veneers with fabulously precise results, all in a single visit. It has allowed me to make a valuable difference in my patients’ lives. My staff and I are impressed with the conveniences and capabilities of the E4D, its intuitive software, small in-office production unit, and the ongoing support we receive. The E4D does what it is designed to do and with sensational results.

ROBERT STANTON, DMD
Robert Stanton, DMD is a practicing dentist in Ft. Lauderdale, FL. Dr. Stanton is a graduate of the University of Miami and Tufts Dental School in Boston, where he earned an MA with honors. Named one of the Top 100 Best Young Dentists in the Country in 2001, Dr. Stanton is also a faculty member in the Department of Prosthodontics at Nova Southeastern Dental School and a member of the American Academy of Cosmetic Dentistry.

Practice Owners have been provided with historically significant tax incentives through 2011–making this the right time to invest in your practice’s future. The government estimates its cost of enhancing Section 179 is
$50 billion alone. Are you poised to seize the opportunity?

Dental Owners have unprecedented incentives to invest in their practices! The Small Business Jobs Act of 2010 increased Section 179 dollar and investment limits to $500,000 and $2,000,000 (for 2010 and 2011). The 2010 Tax Relief Act will reduce the Section 179 dollar amount by 75%, reducing the expensing benefit to $125,000 starting January 1, 2012. The Section 179 benefit is scheduled then to be reduced to a $25,000 and $200,000 investment limit in 2013.

Small Business Owners have many benefits to focus on. The 2010 Tax Relief Act is in favorable treatment of off-the-shelf computer software (i.e., Dentrix, DEXIS) as eligible for Section 179 expensing. In addition, there is a 100% Bonus Depreciation (applies to qualified property acquired before January 1, 2012). The qualifying property for the Bonus Depreciation allowance is only available for new property (the original use begins with the practice owner).

The list of tax incentives for both businesses and personal use expiring in 2011 is extensive. There are more benefits than space in this article (i.e., luxury auto depreciation cap, self-constructed property, credit for energy efficient appliances, above-the-line deduction for qualified tuition and related expenses, conversion credit for plug-in electric vehicles, expansion of adoption credit and adoption assistance programs, tax credit for research and experimentation expenses, etc). Thus, it is recommended that practice owners discuss their individual circumstances with their own advisors.

Annual Internal Revenue Code Section 179 Example:

This deduction may be available whether you are a sole proprietorship, a partnership, or a corporation (S corps are subject to different rules; again, please check with your advisors). If you plan to acquire equipment in the near future, purchasing it before year’s end is prudent. Utilizing a finance agreement or capital lease to acquire technology or equipment will qualify for this benefit (where true leases or fair market value agreements will not). If you use a finance agreement to acquire your equipment and you have deferred payments, you may file your tax returns and achieve the benefits before you have made any payments.

Don’t wait too long to acquire technology or upgrade your office. Although it is true that you can have equipment placed in service until December 31, 2011 to take advantage of the incentives, waiting too far into the year may mean that you will settle on your technology choices due to diminished year-end selections. Now is the right time to meet with an equipment or technology specialist and discuss acquiring the optimal production-enhancing technology and equipment that will help your practice stay “Fiscally Fit.”

If your business uses a fiscal tax year rather than the calendar tax year, you may have additional time to take advantage of the extended $500,000 Section 179 deduction privilege. For example, if your outfit’s next fiscal tax year will begin on November 1, 2011; the $500,000 deduction deal is available for your current tax year. Plus you’ll get another $500,000 allowance for the following tax year that begins next November 1 and ends on October 31, 2011.

If your business uses the calendar year for tax purposes, you only have until December 31, 2011 to take advantage of the generous $500,000 allowance. Don’t wait to see if the rules for 2012 will change to provide the same opportunity! Act now and take advantage of all the benefits available through this current legislative windfall!

Keith Drayer is Vice President of Henry Schein Financial Services. Henry Schein Financial Services provides equipment, technology, and practice start-up and acquisition financing services nationwide. Henry Schein Financial Services can be reached at 800-853-9493 or hsfs@henryschein.com. Please consult your tax advisor regarding your individual circumstances.

Practice Owners have been provided with historically significant tax incentives through 2011–making this the right time to invest in your practice’s future. The government estimates its cost of enhancing Section 179 is $50 billion alone. Are you poised to seize the opportunity?

Dental Owners have unprecedented incentives to invest in their practices! The Small Business Jobs Act of 2010 increased Section 179 dollar and investment limits to $500,000 and $2,000,000 (for 2010 and 2011). The 2010 Tax Relief Act will reduce the Section 179 dollar amount by 75%, reducing the expensing benefit to $125,000 starting January 1, 2012. The Section 179 benefit is scheduled then to be reduced to a $25,000 and $200,000 investment limit in 2013.

Small Business Owners have many benefits to focus on. The 2010 Tax Relief Act is in favorable treatment of off-the-shelf computer software (i.e., Dentrix, DEXIS) as eligible for Section 179 expensing. In addition, there is a 100% Bonus Depreciation (applies to qualified property acquired before January 1, 2012). The qualifying property for the Bonus Depreciation allowance is only available for new property (the original use begins with the practice owner).

The list of tax incentives for both businesses and personal use expiring in 2011 is extensive. There are more benefits than space in this article (i.e., luxury auto depreciation cap, self-constructed property, credit for energy efficient appliances, above-the-line deduction for qualified tuition and related expenses, conversion credit for plug-in electric vehicles, expansion of adoption credit and adoption assistance programs, tax credit for research and experimentation expenses, etc). Thus, it is recommended that practice owners discuss their individual circumstances with their own advisors.

Annual Internal Revenue Code Section 179 Example:

This deduction may be available whether you are a sole proprietorship, a partnership, or a corporation (S corps are subject to different rules; again, please check with your advisors). If you plan to acquire equipment in the near future, purchasing it before year’s end is prudent. Utilizing a finance agreement or capital lease to acquire technology or equipment will qualify for this benefit (where true leases or fair market value agreements will not). If you use a finance agreement to acquire your equipment and you have deferred payments, you may file your tax returns and achieve the benefits before you have made any payments.

Don’t wait too long to acquire technology or upgrade your office. Although it is true that you can have equipment placed in service until December 31, 2011 to take advantage of the incentives, waiting too far into the year may mean that you will settle on your technology choices due to diminished year-end selections. Now is the right time to meet with an equipment or technology specialist and discuss acquiring the optimal production-enhancing technology and equipment that will help your practice stay “Fiscally Fit.”

If your business uses a fiscal tax year rather than the calendar tax year, you may have additional time to take advantage of the extended $500,000 Section 179 deduction privilege. For example, if your outfit’s next fiscal tax year will begin on November 1, 2011; the $500,000 deduction deal is available for your current tax year. Plus you’ll get another $500,000 allowance for the following tax year that begins next November 1 and ends on October 31, 2011.

If your business uses the calendar year for tax purposes, you only have until December 31, 2011 to take advantage of the generous $500,000 allowance. Don’t wait to see if the rules for 2012 will change to provide the same opportunity! Act now and take advantage of all the benefits available through this current legislative windfall!

Keith Drayer is Vice President of Henry Schein Financial Services. Henry Schein Financial Services provides equipment, technology, and practice start-up and acquisition financing services nationwide. Henry Schein Financial Services can be reached at 800-853-9493
or hsfs@henryschein.com. Please consult your tax advisor regarding your individual circumstances.

That’s why, for nearly 10 years, Clay Center Family Dental Care has called on the experts at Henry Schein to deploy, integrate, maintain, and service the computer network and practice-management technologies that drive the efficiencies of its digitally-based practice.

“When I began practicing dentistry in 1977, a computer took up an entire room. I never envisioned that my practice would some day operate in a completely digital environment. We couldn’t have done it without Henry Schein,” says Dr. Rick Hammel of Clay Center Family Dental Care.

Over the years, Clay Center Family Dental Care has grown from a small three-chair practice to a multi-dentist practice with seven operatories in a 3,600-square foot building. “One of the main reasons we are able to grow our practice is the efficiencies we gained from going digital with solutions recommended by Henry Schein,” says Nancy Hammel, Office Manager for Clay Center Family Dental Care. “Henry Schein continually exceeds our expectations as they care for our technology needs. As a dental speaker and someone who is active in various online dental communities, I have access to many the technology experts across the country. There are a lot of companies to choose from. We chose Henry Schein because they have taken such good care of us from day one.”

Dental-Specific Technology Expertise Dr. Hammel and the entire team at Clay Center Family Dental Care rely on Henry Schein because of the solution provider’s decades of expertise and experience in designing, building and supporting integrated technology solutions tailored to the dental industry. “Most dentists believe in doing dentistry right the first time,” Dr. Hammel says. “Redoing procedures is unproductive and expensive. The same is true for technology investments. You want to pick a solution provider you can depend on and who does it right the first time. Over and over, Henry Schein has proven that it does it right the first time.”

In talking about how Henry Schein helped the practice move from a paper office to a digitally based practice, Nancy says, “It can be a stressful leap of faith to make the transition to digital, but it’s much easier when you can put your faith in someone with a good reputation, that you can depend on and that will walk with you through it step by step. Henry Schein will not let you down. They’re professionals you can trust.”

Giving Back with Technology’s Help
Clay Center Family Dental Care also appreciates the fact that Henry Schein provides integrated and fully tested offerings that have optimized their systems’ performance and increased uptime and operational efficiency. That efficiency helps the practice reach out to those in need.

“When we are efficient and productive, we are blessed with more freedom to give back to our community and to the world. Every year we go to Belize with the Belize Mission Project and donate dental care,” said Nancy. “Because of our experience in Belize we began our own mission here in Clay Center, the Clay Center Dental Mission.

On this annual day of providing dentistry to the community, we rely completely on the technology that Henry Schein has provided for us. At last year’s event, we saw over 77 patients in one day – something that could have never happened without digital solutions.”

“Henry Schein not only understands how to tie all of our computers and systems together, but they understand the intricacies of a dental practice,” Nancy said. “Having an integrated digital office reduces our overhead, increases our efficiency, and lets us be more productive. With everything tied together, anyone who is authorized can log in from anywhere in the office, at home, on the road, or even from a smart phone and access any patients’ information. With a click of a button we can see X-rays from yesterday or two years ago. I can schedule them for an appointment. I can see when they last visited and what procedures they had done. It’s a very efficient and cost-effective way to serve our patients.”

With Henry Schein, the Clay Center practice achieves efficiencies and cost savings without the worry of downtime that other practices often deal with. “We simply can’t afford to have our systems go down,” notes Nancy. “Most businesses depend on technology, and dentistry is no different. Downtime affects your ability to care for patients. It affects your patients’ lives, and it impacts your livelihood. That’s why we rely on Henry Schein. I don’t have to worry like I used to.”

More Satisfying, Efficient, and Profitable Dentistry
To summarize how going digital and choosing Henry Schein Dental as its trusted team has benefited Clay Center Family Dental Care, Dr. Hammel stated, “Many dental practices do wonderful dentistry, but they’re not achieving their potential. In today’s economic environment you have to be efficient, and you can’t waste time. With Henry Schein’s help, our digital practice lets us be more efficient and more financially profitable. It also creates a more emotionally fulfilling environment for our patients and our entire office.”

About Clay Center Family Dental Care
Dr. Rick Hammel attended Kansas State University and graduated from UMKC Dental School in 1977. Nancy Hammel has a B.A. in French and Biology from Kansas State University. Together, the Hammels have built a successful and thriving practice that incorporates all facets of dentistry, including sedation dentistry. Their state-of-the-art facility was built in 2000 and continues to incorporate cutting-edge technology in their practice. Nancy is a former speaker for Dental Organization for Conscious Sedation and is an active contributor to DentalTown meetings and forums. To see how Clay Center Family Dental Care gives back dental care to the world’s underserved, please visit their Web site at www.claycenterdentist.com.

Although the success of any organization ultimately depends on its people, the hiring of people is not usually the core competency of an organization. Hiring is, in fact, a source of pain for almost all organizations, but the cost is not borne proportionally. Larger organizations have dedicated HR departments whereas small and medium-sized businesses (SMBs), particularly dental practices, often must rely on the dentist or the office manager. In such cases, hiring is one responsibility among many that the dental team must assume, competing for resources and attention with patient care, scheduling, billing, and inventory management.

Dental practices are extremely people-focused, with a high degree of customer interaction at every level of service delivery, thus increasing the importance of getting hiring done right. However, hiring is made difficult by the very nature of the process. Some aspects that compromise its effectiveness are; high applicant volume; the inherent shortcoming of the resume with its broad variations in quality, content, and presentation; dentists or other team members pressed into the role of hiring manager while maintaining other responsibilities; and finally, the lack of a standardized process that precludes informed candidate comparisons while creating the possibility of decision bias (and its ethical and legal implications). Taken together these elements increase the likelihood of making a bad hire.

The costs of a bad hire are particularly nebulous for dental practices. Hard dollar costs—actual expenditures—include the cost of hiring and, where applicable, providing severance to a bad hire; the cost of posting ads to attract new candidates; the cost of ordering candidate tests and background checks anew; and finally the cost of performing on-the-job training all over again. These can easily add up to thousands of dollars. Bad hires also result in intangible or soft dollar costs, including the cost to a practice’s reputation of a poorly performing employee; the impact of such an employee on patient satisfaction; and finally the impact on colleague morale. Whether such soft dollar costs are short-lived or not, additional effort will need to be deployed by the dentist to mitigate and repair their impact.

So if an ineffective hiring process and its costs can readily be described, what are the components of a successful hiring process? The components of a good hiring process include properly documenting the requirements to perform the job effectively beforehand, as well as determining, in advance, the steps that all candidates will follow, from initial application through to phone interview and in-person interview.

However, what makes a hiring process great, and ultimately successful, is the integration of job requirements and hiring steps with data. Capturing each candidate’s experience, knowledge, skills, attitudes, personality traits, and general employability (using tools such as psychometric tests) and converting them into unbiased, objective data that can be presented in a concise, meaningful way allows for informed comparisons to be made and inappropriate candidates to be filtered out early on. It also drives candid discussion when candidates are interviewed in person. And finally, it provides confidence when it comes time to make a formal job offer.

Keeping in mind the previously discussed constraints on a dental team’s time and resources, the implementation of such a successful hiring process would need to be done in a manner that represents no additional effort or, even better, less effort than the status quo. Such an outcome could be achieved by automating the hiring process, including standardizing the collection and conversion of candidate data, using software.

Such a system would offer pre-defined job profiles, with an ability to customize them, and post job openings automatically to job boards as well as the dental practice’s Web site. It would also have the candidates do most of the work early on in the process, entering their details and qualifications and completing in-depth assessments, freeing up members of the dental team for day-to-day responsibilities. That candidate-generated data would then be presented in a concise, meaningful way (such as a dashboard or a table) allowing the ad hoc hiring manager to quickly weed out inappropriate candidates, and focus on those candidates with the most potential. Only then would an in-person interview be required, and job-specific interview guides would be available to support the process. Additional information such as reference checks and background checks could also be farmed out automatically to complete the picture before a final candidate is chosen and a job offer is made.

An automated solution eliminates many hard dollar costs by minimizing the time from job posting to job offer; and reducing or eliminating potential soft dollar costs by limiting disruption to existing day-to-day responsibilities, patient satisfaction, and employee morale, by ensuring that the right candidate was hired the first time around. Such a solution also captures many of the benefits currently enjoyed by placement agencies but not the actual dental practice customers themselves. Various business models for such solutions exist including the ability to pay for use on a per-job opening basis and the ability to subscribe for the ability to hire a given number of positions on an ongoing basis.

The components of a good hiring process include properly documenting the requirements to perform the job effectively beforehand, as well as determining in advance the steps that all candidates will follow, from initial application through to phone interview and in-person interview.

One example of an automated hiring process is the Henry Schein Dental Hiring Solution, developed by Iscopia Software in concert with the Henry Schein Dental group. Leveraging Iscopia Software’s 15+ years of expertise in human resources solutions and consulting, it is a secure Web-based application—no software to install—that enables dental practices to quickly attract, qualify, rank, and hire new employees. The Henry Schein Dental Hiring Solution includes popular dental team member job profiles such as hygienist, treatment coordinator, assistant, dentist and others. Each profile contains a pre-built job description, a job ad template, and a job-specific interview guide. As they apply, candidates are ranked automatically on the basis of quantitative fit between a dental specific’s hiring needs (target qualifications, experience, etc.) with the best candidates highlighted at the top of the list. The most promising candidates can be tested for qualitative fit using the included psychometric tests and interview guides, and further verified using automated online reference checks and optional background screening.

In conclusion, the availability of automated hiring solutions tailored to the realities of small business, and particularly dental practices, has the potential to permanently change the status quo by providing them with the tools and processes and ultimately the data required to make informed hiring decisions. This ensures that they enjoy all of the benefits that come with business growth and success, while minimizing the risk, uncertainty, and disruption that usually come with a decision to hire a new employee.

Kenneth Trueman is Director of Marketing for Iscopia Software. In collaboration with Henry Schein Dental, Iscopia has developed the Henry Schein Dental Hiring Solution, a secure Internet-based solution that enables dental practices to automate their hiring efforts. More information on the Henry Schein Dental Hiring Solution is available at www.iscopia.com/henryschein/.

Tips from the Top – E4D CAD/CAM Technology

James Kinney

Digital Technology Specialist

Henry Schein Dental

New Orleans, Louisiana

I worked with a Mississippi dental practice that wanted to convert their office to digital. As they weighed the decision, I pointed out their monthly lab fees made them an excellent candidate for an E4D Dentist.

They accepted an invitation to tour the Dallas E4D facility to see the chairside technology in action. They were impressed with the quality of the restorations and during that visit, they also became convinced the E4D Dentist would not just pay for itself, but would also fund all of the digital technology they hoped to purchase!

Within one month, they purchased the E4D Dentist, Dentrix, computers for the operatories, and other upgrades, taking their office from a traditional, non-digital practice to cutting edge technology–all paid for with savings from the E4D!

Substantial savings like this are typical among the practices I’ve worked with. On average, the E4D Dentist will reduce lab fees from 65% to 85% each month and, for some practices, that percent can go even higher.

Some of my clients have positioned their milling machines to be a visible centerpiece of the office. The patient response is amazing as they watch their crown being milled. It creates a buzz in the office and powerful word-of-mouth once they step outside as these patients share the experience of receiving a beautifully designed, precisely fit permanent crown in just
one visit.

Tips from the Top – Office Design

Jim Hammon

Equipment Sales Specialist

Henry Schein Dental

Boston, Massachusetts

I was meeting with a dentist one evening while we were planning his new office when he said to me, “How would you like to be in the only profession where no one ever looks forward to his or her visit?” I thought for a moment and said,“Well, Doc, I’m not sure that is true, no one looks forward to seeing the mortician either.” The point I was trying to make was he was right, I couldn’t remember anyone ever telling me, “What a great day today, I’m going to see my dentist.” So you have to ask yourself when planning your office, how can I make the experience a pleasant one for the patients and the staff? No one really enjoys having intraoral X-rays taken, but if we can create an office with carefully planned design details, from the front door of the reception area all the way through the office to the treatment and private staff areas, we can achieve an office that patients will brag about to their friends and family, and staff will take pleasure in and call the office their own.

On average, the E4D will reduce lab fees from 65% to 85% each month and, for some practices, that percent can go even higher.

The first place in an office to make an impression on your patients is the reception area. Too often this space can be overlooked in terms of fit and finish, perhaps because the overruns of the project budget wouldn’t allow for good quality furnishings or artwork to dress up the space properly. Work closely with your architect and interior designer to develop a palette of colors and finishes that can reflect the personality of the dentist, the geographic region where the office resides, or matches with the architecture of the building. It is very important that comfortable, quality seating, is specified and arranged in different locations; either in groups for family or kid-seating areas, or in single areas for patients who visit the office by themselves. Remember that some of the patients will only sit in the reception area for a short time before their appointment, so you have only so much time to get their attention and set the mood. Be sure to incorporate some accent lighting in the reception area. Pendant lighting or wall sconces are light fixtures that you can chose to make a design statement without breaking the bank. If the space is available, perhaps some crown molding or ceiling soffits with recessed accent lighting can give the reception area added volume.

The front desk in the business area is another example of a space that must be designed to take care of the administrative staff that runs the office, but it must also serve as a location where business and conversation can take place between patients and staff. Its important that the desk be sturdy, constructed from materials that can take the day-to-day action of patients leaning on the transaction top, staff working with computers, the weight and operation of office equipment, and even an area where a consultation can take place. I like to choose an accent material like stone, a rare hardwood, or ceramic tiles as a surface for the transaction top. Accent lighting within a soffit above the transaction top or decorative pendant lights hanging from the soffit can highlight the top and add flare to the business work area.

Flooring materials, wall finishes and accent colors, ceiling materials and heights, are all features with plenty of options available to separate your office from the rest. You can achieve a look that’s your own without upsetting the entire project budget. It is important to work with a qualified design professional who can help you design a palette of colors and materials that will blend and compliment each other. It’s very difficult to look at a carpet sample or a paint chip and picture what they may look like when they fill a space. Try to review the color selections in different lighting, both interior lighting that resembles your space, and natural light if your space will be adjacent to windows. Be sure to change flooring materials between the treatment rooms and the rest of the office. The flooring in the treatment rooms may age quicker than the rest of the office and it’s easier to replace small areas of flooring without disrupting the entire office.

A few well-planned design features can really make the difference between a office that makes your patients feel comfortable during their appointment and refer the practice to the friends, not an office where they are sprinting from the patient chair, out of the office with the bib still around their neck, hoping they never have to return. Remember, your patients have no idea if you hold the handpiece differently from the dentist down the street, but they will talk about their perception and how they feel after every visit to your office. If they feel that good about your office, how do you think they will respond to your treatment planning?

Tips from the Top – Digital Solutions

Adam Jones

Equipment Sales Specialist

Henry Schein Dental

Rocklin, California

As I met with a client the other day he asked me a question that is probably on the minds of most dentists:
“What are other doctors doing to be successful?”

In answering his question I took time to share stories from successful practitioners I know and how they have implemented technology to advance their own practices and to keep them growing. I focussed on four specific technologies that can influence case acceptance, expansion of procedures, time savings, quality of dentistry, and the ability to attract and retain new referrals.

I would like to share some common denominators found in successful practices that focus on using some of the amazing technologies available today. I will discuss four specific technologies and show how such improvements can influence case acceptance, expand procedure options, save time, improve the quality of dentistry, and better attract and retain patients.

Intraoral Cameras. Cameras today are advanced yet easy to use. Simple plug and play USB connections allow you to move from room to room very easily. These high-resolution cameras have the ability to take a variety of pictures: extraoral, full smile, quadrant of teeth, single tooth, or even look down a canal. “Seeing, is believing!” The more a patient can see and understand, the more educated they become about their oral health. An educated patient accepts treatment faster and on a higher level. They now know the value of your services. Pre-op and post-op pictures on any procedure create value and instill confidence. Cameras are one of the simplest ways to communicate with your patients and increase case acceptance.

Intraoral Digital X-ray. With intraoral digital X-ray you take a patient from squinting at a small film to a “wow factor” on a computer screen where you can utilize numerous tools to enhance, magnify, and communicate with the patient on a level they can understand. If you are ready to invest in digital X-rays, you will soon realize that the process is simply a reallocation of funds; funds you are already spending on film, chemicals, and chemical disposal. You will also find that you are able to diagnose more easily and that your patient’s confidence will grow when they see this amazing technology on your monitor and understand that radiation dosage is minimized and diagnostic accuracy is increased.

Digital Panoramic. Digital panoramic X-rays today have amazing technology like automatic exposure control (AEC) where they calibrate to each individual who steps into the machine, giving you great clarity and consistency. They also have the ability to take extraoral bite wings. To quote a few of my clients, “It’s amazing how patients relate to and understand the smile on their panoramic picture compared to an FMX and begin to co-diagnose with me in the treatment planning process.” “My staff loves our new digital panoramic X-ray because we can take panoramic and extraoral bite wings in less than two minutes and supplement with PAs where needed.” I always find that doctors, staff, and patients are amazed when they learn that a digital panoramic in dosage equals two PAs and that extraoral bite wings equal one and a half PAs. Put yourself in the patients’ shoes. Would you rather bite on a bite stick for 10 to 18 seconds or have a domino put in your mouth 18 times? After the installation of a digital panoramic, offices change their radiological baseline and realize that the time saved allows the hygienist to see an extra patient each day. I see a digital panoramic as being the best product an office can have for everyday “bread and butter” dentistry.

Cone Beam CT. 3-D is the hottest topic in dentistry. The ability to slice, measure, and see things in a 3-D format is impressive and assures the patient that they are being treated by an expert clinician who is using the best technology available. It also gives the clinician confidence to expand his or her procedure mix. Doctors who have purchased 3-D technology from me have all come back with similar comments indicating that they are not afraid to do a surgery or place an implant because they have already virtually done so through the software. To quote a client, “Now that I have 3-D Cone Beam, I am faster, less invasive, and my patients are healing quicker because I know exactly where I am going.” I believe that could be said for any and all procedures a clinician could perform with 3-D technology, including specialties such as orthodontics, oral surgery, periodontics, and endodontics.

Time and time again, I have seen these four technologies transform and re-energize dental offices and help to keep doctors on the cutting edge of their profession. Making these technologies part of your practice will increase case acceptance and give you the confidence to expand your treatment procedures. You will save time, increase your quality of dentistry, and find that your patients are referring their friends and family to you. Your return on investment will be great!

You’ve seen them—QR Codes. Grids of seemingly random dots and squares. These
are not just random patterns, however, but coded information waiting to be scanned.

There has been a significant increase in the use of advertising campaigns and other communications that use QR Codes. Several trends have fueled this. There are more smartphones in people’s hands. The use of QR Codes is free of any license, decreasing the cost of creating QR Code-based campaigns, and most importantly, QR Codes are a part of a larger trend toward merging real-life and digital experiences. The real and the digital are coming together, and QR Codes is one way to facilitate this.

A recent Mobio Identity Systems study¹ quantified just how rapidly QR Code use has increased in the past year alone. It’s findings show an explosion of QR Code use. It found that:

• On a year-over-year basis, QR Code scanning has increased by 4,549 percent in the first quarter of 2011.
• People who added QR Code scanning capabilities to their mobile devices during Quarter one 2011 has increased almost ten-fold versus new users added in Quarter one 2010.

With this rapid growth comes an opportunity for dental practices to use these codes to give patients immediate access to relevant digital content. Dental practices can use this technology to build better relationships with existing patients, gain new patients, and ultimately grow their practices. In addition, encouraging digital interactions with your patients will help build and grow a network of patients that can be leveraged in the future.

The Basics
QR stands for Quick Response. A QR Code is a two-dimensional bar code. The technology was developed in 1994 by Denso Wave Corporation. It is similar to the conventional bar codes found on products in a typical grocery store, except that a QR Code is specially made for smartphones, tablets, and other mobile devices. QR Codes have built in error checking so if the code gets dirty or slightly damaged the code can still be read by a scanner. A QR Code can contain several types of data including: URLs, text-messages, phone numbers, and other text-based information.

QR Codes can also contain much more information than a conventional bar code, giving it a great deal of flexibility.

QR Code Data Capacity²
Numeric only Max. 7,089 characters
Alphanumeric Max. 4,296 characters
Binary (8 bits) Max. 2,953 bytes

When a patient sees a QR Code, they can use the camera on their smartphone to scan it. The smartphone users will need to have an application on their phones to allow them to do this, but all the major smartphones either have these apps pre-installed or offer them for download. Once scanned, the user can be taken to a Web site to schedule an appointment; submit a review of your practice to a social media site; or be presented with any content you are interested in providing.

How to Make a QR Code
It’s easy to generate a QR Code. Several free Web sites will create a QR Code for you. In addition, creating a QR Code is free. This makes it very inexpensive for a dental practice to utilize this technology as there are no ongoing fees associated with their use.

Here are a couple popular Web sites for making your own QR Codes.

http://qrcode.kaywa.com/
http://delivr.com/qr-code-generator

These Web sites allow you to enter the information you would like to have embedded in your code and then, with the click of a button, generate a QR Code for you. Once made, you can print your own special code on any surface. The surface could be your waiting room wall, a brochure, a print advertisement, or a hangtag on the toothbrush you give to your patients when they check out.

In addition to the more traditional marketing tactics, there is no shortage of creative uses for QR Codes. You can make QR Code T-shirts or use QR Codes in TV spots. In fact, shows like Late Night with Jimmy Fallon are using QR Codes to further engage their audiences. There is even a tattoo parlor in Phoenix that offers QR Code tattoos.³

After making the effort to send patients to a digital experience, you’ll want to do whatever you can to make sure it is a positive one.

Core Users
The Mobio Identity Systems study also found that women are the top QR Code scanners, with 68% of scans done by females.

Of all people using QR Codes, the top age segments are:

• 26% of QR Code scanning is done by users aged 35-44.
• 23% of QR Code scanning is done by users aged 45-54.
• 22% of QR Code scanning is done by users aged 25-34.

These demographics support marketing tactics targeting these key dental care decision makers with whitening and other cosmetic procedures.

Marketing Ideas
There are several ways a dental practice could integrate QR Codes into its marketing efforts. Here are just a few examples.

Growing Social Media

• As patients leave the office, ask them to leave a testimonial on your Yelp or Facebook page. To further encourage this, you could place a sign on your counter with a QR Code that links directly to these pages.
• Another way to encourage social media participation is to encourage users to check in at your office location. You could do this by creating a sign containing a QR Code that links users to Facebook Places or Foursquare.

Direct Mail and Print Advertising

• Including QR Codes in direct mail and print advertising is a great way to encourage users to visit your Web site. For example, you could include a QR Code in a mailer that links directly to your online scheduling system. This would provide patients an easy way to quickly book an appointment right at the moment they are thinking about it. In addition, QR Codes are still unique enough that they visually stand out in an ad, grabbing your audience’s attention.

Patient Waiting Area

• Add QR Codes to brochures or posters in your waiting areas. These QR Codes could link patients to educational information or videos posted on your web site. Once there, the user could be presented with the benefits of key services you are promoting, and because they can be created relatively inexpensively, the QR Codes could change regularly as you change the services you promote.

Postoperative Information

• Provide patients with postoperative information cards that contain a QR Code. This code could link to postoperative instructions or other educational information.

For each of these tactics, it is important to make sure that the Web site you send your patients to is mobile-friendly. After making the effort to send patients to a digital experience, you’ll want to do whatever you can to make sure it is a positive one.

These are just a few of the possible uses for QR Codes in dental practices. Experimenting with a couple of these is a great way to further engage your patients in the digital world.

The Future
QR Codes themselves may not be around forever. Other technologies such as NFC (Near Field Communication) are on the horizon that will combine quick access to digital content with e-commerce. In March, Google Places removed QR Codes from users’ Places accounts, signaling an end to their support of these codes. But this doesn’t mean the time isn’t right for QR Codes. It will be several years before acceptance and penetration of NFC catches up to QR Codes, making now a great time to pursue QR Code-based tactics.

Regardless of the technology, the real world and the digital will continue to merge, becoming more interconnected and more dependent upon one another.

Patrick Kelly is a Partner at Method Engine, a full-service digital agency based in Chicago Patrick is also available for speaking engagements. He can be reached at www.methodengine.com

Footnotes:
¹http://www.mobioid.com/reports/naked-facts-whiplash/
²http://www.denso-wave.com/qrcode/qrfeature-e.html
³http://ktar.com/category/local-news-articles/20110328/Now-available:-Scannable-bar-codes-on-your-skin

By David Eshom, DDS

Practicing dentistry in today’s economic climate is as challenging as it has ever been in the 25 years I have practiced. The stress of presenting needed and elective treatment to fewer patients can sometimes seem overwhelming. To survive and thrive in these challenging economic times a dentist must do like businesses outside dentistry and diversify. Diversify means to provide more products that answer our patients’ needs under one roof so they can say yes to health and beauty in your office.

Laser dentistry is a great way to please and impress your patients when it comes to treatment acceptance, operative dentistry, hygiene, and cosmetic dentistry.

Over the last 8 years I have invested in dental lasers, and that has increased the diversity of my dental product offerings and helped me weather the economic downturn. I have lasers in my hygiene rooms and in my operatory, and I am thankful for the extra production, comfort and results they provide. Dental lasers are the ultimate in minimally invasive treatment and impress each patient that they touch.

Let’s go over the multiple applications of lasers in every dental office starting with the new patient exam. Take the time to tell the patient they are in a special dental office. Show them the lasers or pictures of the lasers you have to use for their benefit (stressing the patients’ benefits) when they walk in to your practice or exam operatory. This is easily done by the team while taking a health history or X-rays. Patients have been exposed and impressed by laser eye surgery for years, and now they can be impressed by your office’s up-to-date and comfort- centered laser equipment. Less than 10% of dentists practice laser dentistry and you should differentiate yourself as someone special. This all helps build trust and patient acceptance during your new patient exam.

Before procedure

Treatment-day

One week later-temps

One week after seat

When your exam is done and you explain treatment options, lasers will help your patient decide in favor of treatment because you can do regular dentistry more comfortably and in a minimally invasive manner. Starting with operative dentistry, you can tell your patients’ that their cavities can be worked on without a local anesthetic. Patients hate the needle and the whining dental handpiece. The Biolase Waterlase MD Turbo all-tissue laser allows me to do over 50% of my operative dentistry without the need for a shot. Patients love having a filling done without a sting and a poke, the sound of a drill, and a numb lip. More treatment acceptance and referrals will result of being able to say there is often no need for a shot or drill during treatment.

Not all laser dentistry needs to be done by you. Your hygienist can provide laser comfort, treatment acceptance, and additional production as well. Often the hygiene department becomes a place where people get “just a cleaning.” Diode lasers give the hygienist an exclusive tool to make your office stand out in the patient’s mind. Your hygiene department can provide dental health care and optional laser disinfections on top of routine prophylaxis. Medical professionals and general public now accept that the same bacteria that causes plaque in mouths causes plaque in arteries. Diode laser dental therapy kills nearly 100% of bacteria in periodontal pockets. That is better for your patient’s gums and heart. On top of conventional root planning, laser de-epithelialization and decontamination give your hygienist a tool to get better healing without subgingival drugs and the security of a extremely successful bacterial kill. When properly explained and understood, patients will pay out-of-pocket for this more effective method of fighting gum disease. Suddenly your hygienist is excited and your production increases because this new product “diversification.”

Cosmetic dentistry was a “diversification” for dentistry 15 years ago. Dental lasers help you be a more diversified cosmetic dentist. Often, over 50% of my cosmetic cases can be enhanced by laser gum contouring and even osseous contouring. Gingivectomy and closed-flap cosmetic crown lengthening take your smile makeover and veneers from good to great. This laser (Waterlase MD Turbo) method can be done the same day as your prep and temporaries. The gums heal while your patient feels nothing during or after the procedure. Laser gum recontouring keeps the patient and revenues in your office. The cosmetic result is better because the gum contours are correct, which makes your veneers symmetrical. This procedure could not be done in 2 appointments because doing it surgically would necessitate waiting at least 6 weeks for healing. Cosmetic dentistry and lasers are a match made in heaven for your practice.

Practicing in a challenging economic climate requires the doctor to be creative and use business principles outside dentistry to survive and thrive. Laser dentistry is a great way to please and impress your patients when it comes to treatment acceptance, operative dentistry, hygiene, and cosmetic dentistry. Lasers provide a way to diversify your practice and keep your patients in-house, which enhances your bottom line and keeps your practice healthy as well.

Visit Dr. David Eshom’s Web Site at www.eshomdds.com
Check out this article on www.Sidekickmag.com.

In March 2010, Apple sparked a computing revolution with the introduction of the iPad, a mobile computing platform unlike anything previously known. With more than 14 million units sold in 2010 alone, the iPad has gone on to be a resounding success for Apple. And, for Apple’s competitors, it has opened up a new market that until now didn’t even exist. As 2011 has unfolded, Motorola came to the market with the Motorola Xoom, the first Android-powered device to implement Honeycomb, a new version of Android specifically designed for tablet devices. Not long after Motorola brought the Xoom to the marketplace, Apple unveiled the iPad 2, an updated version of their original iPad. So with more choices available in the market, how does one go about deciding on a tablet? Let’s compare and contrast these two devices across several of the key feature areas.

There are a lot of factors that come into play when choosing one of these devices.

Hardware
Let’s start by taking a look under the hood. The iPad 2 and the Xoom both run on 1 GHz dual core processors. The Xoom’s screen is slightly larger and higher resolution than the iPad. Despite the higher resolution screen of the Xoom, the iPad screen produces a clearer, brighter image. The iPad is thinner, lighter, and sleeker, showcasing Apple’s design flare. The Xoom has an odd placement for the on/off button on the back of the device that leaves the user hunting. Both devices have front and rear cameras for photo and video, but the Xoom is the clear winner with twice the resolution in the front facing camera and an even wider gap on the rear facing. Both devices include the ability to connect to a projector or widescreen TV to output to a screen for presentations or multimedia viewing.

Operating System
The hardware may provide the horsepower, but it’s the software that truly provides the experience. The Apple iPad runs Apple’s iOS operating system, the same software that runs its iPhone and iPod Touch. In the mobile space, iOS is a mature OS, packed full of all the features that have made the iPhone, iPod, and iPad platforms so popular. It feels like a polished experience that includes subtle but important tactile feedback that draws the user in. Apple has focused on making their software easy to use and consistent. The menus and navigation are straightforward and require little learning for new users.

The Motorola Xoom runs the latest version of Google’s Android OS called Honeycomb. Honeycomb is the first version of Android OS to be focused on the tablet form factor and the Xoom is its inaugural device. Android offers users more options for customization than iOS does, including widgets and screen layout options. It also has a more sophisticated model for device notifications than Apple’s interrupting pop ups. The trade off more options and customizations is a user experience that doesn’t flow as naturally and easily as it does on the iPad. It may appeal to the techies, but is somewhat confusing for those less inclined to tinker.

Device Ecosystem – Software, Hardware, and Development
The Motorola Xoom and the Apple iPad have strong differences when contrasting the platform approach as an ecosystem. The Xoom is hardware designed by Motorola that runs an operating system designed by Google. The operating system will support devices from other hardware manufacturers and presumably each will build their own variation on the integration of the hardware to the device software. By contrast, Apple builds its own hardware and OS and maintains strong control over the software as a whole. The Apple iOS runs across Apple’s set of mobile class devices; iPod Touch, iPhone and iPad. The variations in the hardware are minimized with a specific set of targets designed by the same company that’s creating the hardware. Given this consistency, app developers have potentially less variables to contend with in making their apps operate in a consistent manner across the platform. Android developers must consider widely varying hardware and software combinations and therefore have potentially more variability to contend with.

Apps!
What would mobile computing be without apps? Tools for business productivity, games to entertain, utilities to eliminate paper processes, and windows into our social networks – the possibilities are limited only by developers creativity. When the original iPad launched back in 2010, the App Store had over 1,000 iPad specific apps at launch. The iPad 2 today boasts of access to more than 65,000 different iPad specific apps. Not every app in Apple’s store is as innovative as the next, but given the sheer number of apps, there’s plenty of variety to choose from and a lot of compelling apps to download. By contrast, when the Motorola Xoom launched earlier this year, there were less than 20 apps in the Android marketplace that were designed for the Honeycomb tablet platform. That number is increasing as the market grows, but as it currently stands, it’s negligible compared to the mature and ever growing Apple App Store. One of the key elements to Apple’s success with the App Store is the strong development community they have nurtured. Part of the App Store’s appeal for developers is its record of success in terms of sales revenue. Many commercial apps have not found the same success in the more loosely-controlled Android marketplaces. In turn, Apple’s App Store tends to have higher quality commercial apps. In order to compete with the iPad, Google will need to build a thriving development community that targets the Honeycomb version of Android for tablets.

Adoption
The market for this new class of mobile devices is young, but growing. The current leader of the pack is clearly the Apple iPad and presumably that will continue with the iPad 2 at least in the short term. Apple released the iPad in April of 2010 and sold over 3 million units in the first two months. Following the early adoption trend, sales remained strong throughout 2010 with nearly 15 million units sold by years end. Most recently, Apple sold 4.7 million iPads during its quarter ending March 26, 2011. Those sales include all of the iPad 2 devices that they were able to make. According to Apple, many of the fortune 500 companies are currently testing or deploying iPads inside their businesses.

As for the Xoom, Motorola recently published sales figures indicating that it sold 250,000 Xoom tablets in the first quarter of 2011.  This indicates a much weaker early adoption rate when compared to the strong launch of the iPad.  Also more recently, sales of the iPad 2 over the same period were significantly higher.  Some analysts have indicated that the initial launch of the Android Honeycomb OS on the Xoom was plagued with glitches that slowed consumer adoption and caused several other hardware manufactures to delay product releases that implement Honeycomb.  Google and Motorola have some kinks to iron out before they will be able to compete with Apple’s iPad and iPad 2 adoption rates.

Value
The Apple iPad 2 is available in several different configurations. One of the largest differences between the two platforms is the availability of apps. Apple’s App Store is full of apps to keep you entertained, connected, and productive. The Honeycomb apps available in the Android Marketplace pale in comparison to the wide range of options available for the iPad. Each of the platforms will continue to mature and more apps will become available on both, but as it stands right now, there’s tremendous value in gaining access to Apple’s App Store.

So which one?
If only there was a simple answer. There are a lot of factors that come into play when choosing one of these devices. The Android device is appealing to the types of users that like to tinker with their devices and customize the settings to create their own unique experience. The iPad, on the other hand, offers a simpler more straightforward design approach to the device and the user interface that’s easy for a wide range of users. The iPad is just as compelling for toddlers playing learning games as it is for seniors plugging in to the social networks–and everyone in between.

There’s no place like home! And, there’s nothing better than being 50 feet from your place of business. Gearhart Dentistry and the Doctor’s residence, located in Gearhart, Oregon, are only footsteps apart and ideally configured to offer an enviable lifestyle—possibly with one of the shortest commutes on record!

Construction began in January 2010 in the new location (the office opened in September of the same year). The new building’s 1,750-square-foot downstairs space houses the reception area and 4 operatories. Its 400-square-foot second level is used for the Doctor’s personal office and storage.

“We feel the office’s environment accurately reflects the quality of care we provide to our patients,” points out Dr. White. “I believe the new office is more relaxing and less stressful for my staff as well…it allows them to work as a strong team and enjoy a greater level of communication and productivity. We have had a measurable increase in new patients in just the last 3 months and there have also been a lot of walk-ins, roughly one to two per week, wanting to check out the new place and inquire about becoming patients.”

“My business being so close to my home is such a wonderful thing,” remarks Dr. White. “There are many matters that need to be handled after patient treatment hours, which means time away from loved ones. I can literally run over to the office and work—guilt-free.”

Through the successful completion of her new office, Dr. White will better realize her business goals and be able to fulfill her personal philosophy of patient care. With new technologies and a perfectly configured space, the Doctor can confidently look forward to supporting an increase in her burgeoning client base and comfortably meet the demands of her personal life as well.

Front row: left to right–Kristeena Robinson, Digital Technology Specialist; Dr. Stephanie White; Jaime Phifer, Field Sales Consultant. Back row: left to right–Chris Whisman, Certified Installation Technician; Mike Corcoran, Equipment Sales Specialist; Lee Lehman, Regional Manager; Jason Paz, Equipment Service Technician; Dan Sands, Equipment Service Technician

Gearhart Dentistry 2011 Making the Dream Work

>Dr. Stephanie White definitely achieved the best of all possible worlds when she opened her new practice in Gearhart, Oregon. With an enviable proximity of the business office to the Doctor’s family residence, everyday concerns over traffic and delayed schedules were overcome from day one. “As a mother, small business owner, and dentist, this relocation provided numerous benefits on many levels, including highway frontage that increases the practice’s visibility,” points out Dr. White.

The new office’s superior ergonomics and enhanced functionality continue to make each workday less stressful and more productive. Industry-leading technologies play a huge part in the office’s ongoing success. “The most beneficial technologies affecting our business are the DEXIS platinum sensor and the Dentrix practice-management software,” notes Dr. White. “We made the switch from conventional film to digital radiography more than four years ago.

It was a very smart move financially. We are able to provide high-quality diagnostic images with less radiation to our patients. With chair-side monitors in each operatory, we are able to enlarge radiographic images and clearly illustrate problem areas to patients—which has a huge impact on case acceptance. We save money on the amount of time it takes to take films (and see a finished product), not to mention the days of painstaking maintenance of processing equipment and chemicals that are a thing of the past. Our Dentrix software allows us to manage operating systems in our practice more efficiently. With the numerous reports that can be run, we are better able to track our patients’ data as well as the practice’s financial status and needs.”

“The space and the new equipment and technology makes them proud to be a part of our Gearhart Dentistry team and provide dental care in such a beautiful office.”

Gearhart Dentistry is also busy increasing its visibility through the Internet. “We are currently working on getting our Web site established,” notes the Doctor. “One of the features on our new Web site is Henry Schein’s Guru. This educational resource integrates with our Dentrix practice-management system and connects with patients in our office, at home, or online, offering multimedia presentations on treatment recommendations by using the patient’s own X-rays and intraoral images. It’s a great communication tool and helps build trust with the patient.”

“Our productivity has increased by 25% and we have seen a 75% increase in our patient base since opening the new facility.”

Working toward greater team harmony is always a prime consideration for the dental practice. Positive morale of the staff directly impacts productivity and influences patient satisfaction, helping to build a bright future for the business. “Our staff loves the new office,” says Dr. White. “The space and the new equipment and technology makes them proud to be a part of our Gearhart Dentistry team and provide dental care in such a beautiful office. They are also excited to implement the latest technologies as they become available.

Front row: left to right–Nicole Clauder, fill-in Hygienist; Cathy Jo Kirkpatrick, full-time Hygienist; Dr. Stephanie White; Megan Kristovich, Sterilization Tech; Back row: left to right– Jamie Stratton,
front-office and financial coordinator; Heidi Ross, front-office coordinator and financial coordinator; Kathy Sue Maltman, Doctor’s Assistant

As a small business owner, Dr. White continuously works to keep her practice goals on track. “We provide dental services in a location that we own, which keeps overhead to a minimum and translates into increased profitability and lower costs to the patient,” adds the Doctor. “Our productivity has increased by 25% and we have seen a 75% increase in our patient base since opening the new facility.”

With the support of its dedicated team and new technology solutions, Gearhart Dentistry is perfectly positioned to pursue continued success in fulfilling its philosophy of patient care while staying competitive in today’s marketplace.

Featured Equipment:
Dentrix Practice Management Software
DEXIS Platinum Digital Sensors
Digital Doc Icon Intraoral Camera
Crown Seating Operatory Stools
Guru Patient Education System
Midmark Assistant Stools
Pelton & Crane 3000 Chairs and Delivery System
Pelton & Crane Helios Light
Pelton & Crane Cabinetry

Left to right: Ron Kettles, Equipment Sales Specialist;
Dr. Tina Nichols; Dr. Samaria Mascagni; Scott Fritz, Field Sales Consultant; Kevin Halter, Equipment Service Technician

A location was chosen about one-half mile away from the existing office. It would better provide the opportunity for continuous growth and enhanced services to more fully meet the Doctors’ vision of the ideal dental practice.

The process began by contacting Henry Schein Dental. A rough draft of the new floor plan was created and then a tour of the Pelton & Crane factory and showroom was set up to view the many upgrades that were available in operatory equipment.

The design impact of the new building harmonized perfectly with its natural setting. The interior design specifically creates a separation of patient care, staff, and clinical areas to streamline activities and aid in accelerating productivity. The airy and colorful entry space infuses energy and vitality to the reception and waiting areas. Every operatory has a window that looks out on the surrounding forest and lush landscaping. Inside the operatories, the patient has multiple options to enjoy the pleasures of electronic entertainment.

Arkansas Family Dental encompasses the best of all possible worlds in its design and functionality—and the office has great street appeal. Doctors Nichols and Mascagni can now comfortably accommodate their busy practice schedule and look forward to a successful future treating their patients with the latest in industry-leading technologies.

Arkansas Family Dental 2011 Technology Makes the Difference

In today’s dental industry, it is well known that a techno-revolution has taken hold. Doctors can now offer a greater variety of treatment options
through the use of evolved, innovative equipment solutions that expand their ability to create new revenue streams and
stay competitive in the marketplace.

“We have complete control of the final restoration. Patients are very impressed and happy with the results and the convenience that the process offers. There are so many positive aspects to working with the E4D—it’s a real practice-builder.”

Since its completion, Arkansas Family Dental has provided its patients with high-quality care and the benefits of superior technology that create the optimal treatment experience The amazingly transformed workplace houses 11 operatories in a 6000-sq.-ft. area, allowing Doctors Nichols and Mascagni to confidently meet the demands of their busy workdays. To better serve their patient base, they have invested in one of today’s most dynamic technologies, the E4D Dentist.

The E4D Dentist CAD/CAM chairside system has been designed and manufactured in the United States and also offers supportive training for its owners. Distributed exclusively by Henry Schein Dental, the E4D makes it possible for the dentist to create metal-free crowns, inlays, onlays, and veneers on-site. Beautiful restorations can be completed in the same day. “The E4D has shown to have the greatest ROI and has continuously increased my revenue stream,” notes Dr. Nichols. “We have complete control of the final restoration. Patients are very impressed and happy with the results and the convenience that the process offers. There are so many positive aspects to working with the E4D—
it’s a real practice-builder.”

Arkansas Dental started out in a strip mall environment with limited square footage and only five operatories. Today, they enjoy a seamless clinical area with multiple operatories, a sterilization center, an on-premises lab space, an impressive array of technological upgrades, and sufficient space to plan for growth. “Everyone comments on how amazing the new office is…and how nice it is to be a patient at our facility,” comments Dr. Mascagni. “Arkansas Family Dental is such a pleasant space to come to work every day!”

Featured Equipment:
Biolase ezlase
Dentrix Practice Management Software
E4D Dentist
KaVo Quattrocare
Pelton & Crane Delta Q
Pelton & Crane Light Fantastic
Pelton & Crane 3000 Chair
Pelton & Crane Cabinetry
Pelton & Crane Delivery System
Pelton & Crane Sterilization Center
SciCan Statim 2000
Sirona XG3 Digital Panoramic X-ray

Gendex — your total imaging solutions provider

Filippo Impieri: “The Gendex tradition in imaging began with intraoral X-ray. The company’s technology solutions adhere to high standards of reliability and quality, but also are simple and very intuitive in their use. During the last few decades, Gendex grew strong with the GX-770™, one of the most popular intraoral X-rays ever built. We then added the expert^® DC, which offers dentists a simple and fast workflow, user-friendly interface, and unique solutions like the quickset control on side of tubehead for rapid selection of the patient size and exposure setting. Besides the convenience and speed, the expert DC also offers extremely clear, sharp X-ray images. A strong complement to this dynamic unit is our GXS-700™ sensors. These ergonomically designed sensors come in two sizes that are comfortable for the patient and easy to position. They produce clearly detailed images and feature direct USB “plug-and- play” connectivity. Gendex has developed a strong commitment to the intraoral dental X-ray business. As we look at the years ahead, we will continue to engage our significantly large customer base and understand how to address their future needs. The voice of our customers is the key source to trigger future innovation.”

Mike Bosha: “One of the most appreciated innovations of Gendex is the panoramic X-ray machine that fits into any dental office footprint at an affordable price point. The Orthoralix^® 8500 DDE product line offers dentists the opportunity to own a digital pan with features necessary for diagnosing both adults and children. We are eager to welcome new panoramic products in the second half of the year, developed with additional features that our customers have requested. Our new panoramic system takes not only a full panoramic image, but can also focus on specific areas of the mouth, with less radiation exposure for the patient, and faster exposure times. Improvements to patient positioning in this unit, usually a tricky aspect of a panoramic machine, make positioning basically “foolproof.” For those who like the workflow of film but also want digital capabilities, our PSP product line is also expanding. The new system is flexible, fast, easy-to use, and familiar to dentists. Our PSP product line covers a wide variety of needs, from standard intraoral sizes to of a full complement of extraoral panoramics and cephalometric images.”

John Steck: “Gendex has a long history of providing panoramic devices. Seizing the opportunity to partner with i-CAT, the company was able to take advantage of the i-CAT-developed 3D technology that is very popular with dentists. Since Gendex historically has been very well known and trusted by general practitioners, the GXCB-500™ 3D system was developed with these particular dentists in mind—for implants, extractions, third-molar extractions, impacted teeth, restorations, endo—all things that would provide better clinical results and expansion of procedures to GPs, as well as oral surgeons and periodontists. This 2-in-1 unit is extremely flexible, with capability for both panoramics and 3D, and it is adjustable to capture from the bottom of chin to base of sinus cavity, and extending to the TMJ. Later in 2011, we are anticipating a new high-quality pan/ceph/3-D combination system with many projections and the ability to capture 3D from a single tooth to the full arch or the TMJ. The system will deliver what GPs need: repeatability in the capture and quality of panoramic images and scans, flexibility to capture the images necessary for the procedures they perform, and the ability to upgrade to ceph and/or 3D as the practice grows.”

“In planning our new location and building, our goal was to make sure we achieved a comfortable atmosphere for staff and patients,” comments Dr. Andrew J. Hoekwater. “Through the combination of homework and preparation by our staff and the experience of the specialists from Henry Schein Dental, we were able to realize that goal.” Henry Schein Dental Equipment Sales Specialist Bill Smith determined the number of operatories and square footage required for Hoekwater Dentistry’s new space. With three doctors, five hygienists, and five assistants, it was calculated that the doctors would need from 9 to 10 operatories and from 4,000 to 5,000-sq. feet to accommodate their needs.

“We have a history with Henry Schein; a long-standing relationship and trust that was built over time,” notes Dr. James C. Hoekwater. [The] consistent quality of [their] service could be depended upon and the communication level regarding details large and small helped to make the project manageable and even enjoyable.”

Technology with the future in mind–Staying abreast of today’s “smart” technologies helps the modern dental facility to streamline their daily activities and offer patients a wide range of treatment options, many of which can be completed in just one visit. For Hoekwater Dentistry, the decision to create a paperless office made a measurable difference in their efficiency. Incorporating intraoral cameras has given them the ability to show the patient what is going on inside their mouth, better facilitating an understanding and acceptance of proposed treatments.

A dependable partnership–“Because of our continuous relationship with Henry Schein Dental, we will be able to provide professional excellence and state-of-the-art technology in a comfortable environment. Our professional goal of having all 3 dentists at the facility full time will be realized in June 2011,” adds Dr. James P. Hoekwater. “With our growth in new patients at 20% since opening—the future looks good!”

“In planning our new location and building, our goal was to make sure we achieved a comfortable atmosphere for staff and patients.”

Left to right: Dan Madsen, Equipment Service Technician; Kathy Christensen, Field Sales Consultant; Dr. James P. Hoekwater, Dr. James C. Hoekwater, Dr. Andrew J. Hoekwater, Bill Smith, Equipment Sales Specialist; Rob Hulick, Regional Manager.

Featured Equipment:

Air Techniques ScanX

Dentrix

KaVo Quattrocare

Midmark Track Light Monitor

Pelton & Crane Ergo Soothe Massage Chairs

Dr. James C. Hoekwater
Dr. James P. Hoekwater
Dr. Andrew Hoekwater
Hoekwater Family Dentistry

It’s a “family affair” at Hoekwater Family Dentistry! Dr. James C. Hoekwater and sons, James and Andrew are all attending to the business at hand at their well-designed new dental facility in Wyoming, Michigan.

Equipment chosen reflected the projected demands of the office. Function, ergonomics, and integration were first and foremost with the Doctors. Reliability and low maintenance were also important factors. Also prominent in the considerations for the office was its ability to stand up to the regulatory requests of the U.S. Green Building Council’s Leadership in Energy and Design (LEED). LEED is the nationally-recognized standard for green buildings.
“It was exciting and challenging to meet the requirements presented to secure certification,” adds Dr. James C. Hoekwater. “The final outcome worked and feels pretty good.”

If you love relaxed and comfortable with a touch of Craftsman-style ambience, you’ll be right at home at Hoekwater Family Dentistry. Warm and welcoming, the waiting area offers wide-screen TV viewing in front of the beautiful, ceiling-to-floor stone-faced fireplace; the XBOX 360® for amusement; and your choice of beverages while awaiting treatment. Wide hallways, high ceilings, and large operatories and staff areas make the office’s traffic flow more easily.

The Doctors agree that the new environment makes coming to work fun and easy. The staff agrees it is exciting to be part of a new and growing health care environment without the old space constraints. The patients love the office—from the operatories with massaging chairs to the easy parking accommodations—it’s a hit over and over again!

“Find people you can trust to work with—and take your time planning,” advises Dr. James C. Hoekwater. “Because of our continuous relationship with Henry Schein Dental, we will be able to provide professional excellence and state-of-the-art technology in a comfortableenvironment for our patients now and in the future.”

The Dental Institute is located on the Midwestern University Campus in Glendale, Arizona. With 242 chairs and 99,000-sq. ft. of space, the facility is a monumental resource dedicated to the betterment of oral health care for a wide variety of patients
in the area. A feasibility study was begun in 2005 by the administrative team at MWU and, after studying the metrics, determined that there was significant need for a new dental school in the state of Arizona. Construction of the Dental Institute began in November 2009; was completed in
February 2010; and opened for operations in July 2010.

The focus of the Dental Institute is educationally based to train men and women entering the profession to provide comprehensive care. All faculty members are clinicians with from 12 to 40 years of clinical experience and will educate the Institute’s students with an emphasis on patient-centered delivery of quality dental care. The facility has 50 faculty members, 64 staff members, and a total of 111 student dentists, which is anticipated to double by June 2011.

The three-story building is based on a private-practice model, and is configured into 10 “suites” with 20 chairs in each suite for 200 operatories for general patient care; 12 operatories devoted to pediatric dentistry; an imaging center for X-rays;
2 surgical suites for dental implants and surgical extraction of teeth; 2 special needs operatories—one with a wheelchair lift; and 25 additional operatories dedicated to specialty care. All newly accepted patients are assigned to a suite and report to that suite for their care. Any financial dealings and future appointments are made in their assigned suites, which prevents bottlenecking at the reception desk in the waiting area.With patient care provided comprehensively by clinicians assigned to each suite, patients receive total care without the need to move to different areas for treatment. Just as in a private practice, complicated treatments are referred to the special facility housed on the lower floor of the Institute so all care is in one location.

“Midwestern University’s new Dental Institute has an efficient and innovative design that effectively supports its vision of success in providing excellent patient care while sustaining a top-quality learning environment that will help many aspiring professionals reach their goals each year.”

Several members of the administrative team had worked with specialists from Henry Schein Dental in the past and knew
the level of their expertise in supporting projects with dynamics such as would be required for the Dental Institute. From inception to completion, Henry Schein Dental’s Special Markets team interfaced with our local Henry Schein Dental group to develop plans that would perfectly fit MWU’s complex and diversified needs. Managing all aspects of this facility’s requirements demanded a broad spectrum of skills
and technical knowledge that is only seen during a project of this girth. Henry Schein Dental’s team of professionals included: Special Markets Regional Manager/Community Health Liaison Andrea Hight; Special Markets Manager Randy Kofron; and Special Markets Equipment Director Chuck Jenkins. Business Development Manager Keith Gauzza worked with Director of Schools John Bellero to set up essential supply orders for the facility.

“This was the first dental school to be established by Midwestern University,” notes Randy Kofron. “We made several presentations to University leadership…and were given the opportunity to review and comment on the design. We provided technical guidance, working closely with MWU’s leadership. Extensive research on technical issues was needed because of the project’s enormity. Our team worked in partnership with MWU to solve challenges that arose during the process—creating ways to develop more efficient and cost-saving approaches to equipment choices and construction demands.”

Since beginning its operations, the Dental Institute has provided over thirteen thousand appointments to patients, including periodontal care, fillings, root canals, implants, partials, and dentures. The impressive workflow and high level of efficiency during daily operations is a real asset to staff and patients. Without the restrictions of individual departments, patients are seen quickly. Materials and supplies needed for treatment are delivered to student doctors each day prior to the patient visit, preventing delays and reducing stress. Chair-side scheduling is a big plus—no waiting in line to make the next appointment.

“We are excited about being located in Glendale and appreciate the opportunity to provide quality dental care for the residents of the greater Phoenix area,” comments the Institute’s Assistant Dean Dr. James Pashayan. “This is a team effort to provide the best possible health care service to our patients. It is a pleasure to work with our faculty and staff and to see the educational growth and development of our students. As our next class enters, we will be able to increase the volume of patient visits. Our expectation is that we will shortly open an additional
120 chairs for treatment.”

Left to right: Front row–Dr. James Pashayan, Assistant Dean, Midwestern University College of Dental Medicine/Arizona;
Dr. Dennis Paulson, Vice President and CAO, Midwestern University; Dr.Kathleen Goeppinger, President and CEO, Midwestern University; Dr. Russell Gilpatrick, Dean, Midwestern University College of Dental Medicine/Arizona; Dr. Arthur Dobbelaere, Executive Vice President and COO, Midwestern University

Left to right: Second row: Randy Kofron, Southwest Regional Special Markets Manager; Kevin Upchurch, Regional Manager; Mary Kellar, Special Markets Manager; Andrea Hight, Special Markets Manager/Community Health Liaison
Left to right: Third row: Fernando Maldonado, Project Coordinator; Stephen Weyenberg, Regional Operations Manager; Steven Cardot, Project Coordinator Henry Schein Dental

“Midwestern University’s new Dental Institute has an efficient and innovative design that effectively supports its vision of success in providing excellent patient care while sustaining a top-quality learning environment that will help many aspiring professionals reach their goals each year,” notes Randy Kofron. “Henry Schein Dental is proud to have been an integral part
of this project. The facility is beautiful, functional, and technologically ahead of the curve. It is well equipped to serve its community, students, and faculty for many years to come.”

Featured Equipment:
Biolase Lasers
DEXIS Digital Sensors
DEXIS Intraoral Camera
E4D Dentist
Gendex 9200 Digital Panoramic
i-CAT 3D Cone Beam
Midmark Chairs, Units and Lights

By Walter Chitwood, DDS

There are certain pieces of equipment, like my cell phone, that make me wonder how I ever got through a day before I owned one.
I feel the same way about my Gendex medium-field-of-view CBCT. The convenience of having access to 3D and the information that it produces is priceless. Unquestionably, I would not go back to practicing implant dentistry without the GXCB-500™.

CBCT scans are a very valuable element of an uneventful implant experience. Prior to my investment in 3D, I had to compensate for the inherent distortion of 2D pans; we were never able to truly check trajectory, width, and bone density. Often, I would treatment plan to place a certain size implant. After verifying the case with 3D, larger or smaller diameter implants were actually indicated.

The 3D view dramatically increases acceptance of implant therapy. In the past, the first time that I would present treatment to patients, they would need time to try to understand the concept. Only 25–30 percent made a decision for treatment on the first visit. These days, we are experiencing about a 60 percent acceptance rate on the initial visit, and a
75 percent overall. Why? We are able to show patients their own case in exact 3-dimensional images with implants in place. Prior to 3D, we relied on photos of other completed cases (and their imagination) to describe their procedure and outcome. Now, we are able to show each patient their own case, non-distorted, and in three dimensions. The Anatomage Invivo5 software shows the exact implant location. This creates a clear understanding of the procedure and its benefits to the patient.

Appointment times are also shorter—about 50 minutes from the time the patient is seated until the proposed treatment presentation. Before 3D, it took at least an hour just to gather the information—including a panoramic X-ray, patient examination, study models, etc. We would then reappoint the patient for a report of findings and consultation. For my out-of-town patients, the second appointment was especially inconvenient. Not only do my patients appreciate the convenience of fewer and shorter appointments, my referral doctors are also pleased that we are able to start surgery by the next appointment.

The following case illustrates the benefit of CBCT. We were the third opinion on a possible implant case for a 19-year-old who lost all of his lower teeth and sustained multiple mandibular fractures due to trauma. He had also lost much of his alveolar bone. The first dentist suggested implants and a removable appliance. The second dentist told them that an implant-supported fixed appliance was possible. We were the first to take a CBCT scan, which the patient had never seen, that showed a horizontal void in the symphysis area that had gone undetected by 2D radiography.

The previous two doctors’ plans would have been impossible without initial grafting to create adequate available bone. It would have been a grave surprise for one of the previous dentists to have started surgery, laying the flap for what was supposedly a “routine operation,” only to discover that he had to abort the operation and discuss a bone graft with the patient. CBCT totally transformed the treatment approach and instantly improved the patient’s confidence in our abilities. Rarely a day goes by that we take less than two or three CBCT scans for implant cases. The GXCB-500 gives me invaluable information and communication with patients and colleagues—an integral part of my growing implant practice.

By Jason Lipscomb

As you probably know by now, social media is the hot new topic in dentistry. The opportunity to take control of your online destiny holds multiple possibilities for the practicing dentist. The most effective form of dental marketing, word of mouth, has taken on new life with the likes of Facebook, Twitter, YouTube, and Foursquare. So how do you implement this new technology in your office? Last quarter we explained social media in a general sense. Now we will start to break it down and get into specific practices for social media.

Let me recount a real life social media occurrence that happened this morning that tied in several types of social media platforms. Every morning I do a quick scan of my social media profiles on Facebook and Twitter. This morning several people used a service called Foursquare to “Check in” to their office. Checking in involves visiting the Foursquare Web site, finding an establishment from a list of those nearby (using GPS technology of the phone), clicking that establishment, and leaving a comment. In essence this check in is saying “I am here now” and “this is what I think about this place”

Their “checking in” then shows up on my Twitter feed and I can see who is doing what and where. You are probably asking, “ How does this help a dentist?” I now know who works down the street and that they are active in social media. The fact that they are active means they may be more responsive to social media contact. I then went over to the ad center on Facebook and constructed an ad for the company down the street.

I find out that 400 people who work there are on Facebook. I can now target advertising to 400 people at a reduced cost instead of using the “shotgun” approach of traditional advertising. The saturation level will be very high with these 400 people – and the price will be kept low due to the
small numbers.

As you can see, different types of social media can give you insights into your advertising. Foursquare tells me where people are and what they are doing. Twitter spreads this information out to people that wouldn’t ordinarily know this information. Facebook then allows me to reach out to these people in a nonconfrontational way and get them in the office. Pretty amazing. So lets talk about some real world implementation of social media. We will start with Facebook.

Facebook recently reached 500 million users. Users in every age range, class, color, and creed have joined Facebook. Over 50% of the entire US population has a Facebook page. Let’s look at this from a marketing standpoint. Does any one television channel, radio station, or newspaper reach 50% of the population for over an hour a day? This may have happened in the 50s, but not today. Traditional media is so fractioned that no one outlet can reach out to the majority of the population. Look at the information Facebook gathers about its users. They have birth dates, E-mail addresses, place of work, interests, known associates, education, and the list goes on. They can use this information to effectively target marketing.

Once you have a thriving Facebook page, stay active. Post something at least twice a week.

When starting Facebook as a dentist, the question of privacy comes up quite often. Many dentists want to protect their privacy but still gain visibility for their office. There have been several news stories about privacy breaches within Facebook. Most of those breaches were not breaches at all. The users did not change their privacy settings. They left all of their information out in the open for the taking. It is quite simple to change privacy settings and should be the first thing you do when you start working with Facebook. Privacy settings can be set where no one can find you and they cannot see what you post. They can be set to remove your name from the Facebook search. In essence, you are a Facebook ghost. Facebook only really requires an E-mail address and a birthdate to start a personal profile. You don’t even need a picture. The initial profile for a Facebook account must represent a real person and not a business. Fake names are not permitted. California has even outlawed falsified profiles.

Dentists should create their own Facebook profile even if they don’t plan on running a social media campaign. They will need to use this profile to claim ownership of all social media efforts. The dentist should have complete access to any profile and retain all passwords. Imagine if a staff member has all the passwords and controls a Facebook presence and then leaves on bad terms. Who controls the Facebook presence of the practice? You guessed it; the angry ex-staff member.

Dentists should also have personal profiles because building a Facebook presence usually starts with friends and family. It always helps to get the ball rolling with people that you know. Once a personal (initial) page is established for the person or persona, a business page can be created. The business page must be managed by personal profiles and will be admins of the page. A business page can have multiple admins. Many dentists have their staff run the page as admins. The page must be created from the dentist’s personal profile so they are the original admin and can never be removed. The business page will be the best representation of the practice on Facebook.

Many people ask, “What do I post on our practice business page?” The answer is “everything!” Start out by informing people about your practice. Share links to your Web site and your local search profiles. Google will provide you with a link to your profile from the search result. Links to blogs make great material for sharing. They add a little spice to your links because the topics are always changing, but it is your own material. Pictures also make for great business page fodder. Pictures naturally catch the eye and users can actually “tag” people in the picture. Users can also be tagged in videos as well. Videos are one of the most powerful things that you can post on Facebook. A video can really tell a story about your practice and can pack in a lot of information. Many dentists have had success answering frequently asked questions in video format, recording patient testimonials, and using videos to teach. The use of portable video recording devices has made recording videos easier than ever. The Flip camera can record videos quickly and upload them to the Internet in a flash. When it comes to subject matter, think about what you already know. Think about questions that people ask all week in the dental office. In fact, write them down as they happen. This will help you write content later on. Many of us get the same questions over and over, “Will bleaching work for me?”… “Are tooth-colored fillings better than silver?”…and the most recent topic…“Are we getting too much fluoride?” Use these hints to post good content. Write a blog post, record a video, or take a picture to illustrate then post it on Facebook. Save excess content for a rainy day. Twenty photos of your office should be released a couple at a time over a period of time. This will make it easy to always have something to post.

A Facebook page should never be a replacement for a Web site, but it does have some advantages over a website. A Web site visitor will come in; look around; and hopefully make an appointment. Most often they will visit and go without leaving a trace. When someone becomes a fan of a page on Facebook they have opened a line of communication. Any time a new post is added to the business page, people who like the page will be updated.

Building a fan base is the next big step when building a Facebook fan page. Start out by “advertising” your Facebook page at your office. Put up signs or posters about your page on Facebook. Add links to your Facebook page in your E-mails and on your Web site. Facebook has several great tools that you can add to your Facebook page at http://www.facebook.com/badges/. Chances are, over half of your patients are on Facebook, and so they should be happy to connect with you there.

Once you have 25 Likes on your Facebook page, claim your vanity URL. A vanity URL is the Web address of your Facebook page, i.e., www.facebook.com/dentistrichmond. The URL can be claimed at http://www.facebook.com/username. Try to claim a name that is rich in the terms that people use to search for a dentist in your area, i.e., “Boston dentist” or “Cleveland dentist.” The URL is the first thing Google sees so a well-designed URL may appear in search engine results. A custom URL will also be much easier to share on business cards and Web sites. It will also be easier to remember.

Try using Facebook ads. As we mentioned before, Facebook ads can be targeted to very specific audiences. A recent study showed that Facebook ads were the most effective way to gain more “Likes” for a page. Remember, a Like means an open line of communication with a patient or potential patient. You can also use Facebook ads to direct people to your Web site or reputation software. Facebook ads are paid, so be careful and set a reasonable budget before getting started.
Once you have a thriving Facebook page, stay active. Post something at least twice a week. An easy way to do this is to use an application named “Networked Blogs.” This Facebook add-on imports your blog automatically to your Facebook page. Your weekly blog can now go directly to your Facebook page. Another great application to use is Tweetdeck (http://www.tweetdeck.com). This program allows you to update multiple social media profiles from one interface. It is a great tool for those using Facebook and Twitter. Make your Facebook page give value to your fans. Give them good information even if it isn’t your own. Make them feel that it is to their advantage to join your page.

Many people don’t realize that the profile picture for the page is a big part of the first impression. The picture can actually be up to 180px X 540px. This is a large picture! Always use a smiling face in the profile picture. Potential patients will make more a connection with a person rather than a logo or a building. Many people create a composite picture that shows all three. Remember to always have a person in the picture, even if it is a group shot of the staff.

These are some of the basics of Facebook business pages. More in-depth instructions can be found in “Social Media for Dentists” at http://www.socialmediadentist.com/book.php.

People have many choices when it comes to dental health care. Why does someone choose one dentist over another? How can you help them choose your practice?

To understand this, let’s examine how we make choices in the first place. Our perceptions dictate our actions. This means that how a potential patient perceives your practice will dictate any actions they take in accordance with your practice. If they perceive you as a better alternative then the competition, they will choose you; if they don’t, they will choose someone else. It is therefore critical to convey the right information about your practice to create the correct perceptions. So how can we do this?

If they perceive you as a better alternative then the competition, they will choose you; if they don’t, they will choose someone else.

Let’s look at how the average patient perceives dental practices in the first place. Currently, to most patients, dentists are all perceived to be the same. It doesn’t matter if they choose one dentist over the next because they feel they will basically get the same results. From a clinical standpoint, it is very difficult for the average patient to tell the difference between you and the next dentist. They really do not know if the filling in their mouth is of the highest quality or something less. From an experiential standpoint however, every dentist is, and will be perceived differently. This is true because every practice has different personalities, priorities, values, and aesthetics. This is why most patients determine their loyalty to a practice based on the experience they have while in the practice.

This means that when conveying a message to potential patients, you should focus on the unique experience you provide in your practice, which should also reflect your strengths. Creating a message based on the experiences and strengths unique to your practice allows potential patients to more quickly relate to you; understand why your different; and decide if you are the right type of practice for them.

There are other important benefits to advertising the unique strengths of your practice. Great messaging acts as a filter to bring in the ideal patient for your practice. Great messaging means that you are most likely attracting those patients who want your unique experience and, as a practice, you are able to better meet the expectations of your patients because they are based on your strengths. Keep in mind that your marketing sets expectations and how well you meet those expectations will determine the level of happiness of your patients. Only happy patients will give referrals. You can see that the way you set expectations and tell your story with your initial marketing efforts will ultimately determine the effectiveness of your referral program.

Let’s summarize:

1. Define who you are. Understand your true strengths and build a messaging strategy around them.
2. Deliver an external message that reflects your core strengths and sets correct expectations.
3. Ensure that internally you are constantly striving to exceed the expectations you set with your external marketing efforts.

For more information, or to build an effective strategy for your practice, contact Dental Branding at 866-375-5511 or at www.dentalbranding.com.

Douglas Sligting is the president of Dental Branding. He and his company work with dentists throughout the country, delivering smart, strategic marketing solutions that help them attract ideal patients and reach their growth goals.

By Dr. Charles Blair

1.D1352 Preventive resin restoration in a moderate to high caries risk patient – permanent tooth

Conservative restoration of an active cavitated lesion in a pit or fissure that does not extend into dentin; includes placement of a sealant in any radiating non-carious fissures or pits.

After January 1, 2011, dental teams can report D1352 if the following criteria are met:

1. The patient has had a risk assessment performed and is classified as moderate to high caries risk;
2. Decay that does not extend into the dentin is removed from a permanent tooth;
3. A composite restoration is placed; and
4. A sealant is placed over any remaining non-carious fissures

or pits on the occlusal surface.

Also note:

• D1352 involves a conservative cavity prep by the dentist.
• The placement of a sealant is included in D1352 and should not be billed separately.
• It is not appropriate to report D1352 if there is no active decay in the enamel, if decay extends into the dentin, or if performed on a primary tooth.

Reporting and Reimbursement Considerations

Dental carriers are expected to carefully monitor the reporting of D1352 because of concern that this code has the potential for abuse similar to claims submitted for multiple one-surface posterior composites—especially for children with no history of caries. Some dental plans are expected to pay an alternate benefit of a sealant, while others are expected to establish a separate allowable fee that will be more than a sealant but less than a one-surface posterior composite restoration. Carriers will likely require a narrative citing the risk factors that qualify the patient as moderate to high caries risk if it is not obvious from the patient’s claims history. Keep this in mind whenever a patient’s dental plan changes.

Note the Difference

2. D3354 Pulpal regeneration – (completion of regenerative treatment in an immature permanent tooth with a necrotic pulp); does not include final restoration

Includes removal of intra-canal medication and procedures necessary to regenerate continued root development and necessary radiographs. This procedure includes placement of a seal at the coronal portion of the root canal system. Conventional root canal is not performed.

Pulpal regeneration is performed on a non-vital permanent tooth with incomplete root development, necrotic pulp, and open apex. The tooth is opened, the pulp space disinfected, intra-canal medication placed, and temporary cement is used to seal the canal. Once regeneration and healing are complete, placement of a coronal seal completes the procedure, and the tooth is ready for final restoration.

The goal of pulpal regeneration is to recreate vital pulp and generate continued root maturation and development in order to avoid root canal therapy. Since the procedure often requires multiple visits and applications of intra-canal medication for successful outcomes, the visits are coded as follows:

Reporting and Reimbursement Considerations

Carriers are expected to pay the final visit for pulpal regeneration (D3354) at a fee similar to that paid for the final visit for apexification (D3353). Initial diagnostic radiographs may be billed separately. However, working radiographs are included in the apexification and pulpal regeneration codes.

3. D5992 Adjust maxillofacial prosthetic appliance, by report

No procedure code has been available in previous editions of CDT to report post-delivery adjustments to a maxillofacial prosthesis, which may need adjustments for a variety of reasons and at differing intervals following initial placement. D5992 should not be reported for adjustments to removable
partial or full dentures. It should only be used to report adjustments to a maxillofacial appliance (such as an obturator).

4. D5993 Maintenance and cleaning of a maxillofacial prosthesis (extra or intraoral) other than required adjustments, by report Maintenance and cleaning of a maxillofacial prosthesis.

5. D6254 Interim pontic

Pontic used as an interim restoration for a duration of less than six months when a final impression is not made to allow adequate time for healing or completion of definitive treatment planning. This is not a temporary pontic for routine fixed partial denture restoration.

This code was requested to report an interim pontic when the clinical conditions and healing requirements of the patient necessitate a provisional pontic of less than six months. The CRC (Coding Revision Committee) originally denied this request, but the request was approved during the appeals process since the need to place an interim fixed partial denture is not an unusual circumstance and the six-month threshold in code D6253 appeared to be arbitrary.

Reporting and Reimbursement Considerations

D6254 should not be confused with D6253—a provisional pontic used for at least six months or more. D6254 should also not be reported for a routine temporary pontic that is placed during a routine fixed partial denture (bridge) procedure.

Note: D6254 is the companion code for new code, D6795 – interim retainer crown (used less than six months).
Some dental plans will pay for a non-routine provisional bridge
placed in the anterior region during implant integration. However, dental plans often specifically exclude temporary, interim, or provisional procedures. Others may deduct the amount paid for the provisional procedure from their reimbursement for the permanent restorative procedure.

6. D6795 Interim retainer crown

Retainer crown used as an interim restoration for a duration of less than six months when a final impression is not made to allow adequate time for healing or completion of definitive treatment planning. This is not a temporary retainer for routine fixed partial denture restoration.
D6795 is used to report an interim bridge retainer when the clinical conditions and healing requirements of the patient necessitate a temporary bridge for less than six months. This code should not be reported for a temporary bridge retainer that is placed during a routine fixed partial denture (bridge) procedure. In other words, if you have taken the impression for the permanent fixed partial denture, this code should not be used.

Reporting and Reimbursement Considerations

If the interim bridge is placed for a patient and healing or completion of other procedures is expected to require at least six months or more, report D6793 – provisional retainer crown. Note: D6795 is the companion code to D6254– interim pontic.

As previously mentioned with D6254, some dental plans will pay for a non-routine provisional bridge placed in the anterior region during implant integration. However, dental plans often specifically exclude temporary, interim, or provisional procedures. Others may deduct the amount paid for the provisional procedure from their reimbursement for the permanent restorative procedure.

7. D7251 Coronectomy – intentional partial tooth removal

Intentional partial tooth removal is performed when a neurovascular complication is likely if the entire impacted tooth is removed.

8. D7295 Harvest of bone for use in autogenous grafting procedure

Reported in addition to those autogenous graft replacement procedures that do not include harvesting of bone.

Existing bone graft codes D7953 and D7955 do not include
harvesting the bone. D7295 can be reported in addition to
D7953 when harvesting a patient’s own bone (autogenous) for a ridge preservation graft or when repairing a maxillofacial hard tissue defect (D7955). It may involve harvesting bone from the mandible or maxilla or from a distant site such as the iliac crest or other appropriate sites, where the surgeon makes an incision over the donor site, elevates a flap, harvests bone for grafting, and closes the wound. D7295 may not be reported with D7950 (osseous, osteoperiosteal, or cartilage graft of the mandible or maxilla – autogenous or non-autogenous, by report) or D7951 (sinus augmentation with bone or bone substitutes) because the descriptors for each of these codes specify that obtaining the bone is included in the procedure code.

Coding with Confidence: The “Go-To” Dental Insurance Guide (CDT-2011/2012 Edition) Henry Schein, Inc. Item Code (367-7233)

This is a unique reference guidebook that goes beyond the typical “list and describe” coding handbook. This book was developed using information compiled from thousands of interviews with doctors and staff just like you, and uses PREDICTIVE ERROR
CORRECTION™ technology to help predict common mistakes before you make them!

Now that we are well into the New Year—has anything changed? Have you kept your new year’s resolutions; eating better, drinking less, are those unwanted extra pounds gone from your frame? How about your dental practice; have you carried through on your ideas to improve your practice and the level of care you provide to your patients? Maybe you don’t plan on changes and are ok with complacency, but dentistry constantly changes and our patients constantly change, not only their dental health needs, but also their knowledge of the care they receive.

The Internet and social media are powerful tools for our patients to learn and educate themselves about dentistry and technology. We must be ready to change the way we provide care to our patients and we must constantly evolve as we practice. Now I know some of the principles of dentistry are set in stone and provide a great foundation year in and year out, but technology changes and constantly improves, which allows us to improve and provide better care for our patients. I believe change is good. Every January, I sit myself down and make a list of how I can improve my skills, improve my practice, and improve the dental care provided for my patients. Some of the typical ideas that come up year after year are great, but never instituted and some ideas are duds. Some of the duds include: changing our hours to accommodate our patients (this never works); buying supplies on the Internet (the deals never are as good as they sound); and service (there is none). However, some ideas are great ways to improve our practices, like attending innovative continuing education classes or looking at new equipment—you can only put so much duct tape on a dental chair! Then there is technology, I believe:

• New technology is what our patients expect
• New technology is what makes dentistry better
• New technology is what makes dentistry fun

Each year we look at new technology and how it has improved; if the price has dropped; or if it really works. One technology that continues to be in the forefront of dentistry is the clinical use of the laser in dentistry. The efficiency of lasers cutting hard tissue (Class 1–6) is now comparable to high-speed handpieces without the damaging side effects. The scope of procedures they can be used for covers the entire dental spectrum and prices are now in the realm of every dental office. So why do so many dentists continue to put off what I believe is the standard of care in dentistry? Being a dentist for 25 years, I believe I know some of the answers to this question, one of which is the fear of change, how we can overcome this fear of change and possible technological failure.

Advances in laser technology make this the best time to introduce this technology into your practice and make this your best year ever.

So let’s take a few minutes to look at what drives a dentist to technology, what dentists fear about technology, and how lasers can help improve the quality of care we provide for our patients. I believe every dentist can benefit greatly from laser technology and I will outline how they can accomplish this and improve their bottom line. Being a dentist and having trained thousands of dentists to use lasers, I can offer a unique perspective on how lasers can change your practice this year.

I believe most dentists (most people) are a little scared of change. The old adage, “if it isn’t broke, don’t fix it” still resonates in many offices. This leads to complacency, or a certain comfort level, but often a certain comfort level leads to the same frustrations over and over, e.g., the inability to achieve a great crown impression because of excess tissue or subgingival margins or the inability to properly fill and contour subgingival class V’s. How we treat periodontal disease and our endodontic predictability also can cause stress in the daily practice of dentistry and the ever-evolving challenge to provide the best esthetics in our cosmetic procedures can sometimes be difficult to achieve. We know there are ways to improve patient care and the most versatile way is by utilizing lasers. Laser technology levels the playing field, giving us the ability to perform numerous procedures to supplement the tools we use on a daily basis. Examples of beneficial laser procedures include:

• Tissue contouring and crown lengthening with minimal bleeding or tissue damage.
• Exposing subgingival margins to make crown & bridge impressions become more predictable.
• Cosmetic recontouring to provide extra special esthetic results.
• Adjunct periodontal procedures to provide a new level of treatment of periodontal disease in a less invasive, patient-friendly way.
• Laser endodontic disinfection techniques, which have been shown to greatly enhance the disinfection of the apical 1⁄3 of the canal.

More and more everyday procedures can be performed with a laser, but perhaps the greatest breakthrough in laser technology is hard-tissue cutting. Lasers have achieved the coveted “as fast as a high-speed handpiece” distinction. In most instances, lasers can cut enamel and dentin with the same efficiency as a high-speed, with minimal or no local anesthetic required.

Having taught thousands of doctors to use all tissue lasers (YSGG), I can say most are skeptical about cutting speed when we start their training, but convinced of their capabilities when we finish. The most common response after cutting their first prep on a patient is “it cuts a lot faster than I thought it would.” Having overcome this hurdle and seeing all the everyday applications lasers have in the dental office has brought lasers time and time again to the front of the list of most desired technology a dentist would like to add to
their practice.
With lasers becoming more affordable, what then is still holding some dentists back from incorporating laser dentistry into their practice? I believe it is a fear of change. All dentists have this fear—some just overcome it a lot easier. Lasers are safe, easy to use, the learning curve is not difficult at all and the benefits are so numerous that we can’t continue to overlook this technology. Add the fact that our patients love new technology and want to be part of it and you have a win-win situation. A technology that allows us to do more procedures (less referrals) more efficiently (multiple quadrant dentistry without anesthetic) and impress our patients (restorative procedures on young children without an injection) is amazing—and is available right now.

Now that we are well into the new year, and our promises to ourselves have largely gone away, I feel it’s time to time to get to work and think about the promises we have made to our patients—to continuously provide the highest level of dental care and, to ourselves—to continue to learn and be open minded about new technology, to educate ourselves and most of all remove the complacency that we sometimes fall into.
I believe dentists are some of the most compassionate people on this planet and constantly thrive to provide the best possible treatment for their patients, but sometimes we need a little push; we need a little change—laser dentistry can provide that change. Advances in laser technology make this the best time to introduce this technology into your practice and make this your best year ever. Just remember, sometimes a little change
is good.

Dr. Michael Koceja has trained thousands of dentists and hygienists on the incorporation of lasers into their practices. His everyday realistic approach cuts through the hype and concentrates on the numerous ways lasers can benefit dentists to provide a higher level of care for their patients. Dr Koceja can be reached at mkoceja@comcast.net or
760-500-6189 and gladly welcomes your questions and comments.

The field of orthodontics is continually evolving. When I went to dental school, no one wore magnifying loupes, and now, that is standard in most dental offices. Similarly, when I went to orthodontic school, no one had in-office 3-D. But, now that I have an i-CAT^® in both of my offices in North Texas, I wouldn’t dream of doing without it—it’s just that useful.

Since I implemented Cone Beam technology, I repeatedly have been asked if there is one case that “saved the day” that justified my investment. My response is that it just doesn’t work that way. Although there are cases that I was able to detect problems earlier, it is the day-in and day-out improvements in the practice that make the difference for me.

There are times when I utilize panoramics. However, when I choose my 3-D imaging option, I don’t guess about what is happening with the eruption of permanent teeth, especially in the case of impactions. Parents appreciate that I have this leading-edge technology that provides more complete data. Before I enter the treatment room, the patient’s 3-D volume is up on the screen. Usually, patient and parent are already talking about the image that they see on the screen; when I join them, I can rotate and slice the 3-D virtual model, and change the translucency to take away the bone and just show the teeth. In the case of an impacted cuspid, I can isolate just that area to view the impacted tooth and surrounding structures. Besides assisting me in determining the best course of treatment, this technology is excellent for communications—parents better understand their child’s condition.

In the full volume, I can see the teeth in a one-to-one (accurate) ratio. With root shortening, I can measure and see the extent of resorption. Often, 2-D images cannot provide the data supplied by a 3-D scan. For example, frequently, flared teeth appear on a 2-D image as root shortening; however, on a 3-D rendering, I can tip the skull down and see that really is not the case.

Without the CBCT information, there were times when I would have halted treatment on such cases, but because I have a one-to-one ratio, I can determine more precisely when the condition warrants stopping treatment. Recently, I extracted a bicuspid and started to retract the cuspid, and after several weeks of attempting to distalize, I realized it wouldn’t move. I reviewed the initial 2-D pan, and nothing suspicious was visible. I took a CBCT scan and saw a dense radiolucent mass at the apex of the cuspid. A biopsy showed that the mass was a florid osseous dysplasia. I would have never seen the real cause without the 3-D scan.

The i-CAT’s collimation function gives me several field of view options to choose from. The 5-second scan exposes the patient to a lowered radiation, and allows me to see just enough of the skull and nasion for a ceph view. Usually, that is all I need. The “bread and butter” of having the i-CAT is being able to communicate my plans to my patients and share information. Sure, it is very satisfying to find unusual conditions, but the benefits that patients receive every day from the 3-D images captured by my i-CAT, makes the orthodontic experience for me and the patient so much better.

Greer, South Carolina

Check out Dr. Roger M. Harris III’s new office! This office displays some of the latest technologies available in today’s dental industry, including the 3M LAVA C.O.S digital impressioning system and the new Cubex 2000 Inventory Management System.

Dr. Roger M. Harris

As small business owners, dentists have the same concerns that any company might—along with the specialized clinical demands of an oral health care provider. When all the elements dovetail perfectly, Doctor, staff, and patients reap the benefits of the best that modern dentistry has to offer.

In November 2010, Roger M. Harris III Family Dentistry relocated from Greenville to Greer, South Carolina to pursue a re-energized vision for the practice. With the old office’s lease coming to an end and the need for more space and better visibility—the time had come to move toward a whole new dimension for the business. What took shape gave everything that great design and planning and new technologies could deliver—superior ergonomics, enhanced potential for treatment options, the ability to successfully expand the patient base, and more stress-free workdays.

A unique and eye-catching Craftsman-style building is the new home of Dr. Harris’s practice. Natural stone, roofline wooden brackets, and porthole and Palladian windows are just some of the charming architectural details that define the exterior. Interior design elements include modern, dark wood furniture, marble countertops, and carpeted floors in the reception area and hallways, producing the relaxed feel of a living room. There is a coffee bar and wall-mounted TV monitors with easy viewing for patients who are awaiting treatment.

“During the creation of my new office, I worked with my Sales Consultants to troubleshoot many aspects of the process,” points out Dr. Harris.

The clinical spaces include 6 operatories; glass quiet rooms used for sedation; a stericenter; and Cubex station for inventory control. Product lines were chosen from Pelton & Crane, Dentrix, KaVo, Air Techniques, SciCan, Lava COS, and Biolase. All the operatories are equipped the same to facilitate convenient treatment. “The equipment chosen was the best all the way around for Dr. Harris,” notes Equipment Sales Specialist Stephen Raley. “He wanted a high-end, low-stress environment…Pelton & Crane had everything he needed. Field Sales Consultant Kirk Greenway also assisted in the creation of the office. It’s a great showpiece. A very nice-looking office with lots of high-tech equipment!”

Henry Schein Dental’s Sales Specialists stay on top of the latest industry changes and patient trends, using that knowledge to develop state-of-the-art planning for dentists who look toward upgrading their practices to fulfill their business goals.“During the creation of my new office, I worked with my Sales Consultants to troubleshoot many aspects of the process,” points out Dr. Harris. “We reviewed what I liked about the designs and what I wanted to change. Stephen and Kirk sat down and listened to my concerns and what I hoped to achieve in the office. I also went with Stephen and Kirk to a Pelton & Crane’s VIP course, ‘Driven to Excellence,’ which helps you uncover the elements that will support your practice’s growth.”

Left to right: Becky Harms, Pam Lassiter, Dr. Roger M. Harris III, Trey Harris, Letitia Skinner, Renee Wooten, Lisa Furmanek, Sarah Kirby, and Julie Pierce.

Left to right: Equipment Service Technician Britt Surles; Equipment Sales Specialist Stephen Raley; Dr. Roger M. Harris III; Field Sales Consultant Kirk Greenway; Digital Technology Specialist Tom Hindmarsh; Regional Manager Russ Baker

Designed by: Tom King, Henry Schein National Design Group

With the office’s vision projected and reinforced by its investments in modern technology and the latest in patient treatment options as well as an environment that caters to the comfort of clients and staff, the mood is upbeat and positive. The practice’s new patient count went from 25 to 60 in just one month. “Referrals are tremendous,” notes Dr. Harris. “Don’t be afraid of change…get connected with your
Henry Schein Sales Specialists…I could not have done this without them!”

Featured Equipment:
3M LAVA C.O.S
Accutron Digital Flush Mount Flowmeters
Air Techniques Polaris Intraoral Camera System
Air Techniques Spectra Caries Detection Camera System
Biolase Waterlase MD
Cubex 2000 Inventory Management System
Dentrix Practice Management System
DEXIS Digital Sensors
Gendex Expert DC Intra Oral X-rays
KaVo COMFORTdrive Handpiece System
KaVo Quattrocare Maintenance System
Midmark M-11 Ultraclave
Pelton & Crane Solaris Sterilization System
Pelton & Crane Renaissance 12 O’clock Cabinet
Pelton & Crane Renaissance Doctor Side Cabinet
Pelton & Crane Renaissance Assistant Side Cabinet
Pelton & Crane 3003 Chair w/ Ergo Soothe Massage Feature
Pelton & Crane 3800 Rear Delivery
Pelton & Crane Helios 3000 Light
Pelton & Crane Doctor Stool 2003
Pelton & Crane Assistant Stool 2004
SciCan Hydrim Instrument Washer 24
Soredex Novus Digital Panoramic

By Tom L. Snyder, DMD, MBA

Now that it’s 2011, some of you may be reflecting on how your career will end.
If you are thinking of a practice transition in the next five years, today is a good time to get started. This article will look at 5 key points that you should consider and act on to maximize a successful transition.

Look at The Big Picture
1. Can I afford to retire?
When wanting to retire collides with being able to retire, the outcome can be devastating. Enlist the services of a financial planner to quantify the answer through a retirement income need analysis, which will project what you will need to live comfortably, for how long, based upon your current assets. If a shortfall is uncovered, plan now so you can make adjustments to your lifestyle or income before it’s too late.

2. Will anyone buy my practice?
The condition of your physical plant will either help or hinder your ability to sell. If your practice has a worn out look, and if your equipment is old, finding a young dentist willing to buy could prove difficult. If you are going to practice five years or more, consider updating equipment, or updating your office through smart interior decorating. You will receive tax breaks for Section 179 expense or depreciation, as well as recouping some of the value when your practice is sold. Remember that in an urban or suburban area, competition will be fierce for buyers. Enhancing your physical plant will help you compete in the long run. For practices located in small towns or rural areas, more time is needed for recruitment of potential candidates since the number of potential purchasers is far less than in Metropolitan or Suburban areas.

3. Am I up to date with technology?
If you are one of the 10% of dentists who do not have a dental software program and you plan to practice at least two years, make the investment to automate. Most purchasers are skeptical of a practice’s potential if computer records cannot be accessed or generated. Generally speaking, investing in clinical technology is only worth it if you can derive benefit from it immediately.

4. How efficient and profitable is my practice?
Building up your practice before retirement is not counter-productive. In fact, increasing your net income for the years leading up to the sale of the practice may increase the value of your practice quite handsomely as well as possibly provide more funds for your retirement plan. Most practice’s benefit from professional consulting and making that investment should provide good returns.

5. What are my real estate issues?
Since most solo practitioners own their office space, special consideration must be made for the majority of buyers who will not want to purchase the real estate with the practice. Most buyers will want to pay rent initially and then make a purchase after a few years of practice ownership. If a deferred real estate sale is part of your future, be sure that your Agreement of Sale for your practice includes a future purchase option, which allows a buyer the first right of refusal to purchase the building. Not being able to sell your practice and your office space may detrimentally affect your financial plan. Work with a financial advisor to allow for this possibility.

In cases where your real estate’s value is greater than the value of your practice, selling both assets together may create problems with funding for potential buyers. If a buyer cannot obtain funding for the down payment for the real estate transaction, you may need to become a landlord, until a purchase can be made. If so, be sure to charge rent that is comparable to other professional practices in your area. Set lease terms to a minimum of five years with a five-year renewal. This provides lenders with assurance that the tenant will remain.

Tom L. Snyder, DMD, MBA is the director of transition services for The Snyder Group, a division of Henry Schein. For more information, you can contact Tom at 800-988-5674 or e-mail Tom.Snyder@henryschein.com.

Clay Center Family Dental Care in Clay Center, Kansas operates its practice on a core set of values that includes honesty, excellence, teamwork, kindness, people first, and leadership. To ensure success, the practice chooses vendors that share those same core values.

That’s why for nearly 10 years Clay Center Family Dental Care has on the experts at Henry Schein to deploy, integrate, maintain and service the computer network and practice-management technologies that drive the efficiencies of its digital-based practice.

“When I began practicing dentistry in 1977 a computer took up an entire room. I never envisioned that my practice would some day operate in a completely digital environment. We couldn’t have done it without Henry Schein,” says Dr. Rick Hammel of Clay Center Family Dental Care.

Over the years, Clay Center Family Dental Care has grown from a small-three-chair practice to a multi-dentist practice with seven operatories in a 3,600-square foot building. “One of the main reasons we are able to grow our practice is due to the efficiencies we gained from going digital with solutions recommended by Henry Schein” says Nancy Hammel, Office Manager for Clay Center Family Dental Care. “Henry Schein continually exceeds our expectations as they care for our technology needs.”

Nancy Hammel adds, “As a dental speaker and as someone who is active in various online dental communities, I have access to many of the technology experts across the country. There are a lot of companies to choose from. We chose Henry Schein because they have taken such good care of us from day one.”

Dental-Specific Technology Expertise
Dr. Hammel and the entire team at Clay Center Family Dental Care rely on Henry Schein because of the solution provider’s decades of expertise and experience in designing, building and supporting integrated technology solutions tailored to the dental industry. “Most dentists believe in doing dentistry right the first time,” Dr. Hammel says. “Redoing procedures is unproductive and expensive. The same is true for technology investments. You want to pick a solution provider you can depend on and who does it right the first time. That’s what Henry Schein has done for us. Over and over, they have proven that they do it right the first time.”

In talking about how Henry Schein helped the practice move from a paper office to a digitally based practice, Nancy says, “It can be a stressful leap of faith to make the transition to digital, but it’s much easier when you can put your faith in someone with a good reputation, that you can depend on and that will walk with you through it step by step. Henry Schein will not let you down. They’re professionals you can trust.”

Giving Back with Technology’s Help
Clay Center Family Dental Care also appreciates the fact that
Henry Schein provides integrated and fully tested offerings that optimized their systems’ performance and increased uptime and operational efficiency. That efficiency helps the practice reach out
to those in need.

“When we are efficient and productive we are blessed with more freedom to give back to our community and to the world. Every year we go to Belize with the Belize Mission Project and donate dental care,” said Nancy. “Because of our experience in Belize we began our own mission here in Clay Center, the Clay Center Dental Mission.
On this annual day of providing dentistry to the community, we rely completely on the technology that Henry Schein has provided for us. At last year’s event, we saw over 77 patients in one day – something that could have never happened without digital solutions.”

“Henry Schein not only understands how to tie all of our computers and systems together, but they understand the intricacies of a dental practice,” Nancy said. “Having an integrated digital office reduces our overhead, increases our efficiency, and lets us be more productive. With everything tied together, anyone who is authorized can log in from anywhere in the office, at home, on the road, or even from a smart phone and access any patient’s information. With a
click of a button we can see their X-rays from yesterday or two years ago. I can schedule them for an appointment. I can see when they last visited and what procedures they had done. It’s a very efficient and cost-effective way to serve our patients.”

With Henry Schein, the Clay Center practice achieves efficiencies and cost savings without the worry of downtime that other practices often deal with. “We simply can’t afford to have our systems go down,” said Nancy. “Most businesses depend on technology, and dentistry is no different. Downtime affects your ability to care for patients. It affects your patient’s lives and it impacts your livelihood. That’s why we rely on Henry Schein. I don’t have to worry like I used to.”

More Satisfying, Efficient and Profitable Dentistry
To summarize how going digital and choosing Henry Schein Dental as its trusted team has benefited Clay Center Family Dental Care, Dr. Hammel stated, “Many dental practices do wonderful dentistry, but they’re not achieving their potential. In today’s economic environment you have to be efficient and you can’t waste time. With
Henry Schein’s help, our digital practice lets us be more efficient and more financially profitable. It also creates a more emotionally fulfilling environment for our patients and our entire office.”

About Clay Center Family Dental Care
Dr. Rick Hammel attended Kansas State University and graduated from UMKC Dental School in 1977. Nancy Hammel has a B.A. in French and Biology from Kansas State University. Together, the Hammels have built a successful and thriving practice that incorporates all facets of dentistry, including sedation dentistry. Their state-of-the-art facility was built in 2000 and continues to incorporate cutting-edge technology in their practice. Nancy is a former speaker for Dental Organization for Conscious Sedation and is an active contributor to DentalTown meetings and forums. To see how Clay Center Family Dental Care gives back dental care to the world’s underserved, please visit their Web site www.claycenterdentist.com.

Using search engine optimization and social media to win and keep customers.

by Lee Odden, CEO TopRankMarketing.com – TopRankBlog.com

Many small businesses have implemented a variety of online marketing efforts to attract new customers and increase overall sales with less than stellar results. The lure of the “next big thing” can create marketing inefficiencies when small business owners try to be a “jack of all trades and master to none.”

Consider these statistics: Google sites handle about 88 billion searches each month, YouTube is the second most popular search engine second only to Google, Facebook is now over 600 million users, Twitter has nearly 200 million accounts, LinkedIn is at 101 million users, and FourSquare grew 3,400% in 2010.

Dentist’s personal use social networking sites like Facebook approaches 71% and an increasing number of dental practices are starting to use Facebook, YouTube and Twitter for marketing or patient loyalty programs. But social media is new territory for most and as with many other industries exploring the social web, these are early days.

Small business marketing questions: The variety of options for customer marketing and engagement ranging from social media to SEO to E-mail marketing to online advertising can be overwhelming. As a result, some of the most common online marketing questions I hear from small businesses revolve around deciding which tactics are best; managing time across so many tactics; or the time needed to see results.

Answering these questions starts with a clear understanding of goals, customers, and a flexible online marketing strategy that assembles the right mix of tactics and measurement practices. Most companies are looking for more customers and to retain those they have, but the concern is how to do these things efficiently.

The answers: In the context of this article, a big part of the answer is through content marketing. If social media and SEO fit together like peanut butter and jelly (if you didn’t know; yes they do) then content is the bread that holds them together.

According to the Pew Internet Project, 80% of U.S. Internet consumers research health information online, followed only by E-mail and search engines. In fact, Forrester Research reports that 24% of U.S. online consumers engage in some form of health-related social media once a month or more.

Google sites handle about 88 billion searches each month.

The trend in search and social information discovery, consumption, and sharing behaviors of consumers are an opportunity for dental practices to become highly valued sources of information wherever their customers are looking.

Search engines favor high value content in the search results. Social media sites favor sharable, linkable content. A dental practice that combines smart social media and SEO tactics can create a competitive advantage for attracting new customers whether they search Google, Facebook, or blogs.

Some keyword homework before you start
With search or social media optimization, it’s important to empathize with the audience you’re trying to reach in terms of the language they use while searching and how they talk on the social Web.

YouTube is the second most popular search engine second only to Google

Optimizing a Web site for topics and specific phrases that customers rarely use, results in a waste of effort on your part and frustration on the part of the customer because they can’t easily find your content.

Keywords from a social media perspective involve discovering what customers are interested in and talking about on the social Web vs. deciding that for them by pushing traditional marketing materials.

Basic search engine keyword research can be done with free tools available from Google: http://www.googlekeywordtool.com

Enter the kinds of phrases that your customers use and the Google Keyword Tool will report back the popularity of those phrases and suggest related phrases to target. The process of doing keyword research should result in the creation of a keyword glossary, which is a list of keyword phrases in a spreadsheet.

Whenever new content is created online, the keyword glossary can be referenced to check keyword relevance and popularity so new information published to the web is of interest to customers that are searching. The process of looking up keywords to determine current popularity and variations should be repeated quarterly to stay current.

Social keyword research is a little trickier because there are no dedicated tools to provide what topics and phrases are most popular on the social web at large. However, there are tools like http://socialmention.com that offer a social search function by providing a list of keywords most often found in Tweets, comments, and other social content based on your query. The keywords can be imported into your keyword glossary spreadsheet for comparison to search keywords.

Social keywords might help you determine topics for Tweets, Facebook updates and content, tags used with videos and images, blog posts, and general names/titles of content and objects that you publish using social media Web sites. Doing so helps guide content that is of interest to those publishing similar content on the social Web.

Quick Tip: Your brand name is a keyword and worth protecting. Check your brand name with a site like http://knowem.com to make sure no one else is squatting on it. You can register accounts yourself or have the folks at Knowem do it for you.

Proven tactics to win the online marketing race
I say race, because in the online world, that’s exactly what it is. A continuous effort toward achieving marketing goals while the competition is doing the same thing. That might seem ominous, but think of it as something you spend a reasonable, scheduled amount of time on consistently. If you keep at it, and work smart, you will win.

Here are 10 content marketing tactics that small businesses can use in combination with SEO and social media to win and keep more customers.

1. Blog – A blog offers numerous social and SEO benefits. Blogs are very effective as the hub in a “hub and spoke” social media content model. The spokes of that model might be Twitter, Facebook, Flickr, YouTube, Foursquare, and other social media sites you’re participating on.

Facebook is now over 600 million users

Blog posts can focus on answering Frequently Asked Questions and topics of interest to patients. Create categories for each area of focus in your practice to serve as an editorial guide.

Schedule posts in advance to save time and encourage staff to comment and promote the blog on any other social sites you’re involved with.

You can find many “how to” articles on blogging at TopRank’s Online Marketing Blog: http://www.toprankblog.com/category/blogging/

2. Newsletters and E-mail Marketing–E-mail newsletters are great ways to connect directly with prospective customers offering tips and other content. A newsletter for existing customers helps reinforce the connection you have with them and can encourage referrals. A single newsletter can meet the needs of both lists with basic segmentation functionality and personalization features.

When publishing content on other social sites like Facebook, your blog, or Twitter, readers can be invited to sign up for your newsletter where they can learn more about your practice.

3. Media Coverage and Contributed Articles–Getting mentioned in the local business media and trade publications can boost awareness, credibility and directly generate new business.

To help make that happen, make a list of local business publications, writers, and editors as well as popular bloggers. Inquire with those Web sites about contributed articles or guest blog posts. Content off of your own site gives you exposure to a new audience and links from the author bio back to your Web site.

Visit industry blogs and make comments that add value, then follow up with more detailed, useful information. Provide “hooks” that give perspectives and insights not normally thought of. Stand out and tell a compelling story. Follow-up but don’t stalk!

Many of the relationships we have at TopRank Online Marketing with journalists came as a result of sending an E-mail offering 1–3 abstracts for potential contributed articles. Now many of those news sites contact us for quotes.

4. Resource Center–One way small businesses are beating their larger competitors in search and in building authority is to be a better resource for customers through useful content. Common formats for helpful information about buying, using and related information on products and services include articles, videos and podcasts. Think of it as an online encyclopedia for content and topics related to your practice.

Again, this is something you can build up little by little over time. Internal staff, outsourced bloggers, and copywriters can handle writing tasks.
An effective resource center will be keyword optimized, easy to share on social media site using embedded sharing widgets like http://sharethis.com and attract links from other Web sites. Keywords + useful content + links = search engine dominance.

5. Social Networks and Media–In the way that customers expect a toll-free number, Web site, and blog, they’re beginning to expect the businesses they engage with to be social. That means having a presence in the social networks that are most relevant to customers. Spending a small amount of time consistently on interaction and relationship building can go a long way toward developing a community.

FourSquare grew 3,400% in 2010.

The key is picking the right platform. It might be a LinkedIn group, Facebook Fan page, or a niche forum. Try out a social media monitoring tool like http://trackur.com to get an idea of which social Web sites might be good places to engage with potential customers.

Don’t be afraid to repurpose content. What you create on the newsletter, blog, and resource center can be modified and cross-promoted with social networking and media-sharing sites.

6. Local and Mobile Content–Although “fish where the fish are” ranks as one of the most over-used clichés in the marketing world, it’s important to recognize consumer trends toward mobile search with the proliferation of smart phones and tablet devices like the iPad. The Web experience has definitively extended beyond the personal computer and marketers must understand their customers’ use of mobile search and what the marketing opportunities are.
Make sure your Web site can be viewed properly on mobile devices and if you see a significant amount of traffic to your site (via Web analytics) from mobile, then you might consider creating a mobile-friendly version.

This tool can check the mobile friendliness of your site: http://validator.w3.org/mobile/ Keep in mind, it doesn’t need to be completely compliant to be useful to customers on their mobile phones. Also, most smart phones like an iPhone or Android can view Web sites the same as you would on a computer.

From a local perspective, for companies that serve customers in specific regions or with geographically specific needs, its essential those businesses are present in local search results, map results, and specific geo-location queries. That means making sure your business is properly listed with Google Places (http://places.google.com/business), Yahoo Local (http://listings.local.yahoo.com), and Bing Local (http://bing.com/Local) listings.

Be sure you take advantage of the opportunity to add content to local listings. In the case of Google Places, you can add images, video, and description content that will make your business stand out.

7. Video–If a picture is worth a thousand words, then a video is worth millions. A video highlighting your practice like the one Dr. Irena Vaksman posts on her YouTube channel http://www.youtube.com/user/DrVaksman can be helpful for patients in getting “to know” who they might be seeing.

Videos can also be used to demonstrate procedures, show patient testimonials, and highlight the personality of staff working within the dental practice. Videos hosted on sites like YouTube can be embedded within blog posts, extending their value as content.
As a small business, should you do all of these things? No, of course not. Wearing many hats and slim resources means all of these tactics won’t be practical. But you can start small and adapt with more or different content according to what’s working vs. what’s not. Just be sure to gain an understanding of what your customers’ information needs are, what topics and keywords are important to them, and how optimized content can fuel your social media strategy.

Over my years in practice, I have experienced several types of X-ray systems. As a military dentist, I used film X-ray for 21 years. When I opened my private practice in 2002, budget constraints led me to believe that purchasing a phosphor-plate system would be more economical. After discovering that image quality was lacking with the phosphor system, I made the decision to upgrade to a direct sensor.

I wanted to experience the system from my patient’s standpoint. Since patient comfort was a primary factor, I decided to try out the system on the most difficult patient I could think of—myself. Even though I am a dentist, as a dental patient, I am prone to gagging and drooling. To put the digital sensor to the ultimate test, I tried four different digital sensors by different manufacturers to capture a set of vertical bitewings and a few periapical images. The DEXIS sensor, with its rounded corners, was by far the most comfortable, and the image quality and software were also very persuasive benefits.

The transition to digital produced such dramatic image improvement that I was reminded of my mother’s reaction after having cataract surgery. She said, “I can’t believe I was driving like that.” The same is true about my switch to digital. This past summer, I upgraded to DEXIS Platinum sensors. Although I knew that some image quality was missing with both my film and phosphor systems, I can’t believe how much more clarity and detail DEXIS sensors bring to my practice.

Hear more about Dr. Chenet’s digital X-ray journey at http://www.meandmydexis.com

The clarity of the images improves my ability to diagnose dental conditions and helps me communicate that diagnosis to the patient.

For my staff, my DEXIS system is a win-win situation and a great time saver. Even though the phosphor-plate system takes less time to develop, it is still more time consuming than digital. My staff does not have to stop working with the patient and spend time developing X-rays, and they don’t have to clean the processor or be exposed to its chemicals. DEXIS images instantaneously pop up on my computer monitor. This speed is especially critical when doing certain procedures; for example, when doing endodontics, if I want to verify a length, the information is there, with no waiting.

Besides sensor comfort, patients also appreciate what has become known as “co-diagnosis,” the ability to sit side-by-side with me and discuss their case. It is so much easier to point out a lesion on a 19-inch monitor than to hold up a little piece of film. My DEXIS sensor and the interactivity of the software make it easier for the patients to understand their conditions and hopefully accept treatment.

Over the years, I have added new technologies that offer my patients the best care possible. I have a lot of “toys” to play with, but of all of my equipment, DEXIS is on my list of top five technology favorites in the office. DEXIS X-rays, captured by the Platinum sensor, have helped to make me a better dentist. The clarity of the images improves my ability to diagnose dental conditions and helps me communicate that diagnosis to the patient. That, together with my intraoral camera, digital photography, and patient education programs, has made my life easier and definitely has resulted in better dental care and an improved office experience for my patients.

From the reception desk to its operatories (and everything in between!) Main Street Pediatric Dentistry, located in Tuckahoe, New York, provides its patients with extraordinary oral health care in a one-of-a-kind environment that is chock full of amazing, fun-filled motifs with loads of color and textural touches waiting around every corner. Kids love to come to the office—and so do their parents!

The waiting room and hallways resemble the interior of a submarine, incorporating the elements of stylized metal-clad walls, floors, and countertops; authentic-looking lighting fixtures; and scuba-gear placed whimsically throughout.
The main treatment room truly brings home the feel of being underwater by the use of window-like wall murals depicting playful sea creatures and an amused, snorkeling boy stopping to gaze into the room as they pass by.

The same charm and high level of creativity can be seen in the remaining operatories as well. Delightful and amusing displays of fantasy and real animation artistically adorn the rooms’ walls, inciting smiles and laughter from viewers. Yes, that is a charging rhinoceros crashing through the wall!

“I want children to like coming to the dentist, not fear it. By creating a warm, comfortable space…they are relaxed and entertained. It defuses what can be a stressful situation.”

Before this new office came to fruition, Dr. Resnick-Graulich had worked continuously to respond to her practice’s evolution. Her 26-year professional progression has moved from a rented space that was operated for 2 days a week to today’s 1,950-sq. foot, 4-operatory new office with technologies that ensure top-of-the-line care for her patients in an environment that can be classified as nothing short of spectacular. “I felt that I was ready to create something unique,” notes the Doctor. “I had been keeping up with all the new technologies…and trends in pediatric dentistry. It is no longer sufficient to have a Mickey Mouse poster on the wall but time to create an environment conducive to the children of today. Every detail was thought out with the patient and parent in mind. The waiting room presents each child with a number of different activities, including games, movies, and interactive materials. There is a coffee bar and TV for the parents.”

The Doctor’s old building offered no hands-on care and parking was a problem. “My lease was expiring; I knew that I needed more space…so I began looking for an appropriate building.
I wanted a place that would be easy for my existing patients to reach; with adequate parking…I picked Tuckahoe, a mere 7 minutes drive from my old location. There is a superintendant on premises and the parking is great.”

After Doctor Resnick-Graulich saw the space, she contacted her Henry Schein Sales Consultants to ask their opinions. “I had worked with Henry Schein in the past and each project has been extremely successful,” notes the Doctor.

“I felt that I was ready to create something unique,” notes the Doctor.

“Equipment Sales Specialist Lee Goldstein understands function and has great vision. My Field Sales Consultant Jack Abrams is the best there is. He makes sure that I am kept abreast of all the latest technologies and is very attentive to my needs.”

Dentrix, Pelton & Crane, Gendex, and DEXIS products were just some of the specialized technologies used in the new office. These products will enhance its efficiency and make it possible to confidently look forward to providing increased treatment options to an expanding patient base. Increased space allows for a higher level of efficiency, increased productivity, and better patient flow. There are 2 chairs per bay, which makes it possible for the Doctor to numb one child, who can watch TV, while she works on a patient in the chair nearby. The new office has reduced workday stress for everyone and made scheduling and dealing with emergency cases much easier.

Left to right: Regional Manager Kristen Esler; Equipment Sales Specialist Lee Goldstein; Dr. Penny Resnick-Graulich;
Field Sales Consultant Jack Abrams

“What means the most to me about my new office is that it allows me to put my philosophy into practice,” comments the Doctor. “I want children to like coming to the dentist, not fear it. By creating a warm, comfortable space…they are relaxed and entertained. It defuses what can be a stressful situation. I worked closely with my contractor to get the this office looking fresh and unique.”

Main Street Pediatric Dentistry is successfully working toward achieving all its practice goals in a remarkable new space that is upbeat and dedicated to its patients’ every need. The addition of an associate is in the near future.

“My advice for any other dentist building a new office is to
go for it,” adds Dr. Resnick-Graulich. “Build your dream!
We spend so much of our time in our office—it should be an enjoyable place. What works for you is what is important.”

Featured Equipment:

Air Techniques AirStar 50

Air Techniques VacStar 50H

Biolase Waterlase C100

DCI Pro30 Units

Dentrix Practice Management Software
DEXIS Digital Sensors
Marus
NuStar Chairs

Pelton & Crane Delivery Systems

Pelton & Crane Spirit 1500 & 1800 Chairs

Pelton & Crane Post Lights

Progeny Preva Intraoral X-ray

SciCan Statim 2000, 5000
Sirona Cabinetry

Sirona XG5 Digital Panoramic/Ceph

The property that housed the shell of the practice and the family residence was purchased in 2007. Dr. White had taken ownership of her already existing business 5 years prior, providing general dentistry services for her patients.

Construction began in January 2010 in the new location, which opened in September of the same year. “I would be able to provide dental services in a location that I owned while being within close proximity to my home,” notes Dr. White. “As a mother, small business owner, and dentist, this relocation provided numerous benefits on many levels, [including highway frontage that increases the practice's visibility].”

Front row: left to right–Kristeena Robinson, Digital Technology Specialist; Dr. Stephanie White; Jaime Phifer, Field Sales Consultant. Back row: from left to right–Chris Whisman, Certified Installation Technician; Mike Corcoran, Equipment Sales Specialist; Lee Lehman, Regional Manager; Jason Paz, Equipment Service Technician; Dan Sands, Equipment Service Technician

The new building’s 1,750-square-foot downstairs space houses the reception area and 4 operatories. Its 400-square-foot second level is used for the Doctor’s personal office and storage. “We already had Dentrix and DEXIS at the old office,” notes Dr. White. “Henry Schein helped with the layout and blueprints; gave us tours of other offices to get ideas for design; and provided information on their products.” TechCentral, part of Henry Schein, installed all the computers and phone systems in the office as well.

Come on in and enjoy the beautiful reception area; you’ll relax to the gentle murmur of a waterfall and bask in the warmth of a fireplace while choosing a refreshment of choice as you await your treatment. The walls showcase custom oil paintings and artwork done by Dr. White’s mother Laurie Kristovich. Decorative accents include Brazilian walnut floors; quartz countertops; custom, hand-blown light fixtures; and comfy leather seating. “I believe the new office is more relaxing and less stressful to my staff as well…it allows them to work as a strong team in a more efficient manner, and enjoy a greater level of communication and productivity, which has increased by about 25% over last year. We have had a 50% increase in new patients in just the last 3 months and there have been a lot of walk-ins, roughly one to two a week, wanting to check out the new place and inquire about becoming patients with our office.”

Gearhart Dentistry’s office designer was Henry Schein National Design Group’s Genevieve Cicero. Equipment Sales Specialist Mike Corcoran worked with Field Sales Consultant Jaime Phifer, supporting the project in achieving all its technical and layout goals. “Dr. White has better ergonomics and enhanced functionality now. The use of the narrow-back chair and delivery unit that allows instruments to be easily accessed gives her a more streamlined work area…and a more stress-free day,” comments Mike Corcoran. “The office’s general atmosphere has the unique ability to increase overall comfort for the patients and the staff as well as helping the staff to work more efficiently because of its well-organized spaces.”

“My business being so close to my home is such a wonderful thing,” remarks Dr. White. “There are many matters that need to be handled after patient treatment hours, which means time away from loved ones. Since I am close to home, I can bring my two-year old over to my upstairs office where she can be with me in a comfy, clean, and child-friendly environment. …Other times, I can literally run over to the office while she naps or sleeps—and work—guilt-free.”

“I believe the new office is more relaxing and less stressful to my staff as well…it allows them to work as a strong team in a more efficient manner, allowing for a greater level of productivity.”

“Henry Schein helped with the layout and blueprints; gave us tours of other offices to get ideas for design; and provided information on their products.”

Through the successful completion of her new office, Dr. White will better realize her business goals and be able to fulfill her personal philosophy of patient care. With enviable new technologies and a perfectly configured space, the Doctor can confidently look forward to supporting an increase in her burgeoning client base and comfortably meeting the demands of her personal life as well.

Designed by: Genevieve Cicero, Henry Schein National Design Group

Front row: left to right–Nicole Clauder, fill-in Hygienist; Cathy Jo Kirkpatrick, full-time Hygienist; Dr. Stephanie White; Megan Kristovich, Sterilization Tech; Back row: left to right– Jamie Stratton,

front-office and financial coordinator; Heidi Ross, front-office coordinator and financial coordinator; Kathy Sue Maltman, Doctor’s Assistant

Featured Equipment:

Dentrix Practice Management Software

DEXIS Platinum Digital Sensors

Digital Doc Icon IntraOral Camera

Crown Seating Operatory Stools

Guru Patient Education System

Midmark Assistant Stools

Pelton & Crane

3000 Chairs and Delivery System

Pelton & Crane Helios Light

Pelton & Crane Cabinetry

By Dr. Jason Lipscomb

When the horse was domesticated thousands of years ago, most were used for labor purposes. It probably didn’t take long for enterprising individuals to hop on the back of a horse and start the first horse race. The same goes for the invention of the automobile. It probably didn’t take long for two car owners to compete in a match of speed and agility. That competitive nature pervades many areas of our personal lives as well as the business of our dental practices. In recent years the dental Web site has been one of the biggest public representations of our businesses. Like the horse and the car, it is only logical that the Web site will be pitted against other Web sites to gain the top spot. This is the race that we call Search Engine Optimization (SEO).

SEO has multiple definitions and components depending on whom you ask, but it all boils down to getting your Web site (Web content) in front of the consumer. Most people consider SEO the act of getting your Web site to the top spot of Google, Bing, or Yahoo.

Why is this so important? You must first consider the consumer (patient) you are trying to reach and their habits on the Internet. Internet users searching for anything on the Web will always be enticed by the low-hanging fruit. The content that is right in front of their face: the top search result on Google, Bing, or Yahoo. When users do an Internet search for a dentist, a majority will never click on to the second or third page of results. Those results on the first page will have the biggest chance of success. Your Web site needs to be on the front page of a Google search to be truly successful. A beautiful Web site may cost thousands of dollars, but if it can’t be found, its message will never be expressed.

Several years ago when the Internet was only populated with Web sites designed by professionals, SEO was an esoteric method that civilians dare not attempt. The Internet has changed. It is the age of crowd-sourcing and social media.

Google and other online directories have placed an emphasis on local search. These changes make it easier than ever to take control of your own online destiny. SEO for Web sites is still best left to those who have expertise, but the new online atmosphere enables you to contribute to the effort.

This is most apparent in the move toward “Local” search within the major search engines like Google. A search for a local business like “Fresno Dentist” will give results of a local business profile and Web site results. A search for something generic like “cookies” has no local component, so the results will all be Web site listings. The Google local listing is one of the first representations of your business on the search engine. It is also an item that any practice owner can claim and optimize.

A recent study claims that most people use 3 keywords when they do a search. A one-keyword search, i.e., “dentist” is a very broad term and will yield thousands of results.

First of all, consider what the average person types in Google to find a dentist. Hint: They will not type in “John Smith D.D.S. F.A.G.D.”. They will most likely type in their location “Richmond” or “23219″ and “dentist.” These search terms are the “keywords.” Keywords are the foundation of any search. A recent study claims that most people use 3 keywords when they do a search. A one-keyword search, i.e., “dentist” is a very broad term and will yield thousands of results. This broad search is very competitive because there are thousands of results vying for the top spot. A three-word search is very specific, i.e., “Dallas dental implants.” This search will have fewer results and therefore a better chance of being seen. What are the keywords someone would use to find your practice? There are several tools available online to find the activity of different keyword combinations. The Google ad words keyword tool is among the most popular. https://adwords.google.com/select/KeywordToolExternal
Find your keywords and remember them well!

Optimizing your local listing can be quite easy. The first step is claiming your listing. One of the biggest problems with listings is not claiming them. Unclaimed listings may have incorrect or missing information. Why be invisible to the search engine just because your listing has the wrong street name? Google listings can be claimed at http://www.google.com/places. Google has a couple verification features. Google will generate a “pin number” to verify your listing. They will either call your office with the pin number or send a postcard with the number.

Another major problem with local listing optimization is having multiple listings. Google does not like multiple listings. In their eyes, every business should only have one listing. Any more than that is a manipulation of the system. Be sure to “Google” yourself and your business. Dental practices that have moved locations, previously had associates, or signed up for marketing services, may have multiple listings. I recently worked with a dentist who had 7 Google listings. These duplicate listings can hurt your search position.

Adding content to your listing is a quick and easy way to optimize it. Google local listings can have 10 pictures and 5 videos. Pictures will always be the best way to gain a good first impression. Evaluate your address and business name. Google listings should only have the legal name of your business. The name of your business is probably not “Denver Dentist John Smith Cosmetic Dentist.” Changing the name of your business for the purpose of the listing is not advised. Follow Google’s suggestions for a complete profile. It will tell how complete your listing will be.

A local search result is often the one representation of your online reputation. These local profiles are often pushed to the top by activity. Many times this activity is that of online reviews. The problem is, Google will treat 20 negative reviews the same as 20 positive reviews. Multiple bad reviews will get you to the top just as fast as positive reviews, but do you want to be there? Being at the top with multiple bad reviews is worse than not being there at all. Using a service like Demandforce (http://www.demandforce.com) can help steer the online conversation. Demandforce submits reviews to your listing, which makes the listing appear active and popular. This will cement your online reputation and help increase your search rank.

Dr. Jason Lipscomb is a general dentist who operates two practices in Virginia. He specializes in helping dentists expand their practices through the use of social media. Jason and his partner Stephen Knight started Social Media for Dentists to help other dentists master social media and attract new patients. Jason and Stephen have also authored the book “Social Media for Dentists”. A 350 page guide to social media as seen from the dental perspective. Visit their website at http://www.socialmediadentist.com or http://facebook.com/socialmediadenist

By Dr. Larry Emmott

Way back in the last century computerswere big and heavy. They needed to be plugged into a wall for power and data. The monitor was a huge piece of glass and plastic that required either a staunch desk or a strong man to support it. Computers were put in one place and they just stayed there. If you needed to use the computer, you went to it—the computer did not come to you.

Amazing new technology has fundamentally changed all that. It is no longer necessary to assign a computer to a place—the computer can be assigned to a person and it simply goes wherever the person goes. It is a bit like an old wall-mounted corded telephone and a handheld cell phone. The old wall mount is the kitchen phone that you use to make or take a call— everybody uses it. Your cell phone is your phone—you carry it with you and it is intensely personal.

The idea of a personal tablet style portable computer is not new. In fact it was introduced by Microsoft as the Tablet PC in 2001. However, it never caught on. It seemed a cool concept—but people just weren’t that interested.

All that changed with the input from that “old MAC magic” and the introduction of the Apple iPad. The iPad is really just a variation on the Tablet PC concept, but it is such a well-designed and exciting variation that it has single-handedly changed the face of personal computing.

Several advances have made this possible including safe and effective wireless networking, reliable long-lived batteries to run mobile devices, ever tinier and more powerful microchips, lightweight portable flat-panel touch screens, and innovative input techniques. When you combine all these advancements you get something like an iPad.

In our homes we can use digital technology to look at and share photos, read the newspaper, take notes, check the weather, and read our mail along with countless other tasks. However, even though we can use our home computer to do these things it seems awkward and it is not always convenient to go to an office and sit down at a desk to use a computer. You don’t really want to drag your friends into your study to sit at your desk to look at photos of the kids at Disney World. It is much more natural and suitable to just have a computer with us wherever we are in the house—hence Netbooks and iPad.

In the dental office, we are faced with similar tasks and activities. That is, things we can do or have our patients do while sitting at a desk, but are really done much more effectively elsewhere. For example—filling out forms; showing images to patients (photos or X-rays); running a patient-education presentation; sending an appointment reminder; or writing a prescription.

Dentrix has a number of special features like Kiosk, Mobile, Guru, and various e-services that allow us to use iPads, smart phones, and other mobile devices.

When you study the history of technology you find that over and over again people adapt and use technology in ways that the inventors of that technology never imagined. Who would have thought we would be using our phones as cameras, maps, address books, and for texting? Who would have guessed “texting”? In the dental office, we will be using these new devices in ways we have not yet imagined. So be creative, try out new technology and new ways of doing things; the future is coming and it will be amazing.

Dr. Larry Emmott is one of the most entertaining speakers in dentistry, and is considered a leading dental high-tech authority. He has addressed hundreds of professional groups, and has been a featured speaker at every major U.S. dental meeting. Dr. Emmott is a pioneer in online publishing with his blog EmmottonTechnology.com. You can contact him at larryemmott@drlarryemmott.com

By Bill Busch, DMD MAGD

It seems like it was just yesterday that I was twenty-seven years old and thinking about digital X-ray. Now, twenty years later, I am writing about digital impression taking—something the great Dr. Gordon Christensen says will be commonplace by 2020.

I got into digital dentistry immediately upon graduating from dental school; thanks to the launch of the personal computer by IBM back in the 80s. I graduated from dental school in 1989 and added my first computer to my office in 1991 to do basic accounting and patient ledgers.

One thing that I learned with any technology that you use is that the more you use it the more impatient you become. I still remember 40-second curing of composite. Now it is down to 3–5 seconds and now I want it down to 1 second!

Knowing that it would be the basis for many future technology-related decisions I would make for my practice, I decided to first purchase a robust practice-management system. That purchase was Dentrix dental systems. I believed back then that the future would include an electronic dental record (EDR) and, in order for that to happen, dentistry would need new science and technology. The first piece to that puzzle would have to be digitizing the radiography process. Once this was done, everything else concerning the patient record could be accomplished.

I added digital impression taking to my practice in 2001 and, next to going paperless, it was probably the biggest milestone. Believe it or not, digital impression taking has been around for twenty-five years but, in my experience, it has only been truly reliable in the last ten. Today, digital impression taking is awesome and gives you many options. It lets you decide if you will make crowns, veneers, inlays, and onlays in your own office (DIY) or send the digital impression directly to the lab via the Internet. The systems for in-office creation of restorations are called CAD/CAM in-office systems, and include D4D (exclusive to Henry Schein Dental) and CEREC. D4D and CEREC users have the ability to take digital impressions from their in-office systems and send them directly to the lab.

Digital impression-taking also allows you to acquire the digital impression—via a specialized intraoral camera—and then forward it to the lab. This can be done with the Lava C.O.S. (“Chairside Optical Scanner” from 3M) and ITero (from Cadent) and, there are several others on the horizon. I personally like the in-office systems such as the D4D because it gives me the option of doing it in-office or
having it be lab-made, depending on the case.

There are many options with digital impressions—and plenty of advantages as well, including:

1. Perfect impressions every time.
2. No messy impressions that take 2–4 minutes to set.
3. No impression material cost, no impression tray, no impression adhesive, no temp cement, no temporary, etc. (in-office system only).
4. No need for a second visit from the patient (in-office system only).
5. Easy, multiple-unit impressions.
6. 100% reliable restorations. (3M’s Lava C.O.S. system takes it a step further by guaranteeing the fit of the restoration.)
7. Smaller carbon footprints. (The lab is not using fuel to physically pick up your case since you are sending it over the Internet and, if you are using one of the in-office systems, you leave an even smaller carbon footprint because the patient does not have to return for a second visit.)
8. Faster completion of the case and ability to produce more in a given year.

You can start with anything when it comes to making digital dentistry a part of your practice—a practice-management system, digital X-rays, electronic dental records, digital impressions, etc. Just be sure to add one at a time. And, do not delay in making the investment because you are waiting for the next improvement. Get moving!

Dr. Bill Busch is a general dentist in Kansas City, Missouri. He has been practicing for over twenty years and focuses on cosmetic, implant, and reconstructive dentistry. He is also the creator and co-founder of TeamSmile, a dental outreach program that helps underserved children around the country.

Web sites: drbusch.com; teamsmile.org
Contact information: phone (816 ) 668-5576;
E-mail doctor@drbusch.com

Low fee schedules and broken appointments are economic disasters for most practices.
On a compounded basis, forgone revenues can reach millions of dollars over a 35- year career. Fee increases go directly to the bottom line. However, a broken appointment deprives the practice of the appointment’s cash flow. For example, all supplies and lab expenses average 14% –18% of revenues. Therefore, a broken $100 visit deprives the practice of $82 to $86 net cash flow or higher if a lab fee is not applicable.

Have you ever calculated the dollars it costs for broken appointments in only one year? The figure could be up to 25% of your take-home every year! Hygiene is generally the greatest economic killer.

The good news is that patients can learn to respond to their dental office in a different manner for the changing times and modern approach to optimal oral health. The changes have to begin with the doctor, staff, and the “corporate attitude.” Most patients will accept change if we exhibit the correct attitude and a positive professional image. Dental teams can convince that it is in the patient’s best interest to be on time and never break an appointment.

To be proactive and effective, it is necessary to understand why patients break appointments. The first reason is we have taught them that it is “OK” to casually miss an appointment. We must demonstrate how it is in their best interest to always keep appointments. Most people aren’t concerned that it costs the doctor money for the missed appointment. We must show the patients the consequences of broken appointments as it affects their well-being and not ours.

The second reason patients break appointments is that on the day of “case acceptance” they thought they could pay, but by the time of their treatment appointment, they do not have the funds. Many times, patients are embarrassed to call and simply do not show. The best remedy for this is preventative medicine.

Tell the patient, “John, this treatment really is in your best interest. I’m saving time just for you, so be sure and be on time every time as we progress through this together!” You must build importance and value with the patient. The practice should also offer easy payment plans through third-party financing companies. This will prevent “no shows” on the day of the appointment.

The third reason for broken appointments is a lack of value in the patient’s mind. Never believe that because a patient nods the head in approval there is a commitment. For real commitment to be in place, the dental team must do several things:

Have you ever calculated the dollars it cost for broken appointments in only one year? The figure could be up to 25% of your take-home every year! Hygiene is generally the greatest economic killer.

1. There must be a “buy in” as to the dental problem. The best tools available for this are the intraoral and digital camera and digital X-ray.

2. The patient must “understand” the solution to their problem. A picture is worth a thousand words, and patient education software such as Guru is extremely valuable. Additionally, the team can use study models and various pictures from periodicals to demonstrate dental solutions. People are not committed to what they don’t understand.

3. The third way to secure commitment is to rehearse verbal skills in case presentation and value building. There are numerous resources for this process.

4. Avoid thinking that your patients trust you so much, that it is not necessary to build value with these tools. To assume that patients will reach for their wallet at your command is a sure path to poverty.

One huge priority for all dental teams in building value for appointments is centered on studies revealing the correlation of periodontal disease and heart disease. An article by the late periodontist John W. Peden states: “Studies involving almost 50,000 people in four different countries continue to verify the association between periodontal disease and heart disease, including death from heart disease. People with periodontal disease have 1.7 times the risk of heart disease and 2.2 times the risk of death. The culprit appears to be porphyromonas gingivalis, the most common strain of bacteria found in periodontal disease, which causes blood clots that induce heart attacks when they escape into the bloodstream.”

Chronic inflammation of the gums due to p. gingivalis also could be involved in arteriosclerosis, the inflammation of the blood vessel lining leading to the buildup of plaque in the arteries and the underlying cause of most heart disease. These same bacteria are also linked to infective endocarditis, an infection of the heart valves.

It is imperative that we use all means possible to convey the above information to patients in understandable form. The proper presentation of this material emphasizes the importance of dental visits. Most dentists need a paradigm shift in their own thinking. Once dentists and staff believe dental office visits are not optional, they can convey this to their patients.

The fourth reason patients break appointments is the mistaken perception that the practice is so busy it won’t make any difference if they come or not. Not running on time perpetuates this perception. The unbooked operatory enhances on-time performance and same-day dentistry production. The team must find creative ways to demonstrate that despite busyness, every person is important to the doctor and all must work together for total health.

It’s equally important to discern the four categories of patient visits in order to prevent broken appointments. Each category requires a unique strategy.

First is the emergency visit. Usually this appointment is scheduled the same day the patient calls. It’s a good idea to develop criteria for what constitutes an emergency. A telephone script reflecting the doctor’s policy is helpful. Don’t be afraid to let the emergency patient know that “working them in” is a challenge and they are fortunate to be seen so quickly. Provide appropriate treatment that allows the doctor and staff to stay on schedule for regular patients. Always emphasize that this is “exclusive time for you.” For emergency visits the next day, call the patient 24 hours in advance. Prompt your message by noting, “The doctor is saving this special time for you because of your emergency. It is imperative that you be on time. I’m sure the doctor can help you.”

Remember that all forms of communication can be a training session for patients. Be sure they understand that dental visits are not optional. Good total health begins at the mouth (for practice and for patients).

The second category of patient visits is the “New Patient.” To decrease broken appointments, be sure to see the patient within three to six working days. “The quicker the better” is the watch phrase here, as the new patient has no relationship with the dentist and could easily break the appointment. Remember that when they called for their new visit, they had money and commitment, but elapsed time can deplete both.

Develop a telephone script for booking the new patient. For the price of a few minutes a day, any doctor can work miracles in broken-appointment prevention. The doctor should call the new patient 48 hours in advance with this or a similar message: “Mrs. Jones, this is Dr. Smith. I noticed you are on my schedule at 2:00 p.m. Thursday. I look forward to meeting you the day after tomorrow.” Now the patient knows the doctor is aware of the visit and will have to suffer embarrassment if they do not show. The call takes less than a minute during the clinical day.

The third category is the “Treatment” visit. Confirm the appointment 48 hours in advance; if the patient should postpone their visit, you need time to fill their slot. Avoid language such as: “I’m calling to confirm your appointment.” This creates negative thoughts for the patient such as: “This is my last opportunity to back out and I better take it.” Rather use words like: “Mr. Jones, we’re calling to see if you have any questions regarding your dental visit on Thursday at 2:00 p.m.” Or “Mr. Jones, we’re looking forward to seeing you Thursday at 2:00 p.m.”

The fourth category and most often broken visit is the “re-care visit.” Each hygiene visit is an opportunity to train patients on the importance of regular care and unbroken appointments. Never say, “just a cleaning.” Always give the patient additional reasons to return other than a cleaning. Prevention of periodontal problems, oral cancer exams, bad breath prevention, etc. is all good reasons for the patient to be faithful in their appointment commitments. Reinforce at every visit a “reason” to return and that appointments are reserved exclusively for the patient. Automated patient contact software such as Demandforce will increase efficiency, decrease broken appointments, and re-activate patients while the patient survey feature enhances Google search ranking.

Remember that all forms of communication can be a training session for patients. Be sure they understand that dental visits are not optional. Good total health begins at the mouth (for practice and for patients).
Dr. Charles Blair is author of Coding With Confidence: The “Go To” Dental Insurance Guide (available through Henry Schein order # 367-7233). He is also publisher of Insurance
Solutions Newsletter (available through Henry Schein order #367-7329 for a one year subscription and order #367-7330 for a two year subscription). He can be reached at info@drcharlesblair.com.

David Jones is CEO of David Jones Consultants. He has 24 years experience helping dentists achieve profitability. He can be reached at David6705@sbcglobal.net. or 559-999-7609.

Coding with Confidence:The “Go-To” Dental Insurance Guide (CDT-2011/2012 Edition) Henry Schein, Inc. Item Code (367-7233)

This is a unique reference guidebook that goes beyond the typical “list and describe” coding handbook. This book was developed using information compiled from thousands of interviews with doctors and staff just like you, and uses PREDICTIVE ERROR CORRECTION™ technology to help predict common mistakes before you make them!

This manual provides expert assistance to practice staff finding it difficult to keep up with the frequent changes, revisions, and deletions in the CDT codes, mandated every other year. It utilizes reader-friendly graphics, like the Coding Correction, Warning, and Watch icons, illustrations, flowcharts, etc. to ensure you know what to look out for with hundreds and hundreds of different CDT codes.

Insurance Solutions Newsletter Henry Schein, Inc. Item Code: 1-year subscription (367-7329) and 2-year subscription (367-7330)

Description of Newsletter: Insurance Solutions Newsletter enjoys a national reputation as dentistry’s leading resource for accurate dental coding and insurance information. Each bi-monthly issue contains sixteen pages of the most detailed and current step-by-step guidance in the industry. When addressing controversial coding and insurance issues, our researchers seek advisory opinions from the American Dental Association, the American Academy of Periodontology, the American Association of Endodontists, the American Association of Oral and Maxillofacial Surgeons, insurance directors, and claims examiners to provide you with the information you need to bill claims accurately–the first time.

Place your order with Henry Schein Dental at 1-800-372-4346 or visit us on the Web at henryscheindental.com

Leadership in Energy and Environmental Design’s (LEED) program uses a rating system that is the nationally recognized standard for green buildings. To become certified, projects must earn “points” within each of LEED’s five categories: sustainable site development, water savings, energy efficiency, materials selection, and indoor environmental quality. “I wanted to invest in an energy-efficient building that would save in the long run and look more desirable to potential buyers in 20 years time,” comments Dr. Evans. “Its environmental controls make it more user friendly for the staff and patients. With the Gold level, we had a host of innovations that gave us both energy efficiency and green-conscious decor that our patients’ families admired and felt comfortable in. We choose a plenum flooring heating/cooling system, which was the first of its kind in Northern Colorado. Solar power and on-demand water heaters feed the system that flows through the floor. Forced air pushes heat or A/C where needed…this should save huge amounts on our heating/ cooling costs.”

“I wanted to invest in an energy-efficient building that would save in the long run and look more desirable to potential buyers in 20 years time,” comments Dr. Evans.

Henry Schein Dental’s Equipment and Design Specialists helped bring this exceptional marriage of concepts in green awareness and high-level dental technologies to fruition. “Henry Schein proved to be head and shoulders above their competitors. Their willingness to help design the practice, work with contractors, and offer technology solutions were in line with my high-tech, green mentality. The entire Henry Schein Dental team came to town to meet with me,” recalls Dr. Evans. “The Equipment Sales Specialist, Field Sales Consultant, Technology Sales Specialist and Regional Manager-all of us in one place made decision-making easy. No other company came close to their customer service, which I consider very important in my own practice. I felt we were a good fit and we understood each other.”

Some of the office’s technology choices included digital radiography, Dentrix practice-management software, and KaVo handpieces for their reliability and options selection. The Doctor spent a whole
day with the team at the Denver Midwinter Meeting, looking at and purchasing equipment. “The team was absolutely wonderful in taking the time to show me items, educate me, and review how the practice would benefit,” notes Dr. Evans. “They
were there to educate in a way that simplified the entire process for my staff. We had numerous seminars on the digital radiographs. That training paid off. We have not lost a single X-ray or had a system
failure.”

The result? A 9-operatory facility with a floor plan that provides maximum mobility for the patients and staff and a bevy of special features that have made Big Grins the “place to be” for pediatric dentistry. Dr. Evans philosophy of patient care is evident as the office’s theme unfolds. Its nurturing environment meets the dental healthcare needs of children aged 0–18, combining education, treatment, and huge amounts of fun for all!

Beginning in the comfortable and quiet reception area, you’ll find amenities for a relaxing wait. The Doctor’s office, business office, and conference area are conveniently positioned for privacy. Only
footsteps away are an amazing array of kid-friendly accommodations that take this dental office way over the top.

Two distinctive play areas have been created to offer children and teens activities that
provide amusement and recreation. The children’s room incorporates a delightful play scenario composed of soft sculpture that mimics a nature preserve (complete with bears!), computer games, and an 8-foot,
round rotating climbing wall—all guaranteed to make waiting for treatment a breeze. Next door, the signage calls out Teen Room…PG-13, fair warning for a very cool place that has plenty of way-above-average
fixtures for the older patient, including Wii games and an iPOD station.

“My staff is completely at home and proud of the new office,” comments Dr. Evans. “Everyone enjoys their time [here];
it’s palpable as soon as you walk in the front door.”

Left to right: Jason Krause, Regional Manager; Maryann Johnson, Field Sales Consultant; Dr. Greg Evans; Jim Ferrell, Equipment Sales Specialist; Dan Powers, Service Technician.

The clinical area’s open concept layout gives the impression of a large friendly classroom with various treatment spaces for the kids. Big Grins also offers infant dental
care exams that gradually introduce the doctor/patient experience to the very young. Teenage patients are seen in a separate treatment area with a sports paraphernalia motif and larger chairs.

“My staff is completely at home and proud of the new office,” comments Dr. Evans. “Everyone enjoys their time [here]; it’s palpable as soon as you walk in the front door. Other offices in the area have had flat growth…our patient numbers and word-of-mouth referrals have skyrocketed and my dentist-to¬dentist referrals went up also. I think we are making a difference in the lives of our patient families. It is as simple and profound as that.”

Big Grins is perfectly positioned for years of continuous growth. Dr. Evans’ forward-looking focus has made his office an outstanding example of design elements that have
the “star quality” to attract patients, substantive and resilient technologies for better patient care, and environmentally sound “green” product choices that will carry the office successfully into the future.

Featured Equipment:

DentalEZ Ramvac Vacuum

Gendex 9200 Digital Panoramic

KaVo Quattrocare

Pelton & Crane 1800 Series Chair

Pelton & Crane VistaPure Sterilization Water System

Pelton & Crane VistaClear Treatment Water System

Progeny Preva DC

Intra Oral X-ray

SciCan Statim 5000

Recent months have brought about a multitude of changes for the work environment, regardless of the industry in which you operate. Today’s employer must tread carefully through the maze of new regulations, enforcement of the weathered ones, and prepare for more scheduled changes. It’s no wonder that regulators are finding non-compliance during their audits! How can an employer maintain their business operations and stay abreast of the legal requirements? The best solution is to audit yourself before a government representative knocks on your door to do the same thing. Consider the following topics for review and institute a regular review of your practice.

Take the time to periodically review the employment policies you have in place. These are typically defined in an employee handbook or a company policy manual. This document is your backup for unemployment claims, discrimination claims, terminations, etc. Your handbook or manual should be reviewed at least twice a year to remain in line with the current pace of regulations. Ignoring this important document could possibly cost you monetarily, not to mention the emotional toll in the added stress. Find someone who is very well-versed in the currently active legislation, and have them review your policies as well. Not only does your handbook and manual need to cover all the right subjects, they also require the correct verbiage. Discrimination claims are rampant in today’s economy, so cautionary steps
are advised.

Hiring practices are a key area that individuals have learned can yield large dollar amounts in litigation. Have someone in the know review your employment application to ensure you meet all the guidelines from an Equal Employment Opportunity Commission (EEOC) and Americans with Disabilities Act (ADA) perspective. Asking the wrong question on an application wreaks its own havoc, when uncovered by a government agency. You will also want to update your job descriptions, and ensure they are ADA and EEOC compliant.

These documents are another important tool for your hiring process, but they can also be utilized as evidence in an agency inquiry or in a court of law. Taking the time now to review and update will save you hours of time and frustration in the future. Now that your application and job descriptions are current and compliant, consider the person who will be conducting your interviews. This person should be well-versed in what to ask and what not to ask during the interview process. You should periodically talk about the questions they are asking so that you are confident they are not drifting into the realm of discriminatory interviewing. If they use a list of standard questions, review them each time you do your audits. If new questions have been added, or old questions re­fashioned, you will want to know they remain within the EEOC and ADA guidelines.

On September 15, 2010, Immigration and Customs Enforcement (ICE) agents began serving notices on 500 businesses to inspect the Employment Eligibility form commonly referred to as the I-9 form. The Immigration and Customs Enforcement Agency has been given worksite enforcement guidelines by the Department of Homeland Security (DHS) to focus their resources on criminal prosecution of employers who knowingly hire illegal workers. ICE will conduct on-site audits of I-9 forms for accuracy and completeness. An additional 1500 inspectors were added to the agency’s workforce this year in order to carry out the new DHS guidelines. Take the time now to review your forms, make corrections, and store them properly. If you are not sure of what constitutes “accuracy and completeness,” you should seek the advice of someone who is knowledgeable in this area. On September 28, 2010 ICE announced that it had settled with clothing retailer Abercrombie & Fitch on a fine in excess of $1,000,000 for violations of the Immigration and Nationality Act. The violations related to an employer’s obligation to verify its workers for employment eligibility. The company was not in violation of knowingly hiring unauthorized workers in the investigation. Instead, this case focused on technology-related deficiencies in Abercrombie & Fitch’s electronic I-9 system, and began in November, 2008, with an I-9 inspection of the company’s retail stores in Michigan.

Your handbook or manual should be reviewed at least twice a year to remain in line with the current pace of regulations. Ignoring this important document could possibly cost you monetarily, not to mention the emotional toll in the added stress.

Employment posters are mandatory by state and federal regulation. They also help you manage employment law compliance, improve workplace safety, and supplement employee training. Be sure you have the most current posters in place, and any torn or unreadable posters are replaced. Your posters should be displayed in an area that is frequented by your employees, and hung at a level that the majority of your personnel will be able to comfortably read the poster.

Last, but certainly not least, are your safety policies. You should meet with your employees on a regular basis to discuss steps in keeping compliant with regulations as well as any safety issues employees want to address. Review your meeting notes to ensure you have addressed any of the issues employees brought to your attention, and, if you have not, be prepared to explain why not.

The best advice to any employer, is to think how you might respond to questions under oath about your employment practices. Is there an area that you believe an attorney might place focus, if you were ever called to testify in a hearing? If there is the slightest twinge, when it comes to mind, then you should be addressing that issue immediately. Don’t wait for the government to do your auditing for
you, because if you do, they will be asking your wallet to “open wide”!

For more information on employment policies, compliance with employment regulations, and record management, please call the Schein Business Center 855-556-9100 or visit www.empowerhr.com.

Gaining insights into innovative treatment options has always been one of my priorities.
My office has been computerized since 1985, with digital imaging implemented in 2004. In-office 3-D scans were the next logical step, so that I could obtain information unavailable from 2-D methods. With my increasing focus on implants and implant preparation, the GXCB-500 HD from Gendex has added a dimension to my practice that allows it to grow on many levels.

The data gained from 3-D scans plays an important role in the implant process. CBCT views provide me with exact measurements, width and height of bone, root position, and tooth position in relation to the nerves and sinus. I easily take accurate measurements in any direction, and quickly compare the left and the right sides. All of the dental anatomy that I need is there in axial, sagittal, and cross-sectional views—with exceptional clarity and detail.

A CBCT scan is a prime teaching aid. I can scroll through all of the necessary views, rotating, enlarging, and zooming in on the scan to spotlight the dental anatomy that generates my treatment plan. With this, patients understand why implants can easily be placed in one area, but not in another. I can highlight and point out the inferior alveolar nerve or teach patients about sinus lifts. When they recognize their own dental anatomy, they understand and accept treatment more quickly. For even more efficiency, my treatment coordinator, Doreen, enters the treatment plan into our DENTRIX® software, as I speak with the patient. When collaboration is necessary, scans are also easy to send electronically or in disk form to referring partners.

A supportive team and innovative technology
increases dentists’ options for patient care.
Left to right: Michael Coletti, Dr. Arthur Schwartz
and Paul Sprang, Jr.

In-office CBCT scans are exceptionally convenient. For years, I sent certain patients for medical CT scans, which, although necessary at the time, exposed the patient to extra radiation, additional expense, and the inconvenience of traveling to the hospital and scheduling extra appointments. After some research, I discovered that the Gendex medium-field-of-view machine was a great fit both physically and professionally. The system focuses on my region of interest, with 8-cm and 14-cm diameters, and heights ranging from 2 cm to 8 cm. The machine fits perfectly in the space formerly filled by my panoramic machine (the new system has a traditional 2-D pan built in), and is ergonomic for patients and staff. With our former pan unit, one of our shorter assistants had to stand on a stepstool to see the alignment lights. In the GXCB-500 HD, the stabilizing lights are clear, and easy to see, and the patient is seated, facing forward, easing alignment and reducing movement issues.

To get the most out of the 3-D experience, it is necessary to get acclimated to reading scans properly. Educational opportunities abound at webinars, seminars, local meetings, or classes such as those at the 3-D Imaging Institute sponsored by i-CAT and Gendex. To ensure a complete and correct diagnosis, I send the vast majority of my scans out to a maxillofacial radiologist. For those who read their own scans, I recommend establishing a good working relationship with an oral and maxillofacial radiologist, for the more complicated cases.

From feasible financing to training, the Henry Schein team worked to create a seamless process. Of all of our training experiences, our Gendex instructor was the best— knowledgeable, easy to communicate with, patient and intuitive. Paul Spang, Jr., my full-service representative, and the equipment manager, Michael Coletti, are quick to respond and “make things happen.”

Three-dimensional technology gives the dentist and the patient more confidence in treatment options and outcomes. It adds a new dimension, literally and figuratively, to radiography, to clinical practice, and has brought “futuristic” technology into my dental office, today.

Flexibility in scan sizes: The i-CAT has a great amount of flexibility in imaging selections that help to reduce radiation. Practitioners have the ability to choose the size of scan appropriate for various treatments, while reducing radiation exposure and helping them to achieve their ALARA goals. The system’s unique feature with the full field-of-view of 16-cm diameter and offers
and extended field-of-view option of 17cm x 23 cm. The system’s feature of collimation, or sizing, facilitates a targeted view of the region of interest by allowing the clinician to change the height from 2 cm to 13 cm or anything between. Furthermore, this collimation happens at the radiation source, thus the reduction of exposure as the scan size lessens.

Flexibility in scan times: Scan time relates to resolution and exposure, and the i-CAT offers several choices. The popular 5-second scan significantly lowers emitted dose, especially useful when follow up scans are deemed necessary.

Flexibility for treatment planning: The extended field of view allows for a complete orthodontic workup, frontal and lateral cephalometric, panoramic, supernumerary, SMV, TMJ, and airway studies. For those who have expanded their practice to include implants, the scans optimize implant placement and selection of the most suitable implant type, size, location, and angulations prior to
surgery. i-CAT scans are also easily transferred into most major orthodontic and implant planning software.

Flexibility in dimensions: For those who require a combination of 2-D and 3-D imaging, the i-CAT has you covered. The system offers both i-PAN, a traditional 2-D pan function and Tru-Pan™ that delivers precise panoramic views from 3-D scans (reconstructed pan).

Flexibility in viewing options: i-CAT images can be enlarged, rotated, and sliced in any direction. They can be viewed with or without Quantum IQ™ image enhancement within the included i-CATVision™ 3-D imaging software. Plus, this software and the patient’s scan can be shared with colleagues so they too, have these viewing options.

Flexibility in scheduling: Having an in-office cone beam scan exposes the patient to less radiation than a medical CT scan. Besides, with an in-office scanner, the patient does not need to make additional appointments for imaging, and then for treatment planning after scanning. The i-CAT offers the fastest time from scan-to-plan to consult—about one minute from scan capture to the images showing in the consultation room or operatory.

Social networking connects the world in so many different ways. It helps people reunite with family and friends and helps professional relationships blossom across international borders. In my practice, technology has connected me with my existing and prospective patients, and has literally given them the opportunity to hold their future dental health in their own hands.

The beauty of all of this is that this technology—my DEXIS® digital X-ray system—has already brought benefits on a clinical level. Digital radiography represented a great evolution, from postage-stamp-size film X-rays to full-screen images displayed on computer monitors. With the introduction of the DEXIS Platinum sensor, X-ray capture became more comfortable for my patients, and the images gained even more clarity and definition.

For me, much of the value of technology is measured by how it affects my patient’s experience. So, I was thrilled to find a way to open up the conversation about their diagnosis and treatment even more by combining two complementary technologies—my digital X-ray and my iPad™. I first got an iPad to show educational dental “apps” on topics such as gum disease and crowns. I don’t like leaving patients alone in the room watching a video, and I was looking for something new that would spark their interest. Because of the opportunity for patient education that my DEXIS system provides, I wanted to find more ways to incorporate it into the diagnostic experience. I decided to try the LogMeIn® Ignition Pro Version app for the iPad that connects me at my chairside computer with the handheld device that the patient can hold in his/her lap.

DEXIS and iPad: Another level of communication

When I bring up digital images on the computer, the patient sees them on the iPad simultaneously, and as I use my mouse to draw on the image on my computer, the patient can see this on the iPad as well. With the DEXIS imaging hub, I can show them before and after photographs, digital images, including intra- and extra-oral photographs and even digital X-rays of various types of dental conditions, bringing the “photo album in the waiting room” concept into my operatory and communication to a higher level than ever before. I can compare veneers to their natural teeth, and see how well they will match. DEXIS’ “Spotlight” feature helps to point out bone loss and caries. The patient accepts the treatment plan, not because of my authoritativeness or even because they trust me, but because they understand and can make an informed decision. This “co-discovery,” encouraged by the digital images and the iPad, seals my message and fulfills expectations for doctor and patient.

Word about my technologies has spread, mostly by patient referrals and through my Web site. Because of the level of detail offered by a digital system, my second-opinion patients have grown as well. Even in this tough economy, my patient base has grown, and I continue to search for ways to reach them though such innovations as digital and computer technologies. My patients know that my investments in special equipment stem from my concern about their dental health. I’m not just talking about it. I don’t just create an image (for my practice or my patients); I deliver it, right into their hands.

If you are reading this article, I am sure you are one of thousands concerned with our economy and our way of life. Every day we hear about unemployment, recession, default rates, foreclosures, and business being down! Well that’s not what this article is all about. This article is about being different and standing out from the crowd! This article is about embracing technology and wanting
more from ourselves and our daily habits. It’s about being better than most others and creating value for our patients. This article is about abundance and positivity.

I purchased my first laser, a Waterlase MD, in October of 2007. In January of 2008, I purchased my second laser, a Biolase ezlase Diode laser. Just like many of you, I was concerned with the cost of the lasers and the return on my investments. For over 3 months, I tracked my production with the lasers very carefully. I created a spread sheet that showed the date of the procedures, the patient names, and production amount for each procedure. I needed to see that I was at least covering my monthly payments for the new lasers. To be realistic with my numbers, I only tracked procedures that I would normally not have been able to do without the lasers. Most procedures done were gingivectomy, crown lengthening, fibrotomy, frenectomy, and laser pocket-reduction therapy. I was impressed to see that at the end of my third month, I had not only covered my payments, but also had gained an additional $2400 in production. We also started seeing patients who expected and wanted more modern and pain-free dentistry. For the first time, we had patients coming in just because we utilized lasers! We had truly created raving fans that had come a long way to seek treatment in our office.

With our new laser technology, we became more efficient by saving patients time and discomfort. We learned to provide a better, more gentle style of dentistry and also learned to stop operating like tooth assassins and save natural tooth structure with more non-invasive procedures. Ultimately, we began to treat our patients the way we wanted to be treated! Our lasers have truly set us apart from most other practices in our area. Much of our current success is due to the successful implementation of modern technology in dentistry.

We learned to provide a better, more gentle style of dentistry and also learned to stop operating like tooth assassins and save natural tooth structure with more non-invasive procedures.

In these difficult economic times, it is very important that we create value for our patients. It is important to be better than most others and to stand out from the crowd! It is important to provide the best care possible. We must raise the bar on how we do things and challenge ourselves to get outside of our comfort zone, learn new procedures, and utilize the incredible new technologies that dentistry now has to offer. If you love what you do, then this is the time to learn to do it better! If you love dentistry as I do, then I challenge you to learn what lasers can do for you. Lasers are becoming the standard of care and if you don’t have one, you are falling behind everyone else. Lasers are no longer a thing of the future. They are here and your patients expect it. The choice is yours. Do you want to wow your patients and provide them with the best in dental care? Or are you OK with them going to another office because you were too set in your ways? As coach John Wooden said: “Things turn out BEST for those who make the BEST of the way things turn out!” We must try to provide the highest quality of care by utilizing all the best dentistry has to offer! Before believing the media and all the negative influence out there, I encourage you to look within yourself. Think more positively! Change your attitude and become more enthusiastic. Find out who you are, what you do and who you do it for. See your vision clearly and stick to it! Cherish your relationship with your team and your patients. Have fun and make the best of the way things are!

Dr. Brian Toorani is the Owner of Dental Oasis Of Orange County, located in Huntington Beach, CA. He practices full time and can be contacted via E-mail at: DrToorani@DentalOasisOfOC.com

Okay, so my last name is Couch and I can get away with a little play on words—but if it makes you read the article, look at the photos, and take a moment to reconsider where you are in dentistry—then I think you will not only forgive me but thank me.
After 25 years of private practice, it seems like we are always evaluating new technology, how it may benefit our patients and balancing the cost of this technology with a return on the investment before the possibility that this newly purchased technology becomes obsolete.

Let’s look at the dental profession. Many dentists are attracted to the profession with a genuine attitude of service. I have had numerous opportunities to talk with fellow professionals who sincerely care about providing the best for their patients. The practice of dentistry may provide a career of service to your patients and the opportunity to provide for your family. With three children (one in law school, one a freshman in college, and an eighth-grader), I feel the pressure to not only provide for my family, but to wisely evaluate any major expenditure for the practice. We simply can’t afford to waste investments in our practice or sit on the “couch” and miss opportunities to give the very best to our patients.

Even though dentistry has improved greatly over the years of my practicing career, I am usually asked daily about “…when will they invent a quieter drill” or “…no offense, I really don’t want to be here.” An article in USA Today (Figure 1) clearly outlined that no matter how great we may think this profession is and the amazing results we can provide our patients; “WE” are still listed as one of people’s greatest fears. So, let’s take a look at what we can do in our practice right now to help lower that fear of dentistry or at least minimize it. Many people are very resistant to change (dentists included) but if you will walk alongside me I will take you on a journey that I found myself in this past year.

Figure 1 “What adults fear” courtesy USA Today.

Over the years, I have tried to keep up with trends in dentistry—intraoral cameras, digital radiography, digital photography, computerized paperless office, and all the new advances in dental materials. I have attended, like many of you, all the continuing education I can in order to improve my skills to provide the very best to my patients. BUT, one of the most exciting and revolutionary advances that I have added to my practice is one that has been with us for most of the past 25 years. Who would have ever thought that the gaming industry that provided these games for our kids, lasers and CAD/CAM has been used in other industries for a long time, could actually be the answer to removing some of the dental anxiety and reinvigorate the practice of dentistry?

Just over a year ago, we invested in high technology that I hoped would not only afford me a benefit as a better caregiver but also provide my patients with an obvious difference in their dental experience. That technology was the E4D Dentist System (Figure 2)—the chairside scanner and designing and milling systems that provide total control of my dentistry in every way. The E4D system allows me to provide metal-free restorations in a single appointment (or whenever I want) to without compromising any aspect of care. Any concerns about fit, form, function, and esthetics are all there—and better than ever (Figures 3, 4, 5). The E4D dentist system is the single-most important piece of hi-tech equipment that I have added to my practice in 25 years. I use it daily in my practice—and it has paid for itself from day one.

Dr. Bryan Couch off the couch.

Figure 3: Dental phobic patient presented with fractured buccal cusp.

Figure 4: Preparation completed, scanned with laser scanner, and designed using E4D DentaLogic software.

Figure 5: Same-day restoration completed using the E4D Dentist System. IPS Empress restoration characterized and glazed for a complete restorative solution.

Many dentists spend countless hours in continuing education to improve their knowledge, techniques, and delivery of procedures, but this technology demands any restorative dentist to look at what it can do to revolutionize their practice. The time is coming (or really it is already here) to provide our patients with a different mode of delivery for crown restorations. It is amazing that dental lab technicians could take an impression, pour models, wax up a coping, cast the coping, apply an opaque layer, hand stack dentin and enamel porcelains, stain and glaze a restoration, and deliver an amazing restoration for us to cement. Let me suggest a new paradigm; you can now prepare teeth and capture this image with the E4D laser scanner. Impressions are not needed! The software is very user-friendly and it becomes as easy as DREAM, DESIGN, DEVELOP, AND DELIVER! All those dental phobic patients now have a chance for relief…reducing the time in our dental chairs for the dental procedures they fear.

The software is very user-friendly and it becomes as easy as DREAM, DESIGN, DEVELOP, AND DELIVER! All those dental phobic patients now have a chance for relief…reducing the time in our dental chairs for the dental procedures they fear.

Studies show that nearly 80% of the dentistry we do is considered re-dentistry. This means that many of the teeth we evaluate have been treated before. It has also been stated that 70% of crown & bridge are single-unit posterior restorations. Take some time to evaluate the cases that come into your office; see if chairside dentistry could work for you. Another important consideration is to evaluate how many teeth you just “watch” because you hesitate to be aggressive on placing a crown. Chairside dentistry will offer you conservative treatment options for your patients that will last them much longer and not involve grinding away a tooth.

Here are my recommendations for getting off your dental “couch” and considering a chairside restorative system:

1. Does the investment make sense (cents)?

This one’s the easy one. You really just have to reach for your smart phone, iPad, or laptop. Go online to e4d.com, click on “Resources” and move to ROI Calculator (there’s also one for Canadian dentists). Read the instructions and fill out the fields. They have made it easy to play “what if” scenarios with all your choices for implementing chairside CAD/CAM.

Only you will know if it is right for YOU and YOUR patients. Make sure you contact your Henry Schein Sales Consultant and ask for a complimentary DPAT (Dental Practice Analysis Tool) that will give you an overview of your practice in all areas of care and relate that to the “norm.”

2. See it for yourself.

If I have piqued your interest then you owe it to yourself and your practice to come and see the E4D System and experience this amazing technology firsthand. Once again, ask your Henry Schein Sales Consultant how you can view the system and experience this hi-tech product. As dentists, we are a touchy, feely profession—we like to see and investigate options for ourselves. Why else would they call an instrument we use everyday an “explorer”? (Sorry for the pun!) Well, again Henry Schein has made it easy by offering a Build-a-Crown event in your area—or come to Dallas, Texas for an E4D Preview. Do some research on preparation design and bring your own case from your office. You can leave with a crown that you can seat in your office. This will show you just how great these restorations look. You get continuing education credit, and I will be surprised if you don’t return to your practice with your own E4D System!

Previews are unique experiences and happen every Friday of the year (except holiday weekends) where clinicians and assistants from all over North America participate in a full-day program at the global headquarters of D4D Technologies. You can see where it all happens— where the system is designed and built. The most important thing to me is the training and support. You will quickly ascertain that this company is committed to helping you learn this system. I can honestly say that you will have the confidence in the restorations you deliver because of D4D’s dedication to support. They genuinely care about you and your patients. And, since I spend a lot of my Fridays sharing my passion and experience at D4D Technologies— I might just meet you here.

Figure 6: Sample E4D calculator demonstrating the return on investment (ROI) possible by incorporating an E4D Dentist System into YOUR practice (www.e4d.com)

3. Just do it!

If you like what you see—just do it! Take the step; I’m right here with you. Invest in this technology. You will not be disappointed. There are many benefits from enhanced tax incentives (Sections 179 and 199) to Total Care Protection (free software upgrades, free remote support, quarterly preventive maintenance, training, and integration) to the amazing clinical realities that become possible. So, just do it— you’ll never look back (or at) another tooth/restoration in the same way…guaranteed! Much like me, you might wonder why you didn’t get off the “couch” sooner and add this technology to your
practice.

Dr. Bryan Couch is a practicing dentist in Coppell, Texas.

Did you know that the median credit score was in the 720 range before the recent economic turmoil and has now dropped to 680? A credit score drop of just 40 points effectively doubles the risk for the creditor. Many creditors who accepted business loans at the 680 score category now require 720. It is almost impossible to get a business loan unless you have an impeccable score, which requires that all of your banks and credit card companies report in the proper manner.

Do you know which banks are reporting your credit card data in a way that they effectively take 20 to 50 points from your score? Did you know you can hurt your credit score if you pay your accounts in full every month or if you arrange a payment plan on an old collection? Do you know which Website is giving you your real credit score?

Doctor L. from New York approached our company after hearing about us at a conference. He was skeptical that we could help, but his source was a well-known businessman. His score was 635 in February 2010 and he was sure that it was due to a late payment even though it was on an automated payment plan. He had reviewed his credit report and was certain he had everything in order. He had no idea that there were several items misreported—taking over 100 points from his score. After a full optimization and three months of collaboration, his score is at 776 as of June 2010—and is still climbing.

Dr W. from Maryland wrote, “When I wanted to open my practice and buy my new home, I discovered that bank regulations had become exceedingly stringent, even for people like me who pay their credit card bills fully every month. I was referred to Monika Nagy, CCA who explained how to would, as she put it, ‘skyrocket.’ She was right. Following her advice I was able to buy my house and open my practice in 90 days. I believe all of us doctors can save substantial amount of money and frustration by using her credit rating improvement services”.

Practitioners should know that “79 percent of credit reports may contain some type of error” per the Federal Reserve Bulletin. Every dentist should have a credit check up and not wait until they apply for a new loan and discover a problem. The rules of the credit system are counterintuitive, complicated and constantly changing.

When was your last credit check up?

Monika Nagy, one of only 130 Certified Credit Analysts in the United States, former professor and recognized author, is helping dentists to raise their credit score. Nagy has been interviewed by AOL.com, MSN.com, The Science Monitor, etc. and has been a featured speaker on radio shows nationwide.

After an initial consultation, Monika Nagy and her associates create a customized plan, specific for each practitioner, which can generate results in as little as 45 days or may take a few months, based on the scope of services.

For more information, you can reach Monika Nagy at monika@FinancialFutureCoach.com or toll-free at
(888) 703-6798.

Dr. Ruben Cohen Park Avenue Oral & Facial Surgery

Dr. Ruben Cohen

State-of-the-art equipment, a prime location, and style elements that harmoniously combine both classical and contemporary design features make Dr. Ruben Cohen’s New York City, New York office, Park Avenue Oral & Facial Surgery, a dream come true.

The practice fulfills the Doctor’s vision for a high-end, chic boutique-like dental office with plenty of upscale sophistication and a high regard for the building site’s architectural details. “It took me almost three years to figure out how to do it,” comments the Doctor. “…Where to open… a solid business plan, and the capital to make it happen. [I wanted] a modern style with traditional elements since it’s on the ground floor of a pre-WWII building and I did not want to lose the essence of that period.”

Left to right: Paige Boller Malik; Lee Goldstein, Equipment Sales Specialist; Dr. Ruben Cohen

Although the economy had taken a downfall and everyone advised the Doctor that the time was perhaps not optimal for such an endeavor, he did not follow that logic. “I believed the opposite,” he notes.
“This was a perfect time to negotiate a great deal on a prime real estate location and do my build out for an affordable price since construction in Manhattan has also significantly slowed down. The
office used to be an orthopedist’s office, which had not been renovated in over two decades. I completely gutted the space and rebuilt it. I wanted to do this once, do it right, and hopefully never have
to do this again until I have outgrown my space and am ready to build a new office three times as big! Square footage is always the limiting factor in Manhattan. My goal was to find an office that would
enable me to have 4 fully equipped surgical rooms, so that as my practice grows, I can have a second surgeon work with me; with each of us having 2 dedicated operatories available for treatment.”

Dr. Cohen’s personal and professional life was evolving. He had finished residency—and he and his wife were awaiting the birth of their second child. Realizing that it takes a long time to build an established
and reputable business, he decided to make his move. “I told myself that the sooner I begin, the sooner I will be up and running Manhattan’s premier oral and maxillofacial surgery practice!”

“I told myself that the sooner I begin, the sooner I will be up and running Manhattan’s premier oral and maxillofacial surgery practice!”

Dr. Cohen turned to his Equipment Sales Specialist Lee Goldstein for advice. Lee introduced the Doctor to the rest of his team. They then began evaluating locations for the business and also created
a preliminary floor plan to see if the space would work for the projected needs of the practice. “Henry Schein Dental’s Specialists…were extremely helpful,” comments
the Doctor. “They visited multiple spaces with me and took measurements. I valued their time, and was extremely appreciative of what they did for me. Their team helped me develop a realistic budget and
accomplish realistic expectations.”

The office’s elegant and restrained décor successfully marries sleek, modern cabinetry, cool marble surfaces on counters and floors, and neutral wall colors with French neoclassical furnishing accents
such as nickel-plated sconces in the hallways and a plush velvet couch in the reception area. The result is stunning—understated and artistically impactful.

The same mood prevails in a room that has been specially designated for the younger clientele. Here, you’ll find a floor­to-ceiling, three-dimensional white lacquer tree with birds and butterflies made
from an assortment of organic and sustainable materials such as wood, leather, and steel. The composition creates a bit of whimsy and fantasy—just the right touch for a bit of delightful distraction
during treatment!

Park Avenue Oral & Maxillofacial Surgery enjoys the streamlined and convenient advantage that a fully digital setup offers staff and patients. Clutter is gone, replaced by well-organized files that
are just a click away. Corresponding with collaborating dentists is easy and stress-free. Referring dentists who visit the office are impressed with the cutting-edge equipment. “Dentists want to send
their patients to an office that [is prepared to deliver high-quality care with the latest in technologies—and an expert staff dedicated to excellence],” comments Dr. Cohen. “The best feeling is walking
into the office every morning and knowing that you have built the office of your dreams—and that nothing can stop you from creating a successful practice that will distinguish you from your peers!”

Designed by: Henry Schein National Design Group

Featured Equipment:

Aribex Intraoral X-ray

DEXIS Digital Sensors

Gendex GXCB-500 HD

Cone Beam CT Midmark M11 Sterilizer

Porter Wall Mount Flowmeters

SciCan Statim 5000 Sterilizer

Although the number of continuing education (CE) options for the general dentist is ever expanding, choosing the best option for the growth of your practice continues to be a challenge. Knowing whether you should attend a one-day lecture, a weekend hands-on course, a live patient experience, or do your expanded training via the worldwide Web, is a difficult decision. The price of dental CE courses is not getting any cheaper—and the real cost is the time away from the practice. Learning to align the best educational experience with your particular practice dynamic is critical if you want to experience an optimum return on investment.

A plan for CE implementation in a practice has to begin with finding the best possible content for what you are trying to accomplish, align it with your schedule, and then create a budget over time that is affordable. Be very clear about what the desired outcome for what the additional training will do for the practice. Training should accomplish one of three goals:

1. Add additional professional services to the practice.
Last month we described the process of implementing surgical implant procedures into a general practice. This additional training comes at a considerable expense, but there is a direct return on the investment that is measurable. At the Dawson Academy, we train dentists on how to predictably do more complex restorative and interdisciplinary cases. Again, training with us should create a measurable increase in the productivity of the practice.

2. Increase the efficiency of current procedures.
Good CE should not only train the team on expanding the number of services a practice provides, but also how to do the procedures efficiently. This goes way beyond what the dentist has to do. Getting the front desk to work with the dental assistants to schedule appropriately and making sure the treatment room has everything ready for the procedure is critical. Efficiency is also easy to measure, as more procedures will be completed during the course of a day.

3. Increasing the quality and predictability of current procedures.
What is more difficult to measure is CE that increases the quality and predictability of the procedures you are currently doing. This will increase profitability over time with a decrease in remakes and fewer unnecessary emergencies. It will also increase your own personal satisfaction for the services you provide and allow you to realize a higher net income with fewer hours worked. This has been a cornerstone in the teachings of Dr. Peter Dawson for the last 30 years.

The Problem With CE in Most Dental Practices

In the vast majority of dental practices, continuing education is an afterthought. A time and financial budget is never created, so CE is considered whenever it is convenient. When a brochure comes across the front desk, if it seems interesting, and the day is open, the course gets scheduled. The problem is that there is a guaranteed lack of congruency from one course to another. Some may actually contradict one another. This leaves the dental team confused, with a great deal of difficulty implementing what they have learned.

Continuing education needs to be an extension of a practice’s big picture. The leader first needs to decide the niche of the practice, get the team aboard, and look for courses that will expand their services, increase efficiency, and increase quality/predictability. It is also strongly recommended to find an approach to dentistry that suits the practice—and stick with it. This leads to a clear approach that can be understood and easily implemented by the team.

The Best Way to Implement CE

One of the greatest challenges in a dental practice is the implementation of high-tech equipment into the practice. This requires a thorough understanding of the equipment as well as necessary training that will be required to perform the procedures. All too often, the technology is purchased without a clear-cut plan for where it will fit in the practice. A great example of this is the implementation of a chairside CAD/CAM system into a general practice. We have been involved with the E4D® system since its inception. I can tell you from experience that the more complicated the technology, the more important a well-defined plan will be to the practice. If the parameters of your practice are not clearly defined prior to the purchase, the impact of an exciting new purchase can quickly throw the practice into chaos. It is far better to clarify who you are; get the team to understand how the new technology fits into the practice; get everyone trained accordingly—then hit the ground running. The following is a five-step implementation strategy for any dental practice. We will continue using the E4D example.

1. Begin With a Sound, Specific Practice Philosophy– Having a clear understanding of the population you serve and a specific idea of the kind of dentistry you want to practice will help you choose the appropriate technologies. Our practice is an adult restorative practice that focuses on solving complex functional/esthetic problems. Because we do a lot of inlays, onlays, crowns, and veneers, chairside CAD/CAM was a logical choice. By controlling a percentage of the lab-fabricated restorations, we could add an additional service to the practice (same-day restorations), increase the efficiency of current procedures as well as decrease our laboratory expense. Although these were all great reasons to get involved with chairside CAD/CAM, we also knew that we would continue to use the dental laboratory for the majority of our multiunit cases. In our reality, this purchase was for our cases that involved 1–2 units, with the occasional quadrant. Once the decision was made, the first step was to assemble the team, and make sure everyone was clear on the role of the new purchase within the vision of the practice. Key point—never let a technology define your practice. Technologies are simply there to make your practice better.

2. Align your Leadership/Management Principles With Your Practice Philosophy–The second step is to make sure you align the technology specifically with your management principles. With E4D, the first thing to preplan is how you are going to schedule these restorations. For traditional crown & bridge, we prep, pack cord, take an impression, and place a provisional restoration. With E4D, we prep, pack cord, take a digital impression, design the restoration, mill it then fire it in an oven.

What had to be discussed is how we were going to schedule this. What part of this procedure could be delegated and still end up with an optimum restorative result? What cases were appropriate for E4D in our philosophy, and when would we need to utilize the services of the dental lab? The point is, these decisions have to made before the technology arrives. Preplanning will allow the practice to stay true to their vision, and allow for the best possible transition into the new reality.

3. Scientific Understanding of Technology and Materials–Once philosophical and managerial principles have been clarified, it is time to immerse the team into the nuances of the chosen technology. With E4D, this was relatively easy. The purchase came with 2 days of training along with an unbelievably good support line. If a practice desires to do larger cases or smile design with E4D, training is also available. Check out www.e4dsky.com/university/courses.php for a detailed list of training possibilities. Nothing can take the place having access to great information/training when it comes to the use of a complex new technology. Keep in mind that it is the practice’s responsibility to determine where this technology best fits (refer to steps 1 and 2). We utilized our relationship with E4D to completely understand the intricacies of technology, porcelains, and cements. Team dedication to becoming an expert on the chosen path is imperative.

4. Attain Procedure Mastery–Procedural mastery comes with experience. Taking the time to creating a philosophy, a managerial plan, and a scientific understanding of the technology will prepare you for mastery. Then and only then can you focus on individual procedures. By having the managerial discussions well in advance, the schedule will be structured to allow the clinical team to do their best and be productive and efficient. Nothing is more stressful than doing a new procedure for the first time without enough time or a properly trained team. We can all remember when we have been in that position. Preplanning and proper training is the key to success.

5. Create Standard Operating Procedures and Checklists–The last step in the process is to take the time to create Standard Operating Procedures (SOPs) and checklists. It may seem mundane, but the more we learn to do things the same way over and over, the more predictable it becomes. SOPs and checklists are tremendously important to make sure that each team member sets up a room and assists the Doctor in the same way, every time. The more complex the technology, the more important SOPs and checklists become to the practice.

Conclusion

Practice growth is directly related to practice improvement. We improve by expanding our services, increasing the efficiency of what we are doing, or increasing the predictability/quality of our services. For the past 25 years, The Dawson Academy has been working with thousands of students to help them create a sound practice vision and learn the procedures necessary to perform restorative procedures at a very high level. As we evolve, we are expanding our lectures and hands-on training to include Web-based learning opportunities (Dawson TV). Our goal is to have educational opportunities at all five levels on the above grid, within the context of one congruent philosophy. Regardless of where you decide on training, make a point to plan your CE choices a year in advance. If you do, you will experience a healthier practice financially—and one that is far more enjoyable.

Business people are always searching for new ways to expand their horizons. Even as a new dentist, investing in new technology has been my priority. As a result, Cone-Beam imaging has had a positive impact on my practice—on diagnostic capabilities, on expanding in-house procedures, and on my patients.

For diagnostics, having a 3-D scan is like having X-ray vision. Without performing surgery, it is not possible to detect anatomical anomalies, hidden nerve canals or nerves extended in unusual directions, impacted teeth, supernumerary teeth, or hard-to-see infections. My Gendex medium field-of-view scanner offers a range of scan sizes ranging from 8 or 14 cm diameter and with a height from 2 to 8 cm, and anything in between. I can capture a single arch, both arches, or expand to include the TMJ.

With these insights, I am confident enough to expand my treatment choices. During a yearlong residency at the Misch Implant Institute in Michigan, I learned how 3-D scans provide information about tooth positions and shapes, and precise measurement of teeth and bone. Having a view of the angulation of teeth and the position of nerves from any angle makes positioning implants less complicated and less stressful.

The system’s built-in 2-D pan captures other necessary views, without needing a separate machine. Before I invested in the Gendex CBCT, I needed to send my patients out for a 3-D scan. This required that they had to take more time away from their work and waste gas money. Even more importantly, an in-office Cone-Beam scanner exposes the patient to as much as 10 times less radiation than medical CT scans,—or even less— depending upon the resolution needed for certain views.

Cone Beam–A wise investment for your practice

In order for patients to accept my recommendations, they must comprehend my reasons for treatment. I have positioned my flat-screen monitor right next to the scanner, so when the patient is still seated in the machine, he/she can see when the scan appears on the screen. When I can slice or rotate the scan 360 degrees, they are very impressed. When a 3-D scan depicts a tooth precariously near a nerve canal, the patient can understand the risks of complications. For colleague consultations, the scans can be quickly and simply shared either by electronic transfer or CD.

After news spread about my Cone-Beam system, oral surgeons began referring patients for scans, which built good relationships and added to the scanner’s potential profitability. With the recent recession, I am thankful that I have this system and am able to expand my procedure offerings.

Building my business and learning new techniques for treatments are two very important parts of my future success. Along with expanding my horizons, Cone-Beam technology has dawned a new day for my own professional enrichment.

Dr. Hanna received his DMD from the Tufts University School of Dental Medicine in Boston, MA and his BA in Psychology from Boston University. He is a member of the American Dental Association, Academy of General Dentistry, and the Massachusetts Dental Society.

With the growing popularity of implants, many dentists are exploring ways to add this type of procedure to their trea™ent options. When implants are indicated, the process of determining the optimal trea™ent plan starts even before the details of the implant itself are considered. The opportunity to view a three-dimensional scan of my patient’s anatomy before starting an implant makes me a better dentist. My i-CAT® provides me with better visualization and a clearer perspective on my options. Most importantly, CBCT gives me the ability to achieve my desired results more easily and less stressfully.

Not only do 3-D images prepare the dentist for surgery, they help the doctor educate the patient to the inevitability, and not just the possibility, for certain pre-implant necessities such as bone grafting. I can use the data garnered from cone-beam scans in conjunction with third-party software such as SimPlant®, EasyGuide™, NobelGuide™, and InVivo5™ to create precise treatment plans and surgical stents for even more accurate implant placement.

Since I’ve chosen an in-office scanning method, both my patients and I are able to benefit from the convenience and time-efficiency over the use of imaging centers or the higher radiation exposure of medical CT scans. I can also avoid over- exposing the patient by reducing the region of interest to capture just the area needed, especially in the case of indicated postoperative scans that allow me to verify the healing and success of procedures such as bone grafting and sinus lifts.

The “surgical view” that cone-beam imaging offers has become an integral part of my implant process. I also believe that it is important to use cone beam not so much as a “Standard of Care,” but more for “Appropriateness of Care.” It is our responsibility as dentists to provide appropriate trea™ent based on the individual’s distinct lifestyle and specific dental issues. I use my cone beam to discern the best course of trea™ent for that particular patient, such as, whether to propose an implant or a conventional bridge.

In the case of my utilization of either 2-D or 3-D imaging for diagnosis, I make my decision on which modality is adequate for that particular case. For example, 2-D images may yield the needed diagnostics for a simple extraction. However, if a patient presents with an impacted tooth that is in close proximity to the nerve, I would select a cone beam scan to gain the most detailed information prior to beginning treatment.

“Determining the optimal trea™ent plan starts even before the details of the implant itself are considered.”

In the 5 years I have had my i-CAT, I’ve observed the many ways that it has improved my practice. Cone beam technology takes the “unforeseen” out of surgery, and allows me to verify that I’ve accomplished my surgical objectives. Three- dimensional imaging provides more opportunities to enrich the dental experience for both the dentist and the patient by providing more information, more confidence, and more options for dental care.

Dr. Rosenlicht is an Oral and Maxillofacial Surgeon and president of the American College of Oral and Maxillofacial Surgeons (ACOMS) and the American Academy of Implant Dentistry (AAID). He is a Diplomat of The American Board of Oral and Maxillofacial Surgery (ABOMS) and The American Board of Implant Dentistry (non- specialty Board). Over his 30 years in dentistry, he has developed techniques for bone grafting, immediate impressions for implants, and prosthetic applications for immediate and delayed restorations. He has authored numerous articles, is published in five textbooks, and has developed and patented the “Fixture Mount Transfer” commonly used in a variety of dental implants. Dr. Rosenlicht currently practices in Manchester, CT, and can be contacted through www.jawfixers.com.

Pelton & Crane emphatically announced its continued investment and support of Henry Schein by opening their new West Coast showroom and training center in Beaverton, Oregon.

Dubbed the “Dr. Richard Pelton Showroom and Training Center,” Pelton & Crane recently opened the doors to the beautiful facility to about 80 Henry Schein Team Members, doctors, and distinguished guests.

The new facility is located on the Tektronix campus in Beaverton, just adjacent to the Nike World Headquarters, is on a beautiful 50-acre campus blanketed in lush foliage with walking trails, ponds, and scenic northwest U.S. beauty.

Beaverton is conveniently located outside of Portland, and only a short drive from Newberg, the home of Marus.

The Pelton & Crane showroom is equipped with a wide variety of operatories, KaVo cutting stations, a suite of Instrumentarium products, Gendex and Soredex 2D and 3D solutions, DEXIS and Gendex digital sensors, KaVo lab area, Solaris Sterilization room and Vista water treatment products.

The facility also boasts a large conference center and training facility for the expansion of the “Driven to Excellence” continuing education seminars as well as other HSD training events.

“The new Pelton & Crane showroom and training facility is outstanding. The showroom is fully loaded with the best of Pelton & Crane, KaVo, and a wide variety of their 2D and 3D imaging brands.”

According to Equipment Sales Specialist Eric Black, “The new Pelton & Crane showroom and training facility is outstanding. The showroom is fully loaded with the best of Pelton & Crane, KaVo, Gendex, DEXIS, Instrumentarium and Imaging Sciences. The showroom now gives me a great opportunity to show my doctors firsthand the Pelton & Crane advantage. It also is perfect for the Driven to Excellence program. I’ll be spending lots of time in Beaverton.”

The new facility is available year round for VIP’s visits, Driven to Excellence events, regional or Zone training, and other events. Simply contact your local Pelton & Crane Sales Consultant for more information.

Dr. Mark Tholen leads the Driven to Excellence events.

Our designers specialize in coordinating dental ergonomics and design elements to give your practice the advantages of increased efficiency, improved patient care, and greater comfort for staff and patients.

We hope this information will assist you in planning your new office. If you have any questions, feel free to e-mail me at jennifer.rhode@henryschein.com or visit us on the web at henryschein.com

Jennifer Rhode
National Design Group Manager
Henry Schein Dental

Designed by: Tom King

General Practice

• Maximum utilization of square footage provides a spacious and open design
• Centralized sterilization and lab allow for easy instrument management, clean-up and ajdustments
• Identically equipped treatment rooms allow for multiple uses
• Curved art displays behind treatment rooms provide an aesthetic appeal to main hallway
• Clear division between public and private areas
• Private staff access eliminates unnecessary circulation through treatment areas

Our design experts offer state-of-the-art-three-dimensional office renderings to help ensure that your new dental practice will be perfect!

Designed by: Tracy Tock

Pediatrics

• Curved soffits provide an aesthetic appeal to main treatment area
• Quiet treatment rooms allow for added patien privacy
• Circular hallway provides for efficient flow of patients and staff
• Centralized sterilization and lab allow for easy instrument management, clean-up, and adjustments
• Clear division between public and private areas
• Mechanical and nitrous closet located near exit door for easy access

For more information, contact your Henry Schein Dental Sales Consultant at 800-645-6594
In Canada, call 800-668-5558

“Less is more”…we have all heard the phrase many times. In this instance, we can showcase Dr. Edward McMurdo’s new practice, East Pointe Trails Dental Centre, to more fully understand the philosophy behind the notion.

After moving to Tecumseh from the Vancouver area, Dr. MacMurdo sought to enter into an associateship. When this was not forthcoming, he revised his plan of action and decided to build new. What evolved was a great plan for a compact and streamlined 1,600-ft., 3-operatory office. “I prefer the smaller office with a single practitioner and hygienist…it’s less like an assembly line,” comments the Doctor.

The vision for the office was further defined as the plans solidified and were taken to the action phase. “I received good ‘word of mouth’ references from other dentists about Henry Schein Dental’s Equipment Sales Specialist Carl Bernat,” recalls Dr. MacMurdo. “I spoke with him…and along with the contractor, we got everything organized. Carl took charge; I was still living in Vancouver at the time of construction.

Having Carl there, keeping it all under control was so much easier. He helped with the equipment selection and supplies and dealt with all the builder/contractor issues. National Design Group’s Odette Legree coordinated the interior design elements.”

“The office is small with a great feel and no details overlooked. Its cozy and comfortable atmosphere is definitely welcoming…everything turned out very well.”

“Our conversations were mostly over the phone during the process…I was in Ontario and the Doctor in Vancouver,” notes Carl. “The office is small with a great feel and no details overlooked. Its cozy and comfortable atmosphere is definitely welcoming…everything turned out very well.”

Through the combined efforts of Henry Schein Dental’s specialists and Dr. MacMurdo, the final product was achieved. The paperless office is well underway with Dentrix practice- management software to simplify the office’s many administrative activities. Patient comfort is at the top of the list; they enjoy the luxury of massage chairs from Pelton & Crane during their visits and digital radiography ensures that their X-rays use minimal radiation. “All the products selected have proven track records and are of high quality,” points out Carl Bernat. “There are excellent features on each of the equipment choices that will dependably fulfill the office’s needs for many years.”

Minimalist style makes the decor crisp and functional. Slate flooring in the ops and durable and beautiful granite on countertops in the reception area and bathroom add texture and interest. The multipurpose consultation room provides privacy for conferences and an extra space for the Doctor to attend to the many details involved in running the practice.

“Ours is a new office that is still growing,” notes Dr. MacMurdo. “We continuously have new patients through advertising our business. And, after only one year, we have quite a few referrals from our current patient base.

Carl Bernat, Field Sales Consultant; Dr. Edward MacMurdo

“I now have a great team… and a modern, clean office where I can offer my patients quality dentistry in a relaxing environment.”

Carl has done a terrific job getting my office built and helping me blend into the community. He constantly went beyond what is expected to ensure that my new office was up and running. I now have a great team…and a modern, clean office where I can offer my patients quality dentistry in a relaxing environment.”

Featured Equipment:

• Biolase ezlase
• Dentrix Practice Management Software
• Midmark M11 Sterilizer
• Pelton & Crane Massage Chairs
• Pelton & Crane Delivery Systems
• Pelton & Crane Light Fantastic
• Pelton & Crane Cabinetry
• Pelton & Crane Solaris Sterilization Center
• SciCan Statim
• Sirona Orthophos XG5
• Sirona Xios Sensors

By Jason Lipscomb

The world of Dentistry has definitely changed over the past several years. It is no longer a business where you can put up a sign and expect to have hundreds of patients knocking down your door. Dentists have embraced marketing and now employ several different methods to drive traffic. Nowhere has this been more noticeable than on the Internet. Dental Web sites are now a universal tool, and offer everything from computer graphics to appointments. They may range from the simple to the complex, but the common consensus is that everyone should have one.

The Web is constantly evolving. More and more of the content is being created by ordinary users like you and me. The Web is no longer an environment of static Web sites, it is a thriving community that allows for immediate communication and information sharing. People don’t just visit Web sites anymore, they live on them. We are in the world of Web 2.0 and Social Media. These are terms that are tossed around quite a bit, but many don’t really know what they mean. Web 2.0 and Social Media is the next step in the evolution of the Web. They give the user the opportunity to take control of their own Web destiny and can create a Web environment that is specific to them.

This type of environment makes it much more conducive to share information and to connect with other people around the world. It also marks a new era of dental marketing, the era of Social Media for dentists. Many dentists are embracing Social Media, by creating pages on Facebook, YouTube, Twitter, and LinkedIn. These platforms allow dentists to step out of the static framework and become more engaging. Dentists can easily share their knowledge and become a real person, not just a name and a logo. Still others don’t see a need to try this alternative marketing. The problem is, this alternative marketing is becoming the new main stream.

Let’s look at the statistics of one of the major Social Media outlets, Facebook. Facebook is the biggest social utility Web site out there. It has over 400 million users. It comes in a close second to Google as the most visited Web site in the world, and it has actually beaten Google on several occasions. Almost 60% of the American population has a Facebook account. That in itself is amazing. Try to get 60% of Americans to the polls on election day! The average user has over 130 friends on Facebook, and spends almost 55 minutes each day on the site. No other Web site can match this. Google may have more traffic, but no one spends almost an hour on Google. A majority of these active users believe that every business should have a presence on the site.

Many dentists are embracing Social Media, by creating pages on Facebook, YouTube, Twitter, and LinkedIn. These platforms allow dentists to step out of the static framework and become more engaging.

What do all of these statistics mean? It means that people are living their lives on Facebook. They are connecting with friends, shopping, and getting their news from one place. It also presents a wonderful opportunity for dentists to connect with over 60% of the population. These are not all teenagers either. One of the fastest growing Facebook demographic is users aged 55–65. Social media viewership is a true phenomenon that encompasses people of all ages, races, and creeds. This type of thing doesn’t happen very often.

Business’ have also jumped on the Social Media bandwagon. The static Web site has become so ingrained in our consciousness, that many major businesses don’t advertise them anymore. What you will see is FORTUNE 500 companies saying, “Find us on Facebook” or “Follow us on Twitter.” Before long the Facebook page or Twitter account will be the standard.

What are the benefits of using Social Media for dentists? The most obvious reason is the sheer number of people using these platforms. Conventional media like T.V., radio, and print is a crap shoot. There are too many alternatives out there for people to view. More people get their news from the Internet than newspapers. Tivo and other video on demand options have lessened the power of commercials. Many people are watching TV shows on the Internet. Satellite and Internet radio is crippling the radio broadcasting industry. More than half of the population still returns to Facebook each day for almost an hour. Most dentists would love to reach 60% of the population in their area.

The financials of Facebook marketing are also strong. Operating a Facebook fan page or a Twitter account is free, so the R.O.I. of Social Media can be very high. Facebook does offer some pay per click advertisement much like Google. Where else can you find an effective way to advertise your office for free.

The great thing about social media is that word of mouth advertising is built right in. It is extremely simple to share content with another user on Facebook or Twitter with the click of a button. That is why many pundits say it is word of mouth on steroids. Information can travel very fast on these sites and can easily go viral. Take for instance the aforementioned factoid that most Facebook users have 130 friends. If a Facebook user posts a comment or picture, it will be seen by 130 people, then to almost 17,000 viewers (130 x130) , and so on. Within minutes content can be seen by thousands of people. All with the click of a button. When people ask me why I would encourage social media use instead of a phone book ad, I usually reply “The phonebook doesn’t have a share button.”

One of the strongest reasons a dentist should use Social Media is because of fear. Thousands of patients cancel their appointments each year because of fear. Many others don’t make an appointment because of fear of the unknown. They don’t have a dentist and they are afraid to start with a new doctor they don’t know. Social Media allows dentists to build an online personality and reduce fear. They can express themselves and not only prove their knowledge, but show their human side. Social media is about building relationships online, and building these virtual relationships will help build your practice. Social media also gives dentists the power to become the local expert. Patients and potential patients often have many questions or concerns. They often are afraid or embarrassed to ask them. Using social media gives them a feeling of anonymity, and allows them to ask questions more freely. Dentists can then answer these questions and it gives them an air of professionalism and compassion. It also cements their status as an important figure in the community, virtual or real.

Although these Social Media Web sites may seem like they are all fun and games to an outsider. They contain a lot of powerful marketing information. Facebook and other Social Media outlets collect great amounts of demographic information from their willing participants. Users freely hand over their address, phone number, birthday, etc. This is a shrewd move on their part, because if any other Web site, even Google, were to ask for this information red flags would be waved. Social Media-users tend to acquiesce and give out a lot of information. Much of this information can be used to target audiences for Social Media marketing, and really let you hone in on a specific demographic. Targeted marketing in any campaign will make marketing efforts more effective and drive traffic.

How then should the average dentist get started with social media? There are many social media platforms to explore, and it can be quite daunting for the newbie. It is best to pick one type of Social Media at first. Some dentists jump into several different platforms at once, and it is very easy to become burned out or watered down. Be diligent and do your research. Start an account on one platform and play around with it. Learn the “language” of the Web site. Each type of Social Media has its own set of rules and etiquette, and it is best to learn this well before diving in.

Time management is a very big part of Social Media for dentists. They must figure out how much time can be spent on a campaign, and how many new patients it will take to validate the usage. Too much or too little time can kill a Social Media campaign. Creating a weekly calendar of goals and procedures will be a big help for most dental offices. Learning how to get a campaign going and maintained without taking up too much time is one of the biggest hindrances for dentists. A successful Social Media campaign can be managed in just minutes minutes or even a day if the correct parameters are put in place. Many dentists believe that they have to constantly contribute creative content to be successful. Contributing content can be as simple as uploading a picture with a short description or as complex as a two- page blog post. As long as you keep your audience engaged with something, however simple, you are making an impact. Many dental offices find it helpful to incorporate their staff or spouses into their Social Media campaign.

Privacy is also a major concern with dentists using Social Media. We as dentists often treasure our privacy and time away from the office, and many see Social Media as a threat to privacy. Don’t let privacy be a deterrent. It is only a speed bump. Many successful Social Media campaigns have been successful without giving up privacy. The one thing to remember about Social Media is, you get out what you put in. Much of the personal information they request is not necessary. It is helpful but not necessary. You can operate a Facebook account on a name only. No picture. No birthday. No credit card number. You may also have a profile for your business, and have no personal information available at all. Google already knows more about you than will ever be found on Social Media. Phishing and other security concerns are still a very real threat on Social Media, but they are no more of a concern than they are on E-mail accounts. A certain level of common sense must be maintained. Don’t fall for the prince from Nigeria who needs $10,000 to get 1 million, no matter how they contact you.

This is the future of the Web, like it or not. Years ago just having a Web site was a major accomplishment, now it is a necessity. Soon a Facebook or YouTube account will turn from a novelty to a necessity. Dentists need to be there with an established following. And why not? We spend hours and hours on patient education to keep them informed, and explain our methods. Their level of understanding makes our job easier and also helps with case acceptance. Social Media marks the first time in history that we can connect with the public, educate them, and have them share their experience in one package. Truly Amazing.

Dr. Jason Lipscomb is a general dentist who operates two practices in Virginia. He specializes in helping dentists expand their practices through the use of social media. Jason and his partner Stephen Knight started Social Media for Dentists to help other dentists master social media and attract new patients. Jason and Stephen have also authored the book “Social Media for Dentists”. A 350 page guide to social media as seen from the dental perspective. Visit their website at http://www.socialmediadentist.com or http://facebook.com/socialmediadenist

In so many aspects, 1956 was a very good year. It was the year videotape was first used on TV; gas cost 22 cents per gallon; and the minimum wage was $1.00. The Yankees beat the Dodgers in the World Series—and I graduated from the University of Missouri School of Dentistry. After serving two years in the Air Force, I began my dental career in Belton, Missouri. During my 55 years in dentistry, I have witnessed new materials and technologies that have improved the dentist’s ability to provide the best patient care. After a half century in business, I became associated with Dr. Terry Myers, who not only enjoys practicing dentistry but also teaches other dentists about new dental technology. He brought many new innovations to the practice, such as digital X-ray, intraoral cameras, and a CBCT scanner. I remember when he brought in the DEXIS system. Having become accustomed to traditional film for so many years, I had some degree of skepticism about my ability to adapt to digital X-ray, but it didn’t take much time before it became an integral part of my daily life.

From my firsthand experience, I know now that digital X-ray saves time and is easier to read. Back when I first started in dentistry, we had to dunk pieces of X-ray film in a tank, first through the developer, then through the fixer and then, hope that the X-ray came out all right. Finally, automatic processors were invented, but we all still had to wait a long time between exposing the film and developing and reading it. Even after all that time, the radiograph was often still too small for the patient to really understand what I was talking about.

Now, when I display the digital X-ray on the monitor, especially with new DEXIS Platinum technology, the clear images really accentuate the details. Digital images are so much easier for everyone to see and understand. After a short learning curve, I was able to adjust images to concentrate on specific areas—I can enlarge, zoom in, change contrast, draw lines to specific areas, just to name a few, with just the click of the mouse. Although the technology behind digital radiography is fascinating, I like to leave all of the complicated technology to the engineers and just take advantage of the good results of all of their hard work.

Digital X-ray—an integral part of my daily life

Collaborating with colleagues is so much easier. For instance, I just e-mailed an oral surgeon a digital photograph and X-ray, and I expect a call back from him in a few minutes. If I had to send X-rays by regular postal mail, three-to-four days might pass before we could collaborate, delaying treatment.

At the age of 77, I am pretty certain that not many in my age group are still practicing. I was very fortunate to become associated with Dr. Myers, a gem of a person to work with, and his well-trained staff. At first, I was just going to stay on for a year or two to introduce him to my patients. Now, I still enjoy working two days a week. Technology like digital X-ray has made it possible for me to get a better look at the patient’s dentition; to be confident about what I am seeing; and be able to collaborate with my trusted colleagues. Some patients I have treated for 40-to-50 years tell me I am not allowed to retire. With technology that makes my life easier, why should I? So, as long as I stay healthy, I’m still hanging in there.

Sitting to work or working to sit? Most dental practitioners sit for the majority of the workday. Generally, dental professionals report experiencing discomfort in the back and neck areas most frequently (ADA membership survey 2007).

When observing dental professionals, we see that they tend to assume a number of awkward postures and positions during the course of their workday—sometimes referred to as “holding patterns.” The practitioners become so focused on their patients and the procedures they are performing, that they often disregard their position, posture, and level of discomfort. Over time, this can have a negative cumulative effect on their body, also afffecting the quality of their work. Pain in the shoulder, wrist, hand, or neck can prohibit the dental professional from completing the required procedures efficiently, effectively, and at the highest level of quality.

Therapeutic Dynamic Seating System

Over time, our bodies tend to accommodate the positions we assume. In addition, if we add age, osteoporosis, and muscular imbalance to the equation, we often find that we are in poor posture that becomes increasingly difficult to correct. Additionally, we find that the amount of stress that our bodies can tolerate becomes much lower and our discomfort and fatigue becomes much higher. Historically, standard solutions to these problems aren’t necessarily helpful or cost effective.

Taking a break or a little time off is rarely the answer to mounting pain or ongoing discomfort. With bills to pay and insurance companies getting more challenging to work with, the dental professional needs to be on their “A” game as much as possible. The economy is pushing everyone to do more with less.

Some things to consider:

1. Are you accommodating to the patient or moving them to allow better access to the oral cavity?
2. Are you “parked” in one position during the day or on the move?
3. Do you balance your day or your schedule to alternate easy patients with more difficult ones?
4. Do you take time off when you need it?
5. Do you gradually increase your work schedule after time off?
6. Are you taking pain medications on a regular basis?
7. Are you treating yourself to regular massage or a chiropractic manipulation?
8. Have you needed surgery?

Some good news—modern solutions are now available, starting with a new approach to an old, tried and true solution. Sitting up straight. There are a number of operator stools out there, but very few that don’t allow you to sit poorly. One in particular provides a dynamic seating surface with an adjustable backrest and available armrests. The Dynacore® by The Brewer Company has a dynamic air bladder under a contoured seating surface. This combination allows the practitioner to sit in an upright position, dynamically throughout the workday. Dynamic sitting allows the practitioner to work their postural muscles; their abdominals, trunk extensors, obliques, transversus abdominus, along with postural stabilizers—literally working your “core” while you sit. Preliminary research in this new area of sitting has shown increased levels of cortical brain activity along with improved attention span and continuous electromyographic muscular activity. This new approach facilitates a more balanced approach to sitting while counteracting the poor postures and typical “holding patterns” that can be detrimental to a fruitful, satisfying dental career. Give dynamic sitting a try. Sitting should not be a job, just another way to strengthen core muscles and increase work satisfaction.

Timothy J. Caruso is a practicing Physical Therapist who has focused his professional expertise in the area of manual therapy and orthopedics, specifically neuromusculoskeletal disorders. He has been credentialed in mechanical diagnosis and therapy from the McKenzie Institute USA and continues in private practice in treatment of spinal disorders. As Founder of Chicagoland Performance Consultants, Mr. Caruso currently works with industrial and professional organizations in the areas of management, job analysis, organizational dynamics, wellness, ergonomics, and injury prevention. He has worked extensively with the dental community since 1988. He continues with direct patient care at Shriner’s Hospital for Children in Chicago and Community Physical Therapy, a private physical therapy practice. Tim has worked extensively with pediatric and adult populations with orthopedic conditions. He is very involved in seating and positioning for children and adults with special needs. In doing so, he has co-founded, and is president of, the Kids Equipment Network Childrens Charity providing medical equipment for children with special needs who have little or no funding. The Charity has helped over 150 children in the Chicagoland area since its inception. carusopt@ameritech.net

Planning

• Set goals for your social media campaign
• Know your audience who are you trying to reach-where do you get most of your patients
• Who will run the campaign
• How much time are you willing to spend on social media
• What type of social media will work best for you Examine each thoroughly:
  • Twitter – Fast paced and fairy temporary Collect email or contact information quickly as most people do not stay with Twitter
  • Facebook – More long lasting interaction, a bit slower
  • LinkedIn – Slower paced, more professional to professional interaction
• Set benchmarks for your efforts.
• Set an information posting schedule. This will make it easier to manage

Implementation

• Make sure your website and Google local listing is up and functioning
• Be sure to obey State and Local advertising guidelines for dentists
• Obey all HIPPAA policies
• Have guidelines in place for staff interaction and subject matter that can be posted
• Set up real world referrals to your social media profiles
  • Links from your website
  • Links from  your email signature
  • Mentions from your staff in the office
  • Links on your business cards
  • Signs or posters in the office
  • Links within your Google Profiles

Suggestions for All Social Media Profiles

• Use Smiling pictures
  • No Logos or pictures of buildings
    Studies prove that people are more likely to connect with a smiling face
• Be interesting and unique
• Be yourself and show that you are a real person
• When talking about business, use key words that sound like natural speech
• Use Google keyword to determine the most popular search terms for your area
• Be genuine, don’t talk about dentistry all the time. Discuss community items and interests that others would like to hear about
• End of positive note, don’t talk about the bad economy
• Don’t worry about numbers! Even if you had 4000 followers, you would never be able to keep up with all of them

Facebook

• Start a persona profile. Fill out online the information you are comfortable with.
• Set Privacy levels to your comfort level
• Create lists to classify your friends
• Create an official fan page for your dental office or business
• Office Facebook fan pages
  • Use a smiling picture of yourself or your staff, making sure there are people in the photo
  • Create a keyword filled description of your practice including address and web address
  • Capture a custom url, for example “http://facebook.com/yourpracticename” once your get 25 fans. This can be claimed at http://facebook.com/username
  • Schedule your content
  • Don’t post more than twice a day
  • Post your visual content like photos, videos or links
  • Become a source of great information so your fans look to you
  • Start with friends and family
  • Consider use of Facebook Ads

Twitter

• Create a username propel will recognize and will make a useful web address i.e. “http://twitter.com/drssmithdentistry”
• Fill our profile information including website. Tell about yourself without emphasizing dentistry.
• Connect with people in the community. Don’t focus on numbers or people who will not be patients.
• Make meaningful connections, avoid marketers and spammers.
• Try to post full length links
• Post Interesting content. But don’t talk about dentistry all the time

YouTube

• Video names should include keywords
• Use these same keywords in the description of the video
• Include your web address first in the video description
• Get as many people as possible to view and comment on the video in first 24-48 hours
• Include a call to action and description i.e. “Make an appointment now”
• Make sure your web address has a prominent location in the video
• Create a custom channel that is branded to your practice

LinkedIn

• Fill out profile with natural speech keywords
• Join local groups and organizations
• Start with people that you know and build from there
• Reach out to business owners around your practice
• Reach out human resource managers in nearby companies (They often know about the dental plans)

Blogging

• Start a blog, start a blog, start a blog
  Create blog posts that inform, educate and entertain
  Blog posts can be short
  Include  videos and pictures often to enrich content
  Blog posts should be keyword rich titles
  Encourage comments on your blog posts and comment on others’ blogs
  Include keyword tags and your web address where possible.

Outgrowing the Old–It was time. After starting out in a strip mall environment with limited footage and only 5 operatories, the Doctors were in need of space. A location was chosen about one-half mile away from the existing office—on one and a half acres that would give the opportunity for continuous growth and enhanced services to more fully meet their vision of the ideal dental practice. The overall formula included an expanded hygiene department and an on-site laboratory.

Work in Progress–The process began by contacting Equipment Sales Specialist Ron Kettles. “We have worked with Henry Schein Dental from the beginning of our careers—so using them was a no-brainer,” comments Dr. Nichols. “They had been an integral part of out practice for years. Ron Kettles helped us get preliminary drawings…and send them to the architect.”

“We sketched a rough draft of the new floor plan and sent it to Jay Kohlhaas at our National Design Group,” recalls Ron. “I also arranged for a tour of the Pelton & Crane factory and showroom to familiarize the Doctors with the many upgrades that had taken place in operatory equipment. Regional Manager Chris Young, Field Sales Consultant Scott Fritz, Digital Technology Specialist Louie Caesar, Lead Equipment Service Technician Johnny Kettles, and Equipment Service Technician Johnny Halter also contributed their expertise to the project.”

Welcome! The Design Impact–The exterior elements of the new building harmonize perfectly with its natural setting. Brick and stone in muted earthy tones have been used on the outside walls. Glancing upward, you’ll see a rendition of the Frenchstyle hip roofline. Its curved lines and gentle, upward slope lend a provincial charm to the building. The interior design specifically created a separation of patient care, staff, and clinical areas to streamline activities and aid in accelerating productivity. The airy and colorful entry space infuses huge vitality to the reception and waiting areas. A water wall behind the reception desk adds tranquility while elements such as the metal and glass tile surround on the desk and the crystal chandelier add distinctively modern touches. Unique scraped-wood flooring has been used throughout with the exception of clinical areas and restrooms—where seamless, surgical floor covering proved a better match. Every operatory has a window that looks out on the surrounding forest and lush landscaping. Inside the operatories, the patient has multiple options to enjoy the pleasures of electronic entertainment through TV, iPOD connections, CD, and satellite radio.

“The office has great street appeal, and the Doctors can now easily accommodate their busy practice schedule—with plenty of room for future growth.”

So Much More Than a Pretty Face–The dental office is a platform from which a variety of dedicated professionals provide services that maintain the oral and general health of the patient. Arkansas Family Dental offers its staff an amazingly transformed workplace. From front office to operatory areas and all that comes in between, they can confidently meet the demands of a busy workday with state-of-the-art technologies and equipment that enable everyone to perform at new levels of excellence. With 6,000-square feet and 11 operatories, lack of space was now a thing of the past.

Arkansas Family Dental encompasses the best of all possible worlds in its design and functionality. “The office has great street appeal, and the Doctors can now easily accommodate their busy practice schedule—with plenty of room for future growth,” notes Ron Kettles.

“Everyone comments on how amazing the new office is… and how nice it is to be a patient at this facility. Arkansas Family Dental is such a pleasant space to come to work every day!”

Designed by Jay Kohlhaas Henry Schein National Design Group

Everyone Is Happy–“We have a seamless clinical area that allows easy flow to all the operatories, sterilization, and lab,” points out Dr. Mascagni. “We really enjoy the design of our front-desk area. There is sufficient space for many patients at any given time, which makes it easy for our staff to work effectively. Everyone comments on how amazing the new office is…and how nice it is to be a patient at this facility. Arkansas Family Dental is such a pleasant space to come to work every day!”

Featured Equipment:

• Biolase ezlase
• Dentrix Practice Management Software
• E4D Dentist KaVo Quattrocare
• Pelton & Crane Delta Q
• Pelton & Crane Light Fantastic
• Pelton & Crane 3000 Chair
• Pelton & Crane Cabinetry
• Pelton & Crane Delivery System
• Pelton & Crane Sterilization Center SciCan Statim 2000
• Sirona XG3 Digital Panoramic X-ray

Left to right: Ron Kettles, Equipment Sales Specialist; Dr. Tina Nichols; Dr. Samaria Mascagni; Scott Fritz, Field Sales Consultant; Kevin Halter, Equipment Service Technician

By Dr. Lorne Lavine

What is the definition of “Everyday Dentistry?” We use this term all the time. In lectures, everyone wants to teach us techniques we can use in “Everyday Dentistry.” Sales people want to sell us products that can be incorporated into “Everyday Dentistry.” So how do we define this term and how can we achieve success in Everyday Dentistry? I define Everyday Dentistry as controlled mayhem, because there is no “everyday.” Each day is different, each day is a new challenge, some days are great and some days—we can’t wait for them to end. A great day is high-quality Dentistry, staying on schedule, and happy patients. Unfortunately sometimes we have days when impressions are difficult, restorations need to be redone, patients show up late, keeping us behind schedule, and—certain patients just can’t be made happy.

So how can we create more great days, reduce our bad days and make Everyday Dentistry better. Technology helps us improve the quality of care we provide for our patients and technology in Dentistry has come a long way. I learned basic principles and the technological advances of the times 25 years ago in dental school; however, a lot of these advances have gone by the wayside. Today’s advances vastly outnumber those of 25 years ago. So as Dentistry constantly evolves and technology advances, which technologies offer the most when practicing Everyday Dentistry. How do we determine the value a certain technology has, not only from a cost basis, but also an ease of use, learning curve, and predictability of outcome points of view. Some technologies make life easier, some technologies make us more money—but all technologies should help us provide better care for our patients.

One technology I feel provides all these advantages is laser technology. Although lasers come in all sizes, types, and costs, I would like to concentrate on soft-tissue diode lasers. Lasers have evolved over the years although many misconceptions still remain. This has prevented numerous practitioners from visualizing the benefits this technology has to offer. I often think of 12 years prior to purchasing my first laser and how I perceived laser technology—too expensive, too few uses, questionable patient acceptance, and numerous other excuses. Luckily I took the plunge and have never looked back. Yes, there were a few times when I questioned my abilities (There have also been a few times I questioned whether I wanted to be a Dentist!) and yes, there was a learning curve but Everyday Dentistry is all about change—changing and improving the quality of care provided to our patients. It’s also about updating our thought processes, keeping us interested and motivated in our profession.

Buccal Frenom Before

Buccal Frenom Immediate Post-Op

Fibroma Before

Fibroma right after removal shot

Fibroma Post-Op

With technology, we can change our Everyday Dentistry into “Extraordinary Dentistry” by providing better, more predictable outcomes to the challenges we face—every day.

So how can soft-tissue laser technology change the way we practice and how or what do we have to do to be successful at incorporating this technology into our Everyday Practice? I like to look at any new technology as an adventure. Too many times we are uncomfortable with change, yet change is what makes life better. So we have to keep an open mind. If your laser doesn’t do what you want or you don’t get the desired result, it’s probably not the laser, it’s probably the operator, remember any new technology has a learning curve, so be open-minded, be innovative.

So what can soft-tissue lasers do? Probably a lot more than you think. First, diode lasers can cut and shape soft tissue, which gives us the opportunity to remove lesions, (fibromas), release frenoms, recontour gingiva, and trough around crown preps. Usually this can be accomplished with little bleeding, minimal collateral tissue damage, and better healing. Unlike an electro- surge unit, diode lasers can be used around crowns, ortho brackets, and implants. Diode lasers can also be utilized to whiten teeth. Diode lasers seek pigment so it makes sense that they would be effective at removing pigment and stain in the whitening procedure. I feel the results are similar or better than any in-office whitening system available, with less sensitivity and a shorter appointment time. (I have seen great results in as little as ten minutes utilizing a laser to whiten teeth.)

Laser Whitening Before

Laser Whitening After

TMJ Treatment Still Image

Certain diode lasers are FDA approved to help treatment of TMD and facial muscle pain. Diode laser can actually penetrate tissue and increase blood flow, decrease edema, and aide in healing. Although diode lasers have been used for many years in treating muscle and joint pain, this could provide another avenue in treating our patients. Diode lasers have been used to help treat periodontal disease and certain studies have shown better results and advantages of utilizing a diode laser in conjunction with scaling and root planning. These studies have shown reduction in bleeding on probing and reduced pocket depth. Other uses for diode laser include treating aphthous ulcers, desensitizing teeth, pulpotomy procedures and, best of all, removing inflamed excess tissue that makes taking your crown impression impossible.

So when we look to technology, we expect a lot—better, faster, easier, but don’t forget our patients; patients have come to expect technology. Old-fashioned Dentistry is the material of outdated jokes, not patient care. If we provide better care, we get better results, better Post-Op, and happier patients. Diode lasers can provide quick healing, less need for sutures, and pain relief. As Dental professionals, we can also know we are providing the latest in technology and taking part of this exciting revolution in patient care.

So, when we hear the term Everyday Dentistry and think of the norm of what we do, let’s think of how we can change it. Everyday Dentistry denotes an unexciting day-to-day existence of providing Dental care for our patients, hoping each day turns out positively, but starting each day wondering if it will. With technology, we can change our Everyday Dentistry into “Extraordinary Dentistry” by providing better, more predictable outcomes to the challenges we face—every day.

It is no longer a business where you can put up a sign and expect to have hundreds of patients knocking down your door. Dentists have embraced marketing and now employ several different methods to drive traffic. Nowhere has this been more noticeable than on the Internet. Dental Web sites are now a universal tool, and offer everything from computer graphics to appointments. They may range from the simple to the complex, but the common consensus is that everyone should have one.

The Web is constantly evolving. More and more of the content is being created by ordinary users like you and me. The Web is no longer an environment of static Web sites, it is a thriving community that allows for immediate communication and information sharing. People don’t just visit Web sites anymore, they live on them. We are in the world of Web 2.0 and Social Media. These are terms that are tossed around quite a bit, but many don’t really know what they mean. Web 2.0 and Social Media is the next step in the evolution of the Web. They give the user the opportunity to take control of their own Web destiny and can create a Web environment that is specific to them.

This type of environment makes it much more conducive to share information and to connect with other people around the world. It also marks a new era of dental marketing, the era of Social Media for dentists. Many dentists are embracing Social Media, by creating pages on Facebook, YouTube, Twitter, and LinkedIn. These platforms allow dentists to step out of the static framework and become more engaging. Dentists can easily share their knowledge and become a real person, not just a name and a logo. Still others don’t see a need to try this alternative marketing. The problem is, this alternative marketing is becoming the new main stream.

Let’s look at the statistics of one of the major Social Media outlets, Facebook. Facebook is the biggest social utility Web site out there. It has over 400 million users. It comes in a close second to Google as the most visited Web site in the world, and it has actually beaten Google on several occasions. Almost 60% of the American population has a Facebook account. That in itself is amazing. Try to get 60% of Americans to the polls on election day! The average user has over 130 friends on Facebook, and spends almost 55 minutes each day on the site. No other Web site can match this. Google may have more traffic, but no one spends almost an hour on Google. A majority of these active users believe that every business should have a presence on the site.

Many dentists are embracing Social Media, by creating pages on Facebook, YouTube, Twitter, and LinkedIn. These platforms allow dentists to step out of the static framework and become more engaging.

What do all of these statistics mean? It means that people are living their lives on Facebook. They are connecting with friends, shopping, and getting their news from one place. It also presents a wonderful opportunity for dentists to connect with over 60% of the population. These are not all teenagers either. One of the fastest growing Facebook demographic is users aged 55–65. Social media viewership is a true phenomenon that encompasses people of all ages, races, and creeds. This type of thing doesn’t happen very often.

Business’ have also jumped on the Social Media bandwagon. The static Web site has become so ingrained in our consciousness, that many major businesses don’t advertise them anymore. What you will see is FORTUNE 500 companies saying, “Find us on Facebook” or “Follow us on Twitter.” Before long the Facebook page or Twitter account will be the standard.

What are the benefits of using Social Media for dentists? The most obvious reason is the sheer number of people using these platforms. Conventional media like T.V., radio, and print is a crap shoot. There are too many alternatives out there for people to view. More people get their news from the Internet than newspapers. Tivo and other video on demand options have lessened the power of commercials. Many people are watching TV shows on the Internet. Satellite and Internet radio is crippling the radio broadcasting industry. More than half of the population still returns to Facebook each day for almost an hour. Most dentists would love to reach 60% of the population in their area.

The financials of Facebook marketing are also strong. Operating a Facebook fan page or a Twitter account is free, so the R.O.I. of Social Media can be very high. Facebook does offer some pay per click advertisement much like Google. Where else can you find an effective way to advertise your
office for free.

The great thing about social media is that word of mouth advertising is built right in. It is extremely simple to share content with another user on Facebook or Twitter with the click of a button. That is why many pundits say it is word of mouth on steroids. Information can travel very fast on these sites and can easily go viral. Take for instance the aforementioned factoid that most Facebook users have 130 friends. If a Facebook user posts a comment or picture, it will be seen by 130 people, then to almost 17,000 viewers (130 x130) , and so on. Within minutes content can be seen by thousands of people. All with the click of a button. When people ask me why I would encourage social media use instead of a phone book ad, I usually reply “The phonebook doesn’t have a share button.”

One of the strongest reasons a dentist should use Social Media is because of fear. Thousands of patients cancel their appointments each year because of fear. Many others don’t make an appointment because of fear of the unknown. They don’t have a dentist and they are afraid to start with a new doctor they don’t know. Social Media allows dentists to build an online personality and reduce fear. They can express themselves and not only prove their knowledge, but show their human side. Social media is about building relationships online, and building these virtual relationships will help build your practice. Social media also gives dentists the power to become the local expert. Patients and potential patients often have many questions or concerns. They often are afraid or embarrassed to ask them. Using social media gives them a feeling of anonymity, and allows them to ask questions more freely. Dentists can then answer these questions and it gives them an air of professionalism and compassion. It also cements their status as an important figure in the community, virtual or real.

Although these Social Media Web sites may seem like they are all fun and games to an outsider. They contain a lot of powerful marketing information. Facebook and other Social Media outlets collect great amounts of demographic information from their willing participants. Users freely hand over their address, phone number, birthday, etc. This is a shrewd move on their part, because if any other Web site, even Google, were to ask for this information red flags would be waved. Social Media-users tend to acquiesce and give out a lot of information. Much of this information can be used to target audiences for Social Media marketing, and really let you hone in on a specific demographic. Targeted marketing in any campaign will make marketing efforts more effective and drive traffic.

How then should the average dentist get started with social media? There are many social media platforms to explore, and it can be quite daunting for the newbie. It is best to pick one type of Social Media at first. Some dentists jump into several different platforms at once, and it is very easy to become burned out or watered down. Be diligent and do your research. Start an account on one platform and play around with it. Learn the “language” of the Web site. Each type of Social Media has its own set of rules and etiquette, and it is best to learn this
well before diving in.

Time management is a very big part of Social Media for dentists. They must figure out how much time can be spent on a campaign, and how many new patients it will take to validate the usage. Too much or too little time can kill a Social Media campaign. Creating a weekly calendar of goals and procedures will be a big help for most dental offices. Learning how to get a campaign going and maintained without taking up too much time is one of the biggest hindrances for dentists. A successful Social Media campaign can be managed in just minutes minutes or even a day if the correct parameters are put in place. Many dentists believe that they have to constantly contribute creative content to be successful. Contributing content can be as simple as uploading a picture with a short description or as complex as a two- page blog post. As long as you keep your audience engaged with something, however simple, you are making an impact. Many dental offices find it helpful to incorporate their staff or spouses into their Social Media
campaign.

Privacy is also a major concern with dentists using Social Media. We as dentists often treasure our privacy and time away from the office, and many see Social Media as a threat to privacy. Don’t let privacy be a deterrent. It is only a speed bump. Many successful Social Media campaigns have been successful without giving up privacy. The one thing to remember about Social Media is, you get out what you put in. Much of the personal information they request is not necessary. It is helpful but not necessary. You can operate a Facebook account on a name only. No picture. No birthday. No credit card number. You may also have a profile for your business, and have no personal information available at all. Google already knows more about you than will ever be found on Social Media. Phishing and other security concerns are still a very real threat on Social Media, but they are no more of a concern than they are on E-mail accounts. A certain level of common sense must be maintained. Don’t fall for the prince from Nigeria who needs $10,000 to get 1 million, no matter how they contact you. This is the future of the Web, like it or not. Years ago just having a Web site was a major accomplishment, now it is a necessity. Soon a Facebook or YouTube account will turn from a novelty to a necessity. Dentists need to be there with an established following. And why not? We spend hours and hours on patient education to keep them informed, and explain our methods. Their level of understanding makes our job easier and also helps with case acceptance. Social Media marks the first time in history that we can connect with the public, educate them, and have them share their experience in one
package. Truly Amazing.

Dr. Jason Lipscomb is a general dentist who operates two practices in Virginia. He specializes in helping dentists expand their practices through the use of social media. Jason and his partner Stephen Knight started Social Media for Dentists to help other dentists master social media and attract new patients. Jason and Stephen have also authored the book “Social Media for Dentists”. A 350 page guide to social media as seen from the dental perspective. Visit their website at http://www.socialmediadentist.com or http://facebook.com/socialmediadenist

Keeping track of the country’s vast and rapid economic changes is interesting and daunting. It is impossible for a dentist to stay aware of all of the clinical breakthroughs in the dental profession and still have time to track all of the changes on the tax scene. Taking advantage of tax incentives, such as Section 179 can result in financial and clinical business improvements.

Right now, even a crystal ball would not give a succinct view of the nation’s tax future. The Section 179 deduction is one sure incentive currently available to businesses this year. In March 2010 President Obama signed into law the Hiring Incentives to Restore Employment (HIRE) Act, with some of its best benefits, such as Section 179, having limited remaining time eligibility. Section 179 allows dentists to write off expenses for the first year of capital equipment purchases up to $250,000. Keith Drayer, vice president of Henry Schein Financial Services says that putting the equipment into service by December 31, 2010, is “crucial because the deduction incentive is expected to decrease on Jan 1, 2011.”

Through tax incentives, Drayer notes, “Doctors are lowering their adjusted gross income (AGI) which could help them qualify for other various deductions which are limited by their AGI.” He offers an example based on a hypothetical $200,000 purchase put into service on or before December 31, 2010. “That whole amount, under Section 179 is 100 percent deductible. Calculating for a person in the 35 percent tax bracket, the potential tax savings is $70,000.” He adds that deferred financing helps. “Even if payment is not made until 2011, doctors can still take advantage of 179 because the tax deduction is defined by when equipment is placed into service. Some practitioners benefit from the grace period of deferred financing while they get used to their new technology.” He continues, “On $200,000 worth of equipment, with five-year financing, payments are approximately $4,000 per month. If you are saving $70,000 in taxes, it is as if you have your first 17-1/2 months of payments paid just from those tax savings.”

Dr. Jim Caskey, a Texas-based orthodontist, has experienced the Section 179 deduction first hand from his purchase of his i-CAT Cone Beam scanner last year. He says, “Patients know that they have come to a place that has invested a lot of money to give them the best of care.” He recalls, “I found out about 179 through discussions with the Henry Schein sales rep, but I also know about the tax laws and have a good relationship with my accountant. He told me that I saved $70,000 last year from the i-CAT purchase in tax savings. That’s big.” He adds, “I recommend anybody considering it to jump on it. It’s worth it for increasing a practice’s efficiency, and they won’t regret it.”

Specific types of products are applicable to the deduction. “The power of Section 179 benefit increasing to $250,000 is that we see practitioners investing in multiple technologies such as E4D CAD/CAM , i-CAT cone-beam, DEXIS digital radiography, and DENTRIX practice management systems,” says Drayer. Many of the products must be off-the-shelf. Drayer specifies, “For example, while DEXIS imaging software and DENTRIX practice management software is eligible, software built from the ground up may not be eligible.” Besides Section 179, dentists still may qualify for other deductions. In many cases, the choice is simple—take advantage of a tax benefit to buy equipment that enhances the practice, quality of care, and the staff and the patient experience, or pay more hard-earned money to the IRS. While in the tax world today, the only thing that remains constant is change, and dentists who take advantage of appropriate tax deductions (with their CPA’s help) get my vote.

CPA Alan Jones holds degrees in both Accounting and History. He services clients throughout the US from his private practice in Raymore, MO.

Information applies to U.S. based practitioners only

(5) DOCTOR SCHEDULED OPPOSITE DOCTOR.

The doctor must have carefully assigned time allotments and responsibilities so that he/she is not scheduled in two rooms at once. There is NO WAY that a doctor can be in two rooms at once! That seems like a silly thing to say, I know, but in thousands of practices across the world, we find that type of scheduling problem to be common. Instead of allowing a scheduling overlap, keep the dentist(s) moving smoothly and carefully from room to room with clear allotments of when they’re to be where. The doctor is given the desired amount of time for each aspect of each procedure. Thus, he or she is able to sit down, concentrate on that procedure, get it done and then move on when the clinical assistant takes over.

(6) IMPROPER DELEGATION.

Each state has its own unique rules, regulations, and laws determining which aspects of a procedure can be performed by the clinical assistant. Abide by those guidelines at all times. Study your own state guidelines and see what can be delegated. Then do so!

Steps for proper delegation are as follows:

• Determine assignable steps of each procedure using the Procedure Analysis Sheets.
• During patient time, explain what and why you’re doing each step. Demonstrate what you want the assistant to do, and explain why. (Caution: At the chair, be aware of your verbal skills. Be kind and diplomatic, and not too technical.)
• Spend non-patient time in hands-on training.
• Next, spend time at the chair with the patients. Have the assistant perform the new task while the doctor carefully guides. (Tell the patient what you’re doing, and ask permission to teach during the appointment. They’ll know how carefully everything is being done and will appreciate your special attention.)
• Then, let go. Let the assistant take over when appropriate. (This may be the most difficult of all steps!) Note: Once you have delegated, trained, and let go, change the necessary steps on your procedure analysis sheets. Your scheduling coordinator must know when both the doctor and assistant are occupied in order to “interface” properly.
• Evaluate on a regular basis to make sure things are going smoothly. Clinical assistants want to do all that they can legally do! Given more responsibility, they will stay in the profession longer and will enjoy their work even more.

Feedback is essential. Don’t assume that they know they’re doing a good job. Tell them. In addition, if you want something done differently, share that also. They want to know. How can they improve if they don’t know there is a problem?

(7) NO DETAIL IN THE SCHEDULE.

The schedule must be specifically detailed such as the following.

• Name: John Jones
• Specific Procedure: Crn Prep #14
• Telephone #: 369-2501
• Fee: (0495)

With this information in the schedule and on the posted schedules, the clinical assistant can have the room properly prepared before the doctor arrives. In this manner, both can sit down, concentrate, and not be disturbed by getting up to get something.

In some instances, the particular material needs to be identified to prevent inaccurate tray/room setup. (i.e., Amalgam or composite)

This detailing serves everyone on the team. 1.) The clinical assistant can be prepared. 2.) The scheduling coordinator can schedule for the daily production goal. 3.) She can confirm easily. 4.) She can answer patient questions about what’s going to be done should this re-information be necessary at the time of the confirmation. (5) The doctor knows what he/she is going to be doing on each patient before entering the treatment room.

(8) INTERRUPTIONS OR POORLY WRITTEN COMMUNICATION BETWEEN FRONT AND BACK.

Your paperwork and/or all electronic files should be so carefully constructed that your business team never have to ask questions like the following of you and your clinical team:

• “What did you do today?”
• “How much was it?”
• “What do you want to do next time?”
• “How long do you need?”
• “How much time do you need between appointments?”

If you are asking these questions and if there are constant interruptions, study your paperwork and the flow of your patient dismissal. It may need to be redesigned. Your business administrator should not have to leave the patient during dismissal to come back to ask questions of the clinical team.

(9) PERSONAL TELEPHONE CALLS AND INTERRUPTIONS.

Personal telephone calls need to be handled before work, at lunchtime or at the end of the day. Facebook updates, Tweets, mobile phone texts, and other easily accessible distractions need to be clearly understood as unacceptable interruptions to the workflow of each day.

Good old-fashioned phone calls can be screened carefully and diplomatically. Place the completed messages on a message board or in assigned message baskets. Make sure the person receives their message. The doctor can let it be known for whom he/she can be called to the phone. There will be some exceptions, but these need to be identified.

If your doctor receives many calls during the day, he/she may find it more time-efficient to schedule half an hour each day for management; perhaps the 30 minutes after lunch. People can be informed that the doctor takes or returns calls at that time.

Come up with a basic expectation for the rest of modern communication so everyone is clear on what is and isn’t acceptable and how to help one another be successful and on schedule.

Some practices have had great success by requiring all mobile phones to be checked in at a central location when they’re on duty. That way everyone can check messages and respond on breaks, but isn’t tempted during work time. It also makes it easier for their friends and family to get out of the habit of contacting them during the work day. Many practices have also locked out Web sites that cause inefficiencies (like Facebook and Twitter), whereas others have set a computer up that’s not connected to the main server (for extra virus protection) and allotted certain break times when such sites are a commonplace favorite stop for team members. This also allows team members to make updates to a practice-associated page, which becomes a valuable marketing tool. Work together to discuss different options and then make a decision about what’s best for the practice.

(10) TALKING TOO MUCH ABOUT UNRELATED ISSUES OR NOT PAYING ATTENTION.

Knowing your patients on a personal level and knowing special things about them is important for practice/relationship building. However, when discussions of non-dental issues have a detrimental effect on the schedule, this can have a negative impact on other patients. Someone eventually loses. Therefore, do an appropriate amount of “personalizing,” and then be about the business of talking about or performing the dentistry. That’s why everyone is there. Focusing on the business at hand is called “compartmentalization.” They expect to see you as a professional so while friendliness is a plus, you’re most respected as a healthcare provider and not just a buddy. This focus will keep you on course, streamline your time management and enhance your patient relationships.

IN SUMMARY

I have identified ten reasons for poor scheduling or for running behind schedule, a major source of stress for many practices. I have suggested a few solutions for those ten problems and look forward to speaking with you more on the November 9th webinar “Scheduling for Productivity, Profitability and Stress Control”. Dentrix customers, register now by clicking here: www.dentrix.com/resourcecenter. Not a Dentrix customer yet? Visit www.dentrix.com now.

Cathy Jameson is founder and CEO of Jameson Management, Inc., an international in-office consulting firm helping improve dental practices. For more information, call 877.369.5558.

Patient education as to the uniqueness and benefits of E4D® should be discussed chairside by the doctor and staff. The digital camera, intraoral camera, GURU (patient education) and E4D® all go hand-in-hand. With the intraoral and/or digital camera, the doctor should take photographs and x-rays to accompany the insurance claim, along with an in-depth narrative to build a strong case for reimbursement.

Explaining to patients that insurance coverage is merely supplemental, and that the longer-lasting treatment is worth the extra out-of-pocket expense, will counter most concerns. The economic decision for coverage by insurance companies is not based on what is necessarily best for the patient clinically or esthetically, but on the level of benefits the employer purchases. Understanding these dilemmas and indoctrinating the staff on proper insurance protocol of codes and narratives will lessen the continual battle between the practice, patient and insurance company.

Insurance Reimbursement for E4D® Restorations

Unfortunately, it is the case that insurance companies may not always reimburse conservative (tooth saving) techniques at the same level as more aggressive C&B procedures (full coverage) despite the fact that the materials and techniques require the same or greater effort on the part of the clinician/office team and actually provide the patient greater benefits. Most dental insurance policies will reimburse indirect intracoronal restorations at a comparable direct (composite or amalgam) rate. On the other hand, most dental insurance policies do reimburse ceramic onlays, ceramic full crowns, and 3/4 ceramic crowns. Ceramic and resin-type veneers are considered

Explaining to patients that insurance coverage is merely supplemental, and that the longer-lasting treatment is worth the extra out-of-pocket expense, will counter most concerns.

“cosmetic,” so generally expect no insurance reimbursement. However, replacing failed veneers may have a chance for reimbursement under some insurance contracts. For the private pay patient, insurance reimbursement policies are immaterial.

Documentation for E4D® Restorations

For E4D® or other indirect restorations, dental insurance reimbursement may be enhanced and delays reduced with excellent documentation. A pre-op X-ray and photo of the tooth may be provided, along with a photo of the prep. This documentation, along with the narrative, should be filed initially with each E4D® restoration for payment, greatly reducing hassles, delay, requests for additional information, etc. Expect headaches without an intraoral camera or digital camera for documentation! Photos often reveal problems that X-rays do not. Submit photos routinely.

One of the unique aspects of utilizing the E4D® Dentist system, besides being able to provide same day indirect restorations, is the fact that each scan made by the E4D® System, whether preoperative or preparation, is saved to the hard drive as a small thumbnail, which can be used to further document the procedure for patient records or insurance justification.

Get an intraoral camera and don’t delay this purchase! Intraoral photos (D0350) are generally not reimbursable – exception, orthodontic records. They are a “cost” of doing business that yields a tremendous profit.

A narrative should generally be provided that discusses fracture and decay, plus any missing, undermined, or fractured cusps. If a photo is included, describe what is seen as supplemental to that seen in the X-ray. For onlays, always mention “capping the cusp(s)” in the narrative. According to the description in the CDT 2010 ADA Glossary (page 212), an onlay requires “restoring one or more cusps and adjoining occlusal surfaces or the entire occlusal surface.” Thus, an MOD is not an onlay – it must include a facial and/or lingual cusp in its description. For example, an MODFL or MOL would be a validly reported onlay. A general rule of thumb is “if the tooth needs a crown, then an onlay will be probably be reimbursed.”

Dental Codes For The E4D® Block Materials

Ivoclar Vivadent® and 3M ESPETM manufacture the ceramic and composite blocks for the E4D® System. Milling prefabricated blocks have the advantage over other methods of fabrication for metal free as they insure the homogeneity of the material through and through and are not subject to many of the variables of hand-stacking, pressing or fabricating restorations by hand. Each type of manufactured block has its own distinct properties, clinical advantages and application.

The Ivoclar Vivadent IPS Empress®, CAD, IPS e.maxTM CAD and 3M ESPE ParadigmTM C blocks are all considered “ceramic” as reported under CDT 2010:

3M ESPETM also manufactures the Paradigm MZ100 (polymer reinforced) block which is considered to be “resin-based.” CDT 2010 defines resin as “refers to any resin-based composite, including fiber or ceramic reinforced polymer compounds.”

Reimbursement-wise, a small percentage of insurance contracts specifically exclude the resin-based, composite restoration as a material. In addition, some contracts reimburse a lower fee for the resin-based restoration compared to the ceramic restoration’s fee.

The 3M ESPE Paradigm MZ100 is considered “resin-based” as reported under CDT 2010:

How To Profit From Inlays

As previously mentioned, the reimbursement level of inlays may be lower compared to onlays or full coverage restorations. Often, the equivalent of an amalgam or composite fee is reimbursed for an inlay. Thus, many patients are reluctant to pay a large amount “out of pocket” for inlays, and dentists rarely mention them for this reason. There is a profitable strategy for E4D® inlays, however. Typically, the E4D® crown, 3/4 crown and onlay are priced at the level of a conventional lab-fabricated restoration ($895 – $1,095). If the volume of these higher-fee restorations “cover” the monthly payment, then the only additional cost to fabricate and deliver chairside inlays is the direct (fixed) cost of about $30/unit (burr, block, materials).

Thus, the concept of the “lower-fee” E4D® inlay strategy may be utilized: The long-lasting inlay is offered as an alternative to the amalgam/composite at a lower fee, say $450. If the materials are $30, the net gross profit is $420. If the dentist will delegate and work with two assistants, the dentist’s chair time for E4D® will be equal or less than an amalgam.

With the addition of inlays and onlays to the clinical service mix, even more additional profits are available while providing the best in patient care.

composite restoration. One of the assistants can work on the imaging, designing, milling and making small occlusal and interproximal adjustments outside the mouth. Thus, the dentist only preps the tooth and bonds the inlay to place. Meanwhile, the dentist produces with the other assistant elsewhere. “Lower-fee” inlays will be quite profitable if the dentist is willing to train/utilize/delegate the dental assistant properly. Many patients will accept inlay treatment if they only pay the fee difference of $450 and the regular amalgam/ composite reimbursement fee. The patient’s out-of-pocket could be less than $200 for an inlay with some plans. Thus, the patient is grateful for a single appointment and long-lasting inlay at an affordable price, while the dentist makes a substantial profit offering the best conservative dentistry available. It’s even more profitable if the inlay is fabricated in conjunction with other E4D® restorations in the same quadrant.

Shouldn’t You Consider Chairside CAD/CAM Technology?

The E4D® Dentist is economically viable for most restorative practices. The economics of a one-visit restoration plus the capacity of “same day dentistry” is compelling. The capital cost of the E4D® is often more than offset by a reduction in the fabrication fees, an increase in upgrading direct restorations and the increase in new patients wanting this type of technology. With the addition of inlays and onlays to the clinical service mix, even more additional profits are available while providing the best in patient care.

Dr. Charles Blair’s consulting services include insurance, fee and procedure mix consulting. He is a highly sought after speaker for dental meetings and conventions nationwide. Dr. Blair is available to work with E4D® users regarding specific strategies, coding and, fees. Proper insurance coding and proper alignment of fees in the practice is all important. Dentists are unaware of their many mistakes, which often leave $100 to $500 a day “on the table!” Most dentists can “get an E4D® for free” with Dr. Blair’s Revenue Enhancement Program, plus a $115,000 tax deduction! For further information, call 866.858.7596 or email info@drcharlesblair.com.

Insurance & revenue content discussed in this article applies to US based practitioners only

To order Coding with Confidence by Charles Blair, D.D.S. place your order with Henry Schein Dental at 1-800-372-4346 or visit us on the Web at henryscheindental.com.

The Web is constantly evolving. More and more of the content is being created by ordinary users like you and me. The Web is no longer an environment of static Web sites, it is a thriving community that allows for immediate communication and information sharing. People don’t just visit Web sites anymore, they live on them. We are in the world of Web 2.0 and Social Media. These are terms that are tossed around quite a bit, but many don’t really know what they mean. Web 2.0 and Social Media is the next step in the evolution of the Web. They give the user the opportunity to take control of their own Web destiny and can create a Web environment that is specific to them.

This type of environment makes it much more conducive to share information and to connect with other people around the world. It also marks a new era of dental marketing, the era of Social Media for dentists. Many dentists are embracing Social Media, by creating pages on Facebook, YouTube, Twitter, and LinkedIn. These platforms allow dentists to step out of the static framework and become more engaging. Dentists can easily share their knowledge and become a real person, not just a name and a logo. Still others don’t see a need to try this alternative marketing. The problem is, this alternative marketing is becoming the new main stream.

Let’s look at the statistics of one of the major Social Media outlets, Facebook. Facebook is the biggest social utility Web site out there. It has over 400 million users. It comes in a close second to Google as the most visited Web site in the world, and it has actually beaten Google on several occasions. Almost 60% of the American population has a Facebook account. That in itself is amazing. Try to get 60% of Americans to the polls on election day! The average user has over 130 friends on Facebook, and spends almost 55 minutes each day on the site. No other Web site can match this. Google may have more traffic, but no one spends almost an hour on Google. A majority of these active users believe that every business should have a presence on the site.

Many dentists are embracing Social Media, by creating pages on Facebook, YouTube, Twitter, and LinkedIn. These platforms allow dentists to step out of the static framework and become more engaging.

What do all of these statistics mean? It means that people are living their lives on Facebook. They are connecting with friends, shopping, and getting their news from one place. It also presents a wonderful opportunity for dentists to connect with over 60% of the population. These are not all teenagers either. One of the fastest growing Facebook demographic is users aged 55–65. Social media viewership is a true phenomenon that encompasses people of all ages, races, and creeds. This type of thing doesn’t happen very often. Business’ have also jumped on the Social Media bandwagon. The static Web site has become so ingrained in our consciousness, that many major businesses don’t advertise them anymore. What you will see is FORTUNE 500 companies saying, “Find us on Facebook” or “Follow us on Twitter.” Before long the Facebook page or Twitter account will be the standard.

What are the benefits of using Social Media for dentists? The most obvious reason is the sheer number of people using these platforms. Conventional media like T.V., radio, and print is a crap shoot. There are too many alternatives out there for people to view. More people get their news from the Internet than newspapers. Tivo and other video on demand options have lessened the power of commercials. Many people are watching TV shows on the Internet. Satellite and Internet radio is crippling the radio broadcasting industry. More than half of the population still returns to Facebook each day for almost an hour. Most dentists would love to reach 60% of the population in their area.

The financials of Facebook marketing are also strong. Operating a Facebook fan page or a Twitter account is free, so the R.O.I. of Social Media can be very high. Facebook does offer some pay per click advertisement much like Google. Where else can you find an effective way to advertise your office for free.

The great thing about social media is that word of mouth advertising is built right in. It is extremely simple to share content with another user on Facebook or Twitter with the click of a button. That is why many pundits say it is word of mouth on steroids. Information can travel very fast on these sites and can easily go viral. Take for instance the aforementioned factoid that most Facebook users have 130 friends. If a Facebook user posts a comment or picture, it will be seen by 130 people, then to almost 17,000 viewers (130 x130) , and so on. Within minutes content can be seen by thousands of people. All with the click of a button. When people ask me why I would encourage social media use instead of a phone book ad, I usually reply “The phonebook doesn’t have a share button.”

One of the strongest reasons a dentist should use Social Media is because of fear. Thousands of patients cancel their appointments each year because of fear. Many others don’t make an appointment because of fear of the unknown. They don’t have a dentist and they are afraid to start with a new doctor they don’t know. Social Media allows dentists to build an online personality and reduce fear. They can express themselves and not only prove their knowledge, but show their human side. Social media is about building relationships online, and building these virtual relationships will help build your practice. Social media also gives dentists the power to become the local expert. Patients and potential patients often have many questions or concerns. They often are afraid or embarrassed to ask them. Using social media gives them a feeling of anonymity, and allows them to ask questions more freely. Dentists can then answer these questions and it gives them an air of professionalism and compassion. It also cements their status as an important figure in the community, virtual or real.

Although these Social Media Web sites may seem like they are all fun and games to an outsider. They contain a lot of powerful marketing information. Facebook and other Social Media outlets collect great amounts of demographic information from their willing participants. Users freely hand over their address, phone number, birthday, etc. This is a shrewd move on their part, because if any other Web site, even Google, were to ask for this information red flags would be waved. Social Media-users tend to acquiesce and give out a lot of information. Much of this information can be used to target audiences for Social Media marketing, and really let you hone in on a specific demographic. Targeted marketing in any campaign will make marketing efforts more effective and drive traffic.

How then should the average dentist get started with social media? There are many social media platforms to explore, and it can be quite daunting for the newbie. It is best to pick one type of Social Media at first. Some dentists jump into several different platforms at once, and it is very easy to become burned out or watered down. Be diligent and do your research. Start an account on one platform and play around with it. Learn the “language” of the Web site. Each type of Social Media has its own set of rules and etiquette, and it is best to learn this well before diving in.

Time management is a very big part of Social Media for dentists. They must figure out how much time can be spent on a campaign, and how many new patients it will take to validate the usage. Too much or too little time can kill a Social Media campaign. Creating a weekly calendar of goals and procedures will be a big help for most dental offices. Learning how to get a campaign going and maintained without taking up too much time is one of the biggest hindrances for dentists. A successful Social Media campaign can be managed in just minutes minutes or even a day if the correct parameters are put in place. Many dentists believe that they have to constantly contribute creative content to be successful. Contributing content can be as simple as uploading a picture with a short description or as complex as a two- page blog post. As long as you keep your audience engaged with something, however simple, you are making an impact. Many dental offices find it helpful to incorporate their staff or spouses into their Social Media campaign.

Privacy is also a major concern with dentists using Social Media. We as dentists often treasure our privacy and time away from the office, and many see Social Media as a threat to privacy. Don’t let privacy be a deterrent. It is only a speed bump. Many successful Social Media campaigns have been successful without giving up privacy. The one thing to remember about Social Media is, you get out what you put in. Much of the personal information they request is not necessary. It is helpful but not necessary. You can operate a Facebook account on a name only. No picture. No birthday. No credit card number. You may also have a profile for your business, and have no personal information available at all. Google already knows more about you than will ever be found on Social Media. Phishing and other security concerns are still a very real threat on Social Media, but they are no more of a concern than they are on E-mail accounts. A certain level of common sense must be maintained. Don’t fall for the prince from Nigeria who needs $10,000 to get 1 million, no matter how they contact you.

This is the future of the Web, like it or not. Years ago just having a Web site was a major accomplishment, now it is a necessity. Soon a Facebook or YouTube account will turn from a novelty to a necessity. Dentists need to be there with an established following. And why not? We spend hours and hours on patient education to keep them informed, and explain our methods. Their level of understanding makes our job easier and also helps with case acceptance. Social Media marks the first time in history that we can connect with the public, educate them, and have them share their experience in one package. Truly Amazing.

Dr. Jason Lipscomb is a general dentist who operates two practices in Virginia. He specializes in helping dentists expand their practices through the use of social media. Jason and his partner Stephen Knight started Social Media for Dentists to help other dentists master social media and attract new patients. Jason and Stephen have also authored the book “Social Media for Dentists”. A 350 page guide to social media as seen from the dental perspective. Visit their website at http://www.socialmediadentist.com or http://facebook.com/socialmediadenist

At 63 years young, Dr. Robert Van Dyke of Distinctive Dentistry has embraced more change in the past decade than most people do in their entire careers. It began when he relocated from his home in Green Bay, Wisconsin, to sunny Las Vegas, Nevada in 2001. After settling in, he purchased an aging practice and set out to rebuild the client base. There were things about the facility itself, however that just weren’t ideal.

His practice was hard to find because it was on the fifth floor of a medical office building. He had no street exposure or signage to tell potential patients that he was there. The inside of the office wasn’t any better. The equipment and furniture he inherited was dated, which made it inefficient, unattractive, and unpleasant to work with. Dr. Van Dyke thought about building a new, state-of-the-art office, but he had to consider the future too.

“I had to evaluate how much longer I wanted to work and whether or not I wanted to assume more expense for a new office, “ said Dr. Van Dyke. “I decided that a new location would give me the opportunity to practice the type of dentistry I wanted, and would give me office space that would be attractive to a new buyer when I decided to sell the practice.”

Change that Exceeded Expectations

With the support of his wife, Pam, he decided to look for a new location. His first decision was to narrow down the site options by keeping the new office within two miles of the existing office so patients could make an easy transition. He had a vision of the office’s look and flow, but he wanted the skills of an interior designer and office design team to translate his ideas into a beautiful and functional office. Dr. Van Dyke turned to Diane Zurko, his Henry Schein Sales Representative. They spent many afternoons scouting potential locations. They discussed his practice needs and future plans, narrowed down equipment choices with Henry Schein Equipment Sales Specialist Roy Dickson, and consulted with the Henry Schein’s Office Design Team to draw up the plans.

“Diane was instrumental in deciding on locations and equipment ideas,” said Dr. Van Dyke. “Diane has been involved in dentistry in Las Vegas for a number of years, and she has a good pulse of the dental practice business here. I have grown to trust Diane and her expertise and found her to be a great source of information.”

“I decided that a new location would give me the opportunity to practice the type of dentistry I wanted, and would give me office space that would be attractive to a new buyer when I decided to sell the practice.”

Today, the new office of Distinctive Dentistry is in Cheyenne Fairways, a new office complex in a gorgeous setting. The 2,500-square foot office was developed with enough space for one doctor to work comfortably or two doctors to work sideby-side or in split shifts. Its five treatment rooms are on the periphery of the practice, providing access to breathtaking views of mountains and the nearby golf course from full-length windows. Patient traffic flows smoothly around the panoramic, sterilization, and consultation rooms, which are in the center of the space.

Nothing Like A Dentist’s Office

Dr. Van Dyke wanted patients to feel as if they were walking into a living room and not a dental office. A stately stone wall in varying hues of brown and tan creates warmth and offers the perfect contrast to the crisp-flat-screen TV and modern lighting mounted on the façade. The commercial-grade wood flooring is homey and inlaid with large black marble tiles splattered with brown and cream veining. The same sleek, yet inviting color combination is repeated on the matching marble counter at the check-in desk.

“Because the design and décor of the office present a comfortable, professional atmosphere, patients are more receptive to treatment recommendations.”

Practically every surface in the operatories is styled with soft, rounded corners, from the cabinetry with its oblong, stylized glass inserts to the sand-colored granite countertops that flow smoothly from room to room. The rooms are outfit with topof- the-line Pelton and Crane Delivery and Support cabinets, track lighting, and luxurious leather massage chairs. Patients are pampered… ceiling-mounted TV monitors offer the choice of Direct TV programming or a selection of movies on DVD as well as music that can be listed to with infrared headphones. The tall windows give patients a full view of the lush scenery, enhancing the open feeling created by the high ceilings.

“Because the design and décor of the office present a comfortable, professional atmosphere, patients are more receptive to treatment recommendations,” said Dr. Van Dyke. “Production increases and patients are eager to refer their relatives, friends, and co-workers.”

In addition, having greater street-side exposure, including a roadside digital sign that can display changing messages, has helped to attract new patients; the practice has grown tremendously since moving to the new office.

“Referral numbers are definitely up,” says Dr. Van Dyke. “Patients feel this is a safe office to refer their relatives, friends, and co-workers. Employees are proud of the new office and also eager to refer their acquaintances.”

Going Digital

Both patients and staff appreciate the new office. The move opened up the door to adopt the latest technology and Dr. Van Dyke’s team has found the new equipment has made their work more productive and enjoyable. The hard work the office staff put into the move has been rewarded through streamlined new systems that save time and make their jobs easier.

Distinctive Dentistry adopted Dentrix Practice Management software after the move; recordkeeping is now completely paperless, saving the staff numerous steps and making patient information more easily accessible. X-rays have gone digital, too. Dr. Van Dyke chose Gendex digital panoramic and intraoral X-rays, which has eliminated film and chemical expenses and has resulted in higher-quality images used chairside with patients for treatment discussions.

Change Is Good

“This was a project years in the making, said Henry Schein representative Diane Zurko. “He would keep pictures in his waiting room of the progress of his new office, and everyone was very excited. He utilized an experienced contractor, a wonderful interior designer, and our fabulous CAD/CAM team to start developing this stunning office.”

Dr. Van Dyke advises other doctors who are considering a build out to research the demographics in their desired area and carefully manage spending and overhead expenses. He also recommends finding help in the right places. “Choose your design people, construction contractor, and decorator carefully.”

Designed By: Justin Crooke, Henry Schein National Design Group

Featured Equipment:

• Dell Computers and ceiling track monitors
• Dentrix Practice Management Software
• Gendex AccuCam Intraoral Camera
• Gendex 9200 X-ray Digital Panoramic
• Pelton & Crane Delivery Systems
• Pelton & Crane Cabinetry
• Pelton & Crane track lights with monitor arms
• Pelton & Crane Deluse leather massage chairs
• Pelton & Crane Solaris Sterilization Center
• SciCan Hydrim Sterilizer

Left to right: Roy Dickson, Equipment Sales Specialist; Diane Zurko, Field Sales Consultant; Mike Rios, Equipment Service Technician; Dr. Robert Van Dyke; Natalie Lenzora Equipment, Coordinator; Ron Fullerton, Regional Operations Manager

We have been heavily involved in the restoration of Dental Implants and recently chose to learn the surgical aspects of the procedure. Although our plan was to maintain a solid relationship with our Oral Surgeon and Periodontist, our goal was to keep the simpler surgeries in house. As our experience grows, we can pick and chose the cases within our comfort zone. We chose to focus on this area of Dentistry, because unlike many of the routine cosmetic services we love to provide, patients are still very motivated to receive implants. This article looks at 6 factors we have utilized to add implant surgical procedures to our busy restorative practice.

1.) Find a mentor

Although there are many ways to learn new things, nothing will shorten the learning curve, and provide you with more confidence, than a good mentor. I met Dr. Baxter Perkinson before I went to dental school. He was my brother’s Dentist. He was not only the one who encouraged me to go to The Medical College of Virginia, he was the person I did my first full-mouth reconstruction with; the one who encouraged me to study with Pete Dawson; the one who talked me into doing my first lecture; and the one I called when I wanted to learn how to place implants. In short, no one has had a more profound impact on the direction of my career.

A good mentor has to be an expert on the subject you are interested in, and they must have the time as well as the desire to help. Baxter has been involved with the surgical and prosthetic phases of implant dentistry for 30 plus years. He also is a close personal friend, and after a couple of conversations agreed that he had the time and the desire to be my mentor. Even though his practice is in Richmond, two hours away, he was still the best person for the job.

Do not underestimate the importance of this person to the success of your endeavor. Find a person from your past that you have a good relationship with, and is an expert on the subject. If the best person is a few hours away, it is worth a car or a plane ride to have the right experience. I have utilized Dr. Perkinson by going to his office and observing very difficult implant surgeries as well as arranging transportation for him to come to my office and be with me for my first surgeries. Nothing is more valuable than having your mentor next to you for the first several cases, so you will be full of confidence prior to going solo!

2.) Create a timeline and a budget

One of the early discussions to have with your mentor is get an idea of the time as well as the cost involved. The economic impact needs to include the additional equipment you will need, the continuing education required, the training of your team, the travel costs involved with CE/visits to your mentor, and the time away from the practice.

Getting involved with implant dentistry is not cheap. We found, however, that many of the implant manufacturers were extremely helpful in putting together a surgical kit that had all the necessary instruments, the surgical (internally irrigated) handpiece, and a nice supply of implants to get me started. They also created a payment plan to pay this over several months, so that our increased production easily paid for the initial investment.

Time involved for continuing education and visits with your mentor also has to be considered. Keep in mind that your greatest expense is the time away from your practice. If you can arrange your CE and time with your mentor on days your practice is not usually open, it will have the least financial impact on your business. Get a calendar that will allow you to see a full year ahead. First block the days that you need to work. Then put in the days for continuing education recommended by your mentor. Lastly, put the days you will visit your mentor (once a quarter is a good place to start). By doing this you can easily do the training that will be required and still work a healthy number of days. Be patient with the learning process. You need to invest in both dollars and time, prior to seeing the return on the investment. Gaining the necessary skill, will decrease stress, and increase both the predictability as well as the profitability of your newfound skill.

3.) Become an expert at treatment planning and occlusion

There is not another discipline in dentistry that will test all aspects of the Dentist’s knowledge then the placement and restoration of dental implants. Esthetics, occlusion, tooth position, neutral zone, anatomy, flap design, surgical technique, laboratory communication, restoration selection, and business acumen all have to be completely understood. Prior to even thinking about placing an implant we have to be completely clear about where the teeth need to be in space for ideal esthetics and ideal function. Proper implant placement is first a prosthodontic process and secondarily a surgical process.

At The Dawson Academy (www.thedawsonacademy.com) our core curricula is devoted to teaching doctors the process for teaching doctors how to create and sequence optimal treatment plans. Treatment plans should provide both an ideal occlusion and an optimum esthetic result. This kind of analysis is required so that it can be determined if there is even enough bone to do an implant supported restoration. In short, as with all aspects of dentistry, a thorough understanding of occlusion and treatment planning is where it all begins. Be sure to keep this on the list of “must-learns” if implant placement is something you want to pursue.

4.) Embrace technology that allows you to do your best work

Technological advances like Cone Beam Computerized Tomography as well as digital radiography are incredibly important advances when it comes to the surgical placement of implants. Having the ability to see the mandibular and maxillary structures in three dimension is the standard of care when it comes to the planning and placement of implants. We are currently utilizing the Sirona GALILEOS in our practice. I initially purchased it for the vvisualization of the TM joint within my restorative and TMD part of my practice. We also utilized it when we were treatment planning implant cases with our specialists.

We soon realized that Cone Beam technology takes the guess work out of surgical placement. If we go through a proper treatment planning process and figure out where the teeth go, surgical guides can be created to guide the surgery. Digital radiography, such as DEXIS, which we utilize, is also an excellent adjunct to take instant radiographs after the pilot drill has been used for the initial ostectomy. Verifying that you are in the correct position, space wise, will eliminate problems with poor placement that may happen at the time of surgery. If only the pilot drill had been used, it is simple to correct the angulation issue.

Although you don’t necessarily need to have all the latest technologies within the walls of the practice, if you are going to place implants, be sure to begin by getting a scan on your patient. It is the standard of care.

5.) Create a support team to facilitate the growth

Creating a support team when you are initiating something new in the practice is hugely important. Part of my evaluation of the different implant systems, was the quality of the support on a national, regional and local level. I wanted to make sure that I had direct access to knowledgeable people who were interested in helping me. There are so many parts and pieces involved with implant services that I wanted to make sure I had a representative with me during my first surgeries. Prior to purchasing any system, meet with your local and regional representatives. Find out how long they have been with the company, and ask for recommendations—and check them.

Make sure you have a good relationship with a laboratory. Lars Hanson who works with Bayview Dental Lab, works with me to create the diagnostic workup, reading the CT scans, and creating the surgical guides. I simply cannot do these cases without his help. Remember that implant treatment is a reverse- engineering process. Figure out where the teeth need to go first, then evaluate the bone to see if it requires grafting and, ultimately, figure out the optimum place for implants. The lab can also be a valuable resource on who they think the best implant companies are to work with. The better labs work with these companies day in and day out, they know the ones that will be most helpful.

Sitting down with your Henry Schein equipment specialist is also a good idea. Keeping them up to date on the vision and direction of your practice, will allow them to make the appropriate equipment recommendations. Having a coordinated plan on the timing of technological implementation is critical for the financial health of the practice.

Lastly assign one team member in your office responsible for the ordering and organizing your implant supplies. You will want him/her to be at all the early meetings with the implant company that you choose and that he/she has a good working relationship with both the lab and the representative. Make sure your team is fully on board with this endeavor—it is a big job!

6.) Control your schedule for optimum focus and quality

Once you are ready to implement the new service into your practice, it is often best to do them on days that you are not usually open. Keep in mind that when you are doing something for the first dozen times, you have no idea how long things take. Whenever I am doing something new I will go in on a day that I don’t have hygiene and just to 2-3 procedures of this type. Give yourself lots of time to focus on the nuances of doing it 100% right. If you have the opportunity to photograph the steps along the way, even better, as it will give your mentor the opportunity to coach you. As you and your team get comfortable with the procedure, you can start scheduling it within the confines of your normal day.

When the economy turns south, it always creates anxiety within the walls of every small business. It is important to remember, however, that the economy will always cycle. There will be great years and there will be challenging years. What I have observed is that economic slow downs are the ideal time to invest on the research and development of your practice. Whether it is attending the courses at The Dawson Academy to master occlusion, learning to do molar endodontics, or getting comfortable with the surgical placement of implants. The process is exactly the same. If you follow the six steps outlined in this article, you will soon have a new and productive procedure that you can offer your patients Not only will it ease the pain of the economic slow down but it will set you up for explosive growth when the economy turns around.

Dr. John C. Cranham is an internationally recognized clinician. He resides in Chesapeake, Virginia and has a private practice that focuses on solving complex functional esthetic problems. He is a Clinical Director of The Dawson Academy and as an educator has presented over 750 days of continuing education throughout the world.

In today’s economy, every patient counts. When I see holes in my schedule, it’s frustrating to me and challenging to my team. I’ve found that the best way for us to fill or refill our schedule with meaningful production is to convert patients from our Hygiene schedule to the operative schedule.

With the E4D Dentist CAD/CAM system from D4D Technologies and Henry Schein Dental, we have a fantastic way to offer patients one-time appointments or same-day crowns, inlays, onlays, or veneers. Patients really value this service because they don’t want to take any more time off from their busy lives than they have to.

We offer every hygiene patient the option to have his or her restorative work done at the same appointment. I will then immediately come in to diagnose/treatment plan the case/tooth. If the patient agrees, my hygienist will anesthetize the patient and place the rubber dam, and I will then break away and prep the tooth.

My hygienist will scan the prep, customize the design, and mill the restoration using the E4D Dentist system. While the restoration is milling, she will clean the patient’s teeth and then try-in the crown. If it meets the patient’s and our approval, I will cement the crown and the patient can return to work with a cleaning and a new crown. Everyone wins!

For patients who require more time during a hygiene appointment for both a cleaning and perhaps multiple crowns, we will offer to prep the teeth, take an impression, clean their teeth, and then have them returned at the end of their work day to have the crowns cemented. While they are at work, my assistant or hygienist will scan the impression of the preps and make the crowns between patients.

The software is so intuitive it practically designs the crowns by itself. This allows my team to scan, design, and mill multiple restorations throughout the day without disrupting the schedule. Both our office and the patients love this service as well. It is not uncommon for me to prep 3-4 crowns in my hygienist room and cement them at the end of my day.

Anther incredible service we are now able to offer our patients is same-day, no prep, or minimal prep veneers. With the introduction of IPS e.max CAD (Ivolcar Vivadent) hightranslucency porcelain, we can mill veneers as thin as .3mm with confidence that they will not break. This allows my hygienist or assistant to take an impression during a hygiene check and use it to create the veneers to be cemented the next day or at the end of the day.

Another great service is the ability to create and seat crowns on implants the same day the abutments are placed—no temporaries or metal post sticking up. Offering these simple, predictable, and very productive procedures in a single visit or with same-day service has allowed my schedule to stay full and my patients to truly enjoy visiting our practice.

It might be unnerving for some dentists to have people studying their every move, but for Dr. John Cranham, it’s something he encourages. Both a practicing dentist with a thriving practice in Chesapeake, Virginia, and a leading educator in the field, he balances his time caring for patients in his esthetic-focused dentistry practice and sharing his expertise in demonstrations and lectures all over the United States and abroad.

Balancing these two passions has become easier now that Dr. Cranham has relocated to a stunning new 2,400-square foot office in the Greenbrier area of the city because it is in the same building as the Mid-Atlantic Center for Advanced Dental Study, a post-graduate education facility affiliated with the Dawson Academy.

“The previous building was older and had space limitations,” explained Dr. Cranham, who also serves as Dawson Academy’s clinical director. “I decided to build a new office to address potential growth, to be closer to the primary lab we use (which is also in the building), and to be connected to the Dawson teaching facility so my office could be used in conjunction with the hands-on courses.”

Wayne Boiselle, the Henry Schein Equipment Sales Specialist who worked with Dr. Cranham explained, “The doctor wanted to create a practice that was congruent with the quality of care he was providing.“

At the same time, Dr. Cranham, the educator, also saw an opportunity to share his expertise by installing cameras in one of the operatories to allow those attending the Academy next door to see training procedures and equipment in action. The result is a new dental office that offers the best of both worlds: the latest technology, a luxurious environment for patients, and a fully wired facility that broadcasts procedures in real-time to those in training right next door.

Space that Transforms and Teaches Patients who come to Dr. Cranham for esthetic procedures have very specific concerns and hopes, so being able to deliver outstanding results in a space that’s both beautiful and inviting is vital to meeting his patients’ high expectations.

When patients enter the new practice, the first thing they see is a waterfall that softly cascades down a wall of dark granite into a bed of natural stones. Scattered throughout the lobby are comfortable, upholstered chairs alternating between a lively pattern and a relaxing, rich green. The clean and simple lines prevalent in the light hardwood laminate floors and lighting fixtures create a sense of serenity and calm. A glass block window set in the lobby wall allows light to radiate through the practice and links the five treatment rooms to the waiting area.

The Pelton and Crane equipped operatories are an oasis of comfort, where patients are treated to leather massage chairs and TV monitors so they can enjoy entertainment while the doctor recreates their smiles. Before deciding on the high-end cabinetry and furniture, Boiselle of Henry Schein and Dr. Cranham flew to the factory for a tour–ultimately, the doctor loved the aesthetics and the ergonomics of the line.

“Dr. Cranham didn’t want his office to look clinical,” remembered Boiselle. “Ultimately the Pelton and Crane cabinetry gave him the look he wanted.”

The color palette borrows from a comfortable swatch of rich neutrals: smooth deep brown in the cabinetry and deep gray Corian countertops that offset the creamy taupe walls. Captioning the operatories are large, rectangular windows that dominate the space, opening up the high-ceilinged rooms to the outdoors. Smiling portraits of former clients serve as inspiration to patients and also highlight the work done by Dr. Cranham.

“The use of the more advanced equipment and organization in the operatories helps utilize our time much better,” remarked Dr. Cranham.

As sharp as the new space looks, it’s also highly functional. The operatories are set up to maximize efficiency for both the doctor and the assistants, and everything flows perfectly. The new central sterilization room was designed to easily accommodate multiple staff members and is easily accessible.

Anne Ellison, Chairside Assistant; Kelly Brown, Hygienist; Dr. John Cranham; Mariah Scofield, Assistant; Sarah McCutcheon, Office Manager

Digital Equipment Meets High Expectations Remaking someone’s smile is an emotional journey for the patient and often something they’ve wanted for a long time, so keen attention to detail is necessary so they feel informed and engaged in every decision about their treatment.

Dr. Cranham invested in top-of-the-line digital radiograph systems including the DEXIS Platinum Digital Sensor and the Sirona GALILEOS Cone Beam CT. Both give him the ability to view high-quality images almost immediately and display those images on the TV monitors so patients can view the X-rays while the doctor makes treatment recommendations. The office also houses an E4D CAD/CAM system, which has streamlined the restoration process for both the patient and staff.

Moving to this advanced digital equipment has accomplished several things for Dr. Cranham’s office. As a dentist energized by new techniques and technology, the addition of the latest digital equipment is exciting. Perhaps more importantly, however, it just makes sense financially. The new equipment was financed by Henry Schein Financial Services, and even this proved to be a positive part of the project for the doctor. “It was so easy to work with them, “said Dr. Cranham. “They exceeded my expectations.”

Left to Right: Michael Marquis, Equipment Service Technician; Bobby Anderson, Regional Manager; Dr. John Cranham; Lisa Pearson, Field Sales Consultant; Wayne Boiselle, Equipment Sales Specialist

The new equipment is faster, allowing the staff to move from the previous phosphorous plates digital system they used before, so there’s one less step. It’s more precise, costs virtually nothing to run, saves time, and simply elevates the doctor’s practice by offering his patients excellent results.

“The use of the more advanced equipment and organization in the operatories helps utilize our time much better,” remarked Dr. Cranham.

Location, Location,Location

The move from the Western Branch location in Chesapeake to the more centrally located Tidewater area has allowed the practice to draw in a more diverse client base. The number of new patients has increased and so have referrals as patients visit the new office, feel good about their experience, and tell others.

Featured Equipment:

• Biolase Waterlase MD Turbo
• Dentrix Practice Management
• DEXIS Digital Sensors
• E4D system
• Pelton & Crane 3000 Chair
• Pelton & Crane Helios Light
• Pelton & Crane Cabinetry
• Pelton & Crane Delivery System
• Pelton & Crane Sterilization Center
• Pelton & Crane Delta Q Sterilizer
• SciCan Statim Sterilizer
• Sirona GALILEOS 3-D Cone Beam

Lean and mean is the buzzword of the times of modern business. Operating “lean” now reflects the values of efficiency, financial responsibility, and good leadership. The concept transfers quite effectively to the dental environment—the lean practice. This method of improving a business is universal to all successful endeavors, especially in this era of evolving technology. The primary concept behind lean office is “continuous improvement.” Although this sounds like a lot of work, actually, these methods result in a calmer, less burdened workplace. To continuously improve, a lean office must concentrate on three aspects: willingness to change, involvement of employees, and effective communication. Digital radiography touches all of these points, making for a leaner, and even greener, office.

Willingness to Change: Many offices continue to use inefficient methods because they are stuck in “the X-ray rut.” Most of us become accustomed to everyday rituals and habits, and even bad ones are tough to break. Such is the case with traditional film X-ray. The lean office involves cutting out unnecessary steps and costs. Implementing digital X-ray allows a practitioner to eliminate such burdens as the darkroom, the cleaning and processing chemicals, the mounts, and the film as well as a huge amount of time saved. Digital X-ray is clean and quick to capture providing instant, clear images that are as large as your computer display will allow.

Involvement of Employees: The office staff should be involved serving the patients, not scrubbing a processor or hanging around in a closet waiting for film to develop. You can easily capture images in much less time than traditional film— cutting the time of an FMX potentially by 20 minutes. Some digital sensors, such as mine (DEXIS® Platinum), are built for efficiency—a slim profile with rounded corners, and a special type of cable exit that lets the assistant move it around the mouth with ease. Team members are happy that they can plug their digital sensor right into the computer with a direct USB connection–everybody wins!

DEXIS, a major component to the Lean Dental Practice

Effective Communication: Digital X-ray speaks. Not literally, but word will get around the community that this technology has made the dental experience a quicker, more comfortable, and more understandable process. Digital X-ray lets the dentist educate the patient, with images that can be enlarged and enhanced. Areas of concern can be highlighted in many ways on the screen, with contrast, color, or arrows, just to name a few. Rather than staring blankly at a small piece of film that they cannot really comprehend, an educated patient is empowered to make the right decisions regarding dental care—leading to increased case acceptance. Technology equals quality in the patient’s mind!

Lean principles are by no means a modern concept. In the mid 1900s, W. Edwards Deming taught Japanese auto executives how to improve quality, reduce expenses, increase productivity and improve market share and lower costs. The concept was so effective that the Japanese Union of Scientists and Engineers established The Deming Prize and bestowed upon him a medal.

Back to modern times, digital imaging has been a real treasure for my dental office. A change toward leaner office practices results in a more efficient, effective, cleaner, greener, calmer, quicker, X-ray process with clearer more “communicable” results. Continuous improvement and a lean office helps you to make more out of less, cutting the fat from the budget and, at the same time, concentrating on the most important aspect of the practice—quality of care for the patients.

Dr. Brad Durham completed his dental training at the Medical University of South Carolina in Charleston in 1982. He has practiced for 28 years with an emphasis on head, neck, and facial pain treatment, dental cosmetics, and complex dental reconstruction. His practice combines art, science, and technology with personalized care. Dr. Durham is a clinical and featured instructor at The Las Vegas Institute of Advanced Dental Education and he was the first to earn the LVI Mastership Award for aesthetic reconstruction. He teaches a series of courses entitled “The Niche Practice” at LVI and at his home base in Savannah, Georgia. He can be reached at: drd@braddurhamdmd.com and www.nichepractice.com.

One mistake providers make is not recognizing the signs of early default. When a patient doesn’t pay their bill within 60 days or hasn’t set up or is not following a payment plan, they are telling you that they are not going to pay! Should you use your staff’s time trying to collect these accounts?

Outsourcing your collection problems to a service bureau can be much more cost effective than working them in-house—and certainly more effective.

As a dental provider, you are implementing state-of-the-art methods to treat your patients’ dental needs. You also need to employ the most up-to-date methods to keep your practice fiscally healthy.

In the past, collection agencies were the only “act on the block” and viewed as the last resort to collecting your money. They can be expensive and often cared little about your relationship with your patients. You had no control over how they treated your patient and you never knew if they collected your money or not. Often the collector, who is paid on a commission basis, “cherry picked” over your accounts and attempted to collect only the larger ones and did not work the smaller ones. And, many of your accounts that were collectable were deemed too small to work. Thus, you lost money when you didn’t need to.

What is needed is a proactive, systematic business model that will work all of your delinquent accounts equally. Providers must take an approach that will reduce losses as well as speed up cash flow from past due accounts. You need to work with your patients quickly and effectively. Outsourcing your collection problems to a service bureau can be much more cost effective than working them in-house—and certainly more effective. Utilizing a third-party collection method that will keep you in complete control of the collection process is a must. The third-party system should be respectful, but firm, and utilizes every possible legal tool to collect your money.

The provider who utilizes a systematic third-party approach to collect their money will see an increase in their bottom line.

Henry Schein Financial Services partners with MaxCollect to provide your business with an effective means to achieve debt resolution with your patients. Benefits of this method include:

1. Collected funds remitted directly to the doctor (not an agency)
2. Low fees, as little as 5%; average cost 15%
3. Every account, regardless of size, is pursued for collection

(MaxCollect is available in U.S. only)

Keith Drayer, Vice President

Henry Schein Financial Services

1.800.443.2756 / hsfs@henryschein.com

As you look around the plush new dental office of Dr. Arthur Stoyshin in Windsor, Ontario, you might not believe that forty years earlier, he started out seeing patients in a tiny 1,200-square foot office that had been an old drugstore. His success and achievements are a testament to the doctor’s firm belief that if you believe it, you can achieve it. And, achieve he has. From his start in 1968 when he was an earnest, young dental school graduate working alone, he expanded into a partnership with several associates in a sprawling 4,200-square foot facility with 10 operatories!

However, like many things in life, bigger isn’t always better and, in 2009, Dr. Stoyshin came full circle and decided to return to a single practice once again, the way he began his career four decades earlier.

He and his partners owned the building that housed their practice, so he was able to move into space vacated by a denture clinic. It needed to be completely gutted, which gave Dr. Stoyshin the opportunity to build an office that met his every specification and improve upon minor annoyances he had experienced in previous workspaces.

“Although the (former) office had an open concept, the length of the operatories was a little confining. It was difficult to work at the 12 o’clock position,” Dr. Stoyshin explained. “The operatories in which I worked were quite removed from the business and reception areas.”

Turning a Positive Vision Into Reality

His new facility has been built around the philosophy that, if you create an atmosphere that has warm and positive feelings, it will, in turn, attract patients and result in high employee morale. The office caters to patients with spa-like comforts and an open, airy layout that’s both clean looking and inviting. It was on the recommendation of Chad Pelletier, an Equipment Service Technician for Henry Schein, that Dr. Stoyshin brought his new office project to Henry Schein. Pelletier had a longstanding relationship with Dr. Stoyshin that went back a number of years, and the doctor liked and respected his work.

“Chad mentioned that Carl Bernat was someone that he worked well with and was competent. I trusted Chad Pelletier’s judgment,” said Dr. Stoyshin. Pelletier remained involved with each step of the design, build, and installation process alongside Bernat, and the Henry Schein Office Design Team, an unusual scenario for a service technician.

“We are able to show patients their intraoral photos and X-rays immediately. This has increased acceptance of crown & bridge and cosmetic dentistry,” said Dr. Stoyshin.

The doctor attended the Mid Winter Meeting in Chicago and a few months later, the Ontario Dental Association Spring Meeting. Bernat introduced Dr. Stoyshin to manufacturers and offered recommendations on equipment choices. It was then that he brought Henry Schein’s office team on board to develop preliminary plans based on the doctor’s specifications.

“The doctor wanted a high-quality product with clean lines and lots of options,” said Bernat. “Once we looked at the Pelton and Crane product at the Ontario Dental Association Meeting, there was no question it was right for this office.”

Relaxation in Every Detail

Contemporary high-backed leather chairs set off the golden color of the Venetian plaster walls and earth tone ceramic tile in the lobby, which leads into four spacious treatment rooms. Every detail…the sights, sounds, and color is meant to relax the patients. Cheerful yellow walls greet patients. As they lay in the buttery soft leather massage chair, they can look up to the 14-foot ceilings to the eye-catching Chicago Metallic architectural ceiling accents that reflect color changing Chauvet Colorstrip LED lights that dance across the ceiling. These same lights brighten Caesars Palace in Windsor! Subtle meditative music is piped into the room’s sound system, which features middle island cabinetry topped in creamy tan granite.

“The new office has definitely helped to reduce stress in the practice. New technology is making the work easier to accomplish and lets us provide the best care for our patients.”

Technology Contributes to the Patient Experience

Even the new equipment contributes to his patients’ positive experiences. Dr. Stoyshin now offers nitrous oxide by Accutron for patients who desire conscious sedation dentistry, a growing market. Digital X-ray equipment – a Sirona XG5 X-Ray Digital Panoramic unit and a Heliodent DS Intraoral X-Ray with Sirona XIOS sensor system – has saved time for the staff, and results in higher- quality images that can be viewed by patients chairside on TV monitors.

“We are able to show patients their intraoral photos and X-rays immediately. This has increased acceptance of crown & bridge and cosmetic dentistry,” said Dr. Stoyshin.

Carl H. Bernat, Field Sales Consultant and Dr. Art Stoyshin

“The doctor had been practicing for years and wanted to renew his passion for dentistry and create a very positive and tranquil office. The colors, lights, and music all contribute to a peaceful office,” remarked Bernat of Henry Schein. “Efficiency is much better, without question.”

Dr. Stoyshin agrees wholeheartedly: “The new office has definitely helped to reduce stress in the practice. New technology is making the work easier to accomplish and lets us provide the best care for our patients. We are working toward a paperless office. The staff and I are very pleased and excited about our new office.”

Featured Equipment:

• Accutron Nitrous Oxide
• Dentrix Practice Management
• KaVo Handpieces
• Miele Dental Washer Disinfector
• Midmark M11 Sterilizer
• Pelton & Crane Cabinetry
• Pelton & Crane Helios Light
• Pelton & Crane Ergo Sooth Massage Chairs
• Pelton & Crane Delivery System
• SciCan Statim
• Sirona XG5 Digital Panoramic
• Sirona XIOS Digital Sensors

Risk or reward?

hat was the crossroads that Dr. Wilton Guillory, Jr. and Dr. David M. Carlton III faced. Each month, 50-60 new patients were walking in the door of Family Dentistry at the Lakes in Alexandria, Louisiana, and the office was simply out of space. The waiting room was crowded on busy days and there was just a small, single check out for patients. Yet, the economic downturn made it a risky time to consider any type of expansion or new construction, even though it appeared to be the logical next step for the practice. What did the Doctors decide to do?

The doctors took a calculated risk and moved ahead with the construction of a new building, knowing that lower interest rates and construction costs made it an opportune time to build. Dr. Courtney Richter joined in the discussions, and the three doctors decided to merge into one practice and move forward with their vision.

They wanted a new office with: 1) More square footage and a layout that facilitated high-quality care. It also needed to accommodate the future growth to a fourthdoctor. 2) Latest technology to give patients an exceptional experience and make the practice more efficient 3) An upscale yet comfortable interior that matched the level of care given to patients.

“Wow” Factor

Construction was completed in November 2009, and the finished office is nothing short of “wow.” It is 6,300 square feet and offers plenty of space to have four doctors practicing full time. Yes, four… even before construction was completed, Dr. Aaron Mangum joined the trio, making the added square footage an instant return on investment!

The “wow” factor begins even before you walk inside. The exterior of the building, with its rich architecture, inviting covered entry, double doors with transom, potted plants, and large windows sets the stage for the service patients receive inside.

“The interior was designed to have a comfortable, “home-like” feeling,” said Dr. Richter. “We paid special attention to the lighting throughout the building, as research has shown that lighting can affect the mood of our guests. We eliminated all commercial-type lighting features and incorporated canned, sconce, and pendant lighting fixtures where possible. The ambiance is now that of a home rather than a clinic.”

Even the floors were carefully chosen – the environmentally friendly bamboo floors don’t just look stunning with the blend of light and dark graining: they also absorb noise. The operatories are painted in earth-tone colors to calm and relax and are outfitted with Belmont cabinetry and chairs, giving an upscale look and storage while also offering ergonomic benefits to both the doctors and patients. The hygiene rooms are painted a crisp and clean oyster blue. Pulling all the colors and design elements together is the original canvas-wrapped photography of Dr. Guillory, which is displayed throughout the waiting room, halls and offices.

The space houses 13 operatories, all of which feature LCD monitors for patients’ use, an in-house dental lab, five centrally-located hygiene ops, a centrally located hygiene coordinator office, a consult office, spacious lounge area, and three privacy checkouts. A large and welcoming waiting area greets patients with a feeling that can only be described as southern hospitality – warm, comfortable, and elegant.

“We visited other state-of-the-art multidoctor practices and drew a design using what we felt were the best qualities from those offices with what we felt was the most efficient patient and team flow for our type of practice,” Dr. Carlton explained.

We located and purchased a great piece of property in a growing area of our community and hired a local architect to help with the building process. We then met with our Field Sales Consultant, Scott Rogers who immediately introduced us to Equipment Sales Specialists John Pruitt and Chris Bratton. From there, we never looked back.”

The Move to Digital

From the initial planning stages all the way through the final construction, Rogers, Pruitt, and Bratton were closely involved with essential aspects of the project. “Henry Schein assisted with plan review and plumbing, electrical and medical gas drawings for the operatories, sterilization, and dental lab. They also assisted with onsite monitoring of the construction and were instrumental in training for the new equipment,” noted Dr. Guillory.

“The interior was designed to have a comfortable “home-like” feeling,” said Dr. Richter.

The new equipment was perhaps the biggest change for the doctors and their staff. In the old office, they didn’t use digital technology; in the new office, they’ve embraced it with the purchase of Dentrix practice management software, which has automated many of their administrative duties, allowing patients to be scheduled, billed, and checked out more quickly.

“The office used film before. It was time-consuming and the chemicals could be messy,” said Rogers. “We looked at what the dollar cost savings would be, and it made sense for them to move to digital imaging.” The Gendex 8500 Digital Pan and an Aribex Nomad X-ray gave the office higher image quality, instant images for faster review and treatment plan discussion, and seamless integration.

Positive, Motivating Work Environment

The new work environment seems to agree with the staff, made up of three hygienists, six assistants, four front-office employees, and an office manager and hygiene coordinator.

“We cannot say enough about what this has done for the team,” said Dr. Guillory. “All the team members feel very fortunate to work in such a great environment, and several have actually improved their patient interaction. New-patient referrals are very high, and the compliments make us feel great about what we have built and can offer to our community. The relationships created early on and the enthusiasm that the team from Henry Schein portrayed made us feel confident that we would be not only satisfied, but also impressed with the final outcome.”

Featured Equipment

• Aribex Nomad X-ray
• Belmont E-Style Cabinetry with Cambria
• Belmont Quolis Chairs
• Brewer Stools
• Dentrix Practice Management Software
• DEXIS Sensors
• Gendex 8500 Digital Pan
• KaVo Quatrocare
• Midmark M11 Sterilizer
• Pelton & Crane Vista Pure
• Pelton & Crane Helios Track Lights
• Ramvac Bulldog Vacuum
• SciCan Statim 5000

It must meet the challenges and satisfy the clinical demands of your practice, your patients and lab partners. It is my opinion that digital impressioning has achieved the status of the gold standard in restorative dentistry. Computers operate with an efficiency and an accuracy that conventional materials cannot consistently attain. One such technology that truly meets these criteria is the 3M™ ESPE™ Lava Chairside Oral Scanner C.O.S.  The following case illustrates how the Lava C.O.S. can provide excellent results in restorative dentistry from impressioning to seating.

Case Report

The patient, a 79-year-old female, presented to the office with a failed fixed partial denture #2XX5. The prosthesis had failed due to recurrent caries beneath the mesial abutment. The patient was given all options for replacement of the failed restoration. She chose to have us fabricate a new ceramometal fixed-partial denture.

Following accepted restorative protocols, the old prosthesis was removed and all decay beneath the abutments was excavated. FluoroCore® (Dentsply, Inc.) was used as a foundation for the preparations, which were then refined to support a four-unit fixed-partial denture. Its design included a semiprecision slot connection between the pontic #4 and abutment tooth #5.

We then proceeded to isolate the teeth in order to scan the full arch using the Lava C.O.S. After verifying that 100% of the preparations were captured in the scan, the jaw relation was recorded by the scanner with the patient closed into centric occlusion. A provisional restoration was fabricated and the patient was dismissed.

The digital information, along with a digital prescription, was transferred wirelessly to the Authorized Lava Design Center. The lab used the digital files to mark the margins. The virtual model was then sent to a model-manufacturing facility to produce a stereolithographic (SLA) model.

This model was used for fabrication of the prosthesis, using the same techniques that would be followed if using gypsum die stone. (The difference is that the digital information does not change dimension in any way after it is captured by the scanner. The same cannot be said for conventional impression materials.) We placed the final restoration without any adjustments needed. The patient was ecstatic about the complete treatment process and she was truly amazed at the difference this new technology brings.

Placing restorations without making any adjustments has become the norm since incorporating the Lava C.O.S. The fit of the restorations is so accurate that rarely are any adjustments needed, provided that the provisional restoration satisfies all requirements.

The Benefits of Digital

When implementing the Lava C.O.S. in my practice, my goal was to provide an increased benefit to the patient through delivering a higher quality restoration. In the end, the benefits of the Lava C.O.S. have extended to my practice as well.

Dentists who have used the system reported a 41% reduction in seating times for single-unit crowns1 and remake rates due to marginal fit were up to 80% lower than the industry average.

In fact, since using the system in my practice, only 6 units of 250 have required modification prior to cementation. None of the errors were related to the scanner. My experience with the first 250 units scanned has been exceptional from both the perspective of my patients and my own. With experience and with continued software improvements from 3M, I see no tarnish on this technology.

Many dentists continued to practice their profession without those first films that showed the inside of the human body, but soon dentists realized that utilizing the best information available resulted in the best service to and the best result for their patients.

The necessity to use the best diagnostic tools is as valid now as it was then, and 3D imaging is as important an upgrade to dentists in 2010 as 2D radiographs were to dentists in 1910.In addition to being a necessity, quality imaging, such as digital intraoral and digital panoramic radiology and Cone Beam scanning technology, has brought even more opportunities for professional excellence and growth.

As an assistant clinical professor in Periodontics & Implant at N.Y.U., I’ve experienced the many facets of technology. Having referred my patients for medical CT scans for many years, my patients’ dental experiences were disrupted by long waits and indifferent service. I was fortunate to discover that my film panorex could be eliminated, and a Cone Beam machine with a 2D panoramic feature was reasonably priced and would fit in the same small space.

I use these machines predominantly for implant-related cases so that I can identify crucial structures. Of utmost importance to me, the GXCB-500, or the “500,” exposes my patients to less radiation than other 2D and 3D options. This leaves my patients and me very comfortable, as its 2D radiation measures 80% less than an FMX, and its 3D emits up to 10 times less radiation than a medical CT scan.

This medium-field-of-view 3D unit is ideal for virtually all services I render and provides the details that I need for successful treatment. I have recently used it midsurgery during an implant placement. The scan revealed a residual root that was undetectable on the prior 2D image and allowed me to complete the procedure successfully.

The software that accompanies the “500” allows me to share information easily with my colleagues, and that is an added bonus, important both from a practice management and a therapeutic viewpoint. I can also display the images on every office computer, enlarge or zoom in on images, and slice the 3D images in any direction, which result in a higher diagnostic capability and greater patient understanding of their condition.

The “500” has markedly increased case acceptance, and patients who come in for consultations and second opinions realize they do not need to look further to decide where they want to be treated. I strongly believe that we should use all tools that enable us to provide the best service possible to our patients. Patients want their dentist to have all of the facts before they begin treatment. They don’t want to hear, “I think we can do it,” or “The nerve shouldn’t be a problem, but you could be numb forever.” If a member of your family were considering treatment, you would want the most precise diagnostic information available before commencing treatment. I want that for my family, and our patients deserve no less.

To Charles Kettering’s point above, have you identified your issue(s)? I am a firm believer in knowing that properly identifying the concerns of your practice is the most important aspect of solving any potential problems. The team at Henry Schein Dental is eager to help you find out what your practice’s main challenges are and expose the objective points of data that will lead you toward the best solutions.

Henry Schein Dental’s Business Discovery Surveys and the Digital Practice Analysis Tool allow us to gather important information about how to improve your practice’s overall performance. In 2009, we set out to effectively state and address the challenges that were affecting dentists across the country. In order to do so, we surveyed over 13,000 dentists.

The results of this survey should not be a surprise to many of you because they represent common issues that you may be experiencing on a daily basis.

The Results:

Of course, a full detail of solutions to these issues above cannot be addressed without knowing the specifics of your practice. I can assure you that our sales team is prepared to help you find solutions to the most commonly identified problems in your practice. Our team participates in career development courses, which requires them to complete over 350 hours of dental business training. Using Henry Schein Dental’s offerings and tools, our sales force can help you identify your challenges and define solutions. We would like to start by sitting down with you, asking questions and most importantly, listening to your concerns.

Today, we are helping our current and future customers uncover challenges and work toward actionable solutions. In over 10 years, we have mastered analyzing dental practices and have concentrated on creating tools to help you grow, sustain, or sell.

One tool we are extremely proud of is the Digital Practice Analysis Tool (DPAT). By using a few pieces of information from your practice management software, we are able to show you how your policies and procedures are playing out in your practice. Of course, all the results are confidential.

We examine many aspects of your practice to see how they influence your standard of care. The chart on the previous page shows you just a few of the many aspects the DPAT focuses on.

Fee Analysis:

Using your current fee schedule and our statistical analysis, we explore with you the possibilities of changes in your fee structure that could involve major financial gains in your practice and evolve into you receiving the fees that you deserve based on your efforts, education, and risk in owning a practice and small business. In addition to showing you what you could financially achieve, we can also discuss possible impacts to your patient base and help you in coaching your team to discuss fees and fee changes with your patients.

Recare:

How often should your patients be seeing you? That’s your call as an expert and doctor. One of the common pitfalls in a practice is the follow-up in communicating with patients. It is often an eye-opening experience when dentists are able to see how many patients are actually coming back twice a year to see their hygienist, and how many true hygiene days that department is filling. Henry Schein Dental Sales Consultants are trained by well-respected practice-management consultants, such as Kerry Straine, on how to effectively get patients in the chair and keep them there.

Production Mix:

It’s often a surprise to see a year’s worth of you and your team’s efforts summed up in one chart, and the information here is amazing. Using coding, you’ll see what percentages certain aspects of your offerings are representing in regard to production. See the Procedure Mix example above.

Obviously, one can see that the DPAT is unique in how it measures the effectiveness of your policies and procedures, and it’s been built based on your challenges and your needs. Basically, anyone can forecast rain; the challenge is partnering with someone who can help you “build the arc.” We’re prepared and excited to help you bring your practice into the future that you desire and help you sustain the practice you’ve worked so hard to create and grow.

For more information of the Digital Practice Analysis Tool, please visit: henryscheinwedothat.com

The person that was interviewing me asked me how many things that I was taught in dental school was I still doing the same way. Having graduated from The Medical College of Virginia in 1988, I had to think about that for a minute. I was struck by the conclusion that I do nothing the way I did it in dental school!

While dentistry has certainly changed dramatically in the last 20 years, the technological advances that are occurring today are moving our profession at warp speed. Even though this is exciting, there are numerous challenges in correctly implementing these high-tech tools in a way that they will be optimally utilized, while not creating a financial burden to the practice  The mistake, often made, is to think the technology will be a “magic bullet” for the practice. A dental office that is in a financially unhealthy place will generally not benefit from an expensive technology, which may even put more economic stress on the practice. It is important to remember that these devices are simply tools that will allow us to do our dentistry better, be more efficient and provide our patients with a better experience. If we start with a well-run practice, with a clear vision for who we are and the services we provide, it will become obvious which technology we should implement first, and a logical timetable for which the other technologies can be brought into the practice environment.

Start with a Philosophy of Practice

Getting clear on the specific mission of your practice is probably the most important thing any dentist can do. In dental school, most of us just hope for a full schedule, but as that begins to happen, most mature practices begin to focus on some aspect of dentistry. At The Dawson Academy, we attract dentists who want to learn to solve complex aesthetic and functional problems. We place a high emphasis on diagnosis, treatment planning and sequencing dentistry in a way that the vast majority of our patients can afford optimum care. The curriculum is structured to train doctors to visual optimally, to procedurally do the work clinically, and to organize the team around them to optimize efficiency as well as profitability. While this is not the only philosophy out there, it has certainly worked with thousands of doctors who have chosen this path. The important philosophy: develop a practice vision and stick to it.

Don’t Let the Technology Define the Practice

All too often, if the vision for the practice is lacking, when technology is purchased it can become the center of the practice. A perfect example of this is chairside CAD/CAM technology. I have been involved with chairside CAD/CAM, currently using the D4D, for 5 years. It is an incredible tool for providing beautiful all-ceramic restorations for your patients. It is not, however, a machine that will allow you to do 100% of fixed prosthetics. Having a solid foundation for treatment planning, restoration selection and adhesion is vital to the integration of this tool into your practice. If this background is lacking, then it is easy for the technology to drive the practice.

This can lead to using the wrong materials in the wrong places, and ultimately an increased failure rate. Whatever technology you choose, remember that it is a tool designed for specific situations. While the training you will receive will emphasize the proper use of the instrumentation, pay special attention to its limitations. As you integrate it into your own practice of excellence, find the “sweet spot” in the practice for when it works best. This will increase the predictability, efficiency and profitability of your purchase.

Align the Technology with the Practice Focus

Once a philosophy of practice is established, the technology that would be of most value is often very obvious. If the doctor does a lot of surgery, perhaps placing implants and doing complex extractions, Cone Beam technology will be a huge benefit. On the other hand, if the dental team does a lot of operative dentistry, crown and bridge, and soft-tissue surgical procedures, the Waterlase MD® will increase the number of procedures you provide your patients, while also increasing efficiency.

Over the years we have gradually implemented various technologies into our restorative practice. These five are at the heart of our new practice:

Digital Radiography (DEXIS)

Digital radiography, in conjunction with digital photography, are often the first technologies introduced into a dental practice. Since we all take X-rays, digitizing the process increases efficiency and diagnostic capabilities of the team. I choose Dexis because of the quality and versatility of the sensor, the software platform, and the integration into Dentrix (my management software). Having the patients chart, progress notes, photographs and X-rays on one screen make treatment planning extremely efficient.

Chairside CAD/CAM (D4D)

Being able to do a percentage of your crowns, inlays and onlays in one appointment, with one injection, and without the need of a temporary restoration, is a tremendous service to the patient. Today with the addition of EMAX CAD, a lithiumdisilicate material, which is an extremely strong ceramic, only expands our opportunity to utilize this technology with total confidence. Dental teams that focus a percentage of their practice to lab-fabricated, indirect restorations will find a good fit with this technology. I chose D4D because of the ability to scan without powder (I do paint a liquid on the teeth prior to scanning), taking images from multiple angles to increase the accuracy of the model, the ease of use of the software, and the quality of the people running the company.

Laser Dentistry (Waterlase MD)

The Waterlase is the latest technology integrated into our practice. While I have had several years of experience with a couple of different diode lasers, the Waterlase MD is at a different level. It gives the dental team the ability to perform procedures on both soft tissue and hard tissues. We utilize it during crown-and-bridge procedures to create microtroughs around our crown preps prior to impressioning, for closed-flap crown-lengthening procedures (when indicated), gingivectomies, and the preparation of teeth during operative procedures. It has decreased the amount of anesthetic that is required during operative dentistry (allowing us to work in multiple quadrants in one appointment), and attracted dentalphobic patients who hate the sound of the drill.

Cone Beam Computerized Tomography (Sirona GALILEOS)

Cone Beam computerized tomography (CBCT), is providing the third dimension in virtual diagnosis and treatment plan. While I was initially interested in the ability to image patients with TMJ problems, I soon found it invaluable when treatment planning implant cases. Having the ability to virtually place implants and precisely communicate to the surgeon where the implants need to go is a “game changer.”

There is no longer the patient who gets opened up and we find that there is not enough bone. We can plan for bone grafts so that the implants are placed in the ideal position for the prosthetic solution. This technology has expanded my diagnostic capabilities helping TMJ patients and increased my confidence enough to begin placing the easier implants in my practice.

Dental Microscopy

Any time we can see better, we have the ability to improve our clinical skills. Caries detection, margination, trying in restorations, tooth preparation and endodontic procedures will all be better performed under a microscope. While dental microscopy has primarily been utilized by dental specialists, it is making its way into restorative practices throughout the world. We have found it not only dramatically improved our ability to see, but also forced us to keep our backs straight, into an ideal posture to provide dental services.

Get Help in Developing Your Business Plan of Implementation

Whatever technology you may be thinking about, get some help with the implementation process. The better your local Henry Schein Technology Specialist knows you and your practice, the better recommendations he or she can make about which technologies should be considered first and how to integrate them into your practice.

Beyond the obvious financial implications to be considered, also do not forget to discuss the training requirements with your team. Remember that not everyone is crazy about change, and some teams have a harder time with it than others. The earlier they get involved with the process, the greater the excitement will be and the smoother the transition. Having the right team attitude about something new in the office can make or break the implementation process. Utilizing the latest technologies to do routine and complex dental procedures has allowed us to do procedures with better quality, increased efficiency, and increased profitability. Beyond that, it is just plain fun! Dentistry is now moving at an everevolving, rapid pace. As you consider technology integration, first get clear on the specific vision of your practice. Then and only then can we choose the right tools for the time. Following this path will make the integration of the latest technology a smooth, fun and rewarding experience.

Lasers are an excellent instrument for everyday dentistry. That statement may surprise many dentists. But a recent study1 indicates that highly successful practitioners are utilizing lasers for common dental procedures, including caries treatment and restorations. Research conducted by Levin Group has found that general dentists who use lasers for routine care able to create a better patient experience and increase practice production, the ideal combination from a practice-management perspective.

Higher case acceptance resulting from happier patients has not been the only important benefit reported by dentists using the laser to perform everyday dentistry. In the same study, doctors attribute robust production growth in part to adding a laser to their standard tray. Everyday dentistry, such as the treatment of caries (even Class V composite restorations), is successfully and effectively performed, frequently in less time, with the use of lasers. “I use the laser with every patient that I see on my schedule,” said one research participant. Another dentist added, “Integrating the laser into our practice has increased production between $12,500 and $15,000 per month.”

Growing the Practice

Lasers increase production of common dental procedures. While most dentists have struggled during the current economic slowdown, many practices with lasers have actually grown during this period. The research indicates that dentists who own lasers are achieving production gains, not by adding complex or “exotic” treatment, but by more efficiently treating the conditions that present most frequently in the practice, such as caries and damaged/broken teeth. These successful dentists are seeing more new patients coming into their practices and accepting treatment. One dentist said, “New patients travel long distances to come to my practice because my patients have told them about how much easier dental treatment is with my laser.

“Practices have also attracted new patients with advertisements offering “an alternative to needles and drills.” Patients who responded to this kind of message told doctors that they appreciated not only a way to avoid injections and drillings, but also the fact that these dentists stood out as progressive and patient-friendly. By letting consumers know about options for their dental care, these doctors attracted new patients to their practices.

The key to practice growth is not only bringing patients into the practice but also offering treatment that they will accept. Lasers, according to our interviews, were extremely helpful as a means to increase case acceptance. Some doctors actually demonstrated the Waterlase MD^TM for patients by aiming the activated yet harmless water stream into a patient’s hand from a distance of a few inches. For patients who delayed or avoided dental treatment in the past due to anxiety, this kind of instrument was reassuring and made them comfortable with the doctor’s recommendations.

“Patients are just more at ease when we use the laser,” said one Northwest dentist. “Some of them have already researched the idea before they come in.”

A Better Patient Experience

Lasers reduce dental anxiety and improve the overall patient experience. When used appropriately, lasers greatly decrease the need for anesthetics and drilling, which are the two leading causes of dental anxiety. Satisfied patients are the goal for every practice. A dental experience that exceeds expectations will motivate patients to keep appointments, accept recommended care and refer their friends, neighbors and family members. The idea of dentistry is often connected to pain or discomfort in the minds of many patients. Practices that can remove this connection through the use of appropriate technology will be the offices that increased patient referrals and case acceptance.

Changing someone’s mind can be a transformative experience. When dentists are able to help patients overcome their dental anxiety, these individuals often become the practice’s biggest advocates. When asked about the connection between patient referrals and laser usage, one California dentist said, “We get lots of new patients that way.”

Another laser user related this experience: “I had seen one of my patients before his golf game. I had restored Class V caries on #20 and #21 using the laser with no anesthetic. He was so impressed that he told all his friends he played with that day and they told their wives.” A few days later, when the dentist was playing a round at the same course, he was inundated with inquiries. “In the span of 15 minutes, he said, “I had five patients and four nonpatients (who after talking to me wanted to become patients) ask me if it was true that I treated their friend using a laser and no anesthetic.” Summing up, the dentist said, “Do not underestimate the power of the laser, especially when a patient experiences it for the first time.”

Ease of Use

Lasers are easy to implement into the practice’s daily regimen. What was reassuring to Biolase owners when they bought the laser was how quickly the device could be incorporated into the practice. Handling a laser, dentists told us, felt very similar to having a drill in their hand. With appropriate training, these doctors were soon performing laser treatment on their own patients. “I felt it was relatively easy to use the laser,” said a West Coast dentist. “After basic training, I felt comfortable performing basic operative and soft-tissue procedures.” Another doctor commented, “It’s not much different than using a handpiece.”

Although dentists with lasers reported that they “would not work without them,” they also said that they would not give up either their drills or the use of local anesthetic. Lasers have made dentistry “much easier,” but that they were “still just another tool on the tray.” Rather than replace their drills, doctors identified what lasers do best and used them in conjunction with other instruments.

Many laser owners were able to grow their practices during the recession. By their calculations, these dentists said it was possible to pay for a laser based on adding only a few more new patients per month. After counting the gains from increased patient referrals, more new patients from advertising, more hygiene production and higher case acceptance, these doctors said that they were very pleased with their investment. “Without a laser today, you’re not as up-to-date as people expect,” said a NorthWest dentist.

Conclusion

Many dentists mistakenly perceive lasers as only an adjunct for high-end procedures. Levin Group research found that dentists who made lasers as a standard part of their armamentarium were able to derive the most benefit from this technology. The frequent use of a laser by offices resulted in a higher level ofpatient comfort, increased case acceptance for routine care and larger cases, and often improved doctor productivity.

“Patients are just more at ease when we use the laser,” said one Northwest dentist. “Some of them have already researched the idea before they come in.”

“Without needing anesthesia, I can take care of 8-10 cavities at a time anywhere in the mouth,” said a research participant. “For a small to medium cavity, I’ve done the procedure in the time I would’ve been waiting for the anesthesia to take effect.”

The popularity of lasers has grown steadily during the last decade, as more dentists became aware of the benefits that laser technology brings to their practices. Once solely the province of high-tech practices, lasers are now widely viewed as just another instrument on the tray by many dentists. In addition, as dentists enhance their clinical skills and offer new treatments in their practices, lasers can easily be used for a variety of procedures, including periodontal, endodontic and surgical treatment.

With the economy expected to improve this year, more consumers who postponed dental treatment during the recession will be looking to resume regular dental care. Practices that offer compassionate care using the advanced technologies, such as lasers, will be the offices that experience the largest influx of new patients. One California doctor captured the sentiments of many research participants about the importance of lasers, “It is a friendly instrument both for me and the patients.” he said.

Levin Group interviewed a cross-section of Biolase users and laser nonusers during October 2009 about the rationale for incorporating lasers into their practices, the frequency of use, and the device’s impact on patient care, productivity and production.

Financials and tooth numbering referenced by U.S. practitioners.

Rushing one appointment so you can get on to the next? Wondering why, at the end of the day, it feels like you’ve been running a chaotic zoo more than an orderly business?

Scheduling can cause stress of great magnitude! The management issue of “running behind” seems to affect all of the dental teams I’ve coached and researched over the past few decades. You feel uncomfortable when others are held up or inconvenienced. This strong feeling of responsibility for so many others—for personnel and patients alike—weighs heavily on you when you are unable to stay on schedule.

Tired of running behind schedule? Stressed out as you realize people are waiting and you’re behind schedule?

Rushing one appointment so you can get on to the next? Wondering why, at the end of the day, it feels like you’ve been running a chaotic zoo more than an orderly business?

Scheduling can cause stress of great magnitude! The management issue of “running behind” seems to affect all of the dental teams I’ve coached and researched over the past few decades. You feel uncomfortable when others are held up or inconvenienced. This strong feeling of responsibility for so many others—for personnel and patients alike—weighs heavily on you when you are unable to stay on schedule.

Rest assured that organizational and management systems that function effectively with one another are essential for the control of stress in the dental environment. Each of the 25 systems within your practice must work with every other system. One system can’t be “out of whack”, or the flow of your practice will be interrupted. Without a doubt, scheduling is one of the most critical systems that must be in place if stress is to be controlled. If you don’t control your appointment flow, who does? Your patients. If your patients control your appointment flow, what results? Chaos, and Chaos breeds stress!

The day of simply putting names into the book or filling in lines is over. Managing your schedule affects the productivity, profitability and stress control of each and every one of your procedures. Scheduling is the heartbeat of the practice. Thus, it deserves the greatest care and attention. The person responsible for making and confirming appointments must have the ability, training, time and desire to engineer each day. That training and subsequent attention will be able to help you avoid the top ten causes of scheduling stress.

(1) LATE PATIENTS

Patients are trained to be late when the office consistently runs late. Waiting is one of the main patient complaints about dentists. In our fast-track world, people want and need to stay on schedule. Your respect of patients’ time will gain the same respect for your time. Do your best to understand the times necessary for each procedure and each appointment. Stay within that time frame. If you are ten minutes past the patient’s scheduled time, acknowledge this to the patient. You will offset some negativity if you will graciously accept the responsibility for the delay. For example: “Mrs. Jones, Dr. Jameson has needed to spend more time with his patient than he had anticipated. He would certainly do the same for you. It will be approximately ten minutes before he can see you. Thanks so much for your patience Can I get you anything – water, a new before-and-after album to look through?”

(2) IMPROPER SCHEDULING OF TIME

One of the most critical aspects of excellent scheduling is having a clear identification of doctor time/assistant time/decontamination of room time. Having this information clearly identified in the appointments gives the scheduling coordinator clear guidelines for the following:

• When the doctor is captive
• When the assistants are captive
• Length of time the room will be occupied
• Length of time the patient will be in the office.

Take one staff meeting and dedicate this meeting to the designing of procedure-analysis sheets. These sheets will identify the following:

• The steps of each procedure
• Who’s doing what
• How long each step of a procedure takes.

With this information, the scheduling coordinator can properly interface one appointment with another. Then you can:

• Practice excellent time management
• Maximize the skills of each team member
• Prevent patients from spending too long at an appointment because of inappropriate scheduling.

Use a procedure-analysis sheet to provide your scheduling coordinator with the data he or she will need to appropriately engineer each appointment. Remember, these are NOT written in concrete! However, they will prove to be an excellent roadmap.

(3) WRONG SOFTWARE OR INSUFFICIENT TRAINING

Use an appointment system with 10-minute units. High tech dentistry and the excellent talent and skill of assistants allow for more efficient management of time. Be careful selecting your appointmentmanagement software and, once selected, maximize training so your scheduling coordinator can provide succinct planning for each active chair.

(4) EMERGENCIES

Placing the coding for the doctor and the assistant in the appointment system will show you where you can schedule emergencies. Emergency patients need to be seen as quickly as possible. However, you do not want emergencies to have a negative effect on your regularly scheduled patients.

Therefore, emergencies (for the most part) should be palliative. Do a quick analysis, prescribe the necessary x-ray, get the patient comfortable and reschedule for the appropriate time. There areexceptions, of course, if you and the patient have the necessary time and if the patient is comfortable with the financial responsibility, you’ll certainly want to proceed with treatment.

Cathy Jameson is founder and CEO of Jameson Management, an international comprehensive coaching firm. As a speaker, she offers fun, entertaining and educational programs packed with decades of proven practice management systems. Cathy and her team of 20+ coaches have lectured and consulted with dental professionals in 26 countries. Cathy’s firm has changed thousands of lives through not only speaking and coaching but books, CDs, DVDs and other products.

Did you max out your credit card? Expect a credit score drop of 10 to 45 points.  Declare bankruptcy? Your score will plummet by up to 240 points, and your odds of getting credit will nosedive with it.

The “damage points” data, unveiled recently by Fair Isaac Corporation (FICO), a leading consumer credit-scoring system, are part of the most revealing glimpse into the firm’s oncesecret – and still mysterious–credit scoring model.  The new information discloses how many points borrowers’ scores will drop when they make the most-common mistakes.

“Help People Understand” Scores

“I hope this information will help people to better understand FICO scores and the value for them of avoiding credit misstep,”
says FICO spokesman Craig Watts. “It illustrates key points such as the higher your score, the farther it can fall if you stumble. Getting and maintaining a good score isn’t complicated.  We all just need to pay our bills on time, keep credit card balances low and take on new debt sparingly.”

The greater transparency about FICO scores is important because American consumers’ ability to get credit rises and falls with the number. FICO, the company that pioneered credit scoring, assigns consumers a three-digit number from 300 to 850, depending on how well they handle credit. Other companies also offer scores, but FICO’s version is the most widely used by lenders in determining whether a consumer can borrow and at what rate.

FICO’s credit score has been around for decades, but only within the past decade have consumers gradually gained access to theirs. Though the raw numbers can be purchased, how they’re figured remains a FICO secret, as closely guarded as the formula for Coca-Cola. Until recently, FICO revealed only broad categories of factors influencing the score, but not the number of points at stake for consumers who fail to pay as agreed. The “damage points” information, revealed in a report by personal finance writer Liz Pulliam Weston, is now available through FICO’s Web site, myfico.com.

The Details

FICO’s information shows that bankruptcy does the most serious damage to a credit score (up to 240 points), followed by foreclosure (up to 160 points), while maxing out a credit card has the least numerical impact (as few as 10 points).  Those with good or excellent credit–so-called prime borrowers––put more points at risk with each mistake. For example, someone with an average credit score of 680 who pays a bill 30 days late will see a drop of 60 to 80 points. But for someone with an excellent credit score–780–that same delinquency can send a FICO score tumbling by 90 to 100 points.

The Cost in Dollars

In order to show just how badly a drop in your FICO score can hurt your wallet, we spoke with members of the home mortgage, auto and credit card lending industries. We presented hypothetical scenarios of a consumer who decided to apply for a $200,000, 30-year mortgage; a $20,000, five-year auto loan; and a credit card. While all the industry insiders stressed that a FICO score isn’t the only factor in determining who gets credit and at what cost (other factors they cited include the borrower’s debt-to-income ratio and whether they have already established a relationship with the lender), they were able to provide an idea of what a borrower who had the following credit scores could expect.

Here’s some of what they told us:

For a consumer who started with a FICO score of 780:

• Following a 30-day late payment, the consumer’s car loan rate would jump nearly 3 percent, costing the borrower $26 more each month.
• Following a debt settlement, the consumer would pay as much as $109 more each month on a home mortgage.

For a consumer who started with a FICO score of 680:

• Following a 30-day late payment, the consumer would pay $41 more each month for a car loan.
• Following a 30-day late payment, the consumer would pay as much as $95 more each month on a home mortgage.
• Following a debt settlement, the consumer would no longer qualify for a credit card.

Some Are Surprised by the Details

Consumer advocates say it’s important for borrowers to know what can damage their FICO scores. “If they know it in advance, they won’t go out and step in a pile of doo-doo,” says Linda Sherry, director of national priorities with advocacy group Consumer Action.“ They won’t go out and do some of these things.”

Even experts found some surprises in today’s news. “FICO imposes bigger hits than I would have thought for being maxed out or 30-days late just once, reinforcing my view that it is a cruder, blunter instrument than they like to claim,” says Ed Mierzwinski, consumer program director for the U.S. PIRG consumer advocacy group. “Nevertheless, it is a powerful, widely used crude blunt instrument.”

Of course, knowing the impact on a FICO score and actually avoiding these mistakes are two separate things: Amid rising unemployment and other daily financial struggles, paying bills and staying on-track financially becomes a much bigger challenge for many borrowers. “Some of these things are out of their control,” Sherry says of consumers.

Additionally consumers with identical FICO scores can have different credit histories. That means the same slip-up-such as maxing out a credit card-could have different impacts on consumers who have the same FICO score. In the examples they provided, FICO assumed each borrower had several active major credit cards, a mortgage, car loan and student loans.

Serry acknowledges the benefit of putting a number to a financial blunder. “I dficoon’t think we necessarily knew the numbers that a bankruptcy could apply to a credit score,” she says.

Helping You Make Better Decisions

While knowing the numbers may not keep you filing for bankruptcy if given no other choice, the information may help you make the best decision when faced with a bad situation.

FICO scores-and the access to credit they provide-are a valuable asset to consumers and supply a safety net when incomes are stretched. Sherry says that it is an asset that needs to be protected, even if job loss or catastrophic illness makes bill paying problematic. “In that period of time, paying down debt is the last thing on your mind,” she says. “Paying the minimum payment may also be the last thing on your mind, but you’ll be doing yourself a big favor if you do.”

The dental office of Dr. E. Morgan Scheiber in downtown Plymouth, Massachusetts was definitely showing its age.

A 200-year old Victorian building housed the practice he purchased from Dr. Joseph Santelli in 2001, and it had character and charm, but it also had problems. It was extremely inefficient to heat and cool and was also repair-prone, requiring the purchase of three new furnaces in less than ten years. Sadly, the stately Victorian home was simply not designed for a modern dental practice. The outside of the building also had issues – the parking lot was cramped and inadequate for handicapped patients.

A Wish List Come True

Dr. Scheiber, a specialist in sedation and cosmetic dentistry, discovered a new medical building slated for construction in an upscale shopping district, and he was gripped by the possibilities of a new office that would be energy efficient and have a smoother flowing floor plan, contemporary décor, and state-of-the-art equipment. Shortly after learning of the new building, he contacted his Henry Schein Equipment Sales Specialist Philip Riley, who had worked with the practice for over 30 years.

“Dr. Scheiber put me in contact with the developers of the proposed building and their architect,” remembered Riley. In just four days, the Henry Schein team began to create a layout that would meet the doctor’s specifications. “We worked together to determine the best location in the building for Dr. Scheiber and the amount of square footage needed to accomplish his wish list for a new facility,” said Riley. “Over time, a footprint was developed for his space, and the planning process began.”

Today, the new office is 3,600 square feet of modern excellence with seven treatment rooms including a private sedation suite, a panoramic X-ray area and digital processing area, a sequential flow sterilization room, onsite lab, employee lounge and changing area, business manager’s office, hygiene coordination station, and a separate office for the doctor with a private bathroom.

The hygiene rooms and operatories have an open, airy feeling with high ceilings that make them appear larger than they are. The virtual floor-to-ceiling windows bring natural light in, and the crisp blue walls are cheerful and bright. The Sirona rear console keeps equipment within easy reach for the doctor, but out of the patients’ view. Instead, patients are treated to views of LCD monitors that broadcast cable TV, educational DVDs, or digital images for treatment planning. Upon Riley’s recommendation, the doctor chose Midmark cabinetry, stools, and chairs for all of the offices because they provide a perfect blend of high-end aesthetics, function, storage, and comfort. Patients enjoy the safety of purified water that comes from Pelton & Crane’s Vista Pure Reverse Osmosis Filtration System, another addition to the office.

With an estimated 30% of the population avoiding dental visits because of fear,* the oversized private sedation room fills a growing need in Dr. Scheiber’s practice to provide anxious patients with a gentle alternative to the traditional dental visit.

Green Office That’s Cost Efficient and Eco-Friendly

In contrast to the Victorian home he previously worked in, Dr. Scheiber’s new office is a shining example of energy efficiency, thanks to a number of green features. Solar panelsproduce added electricity to the office.  Dr. Scheiber also had a state of the art heating system installed, which heats the floor and is one of the most efficient boilers on the market.  The doctor is even able to sell back the unused solar energy produced on weekends to the utility company in exchange for a credit on his monthly bill.

Latest Technology

“Henry Schein handled the office design, equipment purchases, and full install of everything that I needed,” said Dr. Scheiber. That “everything” encompasses a large amount of new technology that was not feasible in the previous building. Working with Riley, Dr. Scheiber chose the Instrumentarium intraoral X-ray machine and OP-200 D Panoramic with VT, which delivers high-quality digital images in real time, saving time and eliminating the cost and mess of film and chemicals. Every aspect of patient contact–check ins, scheduling, and billing–has been computerized and streamlined for more efficient patient flow, thanks to Dentrix practice management software.

“My staff has been bursting with enthusiasm when telling our patients about the new office,” said Dr. Scheiber. “I have planned for this for a long time, so having it actually completed was a huge goal fulfilled.”

Next on the doctor’s to-do list is to add a fourth hygienist to his staff and eventually a third doctor. Dr. Scheiber also has an associate on his team that specializes in implant dentistry. When asked what advice he would give other doctors who want to take on a similar project, he responds simply, “Use Phil Riley of Henry Schein for all your plans.”

“My staff has been bursting with enthusiasm when telling our patients about the new office,” said Dr. Scheiber.

Left to Right: Jeff Blair, Regional Manager; Tommy Smith, Equipment Service Technician; Dr. E. Morgan Scheiber; Evan Harris, Field Sales Consultant; and Phil Riley, Equipment Sales Specialist

“Henry Schein handled the office design, equipment purchases, and full install of everything that I needed,” said Dr. Scheiber.

Equipment List

• Air Techniques ScanX
• DentalEZ Ramvac Vacuum
• Handler Lab Suction
• Handler Dry Model Trimmer
• Instrumentarium Intraoral X-rays
• Instrumentarium OP-200 D Pan w/VT
• Instrumentarium Scanner
• KaVo Lab Bench
• Midmark Chairs and Stools
• Midmark Delivery System
• Midmark Euro Design Cabinets
• Midmark M11 Autoclave
• Pelton & Crane Vista Pure Water Treatment
• Porter Nitrous/02
• SciCan Hydrim
• SciCan Statim Autoclave
• Sirona Rear Treatment Consoles
• Sirona Rear Delivery System

Today’s CAD/CAM systems–both chairside and laboratory based–are being used to design and manufacture metal, alumina, and zirconia frameworks, as well as all-ceramic and composite full-contour crowns, inlays, onlays and veneers that may be stronger, fit better, and are more aesthetic than restorations fabricated using traditional methods.

The accuracy of these types of technologies also allows us to provide cosmetic and restorative options that are minimally invasive. There are more than 20 different CAD/CAM systems that have now been introduced as partial (framework, models) solutions for restorative dentistry. However, still only two promise to offer these options as well as complete chairside solutions for better dentistry. While many of us may have appreciated the evolution of each generation toward the desire of a “more perfect” and whiter smile, the pursuit of perfection is not always the reason to undergo a restorative dental procedure.

Patients that have experienced oral trauma or need only minor cosmetic improvement can greatly benefit from this new approach and the capabilities of new technology. A conservative approach to restorative dentistry allows us to increase patient satisfaction and in some instances complete “minimal or no-prep” restorations without the need of local anesthetic or invasive procedures to hard or soft tissue, making the procedure quicker and less uncomfortable. CAD/CAM technology offers an option for cosmetic dentistry patients seeking an alternative to traditional dental veneers when direct composite bonding is not an option.

Case Studies:

A 22-year-old female with traumatic injury to the maxillary central incisors and left lateral was presented. The original tooth fragments were not available. After the gross initial examination the teeth in question were examined in detail, the teeth were found to be vital with no pulpal exposure. There was absolutely no discernable mobility and the patient was not experiencing any distress or pain. In all other aspects the teeth did not show any other pathology. After detailed clinical observation and further evaluation of the photographs, it was noticed that there were areas of minimal tooth structure, which had been crushed at places along the fracture line and the break was not a clear cut. (Fig. 1)

Hence, a decision was made to incorporate a small chamfer at the fracture line so that it could be masked more effectively with an indirect bonding procedure, which would also help in blending the ceramic restoration fragment seamlessly with the tooth. An intraoral digital impression (scan) was taken using the E4D® Dentist System. The digital model was used to design the restorations that would later be milled from ceramic blocks. (Fig. 2)

During the try-in procedure, it was obvious that the restoration would blend seamlessly with the remaining tooth structure. After glazing, the restorations were prepared with a hydrofluoric acid silanating agent (Monobond-S) and then were bonded using Variolink Veneer resin cement (Ivoclar Vivadent). (Fig. 3a, 3b)

Case 2

A 21-year-old male was presented requesting veneers to improve his smile. After further examination it was discovered that the only aspect that he wanted to improve was the length of his maxillary laterals. The teeth did not present any type of pathology. Both laterals were slightly in linguoversion and no undercuts were found in the facial aspect. (Fig. 4)

The diagnostic findings directed us to conclude that no-prep veneers would be the ideal treatment choice. Recontouring of the gingival architecture was performed using a diode laser (Odyssey Navigator, Ivoclar Vivadent). An intraoral digital impression was taken using the E4D Dentist System. Because no powder was used, there was no hesitancy scanning the intraoral condition immediately following the laser surgical procedure and wound. The digital model was used to design the restorations that would later be milled from ceramic blocks. (Fig. 5a, 5b)

Because of the precision of the mill, the restorations could be designed ideally to a minimal thickness in areas of less than 200 microns. The restorations were bonded without the need of anesthetic, since no tooth structure was removed. (Fig. 6a, 6b & 6c)

While the most obvious benefit for those considering chairside CAD/CAM dentistry is to replace the conventional methods and materials for the restoration of single-unit posterior teeth, the ability to maximize the performance of the system, the capabilities of the technology, and the opportunity to provide better dentistry for the patient, all endorse the profession’s expanding embrace for chairside CAD/CAM options. These cases illustrate how CAD/CAM dentistry represents a completely new way to diagnose, treatment plan, and create functional aesthetic restorations for our patients in a more productive and efficient manner.

Dr. Lida Swann is clinical instructor at E4D University and Assistant Professor at the Advanced Technology Clinic, Baylor College of Dentistry.

A pleasant side effect of Dr. Mark Shuren’s new 6,800-square-foot office in Tecumseh, Ontario–a vibrant town on the shores of Lake St. Clair–is that he finds himself coming in early every day.

“I enjoy coming in so much that I’m always early,” said Dr. Shuren.

He may not have known what a difference his new practice would have on his enthusiasm, but what Dr. Shuren did know was what he wanted in his new office, from its interior design and technology to the patient experience. His desire was to have a facility with cutting-edge equipment and an environment that was pleasing and attracted new patients and referrals.

“I wanted to practice in a facility that was state-of-the-art and would allow for a transition to digital radiography,” said Dr. Shuren. “I envisioned an office with top-of-the-line equipment and modern décor. It was important to me that I could be in control of every aspect of patient care.” That attention to detail has paid off. Referrals are up 30% since he opened the practice in 2009, and patients love the new space and details that make their experience more comfortable. One example is the separate private exit that the new office design created.

“I’m really proud of the new patient flow between surgery and recovery. The layout is so efficient and well planned that I can literally walk a post op/post anesthesia patient right into the parking lot to their ride,” remarked Dr. Shuren.

Thoughtful Planning, Creative Execution

Carl Bernat, Field Sales Consultant for Henry Schein Canada, consulted with Dr. Shuren from day one of the project, scouting out potential sites with him and helping to negotiate for the selected location. Once the location was nailed down, they met several times to identify the doctor’s priorities and wish list for the office. Joining Bernat was a Henry Schein team of professionals who were tasked with taking the dream and turning it into actual plans and equipment: Branch Manager Andrew Tweedie, Equipment Service Technician Chad Pelletier, and Equipment Sales Specialist Cindy Petrie.

Working together, the Henry Schein team designed a look and functionality that allowed for smooth patient flow in a high-tech environment and introduction of digital technology. Bernat traveled with Dr. Shuren to the Chicago Midwinter Meeting for a

“I enjoy coming in so much that I’m always early,” said Dr. Shuren

“shopping trip” of sorts, where the doctor got a close look at the small equipment and cabinetry Bernat had suggested as options. Later, they traveled to meet with a vendor to see the construction process and make final selections. During that visit, the group sat down and made custom design changes on-the-fly while the doctor was onsite.

“Together, we were able to go and see all of the equipment firsthand,” noted Bernat. “The vendor partners and the demos were very important in moving forward. The doctor also felt very comfortable with Henry Schein’s local support with service and sales.”

The research and time investment was well spent – the office turned out magnificent.

Soothing Palette Greets Patients

From the first step into Great Lakes, every part of the spacious interior is meant to set patients at ease and calm their nerves, which are often frayed before oral surgery. A wall of windows flood the waiting area with natural light. Different textures and finishes intermingle–the large loose–patterned granite on the front desk and the multicolored slices in the stone pillars bring a sense of serenity to the space that warms up the minimalist lines of the design. Inside the two fully equipped surgical suites and two consult rooms, soothing cream and beige wall colors set off the richness of the Midmark cabinets and ultraplush oral surgery chairs. Medical-grade nitrous oxide delivery ensures the comfort of the patient. Four additional suites are available for the doctor to enlarge the practice when the time is right.

Digital Technology Front and Center

Patients regularly comment on the beauty of the office, but their experience is more likely enhanced by equipment that may not be as obvious to them. The office is fully computerized which diminishes paper usage, and also allows the staff to attend to patients checking in and scheduling new appointments in a more timely way. Insurance-claim processing is more streamlined, saving time as well. Perhaps the biggest impact on patient care and staff efficiency, however, comes from the new digital-imaging technology provided by the Sirona digital pan and intraoral X-ray machines that allow staff and patients to view images right on monitors in the surgical suites and send them electronically when needed. In fact, Dr. Shuren is so pleased with the impact of the practice’s digital imaging equipment that he has already outfitted his X-ray room for the Cone Beam CT–not yet available in Ontario!

Mission Accomplished

“It was essential to Dr. Shuren that all of the equipment be state of the art, and it is,” concluded Bernat. “Because of our strong relationships with our vendors, he had the opportunity to ask questions directly to the manufacturers to be sure the equipment he liked was the best long-term choice for his goal of attracting not just additional patients but perhaps additional doctors in the future.”

Shuren credits his staff with helping him make key decisions on how the office should run. “Elise, Brandi and Maryjo–my staff–were instrumental in the development of this office,” said Dr. Shuren. “It’s been a lot of hard work for all of us,” he continued, “but I think it has allowed them to feel proud of the office and feel like it’s their office, too.”

Featured Equipment

• Digital Doc Icon Camera
• Midmark Cabinets
• Midmark 641 Oral Surgery Chair
• Midmark Bitmore Classic Chair
• Midmark Ritter 354 lights
• Midmark Ritter 355 lights
• Sirona Orthophos XG5 Pan
• Sirona XIOS Sensors
• Sirona Heliodent Intraoral X-rays

My digital experience began seven years ago with just one laptop and a powerful little sensor, the DEXIS® Classic. Over the years, I have been constantly impressed by the opportunities that digital radiography have offered for improved diagnosis and patient education.

With the debut of a new sensor, DEXIS Platinum, imaging has become even better. The clear, crisp images retain incredible detail even when enlarged. The nice part is that dentists and their teams don’t need to understand the complexities behind the magic. For us, it is as easy as pushing a button. I am not a technology person, but have done a bit of research on the technology behind the research and engineering. It has given me an even greater appreciation for the final result—a sensor that gives us the most diagnostic information.

In life, we learn that that nothing is really ever black and white. We strive to “read between the lines,” in business dealings and in our social interactions. These concepts become particularly appropriate when delving into the Platinum’s sensor technology. This is an extreme case of not seeing things in terms of just black and white. This small sensor has a 14-bit analog-to-digital converter that generates 16,000 shades of gray. With that many gradations, even the subtlest details of the anatomy become visible.

As for “reading between the lines,” the clarity of digital images is, in part, related to lines—specifically the number of pairs of adjacent black-and-white lines that can be seen per millimeter (lp/mm). One way to judge image quality is with the use of a piece of equipment called a line pair “phantom.” When this device is exposed with a sensor, the resulting image shows a numbered gauge along with a V-shaped set of lines. At one end, these lines are far apart; at the other end, they merge.

The goal is to follow the lines as they become closer together. At the point where the lines are not touching or becoming  blurred, notice the number that this area corresponds to on the gauge. This is the number of line pairs the sensor is capable of capturing. The higher the number, the higher the resolution of the image. For Platinum, this “sweet spot” of line pairs is more than 20, creating noticeably detailed resolution.

Related to resolution is another minute measurement—the technology of pixels. One megapixel is equal to one million pixels. Platinum has a 2.2 megapixel size. That’s a lot of pixels squeezed into such a small package. The result is the production of an image so clear that enlarging it will not result in pixilation. Clinically, that means that I can explore the smallest details on the largest image that I need.

Another line to efficiency is the distance between my sensor and the computer’s USB port. With direct-to-USB capability, the extra adaptors and docking stations of other sensors are no longer necessary. Platinum’s technology bypasses the extra accessories and has incorporated the function of these devices into the actual sensor itself—no small feat. To me, this means less equipment to maintain and an easier transfer from one operatory to another. The USB connector is even gold plated, making it more durable.

My practice’s digital evolution has come a long way from one laptop to my present office that is equipped with several radiology areas. After practicing for 39 years, I’ve seen a lot of X-rays, and I gladly admit my team and I have become “digital dependent.” My DEXIS system has paid for itself over and over, and with the Platinum sensor, this remarkable technology offers even more possibilities. While all of this technology is very complicated, as dentists we are lucky that we don’t need to fully understand line pairs and capture devices to use it—for us, it’s as easy as black and white (and 16,000 shades of gray).

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.

Two designs are featured in this publication that provide the optimal use of space, equipment, and design elements. Along with each plan, we have highlighted the key elements that help acheive that perfect practice environment.

Our designers specialize in the coordination of dental ergonomics and design elements to offer your practice all of the advantages of increased efficiency, improved patient care, and greater comfort for staff and patients.

We hope this information will assist you in planning your new office. If you have any questions, feel free to E-mail me at jennifer.rhode@henryschein.com or visit us on the Web at henryschein.com Jennifer Rhode National Design Group Manager Henry Schein Dental

Designed by: Gina Nameth

General Practice

• Waiting area includes a play area and a flat-panel television
• Curved walls at the business office area provide an aesthetic touch
• Consultation and X-ray rooms located near the front of the office for better patient flow
• Large sterilization is centrally located for easy staff access
• Quiet treatment room is located away from the front desk for added patient privacy
• Clear separation between public and private areas

Designed by: Tracy Tock

Orthodontic Practice

• Spacious reception room provides a seating area for parents as well as a small play area for children
• Open office with efficient circular layout facilitates easy flow of both patients and staff while still providing visual privacy
• Centralized sterilization and lab for easy instrument management, clean-up, and adjustments
• Open treatment bay with short partitions allows privacy for patients and visibility for doctor
• Built-in benches provide space for parents to sit inside treatment bay
• Doctor’s private office is situated near front-office activities and also has a view of the treatment bay

For more information, contact your Henry Schein Dental Sales Consultant at 800-645-6594
In Canada, call 800-668-5558

Your principal asset

For most dentists, ownership of their dental practice is the major focus of their energy expenditures, financial situation, and professional lives. Years of blood, sweat, and tears, coupled with the relationships formed with both staff and patients, have caused dentists to form a deep-seated emotional attachment with their practice. For many, the dollar value of that practice represents a significant portion of their financial assets. For the new dentist, there is a definite value in acquiring the patient base which has taken the transitioning dentist years to develop and will provide an immediate and substantial cash flow.

All experience transition

Whether it is due to a change in career direction, a desire to cut back on the responsibilities of ownership while still enjoying the benefits of clinical dental practice, or the desire to retire from dentistry, every practice owner faces an ownership transition. Ownership transition can be a total sale or a partial sale, that is, the formation of a partnership. The level of success achieved as a result of this practice transition will be directly linked to the amount of detail given to and the successful execution of the “Transition Plan.”

A buyer’s market

Decreased dental school enrollments and other demographic factors have created an imbalance in the numbers of graduating versus retiring dentists. This trend, which will continue for at least the next ten years, has contributed to falling dental practice sale prices, and has created a buyer’s market. For the previously difficult to market, more rural dental practices, this dental manpower shortage has made finding dentists to serve almost impossible. These changes in the marketplace relative to practice transitioning have made advance, detailed transition planning mandatory.

Goals of a successful transition

Before discussing the development of a transition plan, a brief discussion of the goals of transition is required. In addition to identifying the actual goals, each dentist will need to assign an order of priority to these goals. This prioritization will have a significant impact on certain aspects of the transition plan. The most common goals discussed by dentists include a (1) desire to, in accordance with their preferred timetable, transfer patient care responsibility, (2) secure future employment for their staff, and give back to the profession by passing the baton to a new dentist, and (3) maximize their practice equity (financial gain from the sale). There is no right or wrong order to the priority emphasis.

The economic health of the transitioning dentist will usually determine the order of the priorities. If the practice sale proceeds are a significant portion of the dentist’s retirement assets, then maximizing the financial return will be at the top of the list. If the doctor has a well-funded pension plan or other financial resources, and the sale proceeds will enhance the quality of retirement rather than providing the primary support for retirement, the order of importance will typically be the desire to provide continuity of patient care, ongoing employment, and passing the baton, with maximizing the financial gain at the end of the list.

Factors affecting successful transitions

Prior to discussing the components of a transition plan, it will be useful to understand what is presently occurring in the transition marketplace. For a successful transfer of ownership, we must first have an interested new dentist. Subsequently, location is at the top of the list relative to a new dentist’s interest in a specific practice opportunity. As previously discussed, rural practices, although typically more profitable than big city practices, are having serious recruitment problems. Ninety percent of all practice sales today are in communities with populations of 50,000 or more people, and eighty percent of these sales are in cities whose metro population exceeds 500,000.

The second factor is the practice’s ability to meet the financial needs of the new dentist. As a result of current levels of dental school related debt, the new dentist must meet specific levels of production to pay for the practice acquisition, school loans, and basic living expenses. Therefore, a practice needs to provide, on the average, $300,000 worth of production for an employed dentist, and $400,000 worth of production if the dentist is purchasing a practice. It is for this reason that eighty-five percent of total practice sales involve practices with gross receipts of $350,000 to $500,000. While the highly productive and profitable practices of today frequently exceed $500,000 in annual receipts, the average new dentist (five years or less since graduation) does not possess the clinical skills required to produce this level of dentistry and subsequently sales trend toward the lower grossing practices. After finding a suitable location and determining that the practice will provide for the financial needs of the new dentist, the new dentist will consider a multitude of other factors in selecting one opportunity over another. The major factors considered include (1) the practice’s overhead to revenue percent, (2) number of active patients, (3) new patient flow, and (4) recall system effectiveness. In addition, (5) quality and length of prior employment of the staff, (6) practice history, (7) types of procedures previously offered and/or produced, (8) involvement in any discounted dental plans, (9) appearance of the physical space occupied by the practice, and (10) the age, type and appearance of the equipment and furnishings will play a major role in the selection process.

The above represents the major concerns and factors reviewed by the new dentist. The owner dentist is concerned with (1) the ability of the new doctor to pay for the practice-obtain financing with all the school debt, the tax implications and subsequent net proceeds derived from the sale, (2) the personality and ability of the new dentist to relate to patients and staff, (3) the amount of post sale relationship required between the seller and buyer, and of course (4) the new dentists’ clinical competence. With the exception of the final concern, the other factors can be readily determined and resolved.

Today, one hundred percent non-owner financing is readily available, the tax implications can be calculated, and typically several meetings with the new dentist will address the communication skills and personality of the new dentist. Patients’evalution of the new dentist Most senior dentists know and understand that the senior dentist’s own patients judge their clinical competence by non-clinical factors such as personality, gentleness, office appearance, etc. It is generally not possible to assess clinical competence until a year or more of actual clinical procedures performed by the new dentist are reviewed.

Unless the transition is preceded by a period of employment prior to the actual ownership change, senior dentists must understand they will have not be able to address the clinical competence issue. Senior dentists must accept the fact that the only control they have over this subject is the fact that the new dentist has been tested and licensed.

Determining the transition plan

The first step in formulating a transition plan involves an appraisal of the practice. The information gathered and evaluated during the appraisal process will aid in determining available transition options. These options may include (1) an outright sale, (2) role reversal sale, (3) partnership, (4) merger, or (5) production acquisition transaction. In addition, the appraisal will typically provide a comparison with other practices involved in transitions, thereby allowing an understanding as to how salable this particular opportunity might be. Finally, the appraisal should also provide ideas regarding enhancing the value of the practice and its desirability as a transition candidate.

Locating a competent transition consultant

The next step is locating a competent transition consultant. A transition consultant is one who understands the entire transaction, the various types of transitions, contractual matters, the operational issues of running a dental practice, and the need to have the relationships of the buyer, seller, staff, and patients intact after the deal is done.

The best source for these individuals is word of mouth referrals and/or recognized reputation. They may be national or regional “transition gurus”, the dentist’s personal accountant or another accountant who restricts their practice to health care providers and is familiar with the health care transition field, or an experienced local dental practice broker. Some of the dental supply companies also have knowledgeable consultants who have been assisting in transitions for years.

The transition consultant will help the dentist identify various aspects of his/her transition. Questions needing answers include the doctor’s financial ability to retire and their personal transition goals. For example, how long do they wish to stay on as an associate and/or remain available to aid in the transition process? What is the dentist’s preferred timetable? Are there any preliminary steps required to enhance the value of the practice? Which method of transition has the greatest chance of successful completion?

Make a plan outline

The answers to these questions should result in a brief written outline of the plan. The topics should include (1) goals, (2) timetable, (3) appraised value, and (4) anticipated post-tax and sale’s expense net sale proceeds, (5) planned transition options, and (6) a list of consultants to be involved. The plan should also contain an action plan for completion of any activities that will enhance the value of the practice or increase the chances the practice will be selected by prospective new dentists. Understanding that an inactive practice loses five percent of its value per week, an important part of the plan should also include a list of people to be called in the event of an un-anticipated career ending disability or death. Aletter of instructions to family should be included listing those contacts and stressing the urgency to act expediently in transitioning the practice. Apart of the plan needs to include sharing this letter and plan with significant family members. Many dentists, especially if incorporated, will execute a power of attorney authorizing a specific individual to immediately begin transition proceedings if required as a result of the dentist’s death.

When and how to start

If an appraisal has not been completed or updated within the past two years, this is the first step. Developing an exit strategy plan, even if it is years away, should also begin as soon as the appraisal is completed. Astockbroker will advise that one should set a target sale price the day one acquires a stock. Similarly, the exit strategy is part of the potential financial reward of practicing. Good business sense dictates the plan should really have been started when the practice was first acquired. Part of a transition plan started early in one’s career will allow for inclusion of a well-funded pension plan and less reliance upon practice sale proceeds for retirement needs. The timetable for the actual implementation of the plan will be dependent upon the personal wishes, needs and financial resources of the dentist. Metro areas are seeing a common market time of one-to- two years from listing to sale. Rural area practices face three-to-five years if they can be transitioned at all. The length of time required for location of a prospect and transitioning of the practice requires that the practice opportunity be listed at the earliest time that the doctor is willing to complete the transition. If the seller is fortunate enough to immediately locate a buyer after listing, the dentist needs to be ready to act. At the time of listing, he/she must also realize they may be continuing to own the practice for a long time.

An alternative

For dentists considering retirement, many have a difficult time starting the process because of the emotional attachment to their practice. These dentists, unless or until they find something else they would rather do than practice dentistry, will be unable to activate their transition plan. If the practice of dentistry is their only interest, their hobby, and the center of their later life, there is no law stating that they must transition their practice. For these dentists, their transition plan is to practice until they can no longer do so. Their plan may be as simple as one day closing the doors and retiring.

Many clinicians, general dentist, and specialists alike, are adding Cone Beam 3-D technology (CBCT) to their practices to facilitate implant placement. Since CBCT offers the most precise and complete information for diagnosis and the treatment planning for implants, these dentists understand that they can experience greater predictability in the success of this highly sought after procedure.

For those placing implants now with 2-D radiography, the stages of placement become more accurate with the adjunct of CBCT. It’s all in the planning, and CBCT arms the doctor with critical planning information in three dimensions—for their three dimensional patients. Here is an example of the process.

Along with a physical examination, an 8.9 second i-CAT® scan of the desired area is taken on the patient (Fig.1). There are 6 scan-size options ranging from single arch to full skull. Images are ready for viewing and use in 30 seconds.

Figure 1. Fast scan and reconstruction times

The clinician can then proceed with diagnosis, evaluation, measurement, and treatment planning within i-CATVision™ software (Fig. 2).

Figure 2. Crosssectional display with precise measurements

If desired, the doctor can use the captured 3-D data in other 3-D imaging implant programs. As seen here with i-CAT scan data in InVivioDental’s™ Anatomage, the dentist can use the many tools found in the program, including virtual placement of the implant (Fig. 3).

Figure 3. Compatibility with 3-D planning software

Current advancements also allow clinicians to plan the restorative phase using CBCT scans in 3-D imaging programs, seen here with Anatomage (Fig. 4).

Figure 4. Restorative planning possibilities with CBCT data

Once the type and style of the implant and the exact location are chosen, surgery commences after which restoration of the implant follows.

Benefiting both patient and doctor, CBCT simply yields data that generates more positive surgical and restorative outcomes, and creates a higher level of confidence for a doctor’s implant program.

Brown Family Dentistry, located in Neenah, Wisconsin, is a showcase office for style and efficiency—as well as an extensive lineup of dedicated dentists who all bear the last name of—you guessed it—Brown. Specifically, Dr. Tim Brown; his son Tipton; Tipton’s wife Dawn; and son Tyler complete the roster of “Brown” family members.

Dr. Tim Brown started the practice over 30 years ago. In 1999, son Tip and daughter-in-law Dawn came on board—and Tyler joined the group after the renovation was completed in the summer of 2009. The need for expansion of the practice to accommodate Tyler provided the opportunity to assess the overall requirements of the business, resulting in the decision to go for an upgrade and renovation that would make the facility future ready.

Contact with their local Henry Schein Sales Specialists opened up discussions on the exploration of options that could best fulfill the new office’s goals. With 4 doctors and additional staff in the mix, it was clear that space and access were crucial to the success of the new facility. The outdated infrastructure with its inadequate plumbing, heating, air conditioning, and vacuum systems required updating to enable smooth operations on a daily basis. Redesign would focus on the functional aspects of operations as well as addressing the need for privacy in consultation and operatory areas. “We had over 10 years of history with Henry Schein Dental’s experts,” notes Dr. Tim Brown. “Equipment Sales Specialist Dan Kroeger, Field Sales Consultant Todd Gregory, Interior Designer Cindi Matt, Designers Tracy Tock and Kory Schneider, and Lead Equipment Service Technician Bob Ross [rolled out a plan that worked perfectly for us.]“

The Brown’s also took CE courses on office design and also visited a leading manufacturing plant and showroom for a genuine hands-on approach to choosing equipment that was a good match for the new premises.

“We [first] did an interview to determine needs, wants, and desires for the practice,” comments Equipment Sales Specialist Dan Kroeger. “The original thought was to move the location and build a new building but after consideration of the current location and available land sites, the determination was made to remodel the existing location in a two-phase event, starting with the acquired new half of the building and then migrating to the old half. The two projects were coordinated so that the Doctors could continue to work as the remodel took place.”

Dr. Dawn Brown worked very closely with the Interior Designer, Cindi Matt, to create the perfect interior for the new office. The office’s relaxed contemporary motif works well— from the reception area straight through to the operatories.

“The quality, warranty, and adaptability of the equipment to be used by multiple doctors and hygienists…[ensures] better patient comfort and ease of use for staff because of the standardization of products used in the operatories.”

A canvas of muted browns and beige tones succeed in setting a calm and inviting mood. Soft, natural light pours inside from the large windows in the operatories, which offer views of the facility’s treelaced surroundings—including a stream that runs behind the building. The office is a serene haven where patients and staff can feel completely comfortable and refreshed while getting down to the business of dentistry.

“We are particularly fond of the vaulted ceilings in the hallway outside the operatories,” adds the Doctor. “It feels very open and makes a statement. We were impressed with Dan’s design to house the lighting in the ops. It came together so nicely.”

The high-quality state-of-the-art equipment chosen for the office is a confirmation of Brown Family Dentistry’s commitment to providing the finest treatment options for their patients and the best working environment possible for their staff. “The quality, warranty, and adaptability of the equipment to be used by multiple doctors and hygienists…[ensures] better patient comfort and ease of use for staff because of the standardization of products used in the operatories,” comments Equipment Sales Specialist Dan Kroeger. “The cassette system in place in the sterilization area allows for better instrument management and the protection of staff from ‘sticks.’ “

The addition of another dentist gave new dimension to the plans for the facility. “We could not have done it in our old space,” points out Dr. Tip Brown. “The elevator made access more convenient for patients. Workflow is greatly enhanced, as is privacy at the reception desk, in consultation area, and in the ops—in compliance with HIPPA regulations. Improved technology and equipment systems mean less stress. We are more flexible, organized, and informed, and we will be able to accommodate a growing staff, an increased patient base, and acquire new technologies in the future.”

“We are more flexible, organized, and informed, and we will be able to accommodate a growing staff, an increased patient base, and acquire new technologies in the future.”

Left to right: Dr. Tim Brown, Dr. Tip Brown, Dr. Dawn Brown, Dr. Tyler Brown; Dan Kroeger, Equipment Sales Specialist; Cindi Matt, Interior Designer; Paul Batley, Regional Manager, Bob Ross, Lead Equipment Service Technician; Dick Johnson, Equipment Service Technician; Todd Gregory, Field Sales Consultant

The overall design brings exceptional comfort to the patient, a streamlined workplace for the staff, and a mood of competency and dedication to patient satisfaction that Brown Family Dentistry wishes to project about its business. ” Our practice reflects who we are and what we are trying to achieve,” notes Dr. Tim Brown. “We think that from the moment patients make their first contact with us—on the phone with a happy team member or walking through the door—they begin to understand our mission. A warm, inviting office with state-ofthe- art technology and equipment is part of what means the most to all of us at Brown Family Dentistry–quality service, experience, and growing relationships.”

Featured Equipment

• Pelton & Crane 3000 Chairs
• Pelton & Crane Helios Light
• Pelton & Crane Cabinetry
• Pelton & Crane 3000 Delivery Units
• Pelton & Crane Magna Clave Sterilization Equipment
• SciCan Hydrim and Statim 2000
• KaVo Electric and Pneumatic Handpieces Instrumentarium OP200
• Air Techniques Mechanical Room Equipment

The Center for Pediatric Dentistry is a merger of the former pediatric dentistry clinics at the University of Washington and the Seattle Children’s Hospital.

The new clinic resides in the Washington Dental Services Building at the University of Washington. In order to respect the historically preserved building during the repurposing process, existing challenges were met with a combination of creativity and commitment that saw the premises emerge from nearly three years of design and planning into a facility that is beautiful, functional, and technologically on the front lines.

Henry Schein Dental’s unique market strategy and network in special markets make it an ideal provider for institutional healthcare facilities. Innovative solutions can be tailored to meet diverse, customized needs that reinforce an organization’s special point of view in providing services to their patients and the community.

“The Center will see patients from Seattle Children’s Hospital and those who have medical diagnoses and/or developmental anomalies,” notes Dr. Berg, Director.

“We will see any child who needs pediatric dental care, but will focus on early intervention and prevention of dental disease for all children. Our mission is to have a first visit by the first birthday for all children [we care for].”

Both Henry Schein Dental and its Medical Division worked together to coordinate the project’s activities. The Dental Group’s Specialists—Regional General Manager Ron Brown, Regional Operations Manager Dan Stalford, Field Sales Consultant Rochelle White, and Equipment Sales Specialist Scott Graversen and the Medical Division’s Specialists—Special Markets President Hal Muller, Director of Special Market Sales Chuck Jenkins, and Special Markets Technology Manager Marc Capots provided advice and support with an eye toward the Center’s current and future needs. Andrea Hight, Dental Special Markets Regional Manager and Virginia Harper, Medical Equipment Sales Specialist also contributed to this project.

The Center’s floor plan includes a total of 32 treatment areas, which, when full capacity is reached, give the capability to care for a projected 30,000 patients per year. With an ergonomically sound layout to ensure comfortable and stress- free mobility during busy workdays; integrated practice- management systems to aid in both clinical and administrative efficiency; and state-of-the-art equipment choices that offer durability and reliability that are so necessary, this multifaceted/high volume dental healthcare facility is ready to take on a full schedule of patient care. The Center also has an ambulatory surgery center built into its facility.

“We are proud to have one of the most refined pediatric dental practices within an environment that will be the basis for an academic health center practice and a teaching clinic for…pediatric dentists of the future,” comments Dr. Berg. “[We are also implementing] a ‘pod’ concept that will allow us to create practices within the practice that utilize the same resources.”

Technologically well integrated with a multipurpose design that gives the flexibility to accommodate reconfiguration as required, the facility should have little difficulty staying on top of a full range of activities while pursuing its fundamental aims as presented in its mission strategy. “The Center is now prepared to fulfill the need for increased access to quality pediatric healthcare,” notes Equipment Sales Specialist Scott Graversen. “Paperless and low maintenance with the latest in diagnostic tools and our continuous technical support, the Center can look forward to better serving its patients and the community.”

Left to right: Dan Stalford, Regional Operations Manager; Ron Brown, Regional Manager; David Welch, Equipment Service Technician; Eric Nielson, Equipment Service Technician; Steven Kennedy, Equipment Service Technician; Rochelle White, Field Sales Consultant; Scott Graversen, Equipment Sales Specialist; Joel Berg DDS, MS–Director, The Center for Pediatric Dentistry; Martha Somerman DDS, PhD–Dean, School of Dentistry, University of Washington; Roberta Greene, MS, PhD (honorary)–Chair, Washington Dental Service Foundation; Cindy Evans RN, MN, MHA–Vice President, Ambulatory and Regional Services, Seattle Children’s Hospital

“We will work to stay true to our commitment to see at-risk children—and be a resource for even those not making it to our Center,” comments Dr. Berg. “Through developing best practices, we can convey to others all over the world better ways to deliver productive and efficient care to more children. We plan to create these solutions within the Center for Pediatric Dentistry.”

“We will work to stay true to our commitment to see at-risk children—and be a resource for even those not making it to our Center,” comments Dr. Berg.

Featured Equipment for UW School:

• Accutron Nitrous Oxide System
• Air Techniques ScanX Digital Processor
• Aribex Nomad Intra-Oral Camera
• DEXIS
• DEXcam Intra Oral Camera
• Forest Delivery Carts
• Gendex 9212 X-ray Digital Panoramic
• i-CAT Cone Beam CT
• Pelton & Crane 3000 Chairs
• Pelton & Crane Delivery Systems
• Pelton & Crane Helios lights
• Pelton & Crane Renaissance Cabinetry
• Pelton & Crane Delta Q Sterilizer
• SciCan Statim Hydrim
• Tuttnauer 3870

Basement

Floor 1st

Floor 2nd

1. Meet with the Seller/Owner to determine their ideal transition (sales) plan and assist in identifying the most likely type of transition and candidate.

2. If a full or partial sale is involved, gather the necessary tax returns, and other documents and discuss documentation and missing or unclear information with the Seller/Owner’s accountant.

3. Conduct the necessary financial analysis and appraisal calculations.

4. Discuss the appraised value, determine the asking price, and list the practice for sale or associateship available. (The listing agreement gives the broker the “right” to offer the practice).

5. Implement the necessary marketing plan including advertisements, website listings, and announcements to area Team Schein members.

6. Respond to various inquiries, secure confidentiality agreements, and discuss opportunities with prospective candidates.

7. Qualify the candidate to their ability to secure financing, if ownership will be offered, and qualify their ability to take over the practice when considering the production required and their business skills background.

8. Introduce the candidate to the Seller/Owner and show practice. This will typically require multiple meetings per prospective candidate.

9. Write the “Offer to Purchase” and any subsequent “Counter-Offers”, or write the proposed templates for the Employment Agreement and Letter of Intent.

10. Secure financing. Prepare the financing request (loan package), discuss the transaction with finance vendors, and secure financing commitment.

11. Draft the initial transfer document template (Practice Sale Agreement). Discuss the template with Buyer and Seller and negotiate the agreement between the parties, redrafting as required.

12. Present the proposed template to the individual parties’ attorneys and accountants, discuss questions and/or required changes, and present requested changes to the opposing party and their consultants, coordinating final negotiations. If required by parties’ attorneys, prepare final documents.

13. Provide guidance, checklists, and other material to both parties relative to required steps prior to commencement of associateship or closing (that is, drafting of announcement, handling staff issues, printing new owner’s business cards, securing business checking account for new owner, and payroll arrangements).

14. Assist finance source in securing final loan documentation required, such as proof of satisfaction of unpaid prior liens.

15. Act as trust and closing agent for final document execution and money transfer.

The average practice sale involves 100–200 hours. A transition involving an associateship leading to a partnership may typically involve more than 200 hours. Henry Schein Professional Practice Transitions’ role is to facilitate these arrangements based upon the knowledge gained from our 15 years experience involving hundreds of transitions.

The United States is in a recession. And whether the U.S. led or precipitated the problem, or it occurred simultaneously worldwide, this is not just a U.S. problem. It has affected International Trade and International Economy’s. And all of this might be the good news.

By now you should be asking, if that might be the good news, what is the bad news? The bad news is this has all occurred at approximately the same time that 4200 new dentists are graduating from dental school, joined by 12,000+ graduates from the prior three years, most of whom are trying to find associate positions or become business and dental practice owners. After four years of dental school training and record dental school debt, will today’s graduates have to delay becoming practice owners? Probably not!

Economy’s Impact on Existing Dentists
Before we can discuss how to become a practice owner in today’s economy, we need to address the economic status of current dental practice owners. Like the rest of world, they have lost a significant amount of their personal retirement plans. Several, in the midst of transitioning their dental practice to a new dentist, have stopped the sale process and announced they can no longer afford to retire.

Many more, planning on retiring over the next couple of years, have put their retirement plans on hold. This means fewer practices will be available to buy over the next couple of years. Fewer practices on the market triggers a well known economic principal, “supply and demand”. As demand increases for a dwindling supply of practices, prices will reverse their past slow decline and in fact start to rise. Simply put, fewer practices means the ones that are available are worth more.

In addition, many existing practices are seeing reduced demand for services. For dentists considering taking on associates, whether part of a future sale, future partnership, or just to take care of a growing demand that they can no longer service, they have also put their plans to hire an associate on hold. This means less employment options for all of the new graduates.

Why Ownership is Critical
Historically, according to American Dental Association statistics, 80% of new graduates become dental practice owners within five years of graduation. The initial offer of $80,000-$100,000 as associate compensation after years of poverty level income seems like, to many new dentists, that they have finally reached the “promised land”. The reality is, however, that as a practice owner, they will earn three-to-four times as much as they can as an associate. This is why most dentists quickly begin seeking ownership opportunities. And in today’s economy, fewer associate positions means more new dentists will need to get into ownership sooner than ever.

The average general dentist in practice today produces and collects approximately $50,000 per month (including hygiene). Assuming a 55% adjusted overhead (adjusted to remove discretionary expenses, interest, and personal benefits paid through the practice), this means $22,500 is left in pre-tax income for the owner. When compared with the $7,500 starting associate compensation, this means each month ownership is delayed will cost the new dentist $15,000 in pre-tax income, or approximately $10,000 in after tax income.

Fewer partnerships and associate positions will force new dentists into ownership earlier than many planned. In addition, delayed retirements will force many new dentists to begin practice ownership through start-ups. Finally, the average quality of practices available to purchase despite the economic conditions will improve. The reason for this is that marginal practice owners will be forced to continue practicing instead of retiring.

Assessing Practice Purchase Opportunities
While there are many differences between individual general or specialty dental practices, there is one difference that makes a significant impact on the ultimate success of any practice. This is the “business efficiency” of the practice. While the delivery of one aspect of “healthcare”, i.e. clinical dentistry, is the product of dentistry, the vehicle of delivery of that product is the “business of dentistry”.

Those dentist owners who realize their practice is a business and have learned how to run a “successful and profitable” business do better “clinically and financially”. The more treatment they deliver, the more profitable their business. Furthermore, they realize comprehensive treatment is better for their patients than triage dentistry which furthers their “business success”. The delivery and integration of preventative, emergency, restorative, and reconstructive dentistry is the definition of “comprehensive” dentistry. This type of practice is also, like other healthcare delivery, fairly resistant to economic cycles. Protecting one’s health and treating illness is not optional for patients who frequent this type of practice.

Conversely, those practices without an effective recall/recare program and/or comprehensive soft-tissue management program, without comprehensive treatment planning and case presentation, and without a “total patient focus”, struggle the most during difficult economic times. Patients in these practice are delaying elective treatments and even preventative visits. These practices “survive” day-to-day doing emergency treatment and individual restorations. These can be best described as triage practices.

Obviously, if entrance into ownership takes the path of purchasing an existing practice, the former type (comprehensive) is more desirable. These are also the type more likely to be available during difficult economic times because their owners are in a better financial place and many are going ahead with their sale and retirement plans.

Is Ownership Possible in Today’s Economy?
This is the best news. The answer is absolutely, although it will be more of a challenge than previous new graduates have experienced. Whether purchasing an existing practice, or starting a practice from scratch, if your credit history is good, new dentists are still having no problem securing the necessary financing to become practice owners. The reason is the Small Business Administration’s (SBA) “loan failure” tracking history.

By comparison to other businesses, new dentists have among the lowest, if not the lowest, business and subsequent loan failure rate of any business loan guaranteed by the SBA. The last published numbers put this failure rate at 2.1% during their first five years of ownership for new dentists, whether purchasing an existing practice or starting from scratch. This figure is compared with other business start-ups which experience a failure ten times greater than dentists.

Despite all the bad economic news, dentistry is still a fairly “necessary” service. Yes, unless a patient is in pain, has swelling, or infection, care can be delayed, but the best patients will continue with routine care. Yes, demand for dental services will also be down, but when compared with the rest of the U.S. economy, dentistry is still in much better shape.

Purchasing an existing practice is still the easier route to ownership. However, as the difference between the number of new available dentists compared with dentists trying to leave practice and an ever-increasing U.S. population widens, it is getting easier and easier to find locations that can readily support a start-up practice despite the economy. These areas are, however, generally more rural in location. Starting up in a metro area or around your dental school where there is an existing high concentration of new dentists will still be a problem.

Financing Considerations
Historically, because of the low failure rate for new dentists, obtaining the necessary financing to become a practice owner has been fairly easy, providing certain requirements are met. With the new economic world we now live in, this is still true, although requirements have been tightened. As a direct result of the banking industry problems, a couple of the major dental lenders have left the market. But a couple of others have entered the market to replace them. The future of those that stayed in the market may change, but for now, there is plenty of financing available for “good credit risks”, and dentists are extremely good credit risks, even in today’s economy.

The number one requirement, a clean credit history, has not changed. There are no exceptions to that rule. A couple of minor blemishes, as long as they are disclosed at the time of application, will normally be overlooked but any undisclosed problems discovered by the lender when they run the new dentist’s credit history will end the attempted ownership process.

If the intent to enter ownership is by purchasing an existing practice, two additional requirements must be met. The first is that the subject practice must historically generate enough revenue to meet all operating expenses, the payments on the purchase financing, and generate enough profit to pay your personal living expenses and personal debt service. The second requirement is that the purchaser is able to produce the historical amount of “dentist only production”.

If ownership is to be acquired by starting a practice from scratch, obtaining financing will be more difficult. The new dentist will need to prove to the lender that they have sufficient experience, have a plan to supplement their income, and have a well thought out plan to develop a practice. This means they typically have a business and marketing plan, and are working with a dental supply company that has an acceptable track record with the lender in assisting the new dentist with the tools necessary to start a practice. Just selling and installing dental equipment does not guarantee success.

Most importantly, the lender must be comfortable with the demographics of the area which will have to support the start-up. This means the population to general dentist ratio must be more than 2,000 adult residents per dentist. Most will require a formal demographic study prior to approving financing. Again, reputable local dental equipment and supply companies will know the area and can provide that information.

If a partnership, either short or long term, is the desired route to ownership, financing is typically provided primarily by the seller. The reason for this is primarily tax considerations. Therefore, nothing has changed related to the economy that affects this type of ownership opportunity.

Get Competent Help
No matter which route to ownership is chosen, the new dentist must surround themselves with competent advisors. When selecting these advisors, get and check references. When checking references, you want the opinion of new dentists who have used these consultants to successfully become owners. Check at least three of their prior clients. Ask them about their experience, and most importantly, would the new-dentist owner use or recommend this consultant again.

Carefully consider what is in the sale “for the consultant”. If the consultant is a broker/transition consultant, there is a tendency to tell the new dentist whatever the new dentist wants to hear in order to secure a commission for the broker. Therefore, the best transition consultants are consultants employed by a dental supply company. Note the word, “employed by”, versus associated with. While this advice may seem to be self- serving, the new dentist must realize that it is the future business of the new dentist that is at stake, and therefore, these dental company “employed” consultants, while typically paid by the seller, need to protect the buyer or risk forever losing their future supply and equipment business.

An accountant or practice management consultant who deals only with dentists is another good type of consultant to utilize. These two types of consultants are not dependent upon the current commission earned, but rather are also far more interested in the future business of the buyer.

The final consultant required is an attorney. However, extreme caution in selecting an attorney cannot be overstated. They are best used to review agreements, not “negotiate” a deal on behalf of the new dentist. To purchase a practice, typical attorney fees are $1,000-$2,000. However, we have seen attorneys charge $20,000+. It is critical to the process to obtain a quote for services before an attorney is engaged. And again, get and check references before employing an attorney.

One of the challenges may be employee theft. Estimates of the number of dentists who will experience theft at least once during their dental career range from 35–50%. Estimates in dollar loss range from $100 to $500,000+. Loss due to employee dishonesty may take the form of theft, fraud, or embezzlement.

With certain minimal protective measures, the majority of this theft is preventable. The key is to understand where the potential exists for theft to occur and implementing strategies to prevent the loss.

Meet the Thieves (All names are fictitious)
Jane the Eraser–Jane simply withheld any cash payments that were made for services and then erased the patient’s account information after posting the payment (and giving the patient a receipt), thereby removing any record of the payment from the system. Estimated loss—$50,000+ over a three-year period. The doctor recovered $25,000 from his office insurance plan. Jane was ordered to pay $10,000 restitution.

Doris the Duplicator–When hired, Doris had successfully lobbied against computerization, convincing the doctor that it was not as efficient as the old manual pegboard system. In turn, Doris kept a duplicate set of patient ledgers. Payments and receipts were recorded on the duplicate ledgers while charges were posted on the real ledgers. Over a period of 18 months, Doris stole an estimated $40,000.

Mary the Master–Mary was involved in skimming, taking cash and not posting it; layering, a technique involving the taking of checks and withholding them for posting later; and an excessive need for petty cash, going through about $100 per week. Mary also set up a second business checking account in the dentists’ name (she was the only authorized signer) and subsequently diverted the office credit card deposits to that account.

Mary paid all office bills, using erasable ink and thereby allowing for the checks to be made out to her personally and then changing them back to legitimate vendors after they cleared the bank. The deposit slips never matched the bank deposits actually made, and subsequently the checking account could never be balanced with the ledger.

The doctors noted that while each year their taxable income had increased over the prior year, according to the computer, their accounts receivable had spiraled out of control and was showing a balance of $500,000+. Over a five-year period, Mary had embezzled $400,000.

Definitions
Different terms can be used to describe loss by “staff dishonesty.” Theft is simply defined as “the taking of another’s property.” Embezzlement is the theft of an employer’s property while in the embezzler’s trust. It is also defined as a misappropriation or conversion of entrusted money, property, etc., to the personal use of the employee. Fraud is the intentional deception that causes another to give up his/her money, property, etc.

Understanding the Thief
There are different reasons for individuals to steal. It may be the need for money; for others, it is revenge or the feeling they are not compensated properly for their work; and for some, just like gamblers who continue to lose but continue to bet, it is the “excitement.”

Staff members who steal do share certain characteristics. Many have lifestyles beyond their means; excessive debt from children, spouses/significant others, and “ex” spouses/significant others; or excessive habits including alcohol, drugs, and gambling.

Employees who are likely to steal are intelligent, knowledgeable in office procedures, personable and friendly. They may be tireless workers who are willing to put uncompensated overtime—rarely taking allotted vacation time. Basically, the perfect employee, except for one tiny character flaw—they are dishonest!

Signs Theft May Be Occurring
The most common sign that theft by embezzlement may be occurring is patient complaints regarding their accounts. Also note that constant requests for petty cash reimbursements should be closely monitored. Outright theft of petty cash in a multiple-staff office is difficult to track. Excess patient account write-offs or adjustments and inactivated accounts are also warning signs, as are increases in accounts receivables with no off-setting increase in overall office production.

Missing documents–invoices, insurance claim forms, explanation-of-benefits (EOB) forms, patient checks, practice checks, checking account records, patient clinical records, patient account records, etc–are definite signs of a problem as are sloppy filing and record keeping.

The practice checking account also holds potential signs of a problem. Unusual deposit patterns and deposits; inability to balance the checking account; and missing sequential checks are all red flags that should be investigated.

Preventing Theft
Whether theft takes the form of fraud or embezzlement, theft by an employee shares three steps. For theft to occur, all three components of the theft triangle must be intact. The first is “Motive.” The employee needs a reason to steal. Next is “Opportunity.” In a dental office, unimpeded access to the funds with minimal or no restraints, checks, or accountability provide an easy route to employee theft. And, the need to “Rationalize” behavior creates justification that what they are doing is acceptable.

The key to preventing theft is to remove the “Opportunity.” Controlling access to “Opportunity” must be done to avoid theft:
1) Control how money is handled. 2) Split money-handling duties; discrepancies can be more easily noticed in this way. 3) The doctor must also do some of the money handling duties by authorizing account adjustments; checking the adjustment report daily; authorizing check refund requests; signing and mailing all checks if a staff person makes out the checks for vendors. The signed check should not be put back into the control of a staff person. 4) The doctor or his/her accountant must open and balance the bank statement. This means bank statements should be mailed to the doctor’s residence or directly to the accountant. 5) Either the accountant or a payroll service should prepare payroll. If a payroll service is used, it is the doctor’s or accountant’s responsibility to call the information into the payroll service.

Other Preventative Areas
Each office should use a time clock, and manual entries must be initialed by the doctor. Petty cash should be counted and balanced daily. The amount of receipts plus cash on hand should equal the same balance every day. The outside of the envelope containing the petty cash should be used to monitor the daily balance. Each day, the date, the receipt total, the cash total, and the sum of receipts and cash should be listed along with the initials of the person reconciling the petty cash.

When the age of computerization came to dentistry, one of the selling points was that computers would make it more difficult to embezzle. Nothing could be further from the truth. Whether computer-related, computer-enabled, or computer-camouflaged, the use of computers has made embezzlement easier than ever unless the proper safeguards are instituted.

Preventing theft by computer requires a thorough understanding by the doctor of the security features built into the office’s software. This information must be carefully reviewed with the software vendor’s support team to ascertain that access to various features of the system is correctly restricted.

No system should allow the “deletion” or “erasing” of accounts or charges by staff or allow deletion/disabling of the entire system. The statement generator should never be turned off. Any patient complaints relative to payments and balances must be carefully investigated.

Computer reports are designed to assist in avoiding theft problems. But to work, someone (i.e., the doctor) must review them. These will only take a few minutes to review, but this must be done. Adjustment, refund, and write-off reports should be read by the doctor daily. Posting reports should be scanned by the doctor daily. The doctor can quickly spot incorrect charges posted for procedures they have just performed.

The accounts receivable (A/R) aging report should be checked monthly and discussed monthly with the financial coordinator. The financial coordinator should be prepared to respond to each account over 90 days old with why, what has been done, and when payment is expected. In addition to demonstrating that the doctor is monitoring things, this also greatly assists in making certain that collection procedures are being followed, thereby keeping accounts receivable under control.

Dealing with Embezzlement
Dealing with embezzlement, fraud, and theft involves four steps. “Discovery” is the first step. It is the doctor’s responsibility to diligently observe what is going on in his/her office relative to the handling of money.

If theft is suspected or discovered, the next step is “Investigation”. Before making any accusations, the doctor must make certain that the evidence supports the alleged crime. This means reviewing entries, reports, patient account records, etc., to gather the hard evidence necessary to confront the thief.

“Prosecution” is the next step. This is sometimes harder for the doctor than the realization that their trust has been betrayed. But it is a necessary step. If not, the theft will continue, either from you or another doctor. This means calling the police.

Reasons Doctors Do Not Prosecute
Why do some doctors elect to forgo prosecution? Topping the list is the fear of a slander suit. Avoiding this allegation is the purpose of the “Investigation” stage. If you have the evidence, you are not guilty of, nor can you be accused of, slander. Involving the police once you are certain you have become a victim will aid in protection against these false allegations.

Many doctors fear to prosecute because of fear of the IRS. After all, they have unreported income. If one fails to report and prosecute the theft, the IRS takes the position that income has been fraudulently under-reported. If one reports the loss to the authorities, the IRS views this as proof that a loss by theft has occurred and therefore the under-reported income is offset by the theft loss and no charges by the IRS will be levied.

Non-reporting of employee theft can also be the fear of blackmail. Some of the doctors suffering losses from theft are themselves involved in insurance fraud, unreported income, and/or income tax evasion. They know the offending staff member is aware of this and out of fear of retaliation, they elect to terminate the employee but not prosecute.

Recovery
The last of the four steps of dealing with employee theft is “Recovery.” Total recovery is usually not possible. Even if successfully prosecuted involving a judgment requiring repayment, most staff members involved in theft no longer have the money nor do they possess the ability to repay, even if spread over a lifetime. Actual judgments issued such as $50 per month until the amount embezzled has been repaid would require one hundred years of monthly payments to recover a $60,000 loss (that does not even include interest).

The best chance of partial recovery comes from the office insurance policy. Limits of $10,000 to $25,000 are common. The policy will pay the actual amount of loss or the policy limit, whichever is less. However, most policies require the reporting of the loss to police, and prosecution, if advised by the local district attorney.

Conclusion
Most theft, fraud, and embezzlement is avoidable if minimal safeguards are instituted. However, the doctor must take an active role. Doctors who blindly trust their employees are the easiest targets and may suffer the greatest losses.

Many new dentists who acquire their dental practice by purchasing an existing practice face the same problem relative to implementing safeguards as older dentists in practice for many years face. How? Blame it on your accountant. Tell your staff that your accountant has recommended certain changes be made in how things are done because this represents better compliance with GAAP (Generally Accepted Accounting Principles). In this manner, these changes will barely be questioned, except perhaps by a staff person who is guilty of theft.

Back left: Brian Nolan, Equipment Sales Specialist; Wade Hinds, Field Sales Consultant; Rob Brenneman, Equipment Service Technician and Dr. Juliann Demand-Balski.

Henry Schein Dental’s Equipment and Technical Specialists realize the importance of innovative thinking when planning a new dental office. Obstacles become challenges that simply need the right approach and the specific insights of each of the various experts who are part of the “team” effort during the project.

There are amazing products and technologies available to today’s dental office, making the total dental healthcare experience quite different than ever before. Patients are the glad recipients of many new treatment options, including cosmetic dentistry, which can have a terrific impact on a patient’s self-esteem and overall confidence. Dentists now have enhanced treatment capabilities, new ways to generate revenues, and a greater control over efficiency and increased productivity. All together, it is clear that everyone wins during this exceptional period of advances in dental care.

Brian Nolan, Equipment Sales Specialist; Wade Hinds, Field Sales Consultant; and Rob Brenneman, Equipment Service Technician collaborated during the creation of Dr. Juliann Demand-Balski’s new office in Brunswick, Ohio. The 4,800-sq.-ft. premises, formerly a McDonald’s restaurant, has been designed to carry out the Doctor’s vision for patient care and support her plans to keep her business competitive and successful into the future. “The first step in the process was to…talk to Wade…and Brian,” comments the Doctor. “[They] helped me design the office and pick out the equipment that would be right for me…[and] assisted me from beginning to end—construction, renovation, design, equipment, and installation.”

Beautiful and functional, the office is equipped with top-ofthe- line technology and an ergonomically sound layout to help the workday go smoothly. One of the operatories is a “kid-friendly” zone, boasting sky-illuminated ceiling tiles, wall murals, and a pediatric dental chair.

 “We now offer in-office tooth whitening, intraoral cameras in the operatories, computerized charting, and the Dexis® radiology system,” notes the Doctor. “The new design allowed [better] patient flow and production [has] increased…[and] the staff works more efficiently.”

Patient load has increased tremendously at the new office. “I had to hire a few dentists to keep up,” adds Dr. Demand-Balski.

Through their combined talents, team members, Brian, Wade, and Rob have provided Dr. Demand-Balski with an ideal setup to pursue her professional goals and achieve a greater level of patient satisfaction in an environment that truly reflects her philosophy on the practice of dentistry.

Front Row (L to R): Dave Luckenbaugh, SE Regional Manager Special Markets/Equipment; Jean Vaughn, Practice Manager; Jennifer Clark, COO; Dr. Monique Smith. Second Row (L to R): Mike Templeton, FSC; Marion Stokes, ESS; Bryan Allem, South Carolina Regional Manager; Dr. Cemeron Longstreet; Will Banister, EST.

New Horizon Family Dental Care (NHFDC) is a subsidiary of New Horizon Family Health Services (NHFHS), a not-for-profit federally qualified health center that has served the city of Greenville and 13 counties in Upstate South Carolina since 1992. All of the counties have been designated as a Health Professional Shortage Area either for all or part of the county or for the lowincome population. The new facility is designed to treat Medicaid and lower income populations of the community that would not otherwise have access to dental care.

NHFDC is housed in a renovated space previously used as a doctor’s office. The 6,000-sq. ft. facility accommodates 13 operatories with professional services provided by a staff of 2 dentists and 2 assistants. Community needs and backing from numerous public, private, corporate, and foundation partners made the creation of the NHFDC possible.

Marion Stokes, Equipment Sales Specialist; Mike Templeton, Field Sales Consultant; Will Banister, Equipment Service Technician; Bryan Allem, Regional Manager–South Carolina; and Dave Luckenbaugh, Regional Manager–Special Markets/Equipment brought their diverse skills to the project, offering facility design, supply and equipment acquisition—plus support and advice during each phase of the transformation. “Everyone involved from Henry Schein Dental stressed how important it was to us to help New Horizon achieve their goals…they felt we were truly [their] partner in the endeavor,” notes Marion Stokes. “We offered total involvement…from our local team…and on the corporate level. [NHFDC appreciated the fact that] we could be a complete source for all their needs.”

NHFDC needed dependable, durable, and aesthetically pleasing equipment. Pelton & Crane met the standards required and also backed the equipment with a 5-year warranty, helping to maximize the facility’s budget. The clean, modern appearance of the facility and its equipment creates an environment that reduces stress— a necessity for successful treatment.

 “New Horizon began to realize their increased productivity almost immediately,” adds Marion Stokes. “The overall appearance of the facility and equipment are something that NHFDC and Henry Schein Dental are very proud of. The new equipment and systems invested in make all staff members more productive…they are able to treat more patients…very comfortably. This facility will enable treatment of the underserved population in a first-class environment.”

NHFDC now receives increased referrals from community-based health and human services providers. They operate more efficiently with greatly enhanced quality of care for their patients. Staff and doctors concur that the center has positively increased access to care for the community’s most vulnerable residents, including children, the homeless, seniors, HIV/AIDS patients, those covered by Medicaid, and the uninsured.

The clinic’s future plans include a dental residency program and expanded pediatric services. The new facility can confidently look forward to fulfilling all their goals—and better serving all who depend on their enthusiasm and dedication.

By Roy H. Stevens, Professor and Chairman, Department of Endodontology, Temple University Kornberg School of Dentistry.

The new Endolase™ Radial Firing Tips Root Canal Therapy System enables endodontists and general dentists to perform root canal procedures faster and more effectively than with conventional treatment methods.

Endolase RFT System includes two newly designed, single-use laser tips, called endoTips™, and the procedure protocol for use with the Waterlase MD™ YSGG laser system. BIOLASE received U.S. Food and Drug Administration (FDA) 510(k) clearance of its Waterlase MD with RFT endoTips for root canal disinfection after endodontic instrumentation, making BIOLASE the first company to receive clearances allowing dentists to treat root canals with advanced laser technology.

Only two-to-three times the width of a human hair and very flexible, endoTips™ are shaped so the laser energy is emitted in a radial pattern, allowing the dentist to disinfect the root cavity while protecting and preserving tooth structure.

A research team from BIOLASE and Temple University, led by Dr. Roy Stevens, Professor and Chairman, Department of Endodontology at Temple’s Kornberg School of Dentistry, demonstrated that Er,Cr:YSGG laser light is capable of significantly reducing the level of infection in root canals and adjacent infected dentin by up to 99.7 percent. (1,2,3)

 “The effectiveness of this treatment lends itself to improving the way that we perform root canal therapy,” Dr. Stevens said, adding that the results of the team’s research were of “great significance” for several reasons. “First, these bacteria are known to be highly resistant to other disinfection currently used in root canal therapy,” Dr. Stevens said. “Second, the research demonstrates that the disinfection capability of the laser is effective at a distance into the dentin surrounding the canal, overcoming some accessibility problems for conventional treatment methods. Third, a high level of disinfection can be achieved in minutes, saving both the patient and dentist considerable time during endodontic treatment.”

As the Radial Firing Tip moves along the canal wall, its radial YSGG laser energy penetrates deep into dentin and tubules to reach and destroy hidden bacteria

 Why do conventional treatments fail even when all canals are located and cleaning and enlargement is successful? Research has shown that most root canal treatment failures are caused by persistent or secondary intraradicular infections, with E. faecalis, the most prevalent species.(4)

Waterlase MD™ YSGG treatment may reduce the risk of retreatment. Waterlase MD™ treatment with radial firing EndoTips™ reduces bacterial counts to levels approaching sterilization. Waterlase YSGG 2780nm laser energy penetrates deep into dentinal tubules to kill more bacteria without subjecting patients to the potential toxicity of sodium hypochlorite solutions.

 The smear layer remaining after rotary or hand instrumentation contains infected tissue that can seal infection within dentinal tubules. Scanning Electron Microscopy shows how treatment with Waterlase MD™ radial firing EndoTips™ leaves canal walls free of smear layer and opens dental tubules, allowing YSGG laser energy to penetrate and destroy bacteria.

Artist’s rendering of Endolase™ Radial Firing Tip disinfecting a root canal.

The EndoTips™ System removes smear layer without chemical irrigants, in only 2-3 minutes per canal. The Hydrophotonics™ effect of Waterlase MD™ YSGG laser energy and water creates a powerful microagitation throughout the entire length of the canal, scouring tissue debris from dental walls and tubules, and flushing it from the canal. At the same time, the minimally invasive ablation of the Waterlase creates only the required widening of the canal, avoiding unnecessary coronal widening and weakening of the root.

Laser Disinfection

The Endolase™ disinfection process is simple. Using the RFT2 endoTip™, place the tip into the handpiece and select 10 percent air flow and 0 percent water settings on the Waterlase MD. Insert the tip to 1mm short of the apex and, using the tip’s depth guide, activate the laser and start moving the tip coronally at approximately 1 mm/s. Use a contact brushing technique to deliver YSGG laser energy to the surface, peri- and inner-tubular dentin. Re-insert the tip immediately and perform an additional pass over the same area. Then repeat four or more times to ensure disinfection of the apical and partial coronal two-thirds of the canal.

For more information, call Biolase at 1-800-321-6717

 For more information in Canada, call 1-800-668-5558

Anterior Part No. 7200795: RFT2, 25mm Tip – 1 (EA) / RFT3, 21mm Tip – 1 (EA)

Posterior Part No. 7200801: RFT2, 21mm Tip – 1 (EA) / RFT3,

FOOTNOTES:

1. The antimicrobial efficacy of the erbium, chromium:yttrium-scandium-gallium-garnet laser with radial emitting tips on root canal dentin walls infected with Enterococcus faecalis: Wanda Gordon, DMD, Vahid A. Atabakhsh, DDS, Fernando Meza, DMD, Aaron Doms, DDS, Roni Nissan, DMD, Ioana Rizoiu, MS and Roy H. Stevens, DDS, MS. JADA 2007; 138(7): 992-1002.

2. The impact of an erbium, chromium: yttrium-scandium-gallium-garnet laser with radial-firing tips on endodontic treatment:U. Schoop, A. Barylyak, K. Goharkhay, F. Beer, J. Wernisch, A. Georgopoulos,W. Sperr, A. Moritz. Lasers in Medical Science DOI 10.1007/s10103-007-0520-4.

3. The use of the erbium, chromium:yttrium-scandium-gallium-garnet laser in endodontic treatment. The results of an in vitro study: Ulrich Schoop, DDS, MD, Kawe Goharkhay, DMD, MD, Johannes Klimscha, DMD, MD, Manuela Zagler, DMD, Johann Wernisch, TD, PhD, Apostolos Georgopoulos, MD, PhD, Wolfgang Sperr, DDS, MD, PhD and Andreas Moritz, DMD, MD, PhD JADA.

4. Siqueira and Rocas; “Polymerase chain reaction-based analysis of microorganisms associated with failed endodontic treatment. OO 2004 97;85-94.

By Marvin Berlin DDS,* Gary Severance DDS,** and Sherri White RDA CDD

Yes, the buzzwords in dentistry today are digital impressions; getting rid of the goop in the mouth, the potential of gagging and numerous other benefits for the patient and the dental team. But are there truly advantages to just capturing the information digitally that make it worth an investment? Unfortunately, several systems have been grouped together both in style and categories, and dental professionals should be aware of the differences and what each system can really offer. There are basically 1) acquisition units—or scanners only—Itero, LAVA COS and 2) Total Digital Solutions-E4D Dentist, CEREC 3D.

The Itero and LAVA COS systems both capture data. The data is then transmitted digitally to a model center (Itero mills their models; LAVA uses stereo lithography). In the case of the LAVA COS System, the information could also go to a coping/milling center (LAVA) for fabrication of a Zirconia coping. This is where the digital flow ends—the end result is back to conventional dentistry in the laboratory where the hard model is used just as it has always been and the restorative material is then built by hand or conventional methods. So, although these systems provide a valuable service, they don’t go all the way. Consider the perception of a capture only system versus the reality:

The perception is that you will not have to take a conventional impression in the mouth, but instead you have scanning device in the mouth for a period of time scanning the area.

The perception is that you get rid of the $10 cost of taking a VPS impression— but in reality there is a surcharge of $20+ for each scan series by both manufacturers to the dentist and in addition the laboratory is charged $25–$40 for the model that is fabricated depending on the complexity of the model.

The perception you won’t have to use UPS, FEDEX or any other method to ship your impression, but the model has to go to the lab via conventional shipping methods and then final restoration still has to be shipped back to you.

 And finally, no more disinfecting the impressions prior to sending to the lab—it’s digital—but don’t forget after each patient you’ll have to disinfect/sterilize the wand that was used intraorally.

So the capture-only devices sound good, but more for marketing purposes and competitive claims than anything else add to that the $20–$25,000 price tag along with a per use charge, and it is a significant investment for eliminating only one step—the impression. Unless this type of system (acquisition units) can be combined with a total solution with design center (full contours) and mill capabilities both chairside and through laboratories, they don’t offer the complete solution that dentistry is looking for, now and in the future.

The real benefits and advantages come from going to one of the total restorative chairside solutions—to not only be able to complete digital impressions, but then to design and mill full-coverage, single-unit restorations right then and there— and offer SAME-DAY DENTISTRY. In previous issues of Sidekick magazine—we’ve spoken of the numerous advantages to the practice, the patient, the team and even to the health of the tooth with preparations that are restored the same day. Here we’ll emphasize the true benefits and potential of digital impression systems combined with a restorative milling solution in the office with E4D Dentist. There are two full contour chairside systems available—the CEREC System by Sirona Dental was introduced over 20 years ago and utilizes an image system that requires a complete contrast of the operative site—therefore requires application of a powder or spray to completely cover the area intending to be scanned. The other system, the E4D Dentist System, uses laser-based scanning to capture the intraoral conditions in its true state and can also scan impressions, bite registrations, and models without the use of powder or a contrast agent. In fact the E4D Dentist System is so versatile that it is the only digital capture system that has Three Source Scanning (TSS).

The real benefits to the patients, the practice, and the bottom line is the total solution of E4D Dentist and its powder-free Three Source Scanning options.

It can scan intraorally, it can scan an impression (even alginate) and, then if needed, scan a model and from anyone of those generate the same virtual model. So it allows you to immediately adjust to the clinical conditions and choose your preferred method while all still offering a Same-Day Solution. What does that mean to you and your practice? You are in control at every step and can adjust as necessary. Consider the following situations.

Scenario #1–Patient arrives for a simple crown prep and seat in same appointment. You prep the tooth using the all ceramic protocol of adequate clearance, rounded internal angles, visible butt joint margins. The prep is complete and the patient and prep is ideal for intraoral scanning. Simply clean and dry the areas, capture the scans, have the patient close and go on with the design and mill. Try-in of the final restoration is done right in the mouth and then it is seated—all in one appointment.

Scenario #2–Patient arrives for simple crown prep and seat in the same appointment. After prepping the tooth and starting to scan, the area is difficult to keep isolated, the patient’s mouth opening is small and there is a struggle keeping the wand in the ideal location. Simply tell the patient you are going to take a quick setting impression— alginate or VPS and in a couple minutes, pull the impression have the patient close and then you have the impression to scan, invert, and begin the design process followed by milling. Again seated in one appointment in the same time it took for scenario #1.

Scenario #3–Patient arrives for a simple crown prep, and will need to come back for the final crown later due to her schedule—so she’ll come back later in the day—or even tomorrow for the final, but she needs it before the weekend. Prep is completed, an impression is made and using quick-setting, single-use stone (EarthStone, Tak via Henry Schein), the assistant pours it up and dismisses the patient with a temporary. Knowing that having the patient in a temporary for only a couple hours or even a day will minimize any occlusal changes or shifting of the teeth as well as sensitivity from exposure to bacteria or debris this is an ideal solution especially for a two-appointment schedule. During a break in the day’s schedule, the assistant scans the model and the bite (triple tray) and after designing and milling does a try-in on the solid model to confirm fit and contours, then stains and glazes and has the restoration ready for whenever the patient returns.

All of these scenarios are possible with the E4D Dentist, Same-Day Dentistry—or Dentistry that you control—with many possibilities adapting to the need of the practice and the patient. Although digital impressions are the wave of the future, this is only half the story. The real benefits to the patients, the practice, and the bottom line is the total solution of E4D Dentist and its powder-free Three Source Scanning options.

 Drs. Joseph Bender and John Watters have made it the “home” of their new dental practice, the Panther Hollow Dental Lodge. The architecture chosen for the new building is characteristic of the style used in the 1930s and 1940s when dude ranches and lodges became the theme for many retreats and U.S. national parks. There is a rugged romanticism in the distinctive architectural elements that identify the “lodge” style. You quickly sense its relationship to the Wild West, the powerful influence of natural surroundings, and its similarity to the vast, open spaces so typical of the American wilderness. The raw materials of the style include generous proportions overall—open-beamed vaulted ceilings, sensuous natural woods, grand stone fireplaces, and often leather and rich, woven fabrics to enhance its casual but cozy elegance.

The rustic and inviting style captured the imaginations of Drs. Bender and Watters, and inspired them to choose it for their new office. 

 Panther Hollow Dental Lodge would be a complete about face from the cramped space they had practiced in since 1980 at their original facility. The change was long overdue and prompted by the explosive patient growth being experienced by their business.

Drs. Bender and Watters were especially happy at the completion of the project. Its progress was dramatically slowed when, in 2004, hurricane Charley carved a destructive path through the area. The storm leveled the block walls at the construction site, preventing the placement of the headers for the building and forcing a redo of the site. Many businesses in Florida were devastated by the storm. Henry Schein, Inc., the parent company of Sullivan-Schein, is part of an extensive network of organizations that provide emergency response to relief efforts globally. Its corporate contributions go to many needy causes, including donations to agencies that fund reconstruction for areas such as Florida, which was very hard hit after the turbulent 2004 hurricane season.

                           Before Hurricane Charley                                                                                 After Hurricane Charley

 The Sullivan-Schein team doubled their efforts to get the project back on track so that the office could achieve its goals in a timely manner.

 “Our patients and staff love the new office,” the Doctors comment. “It’s the buzz of our entire community! Our Sullivan-Schein team…always goes way above the call of duty to help with any of our concerns or problems. We’ve worked with them for years…and they’ve been there through every phase of this adventure—from early designs…to equipment selection…the newest technologies, and financial arrangements.”

Panther Hollow Dental Lodge’s 6,900-sq. ft., 13-operatory facility has been designed to accommodate a streamlined workflow. Its operatories are configured for ease of use by staff and exceptional comfort for the patient. Sleek, ergonomically designed chairs, duo carts, and track lights from Midmark help to improve productivity. The multifunctional Midmark Sterilization Center saves time and energy by efficiently processing instruments with the highest levels of asepsis possible while ensuring regulatory compliance is met. The facility’s restful, contemporary conference rooms make consultations a pleasant experience for Doctors and patients alike.

Jim Puckett and Bob O’Neill, Equipment Sales Specialists; Richard McBride, Field Sales Consultant and Mike Whelan, Henry Schein Financial Services (HSFS) Regional Manager, merged their talents to create a package that incorporates the many comprehensive services Sullivan-Schein provides for dental practitioners. The Sullivan-Schein perspective is one of partnership with its customers. By supporting their goals and delivering the products and services that will keep them competitive and profitable in the industry, our specialists help to ensure that customers’ businesses cost-effectively achieve the success they envision. Drs. Bender and Watters chose to finance their equipment and full practice needs through HSFS. HSFS’ business solutions and resources offer enhanced financial capabilities to healthcare providers so their plans can be fulfilled in a timely manner. Dr. Watters notes, “Mike Whelan was a pleasure to work with. The follow through on every detail was terrific. Our financing was customized to our practice goals…we are still operating our old office as well. The payment arrangements were simplified to cover all our financial needs without creating added burdens that could jeopardize our plans. I am very impressed by Mike’s dedication to our business needs… I can’t imagine looking elsewhere…HSFS and Mike provided thorough, courteous, and cost-effective means for our vision to reach fruition.”

Sullivan-Schein’s CAD designer, Jennifer Rhode, was integral in properly fulfilling the office’s technical design needs and maintaining the essentials that define the lodge style. The lofty great-room look in the reception area effectively combines the architectural details that make the environment come alive with the particular charm of the style. Welcoming, relaxed, and spacious—with plenty of the customized touches that infuse the room with the spirit of a wilderness retreat—the area boasts a large stone fireplace with a wooden mantle, stone columns and wall treatment, vaulted ceilings with exposed timber beams, an antler chandelier, wildlife photographs, and national park posters. Patients delight in the unusual atmosphere while they await treatment.

The office’s upgraded technologies allow faster and better patient care. Sullivan-Schein’s Dentrix® Practice-Management System gives the office seamless integration of its practice information, including detailed clinical data, imaging, patients’ records, scheduling, claims processing, lab management, ordering and inventory, and more. Effective Dentist/patient communication and interaction is achieved with the Dentrix ImageCAM. It gives the patient the ability to see what the dentist sees and understand the diagnosis. Visually educating patients about their specific concerns helps to involve them in their own procedures and results in more successful treatment as well as increased confidence in the caregiver.

Panther Hollow Lodge’s Dentists, hygienists, and assistants now enjoy the ideal environment to confidently increase productivity and provide a greater level of patient satisfaction. They can dedicate themselves to practicing the finest dentistry with the latest technologies while making each patient’s experience a pleasurable one. Both Doctors and staff can depend on the support system provided by Sullivan-Schein’s experts to comfortably help them pursue continued growth and best serve their patients in today’s highly competitive business environment.

Left to right: James Kinney, Equipment Service Technician; Richard McBride, Field Sales Consultant; Dr. Josephy Bender; Dr. John Watters; and Bob O’Neill, Equipment Sales Specialist.

With the introduction of the new E4D Dentist® System (Figure 1) through Henry Schein Dental, providing Same Day Dentistry™ solutions for single-unit indirect restorations is a more viable alternative to conventional two-appointment “prep and seat” procedures than ever before. Although the opportunity is not new, the E4D Dentist System makes Same Day Dentistry™ more practical by offering multiple options for capturing data; more efficient, with DentaLogic Software that guides the user through an easy to use and easy to understand design process (Figure 2); and more exciting with Autogenesis™, SOS™ remote access, and Henry Schein Dental Sales and Support. Let’s take a look at some of the factors that you can consider to determine if Same Day Dentistry with a chairside CAD/CAM system is something you, your practice and your patients can benefit from. In other words…Is E4D 4U?

Figure 1

Healthier Dentistry

Consider a daily practice situation where after prepping, impressions, and placement of the temporary, the patient turns to a clinician when told about coming back for the final restoration in a couple weeks, and asks “why?” Why do I have to come back again, just to get the final restoration? Unless we are dramatically changing the occlusal scheme, or the life of the tooth is questionable, the only answer we as clinicians can provide the patient is really “That’s how long it takes to make the final restoration.” In other words, the dental profession is one of the few healthcare professions that makes an incision into the body and then rather than seal, suture, or stabilize the situation, we basically allow the patient to leave our office and bathe the preparation/provisional in bacteria for a few weeks, allow tooth movement to occur, including hyper-eruption and leave the tooth in a more susceptible, structurally weakened situation than ever before—all because we didn’t think we could offer a Same Day Solution for single unit indirect restorations without a compromise in form, function, or esthetics. That was before the E4D Dentist System. Being able to provide a permanent solution within minutes of prepping the tooth minimizes or eliminates the deleterious effects possible with provisionalization of these singleunit restorations and provides the office with economic benefits and the patient with extraordinary convenience.

Figure 2

Better Economics

Determining if this type of high technology is right for your practice requires careful analysis of the return on investment (ROI). A practice must not only consider hard costs and the potential financial return, but also the positive marketing impact to patients—current and future. In the case of chairside CAD/CAM dentistry there is also a shifting of some financial and human resources from an outside fabrication service to in-office design and fabrication (i.e., milling) processes.

Practice overhead (typically 60%–70%) makes up the majority of “costs” of any dental procedure and being able to complete a procedure in one appointment that previously took two appointments, with about the same amount of chairtime, automatically saves the practice time and money. With no second appointment, there is no expense for greeting, seating, patient preparation, operatory turnover or the possibility of second-visit cancellations.

Figure 3

Every ROI is unique to the individual practice but in most scenarios, if examined closely, the time-tested practice of delivering one restoration over two appointments—separated by up to three to four weeks—is a suspect income generator. Consider a situation where a dentist resists raising his/her fees for the next six years—for fear of losing patients. He/she charges $1000 for an all-ceramic indirectly fabricated restoration. If the practice is prepping and delivering a single-unit restoration over two appointments (based upon a 60%–70% overhead and a $150 fabrication fee) the procedure becomes at most a break-even situation after a certain period of time. With the introduction of Chairside CAD/CAM dentistry, the same doctor completing 20 restorations a month in single appointments versus two appointments and with no fabrication fee, lowers overhead and increases the profit/restoration for the practice dramatically—even without raising fees. This assumes material costs remain similar, five years of payment on the equipment, but does not take into account the potential upgrade of some direct restorations to indirect restorations because of a greater confidence in proximal contacts, contours, and occlusal form and function. Chairside CAD/CAM dentistry—the ability to scan, design, mill, and deliver a restoration in one appointment—may make economic sense for a practice such as this (Figure 3).

During economic slowdowns, it is more important than ever to be in control of major expense categories and analyzing areas where monthly outlays can be conserved and in-house services expanded. Unfortunately, determining if Chairside CAD/CAM dentistry is right for a practice isn’t just a matter of plugging in the number of restorations/month x laboratory fee to determine investment potential. A practice has to take into account the potential “upgrade” of large direct restorations, the impact and awareness to a potential patient base, and the general perception of the practice on being on the cutting (aka milling) edge of new technology. Your local Henry Schein CAD/CAM Specialist can assist you and your practice to determine if this type of technology is right for you economically.

Figure 4

More Convenient

Modern Dentistry for Modern Lifestyles™— that’s what successful dental healthcare professionals today must offer. Patients’ lives are busier than ever before—with carpools, business meetings and travel and just an overall more hectic schedule. Maximizing the efficiency of a dental visit, with the potential of reducing the number of visits to the office by half is an extremely attractive option for most patients.

Chairside CAD/CAM Dentistry is also a convenience for the office and team members. The office is now in complete control—of its schedule…no second appointment scheduling conflicts, of the restoration…knowing exactly where the restoration is and its status…as well as complete control of the treatment options and material selections. With this type of dentistry, digital images of the preoperative condition, the preparation, and the final design can be saved for patient records, future restorative options, or team member education and training. In addition dental assistants can take advantage of the CDD (Chairside Dental Designer) Program (Figure 4), exclusively through E4D University, where they can elevate their creativity, design, and chairside participation through additional CAD/CAM instruction, intraoral photography (Figure 5), and staining and glazing skills.

Figure 5

The E4D Dentist System provides dental offices with an all-in-one solution for Same Day Dentistry.

Laser-based Scanning: Scanning of the preparation and neighboring dentition can be done without the use of a contrasting agent (aka “powder”). Impressions (even alginates) and stone models can also be scanned providing several options for case completion.

 Intuitive Design: DentaLogic software and proprietary automation (Autogenesis™) guide the designer through the process from detailing margins through final restorative design.

Mill: Precise milling of metal-free composite and ceramic restorations is accomplished in minutes with the robust E4D Milling Center. Wireless communication, automatic tool changer, and touch-screen display facilitate utilization in the office.

Contact your local Henry Schein CAD/CAM Specialist to see if E4D is 4U.

The diagnostic attributes of digital X-ray were already
apparent-it’s easy to use, fast, and promotes co-diagnosis and
co-discovery. In addition, switching to digital radiography
helps us to become better environmental stewards.

Reduced radiation-Digital X-ray utilizes up to 90 percent
less radiation that traditional film X-ray-that means less
radiation exposure for my patients, for my team, and in our
office environment.

Less hazardous waste-Developing traditional X-rays means
exposing my staff to very toxic chemicals that are considered
hazardous waste. Some examples fixer and traditional X-ray
film are considered hazardous waste because of their silver

Many states are implementing stringent disposal laws for these
chemicals. Under California law, X-ray fixer, developer, cleaner,
lead foils, and shields cannot be poured down the drain or
disposed of as garbage. They must be stored in appropriate
containers away from the public and inspected once a week for
leakage and deterioration and must be disposed of within 90
days of the date of accumulation, or for smaller users, after it
reaches a 27-gallon limit. Needless to say, we don’t need any of
these anymore, now that we’re digital.

Also, we must put removed amalgam fillings in a separate
receptacle to catch the mercury so it doesn’t pollute San
Francisco Bay. When the city and county inspectors came to
check our office for this and saw our digital radiography
system, they loved it because they didn’t have to deal with all
of the related chemical storage and hauling issues.

Healthier for the team-More importantly, now, my team
members don’t have to breathe the fixer or developer fumes as
they process the X-rays or clean the processor with caustic
chemicals while wearing protective glasses, gloves, and masks.

Healthier for the budget-In my office, before we initiated
digital X-ray, we’d store used chemicals until the hazardous
waste hauler came to remove them. That was an extra expense.

As a dentist, I’m glad to invest in
equipment that improves my patient care
and business, and that will also have an
impact on our future quality of life.

Some dental offices treat spent fixer with an onsite silver
recovery unit that requires a strict maintenance schedule. We’d
rather spend more time with the patients.

Less “busy work”-Toxic chemicals must be specifically
labeled as hazardous waste. Employees must receive training on
hazardous material handling, storage, disposal, spill cleanup-
and take an annual refresher course. Dental offices must
maintain records of all hazardous wastes generated on site.
Documentation has to be maintained for three years.

And more-We always inform our patients of our efforts to
promote a cleaner, greener world. It’s good marketing. We
always use the term “digital” X-ray. “Digital” connotes “safer.”
We discuss how we have gotten rid of our processing and
cleaning chemicals and darkroom, so we can use the space more
efficiently for them.

Investing in a digital radiography system is such an easy way
to streamline office procedures and be friendly to the
environment at the same time. Patients love that we care about
them and care about the environment-it’s a great message. As
a dentist, I’m glad to invest in equipment that improves my
patient care and business, and that will also have an impact on
our future quality of life.

Dr. Cynthia Brattesani owns a private practice in San Francisco
where she implemented digital X-ray more than six years ago. She was
awarded the prestigious ADA Golden Apple New Dentist Leadership
Award in 1996. An enthusiastic member of organized dentistry, she
has held positions at the local, state, and national levels. Dr.
Brattesani is a graduate of University of California at San Francisco,
School of Dentistry. You may reach her at info@drcynthiab.com

Considerable attention has been given to plan fees in the past year, with a goal of making them more transparent and more easily understood by plan participants. Fees have been the subject of several Congressional Hearings, Government Accountability Office (GAO) reports, and regulatory initiatives.

Employers today have a variety of options for how to implement a workplace savings plan. These affect the types of fees and expenses the plan will incur. Although employers traditionally managed these plans in-house with the help of an external trustee, that model has become outdated. Today, two of three employers outsource 401(k) administration functions to a service provider.(1)

Roles and responsibilities

 In terms of obligations that can arise in offering a 401(k) plan, both the plan sponsor and service provider have distinct roles and responsibilities.

The plan sponsor has fiduciary obligations under the Employee Retirement Income Security Act of 1974 (ERISA), a federal law that covers retirement, health and other welfare benefit plans. For example, the sponsor must carefully select and monitor its service provider to ensure that the fees and expenses are reasonable and fair. Sponsors don’t have to choose the lowest cost plan, but they must ensure that costs are reasonable. The Department of Labor (DOL) has noted that the cheapest provider may not necessarily be the best.

 The service provider must offer accurate recordkeeping and administrative services that can help plan sponsors minimize risk and produce measurable results. All of this can help plan sponsors enhance the value of this benefit for the plan participants. Of course, service providers must be able to maintain a reasonable profit margin, which can help them finance ongoing innovation in products and services and stay competitive in the market.

The plan participants have the responsibility to use the plan as it is intended—to save and invest for retirement. That means making well-informed decisions on how much to save, which funds to choose, and how often to make changes. Participants should understand that there are fees associated with 401(k) plans and they should have a working knowledge of those fees.

Bundled or unbundled?

Two basic service models have emerged in the workplace savings market: bundled and unbundled offerings. Traditionally, plan sponsors have contracted with separate parties for these services. In this “unbundled” service model, they may have distinct relationships with a recordkeeper, trustee, advisor /broker, and third-party administrators. Unbundled providers tend to have a complex fee structure, which may include:

• Administration fees–can be charged as a per-participant fee, a flat rate or a transaction-based fee. 
•  Asset-based fees (often referred to as the “expense ratio”)–they are not deducted directly from the participants’ plan accounts. Instead, they are typically paid by the investment option and result in a reduction in the investment return.

Other fees include sales loads, 12b-1 fees and wrap fees, which may or may not be charged by some mutual funds, brokerages and investment programs.

Alternatively, the use of “bundled” service providers has become more common over time—they currently serve about 75 percent of plans. They offer one-stop shopping for all aspects of retirement plan administration, including recordkeeping services, trustee services, and brokerage/investment management. Most bundled providers have a simple fee structure, which includes administration fees and asset-based fees.

Putting fees in context

Workplace savings plans are hardly unique in having costs or charging fees for the financial services they provide. All savings vehicles have administrative costs. Banks, insurers, mutual funds, and brokerage houses charge customers for their services. Bank customers are familiar with ATM fees, low-balance fees, check writing fees, overdraft fees, and monthly maintenance fees. Similarly, an investor might incur mutual fund fees in connection with transactions as well as regular fund operating costs.

As important as it is to have competitive and equitable fees for your savings plan, it’s equally important for those fees to be disclosed clearly and provided in a meaningful context. Disclosure of fees shouldn’t be considered in isolation, but rather within the framework of ”full disclosure” of a fund’s investment objectives, including risk levels, past performance, and tax consequences. After all, what should matter most to participants investing in workplace savings plans is the potential total return they may receive—after fees.

So what does this mean?

Legislation mandating extensive disclosure may actually have a negative affect, inadvertently deterring participants from making decisions if they are overwhelmed with information. Disclosure obviously serves an important purpose, but in order to secure trust in workplace savings plans, it should be clear, relevant and actionable. In short, it should help plan sponsors and participants to make sound decisions.

If you are the fiduciary responsible for managing your practice’s employee benefit plan and its assets, it’s critically important to stay informed. One way is to work with a reputable service provider to help you evaluate your plan annually and then make changes if necessary.

To learn more about the long-term impact fees can have on a 401(k) plan, contact Fidelity Investments at 866-467-0633 for a no obligation review of your plan. A plan review with a Fidelity Representative can help you learn how your plan is working— and considerations to help make it better.

 Henry Schein has made Fidelity Investments—one of the nation’s leading retirement service companies—a preferred provider of workplace retirement products and services. Fidelity now offers Henry Schein customers a 401(k) plan with discounted pricing.

Visit www.Fidelity401kForYourPractice.com for more information.

Additional resources

The DOL offers brochures to help participants and plan sponsors to better understand the fees associated with a 401(k) plan.

They can be found at: http://www.dol.gov/ebsa/publications/401k_employee.html and http://www.dol.gov/ebsa/publications/undrstndgrtrmnt.html.

Available only to U.S. dental practitioners.

Henry Schein and Fidelity Invesments are independent entities and are not legally affiliated.

There are many kinds of workplace retirement plans. When determining which plan may be appropriate for your practice, you should consider all relevant factors including, but not limited to, contribution types and limits, ease of administration, investment options, initial costs and ongoing costs.

Neither Henry Schein, Inc. nor any of its affiliates are a registered broker-dealer under the federal securities laws. The Fidelity retirement plan products offered under this discount program are offered by Fidelity Brokerage Services LLC, Member NYSE, SIPC, 100 Summer Street, Boston, MA 02110. 491965.1.0

DRC Benefits:

In your busy office, time equals money. The Dental Resource Center saves you time and money by enabling you to perform many essential practice-management activities in a more efficient and cost-effective manner. With the DRC you can:

1.  Provide continuing education for you and your staff without the time and expense involved with traveling by choosing from over 130 Continuing Education Units (CEU) 
2.  Learn how to employ new office protocol and technologies to enhance your practice-management skills and increase office productivity
3. Learn how to deliver new dental products and services that can expand your practice and increase revenues
4. Make better purchasing decisions by learning about products and equipment online before you buy them

 DRC Features:

Comprehensive Training Catalog library complete with concise, practical, online dental training modules, including everything from dental assisting techniques, current infection control protocols, and regulatory issues. The Dental Resource Center offers your practice a fast, convenient and cost effective way of staying up-to-date with quality, accredited continuing education.

 Industry Key Opinion Leaders who are among the most respected and knowledgeable in the dental industry.

CE Manager that allows you and every member of your dental team to have their own personal account, which enables you to track and manage your continuing education credits online.

Interactive Training Console that allows you to immediately follow-up on what you’ve learned. For instance, you can take notes and share them with your entire dental team. You can schedule an in-office demo and request clinical studies to be mailed directly to your office.

 News, Trends & Innovations are captured in the DRC Blog that is a continual source of practical and relevant dental information that can help you stay connected and current on news, trends, new products, and new clinical techniques that you can implement into your practice immediately.

Special Offers are available to DRC subscribers for innovative products and equipment.

Dental Guidelines on the most current OSHA, HIPAA, and American Heart Association recommendations, and adverse drug interactions that are relevant to dentistry. Operating/Instruction Manuals are easily accessible through the DRC allowing you to get information on hundreds of different pieces of dental equipment.

The DRC Advantage:

1.  Satisfy Annual OSHA Training Requirements Save an average in-office training cost – save $600/year
2. Reduce Hygiene Department Cancellations Save the average “no-show” amount – save $85/day 
3.  Enhance Case Acceptance Potential Potential new production – add $2,000/month
4. Select from over 130 CEUs with subscription Save the average cost per CEU –save $35/unit

The numbers are on your side. By signing up for the DRC today, you will have the access to the ultimate in dental education. Your entire office can enjoy all the benefits of DRC with unlimited access for only $499/year – about $1/day.

Visit www.drcdental.com or ask your Henry Schein Sales Consultant for a free demo today. Not available in Canada

Today’s technologies allow the doctor and staff to deliver exceptional oral healthcare to their patients. Advances in technology will continue to drive improved patient care and team satisfaction in the coming years. Technology enhances the performance level in every phase of the dental office’s activities—from front office to in-house laboratories, and even in consultation areas that provide the patient and doctor with the ability to review treatment options and view before-and-after pictures of the potential changes being considered. Of course, there is ease of use. Equipment continues to be groomed and re-groomed to meet the exact needs of the user—and the overall value to the business can be positively calculated in time, energy, and profitability.

Doctors Ritter & Ramsey’s beautiful new office in Jupiter, Florida showcases the perfect marriage of sophisticated and inviting decor with the technologies that will support their business as it evolves. “Yes!” is the perfect word to describe the reception area. Warm, earthy tones are used on the walls, overstuffed furniture, and floor coverings that mingle effortlessly with the room’s golden-hued woodwork. Black granite countertops and tabletops found in the reception area and doctor’s offices add just the right dramatic contrast. Various styles in side chairs appear throughout the office, catching the eye with their unique artistry. Cabinetry and equipment in the 9 operatories continues the office’s style theme. Sleek, contemporary equipment surrounded by the same design elements that make the rest of the facility so memorable. The office’s architecture allows lots of natural light to flow in, taking full advantage of Florida’s abundant fair weather.

Left to Right: Jerry Hardman, Equipment Service Technician; Kathy Rowley, Field Sales Consultant; Dr. Robert Ritter; Dr. Christopher Ramsey; Michael Finnan, Regional Manager; Alfredo Malagon, Equipment Sales Specialist

“Very careful planning went into this project,” comments Henry Schein Equipment Sales Specialist Alfredo Malagon. “We spent many hours going over design and layout. I knew the doctors were looking for something special— and we made sure all the steps were taken to make this a successful project. Equipment [was chosen] that best suited the doctors needs and budget. The entire office was created for staff comfort and productivity. This space is a joy to visit as a patient or work in as a staff member.”

 “We had the space to build in a beautiful conference room with full media,” adds Dr. Ramsey. “We have utilized the room for meetings and continuing education for the staff—it really is a great room. The new facility also allowed us to [streamline the office workflow]. From check-in to exit, the whole experience is seamless and easy for patients and team members.”

Doctors and staff agree—stress is definitely down. “Everyone has had such a surge of positive energy that a decrease in stress was inevitable,” notes Dr. Ritter. “The new facility has helped us to attract new personnel to our business, which has rounded out the ideal team [for our practice].”

 “The new space will provide the doctors and staff with years of worry-free dentistry,” adds Alfredo Malagon. “Every time they walk into the office, they feel reenergized by the new technologies and the latest in dental equipment. Patients can’t help feeling great when they visit this office—and productivity and case acceptance is through the roof! It was a pleasure to be involved with this project.”

 The new office unfolds a whole new era in the practice’s history. Dr. Ramsey notes, “Our practice represents a new beginning [for us]. When you are able to build your dream facility with your partner, it creates a positive energy that everyone can see and feel!”

 Dr. Ritter and Dr. Ramsey should have no difficulty in meeting the challenges that will come their way. The business now has “the right stuff” to continue its legacy of excellence in patient care and increased prosperity as well.

 Now on view in the National Museum of Dentistry is the Modern Dental Office, which showcases some of the most technologically advanced dental treatment systems available for dental offices. It illustrates how state-of-the-art equipment positively affects a patient’s experience, improves patient care, and reduces waiting time in the office. In short, today’s dental equipment increases productivity and improves quality of oral health care. The Modern Dental Office, made possible by Henry Schein, Inc., features a Pelton & Crane 3004 chair with 3000 Ellipse unit, camera, curing light, KaVo air and electric handpieces, Ellipse monitor, rear cabinet with monitor, Gendex Expert X-ray with DEXIS sensor, Biolase WaterlaseMD, Biolase ezlase and the E4D Dentist.

For more information about the National Museum of Dentistry, visit www.dentalmuseum.org.

Dental practice-management software like DENTRIX® and Easy Dental are excellent solutions for a general dentist. A dental specialist’s needs, however, cannot be met with typical practice-management software created for general dentists. Specialists need a solution created with their specialty’s specific needs in mind.

The general dentist’s customer is the patient; the specialist’s customer is the general dentist. Thus, specialists need software with robust referral tracking—to know where past business originated and where potential business will come from in the future. Referral management and communication is key to building and operating a successful specialty practice. The ability to generate reports and rank referrers is a key element in growing a practice.

Specialty practices–periodontists, endodontists, and oral and maxillofacial surgeons–continue to have sophisticated technology needs. The use of Electronic Medical Record (EMR) technology affords the specialty practice with comprehensive tools to create a truly efficient, comprehensive, and digital chairside experience as well as outcomes tool. An EMR in a dental specialty practice is the central point of all patient information. It dynamically documents all aspects of a patient’s treatment and medical/dental history in a standard SOAP format. With a patient’s entire history accessible with just the click of a button, a dental specialist can create step-bystep treatment plans and check the records for tests and exam data. EMR stores images from both the referring dentist, or taken in the office along with documentation related to the patient’s case. With EMR, a dental specialist has an efficient, digitally organized, and easily searchable database that is far more efficient than traditional paper charts.

A single patient’s visit consists of many different parts: procedures, prescriptions, diagnosis codes, and more. An electronic routing system gives a dental specialty practice one-screen access to the entire visit. This system facilitates, through the use of digital forms, an efficient communications mechanism in the treatment operatory and the front desk and, therefore, affords the practice completely paperless transactions.

Although there are many needs that every dental specialist has, the needs also vary from specialty to specialty.

For a Periodontist: A periodontist needs to be able to chart quickly, efficiently, and visually. Using a completely voice-enabled chart provides the practice with automatic data input, reduces the risk of cross-contamination, eliminates the need for an assistant, improves communication between the doctor and the patient, and stores and presents a patient’s restorative and periodontal clinical data in a natural and graphical format. This specific dental specialty also needs to be able to track implants, including dates for the placement, uncovering, and removal as well as radiographs and other images.

 For an Endodontist: An endodontic practice requires a software solution specifically designed for endodontists. Endodontists need to be able to record and trace very specific tooth or teeth findings. These include: clinical and radiograph exams and tests, canal depths, trial lengths, and actual lengths. In addition, an endodontic software application will need to store photos, X-rays and images, track medications and prescriptions, and monitor and record vital signs.

For an Oral and Maxillofacial Surgeon: Oral and maxillofacial surgeons have very unique needs. An OMS practice needs a software solution that allows it to manage both medical and dental data, including medical and dental insurance claims, and has advanced clinical tools including an Electronic Medical Record and single-solution posting. Oral and maxillofacial surgeons look to the AAOMS for guidance on practice-management software through its education, research, and advocacy programs. A partnership between the AAOMS and an OMS software application results in the continued enhancement of the specialty software to meet the continuing needs of an Oral and Maxillofacial Surgeon.

Although it may seem that all dental specialty software is alike, only a specialty practice-management system like PerioVision, EndoVision, and OMSVision, can truly meet the unique needs of a specialty practice.

Easy Dental is not available in Canada.

Part 1: The “Sense” of Implants for the General Practitioner

Mark A. Iacobelli, D.D.S.,
F.A.G.D., F.I.C.D., M.I.I.F.

Twenty years ago, when my exposure to
implantology was in its infancy, implants
were viewed as experimental at best. I was
constantly reminded that implants “don’t work” by my peers as
well as by patients. It is a constant amazement to me how,
through education and marketing, the pendulum has swung
into favoring dental implants. Currently implants are riding a
huge wave of acceptance not only in the dental community,
but also by the dental consumer. Patients are now routinely
inquiring about dental implants as a part of their desired
treatments.

At first glance, this good news of acceptance provides us better
alternatives for replacing missing teeth. Fortunately for
general dentists such as myself, it goes much deeper than that.
In order to understand the true benefits of this acceptance, one
must remember that potential implant patients fall into two
categories; those who are already missing teeth and those who
will be missing teeth!

For dentists who are considering becoming involved with
placing implants and for novice implantologists, some patients
who are already missing teeth present with unpredictable
implant sites and more difficult diagnoses (Is the maxillary
sinus too close? Is there enough bone to place the implant
above the inferior alveolar nerve? What happened to all of the
attached gingiva? Is the bone wide enough to accept the
implant?). This unpredictability is the main reason general
dentists might shy away from learning to place implants and
these are the same concerns of most new implantologists as
they move ahead in their education.

Complicated cases likely should still be referred to a trusted
specialist, but increased knowledge about the diagnosis and
treatment in planning these types of cases will remove many of
the uncertainties about implant dentistry to your patients.
This will lead to greater treatment acceptance for your general
practice.

Tooth #30 has been endodontically treated, hemisected,
and treated with individual crowns on each root.
Note the lingual fistula on the mesial root.

Conversely, let’s get back to the implant patients who will be
missing teeth. This is significant for all general practitioners
who have ever gotten the emergency patient call stating that
their crown has “come off.” Undoubtedly, the patient presents
(usually late on a Friday afternoon!) with the crown, buildup,
and probably some natural tooth in hand. Now comes your
moment of truth. Do you assume the role of “Super-Dentist”
trying to retrofit the crown over no remaining ferrule, while
hoping that the patient pays their bill and never returns to your
office for fear of the “crown falling off” again? Or, do you begin
the educational process, based upon science and predictable
results, to guide your patient through understanding the
problem that they have?