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Caries Prevention Risk assessment and caries management must start early to prevent or minimize the disease.

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APRIL 2019

6 8 10 16 20

Publisher’s Note

Focusing on the Rep

Meet the 2019 First Impressions Editorial Board Women’s Influence in Dentistry

It’s not just about more women in leadership roles; it’s also about a better balance of male and female characteristics in the industry.

2019 OSAP Annual Conference Faster, Easier, Better

Cone beam technology and 3D printing continue to be game-changers for dentists and patients alike.

22

Dental Implants

24

To the Point

26

Greater Efficiency, Better Care

29

A New Standard of Care

30

A Clean Finish

32

Proof Positive

36

Bootcamp 101! Personal Protective Equipment

41 48 54 4

FOR DENTAL SALES PROFESSIONALS

April 2019

Newer technology has made implants simpler and more accurate.

When instruments stay sharp longer, hygienists can work faster, with better results.

When sales reps truly understand the needs of their customers, they can provide the right hand instrument solutions to ensure best results.

Newer dental materials combine the benefits of composites, glass ionomers and RMGIs without their disadvantages.

Caries Prevention 14

Risk assessment and caries management must start early to prevent or minimize the disease.

A Successful NDC Dental Forum in Sunny Florida

34

A high quality prophy paste leaves patients with a clean, polished feeling

Making a Difference

After 38 years, Monetta Reyes continues to impact the lives of dentists and patients for the better.

Burkhart’s Proven Solutions Center helps dental practices make the right equipment decisions.

44

Infection control and the correct use of personal protective equipment should be top concerns for your dental customers.

Oral Arguments

As researchers continue to make a connection between oral health and chronic disease, the question begs: What will this mean for dental professionals?

Benco sales consultant Ian Pryor thrives on a fulfilling career and a healthy lifestyle.

46

News Editor’s Note

Forging Ahead First Impressions

Striking a Balance

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PUBLISHER’S NOTE

SCOTT ADAMS Editorial Staff Editor Laura Thill lthill@ sharemovingmedia.com

Focusing on the Rep I’m excited to

take over the responsibility of publishing First Impressions. For the past 10 years, I’ve been with Share Moving Media, the parent company of this magazine. During the last four years, I’ve been publishing Repertoire Magazine, a sister publication of First Impressions. Prior to that, I worked for manufacturers and distributors in both medical and dental spaces.

I share that bit of background with you to say I have a genuine passion for distribution and the manufacturing community that serves them in calling on practices. The founder of First Impressions and of my company today was a gentleman named Brian Taylor, which many of you probably remember as the publisher of this magazine for its first 7-8 years. He gave me incredible advice before he retired a few years ago, back when I was fortunate enough to take over his publishing role for Repertoire Magazine.

In no way did I take that lightly. I was about to start writing to an incredible audience that had been receiving the magazine for 20 years. I remember asking Brian, “How do I write to an audience of both manufacturers, distributors, reps, managers, CEOs, CFOs?” His reply was perfect then for Repertoire, and perfect now for FI. “Scott, you don’t write to all of those audiences, you think about that rep in the field. Can you remember that rep you did ride-days with? The rep that took care of their customer first, the rep that received 200 emails a day, the rep that took care of back orders, the rep that was there when a practice was moving, the rep that was there when a practice ran out of a product?”

First Impression is about one thing – distributor reps. So, as we continue this journey together, I want to say thank you for allowing us into your business life.

Our goal is to bring you content with every issue that betters your career and life.

I look forward to what the coming years bring the dental space, and watching distributor reps continue to make an impact on practices and their patients.

R. Scott Adams Publisher

April 2019

First Impressions

Publisher Scott Adams sadams@ sharemovingmedia.com Founder Brian Taylor btaylor@ sharemovingmedia.com Senior Director of Business Development Diana Partin dpartin@ sharemovingmedia.com

Art Director Brent Cashman bcashman@ sharemovingmedia.com Circulation Wai Bun Cheung wcheung@ sharemovingmedia.com The Dental Facts Editor Alan Cherry acherry@ sharemovingmedia.com

First Impressions is published bi-monthly by Share Moving Media 1735 N. Brown Rd. Ste. 140 • Lawrenceville, GA 30043-8153 Phone: 770/263-5257 • Fax: 770/236-8023 www.firstimpressionsmag.com First Impressions (ISSN 1548-4165) is published bi-monthly by Share Moving Media., 1735 N. Brown Rd. Ste. 140, Lawrenceville, GA 30043-8153. Copyright 2019 by Share Moving Media. All rights reserved. Subscriptions: $48 per year. If you would like to subscribe or notify us of address changes, please contact us at the above numbers or address.

POSTMASTER: Send address changes to Share Moving Media., 1735 N. Brown Rd. Ste. 140, Lawrenceville, GA 30043-8153. Please note: The acceptance of advertising or products mentioned by contributing authors does not constitute endorsement by the publisher. Publisher cannot accept responsibility for the correctness of an opinion expressed by contributing authors.

First Impressions editorial advisory board Shannon Bruil, Burkhart Dental Frank Cohen, Safco Steve Desautel, Dental Health Products Inc. Nicole Fox, Patterson Dental Suzanne Kump, Patterson Dental Dawn Metcalf, Midway Dental Supply Lori Paulson, NDC Patrick Ryan, Benco Dental Co. Scott Smith, Benco Dental Co. Tim Sullivan, Henry Schein Dental

Clinical board Brent Agran, DDS, Northbrook, Ill. Clayton Davis, DMD, Duluth, Ga. Sheri Doniger, DDS, Lincolnwood, Ill. Nicholas Hein, DDS, Billings, Mo. Roshan Parikh, DDS, Olympia Fields, Ill Tony Stefanou, DMD, Dental Sales Academy

Dedicated to the Industry,

6

Managing Editor Graham Garrison ggarrison@ sharemovingmedia.com

Director of Business Development Jamie Falasz, RDH jfalasz@ sharemovingmedia.com

www.firstimpressionsmag.com

www.TheDentalFacts.com

Brought to you by Share Moving Media DentalFacts was founded in 1994 to provide timely and accurate business and technical information to the worldwide dental industry.

Today, Share Moving Media, your trusted providers of First Impressions, and Efficiency in Group Practice magazines is carrying out this legacy and continuing to deliver the most up-to-date industry news!

Subscribe today to keep up with the latest technical information in the dental industry.

Contact us today for more information...

WHAT YOUBOARD MAY EDITORIAL HAVE MISSED

Meet the 2019 First Impressions Editorial Board Steve Desautel, Vice President, Sales & Marketing, Dental Health Products, Inc.

Matthew Berger, Director of Equipment Support, and Pat Ryan, Equipment, Research & Development/Field Director, Strategic Markets, Benco Dental Company

Suzanne Kump, Manager of Professional Relations, and Nicole Fox (not pictured), Director of Customer Marketing Patterson Dental 8

April 2019

First Impressions

Lori Paulson, Chief Commercial Officer, Dental & Specialty Markets at NDC, Inc.

www.firstimpressionsmag.com

Shannon Bruil, Director of Field Operations, Burkhart Dental

Andy Whitehead, President, Classz Consulting, Inc., Chief Engagement & Development Officer, OSAP

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PRACTICE POINTS

BY KRISTINE BERRY, RDH, MSEC

Women’s Influence in Dentistry It’s not just about more women in leadership roles; it’s also about a better balance of male and female characteristics in the industry.

This is a

tremendous moment in history for women. Although there’s still work to be done to create global gender equality throughout the world, women in the dental industry have incredible opportunities for breaking out of traditional roles – largely due to the efforts by women in the industry who have come before them. As they do so, the entire industry – male and female – will benefit.

The question is, given the state of play within the leadership ranks, and the succession planning of dental organizations and dental practices, how will the influence of women be fostered and progress within the dental industry? This article will explore what leadership is from the behavioral psychology, trade and gender-related research of masculine and feminine traits, or – in terms more familiar to some – transactional leadership and transformational leadership.

What is leadership?

In my view, leadership at an individual level is a decision, a mindset. It is not a title or position. I believe we can lead, positively influence, serve, call others to action and create change from wherever we are. Some of you lead because you are CEOs, regional managers, directors, VPs, involved in business development, social media or marketing superstars, entrepreneurs or speakers. You are standing in public and/or have external facing leadership roles. Other women in dentistry work quietly in the background in supportive roles, yet they have tremenedous influence shaping the direction and values of their associations, offices, departments and/or companies.

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Over the course of our professional careers, we see a multiplicity of leadership styles and approaches to leadership that are shaped as much by people’s personality as by their backgrounds, education, life journeys, gender, ethnicity, sexual orientation, emotional intelligence and empathy skills, performance anxiety or psychologicial threats, flight or flight responses, disabilities, vision, need for safety, need for belonging and personal standards of excellence, to name but a few. Behind our individual leadership is a complex blend of ingredients that makes us unique, including a core set of values that drive our purposeful work in leadership.

If we are to be leaders who serve and lead others, we must first understand and lead ourselves and practice checking in on whether we are living up to our own leadership principles. On a basic level, we must have an understanding of our internal triggers and biases about our masculine and feminine energy traits. These traits, either embraced or denied, will influence how we perceive the world and our vision of what can and must be, our place and role in it, and the actions needed to make that vision our reality.

Leadership reimagined The challenge of leadership is to be able to re-imagine the traditions – that which has always been. There is a groundswell of conversation and vigor driving those who hold the formal power, influence and money to reflect and be cognizant of the people they serve and

the employees they represent. For instance, we can learn from statistics that tell us more dentists will retire in the next three years than ever before, and most of them are white male solo practitioners; or, we can learn from the fact that more than 50 percent of graduates are female, or that among the 198,517 dentists practicing in 2017, 31 percent were female; of that 95 percent of the nation’s dental hygienists are female as are 94 percent of dental assistants and office managers.

For me, these trends don’t reveal the feminization of the industry. The drive for diversity is trending, but not at every level, including corporate boardrooms, as part of investment or senior executive teams, regional or special market groups, practice ownership, Csuite positions and/or high profiled podium speakers. Restating the words of journalists Nicholas Kristof and Sheryl WuDunn, women in the world hold up half the sky. The single most significant opportunity in dentistry is to create opportunities for women across the industry.

The book, “The Athena Doctrine: How women (and men who think like them) will rule the future”, by John Gezerma and Michael D’Antonio, recounts the results of a global research initiative they conducted in 2011 investigating how the world defined traditional feminine/masculine qualities and leadership. In a global survey of 64,000 people across 13 countries that represent 65 percent of the world’s GDP (including Brazil, Canada, Chile, China, France, Germany, India, Indonesia, Japan, Mexico, South Korea, UK and USA), the authors report that 66 percent of participants agreed “the world would be a better place if men thought more like women.” Gezerma and D’Antonio note that countries with higher levels of feminine thinking/ leadership behavior have a higher per capita GDP and a higher quality of life.

Additionally, a 2014 Peterson Institute for International Economics white paper found the bottom line of companies with women in corporate leadership (i.e., CEO, board and other C-suite positions) is associated with a one-percentage point increase per net margin, which, for a typical firm, translates into a 15 percent increase in profitability. And companies that have women in leadership roles are showing higher performance assists, revenues and stockholder value.

Defining masculine and feminine traits To determine masculine and feminine traits, Gezerma and D’Antonio did two separate studies. In the first study, participants were asked to classify human behavioral traits as masculine, feminine or neither (Figure 1). In the second study, another group of participants received the same list of words, without credit of gender, and were asked to rate their significance to certain virtues: leadership, success,

morality and happiness. When they statistically compared the samples, they could see that across age, gender and culture, people around the world feel that feminine traits correlate more strongly with making the world a better place!

The following, according to the authors, are the top qualities for the ideal modern leader: • Connectedness. • Humility.

• Candor.

• Patience.

• Empathy.

• Trustworthiness.

• Openness.

• Flexibility.

• Vulnerability.

• Balance.

Masculine and feminine leadership According to other researchers’ empirical studies on behavioral psychology and gender-related research, masculine energy is about doing, while feminine energy is about being. When the masculine energy sees or encounters a problem, the sole goal is to find a solution. When the feminine energy sees or encounters a problem, there is a sincere desire to share and connect. The masculine energy wants to hunt, pursue and chase; it wants to be needed.

Leadership at an individual level is a decision, a mindset. It is not a title or position. I believe we can lead, positively influence, serve, call others to action and create change from wherever we are.

The feminine energy wants to be sought after, pursued, cherished and honored, and to feel safe, seen and understood.

The masculine energy is analytical, impatient, assertive and logical; it moves with a dominant single-mindedness. It generally focuses on one task or issue at a time, concentrating its attention on a singular focus. The feminine energy is nurturing, understanding and all about intuition and feeling. It feels and sees everything, continuously multi-tasks and processes everything at once.

All people have both masculine and feminine energy traits.

The way in which we call upon these assets contributes to our individual style of leadership. The research suggests a balancing of stereotypical feminine and masculine traits vastly increases the capacity of both men and women to solve problems, lead/ grow their teams and increase their enterprise’s profits. This

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April 2019

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PRACTICE POINTS

is not a male-versus-female issue. Men can be as caring as women, and women can be as analytical and assertive as men.

Our gender is who we are conditioned to be, rather than what we can be. We must all see feminine values not as belonging to one gender, but as a new form of innovation for today’s world. According to Howard Morgan and Joelle Jay, authors of “The New Advantage: How Women in Leadership Can Create Win-Wins for Their Companies and Themselves,” women in leadership and implementing feminine assets is a global competitive advantage.

If we want to foster women’s leadership and advancements in the dental industry, we need to re-imagine a world in which a new leadership model exists. We need to rethink and reshape

what women’s leadership looks like in dentistry. Seasoned women leaders must analyze their leadership values, practices and structures and consider what they are doing to sponsor the next generation of leaders. All leaders - both male and female - must ask themselves if they are excluding any populations or groups from embracing leadership.

We must expand our concept of leadership and what it should look like. As experienced leaders, we must acknowledge that to remain relevant and make a positive change in oral healthcare, we must face the truth that we do not have all the wisdom that is required in today’s world. We must draw on the wisdom of women leaders from across all walks of life.

Figure 1. Human Behavioral Traits Male Traits

Female Traits

Traits Reflecting Both Males and Females

Aggressive

Agile

Ambitious

Analytical

Arrogant

Articulate

Assertive

Authentic

Candid

Career Oriented

Charming

Collaborative

Committed

Competitive

Cunning

Decisive

Dedicated

Dependable

Different

Direct

Dominant

Emotional

Empathetic

Energetic

Focused

Free Spirited

Fun

Hard working

Healthy

Helpful

Intelligent

Leader

Logical

Loyal

Nurturing

Original

Overbearing

Passive

Proud

Reasonable

Reliable

Rigid

Rugged

Simple

Strong

Team Player

Traditional

Visionary

Source: Gezerma, J. & D’Antonio, M. (2013). The Athena Doctrine. San Francisco: Jossey-Bass.

References:

1. Gezerma, J. & D’Antonio, M. (2013). The Athena Doctrine. San Francisco: Jossey-Bass.

2. G ilbert, E. (2015). Big Magic. New York: Riverhead Books.

3. Jironet, K. (2011). Female Leadership. London: Routledge.

4. M organ, H. J. & Jay, J. K. (2016). The New Advantage: How Women in Leadership Can Create Win-Wins for Their Companies and Themselves. Santa Barbara: PRAEGER. 5. O’Reilly, N. D. (2015). Leading Women: 20 Influencial Women Share Their Secrets to Ledership, Business and Life. Avon: Adamsmedia.

6. Orser, B. & Elliott, C. (2015). Feminine Capital: Unclocking the Power of Women Entrepreneurs. Standford: Standford University Press.

Editor’s note: Kristine Berry is an international speaker and executive coach, specializing in enhancing group practices. Looking for a speaker or coach, she invites you to contact her via email at kristine@kristineberry.com or visit her website www.kristineberry.com

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April 2019

First Impressions

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Caries Prevention Risk assessment and caries management must start early to prevent or minimize the disease.

Once considered a solution for addressing decayed and diseased tissue, fill and drill – the practice of drilling out pits and fissures or surgically removing decayed and diseased tissue and placing permanent restorations – has taken a back seat to a more modern, holistic approach to caries prevention, according to the American Dental AssociationŽ (ADA). The focus has evolved to address the full continuum of the caries disease process, including microbial activity and the balance between enamel remineralization and demineralization, the association points out, noting that systematic methods of caries detection, classification and risk assessment, as well as prevention/ risk management strategies, can help prevent the disease from progressing to an advanced stage.

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April 2019

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Risk assessment Dental caries, or tooth decay, is estimated to affect 97 percent of people worldwide, according to the ADA, and risk assessment remains a valuable tool to prevent and/or manage the disease.

The ADA describes two models in particular: • The International Caries Detection and Assessment System (ICDAS). An evidence-based, preventively oriented strategy, the ICDAS classifies the visual appearance of a lesion, followed by characterization and monitoring once the lesion is detected and, finally, diagnosis. The system is scored on clean, dry teeth and advises clinicians against using sharp probes that can damage the tooth.

The classification criteria are based on the histological extension of lesions spreading into the tooth and scored on a seven-point rating scale:

0

Clinically sound

1-2

Clinically detected intact enamel lesions, or initial stage decay.

3-4

Clinically detectable early, shallow or microcavitations.

5-6

Clinically detectable late or deep microcavitations.

their consumption of carbohydrates, limit sugary snacks and follow a healthy diet that limits added sugars and high-acid foods that can harm tooth enamel. Patients should also be educated in appropriate oral hygiene, including brushing with fluoride toothpaste twice each day and cleaning between teeth daily.

A 2013 systematic review by the ADA CSA Expert Panel on Topical Fluoride Caries Preventive Agents offered evidence-based clinical recommendations regarding professionally applied and prescription strength home-use topical fluoride agents for caries prevention for those at high-risk of developing caries. Examples include 2.26 percent fluoride varnish; 1.23 percent fluoride gel; prescription-strength, home-use 0.5 percent fluoride gel or paste; or 0.09 percent fluoride mouth rinse for patients six years and older. (Only the 2.26 percent fluoride varnish is recommended for children under six.)

The ADA also has recommended the use of sealants to prevent or arrest pit-and-fissure occlusal caries lesions of primary and permanent molars in children and adolescents.

Anatomical grooves, pits and fissures on the surfaces of permanent molars can trap food particles and promote the presence of bacterial biofilm, leading to the development of caries lesions, the Association notes. Sealants (e.g., pitand-fissure sealants) can minimize the progression of noncavitated occlusal caries lesions and are considered part of a comprehensive management approach.

Childhood caries

• The International Caries Classification and Management System (ICCMS). The ICCMS takes the results of the ICDAS classification and translates them into a risk-assessed caries management system that is individualized for the patient. The key elements of ICCMS include: • Initial patient assessments.

• L esions detection, activity and appropriate risk assessment.

• Synthesis and decision making.

•C linical treatments (surgical and nonsurgical) with prevention.

Caries prevention strategies The ADA recommends clinicians advise their patients – particularly those at high risk of caries development – to reduce

The ADA considers some children at higher risk of tooth decay, including those exposed to sugary foods and drinks or chemo/ radiation therapy before the age of six. Children with special needs who are unable to perform adequate oral health are also at higher risk, as are those with cavitated or noncavitated carious lesions, teeth missing due to caries or severe dry mouth.

The Association recommends parents and guardians take steps to prevent dental caries as soon as a child’s first tooth erupts. At that time they should: • Schedule a first dental visit.

• Begin brushing twice daily with no more than a smear of fluoride toothpaste for children under three years, and a pea-sized amount of fluoride toothpaste for children between 3-6 years.

Source: The American Dental Association®. For more information visit https://www.ada.org/en/member-center/oral-healthtopics/caries-risk-assessment-and-management.

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April 2019

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Safest Dental Visit

TM

2019 OSAP Annual Conference The Organization for

Safety, Asepsis and Prevention (OSAP) – a community of clinicians, educators, policy makers, consultants and industry representatives who advocate for the Safest Dental Visit™ – will host its 2019 OSAP Annual Conference May 30 - June, 2, 2019 at the Westin La Paloma Resort and Spa in Tucson, Arizona. Billed as the premier patient infection and patient safety education networking event, the conference will deliver the latest updates on evolving guidance and emerging infection prevention and safety issues.

Attendees will have the opportunity to customize their experience through multiple topic tracks, gaining valuable information, resources and products designed to help them better address infection prevention and safety challenges, as well as meet new colleagues who share their interest in this critically important topic area.

Leading up to the 2019 annual conference, OSAP has partnered with Indian Health Services (IHS) to offer an IHS-only dental infection prevention and safety program May 29-30. The private event will offer up to nine hours of CE credit.

Preconference sessions will be available for educators and consultants to earn additional CE credits.

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The 2019 OSAP Annual Conference is targeted to: • Educators.

• Infection control coordinators.

• Consultants and lecturers.

• Compliance officers of state dental boards.

• Risk managers.

• Policy makers.

• Sterilization technicians.

• Compliance officers of state dental boards.

• Hospitals and Federally Qualified Health Centers (FQHC) with dental clinics.

• Companies engaged in infection control and safety products and services.

Registration Space is limited so register online today! OSAP member registration fees apply to all membership levels above Basic.

You must log into your OSAP account to receive the member rate.

2019 OSAP Annual Conference May 30-June 2, 2019, Tucson, AZ Registration Open!

Registration Fees

Early Bird

Regular Rates

On-Site Rates

OSAP Member

$595

$675

$755

Additional Attendees from Same Facility

$495

$575

$655

Non-Member

$750

$830

$910

Additional Attendees from Same Facility

$650

$730

$810

Student (Full-time only)

$100

$180

$260

Register today! https://www.osap.org/default.aspx After attending the conference, participants will be able to: • Describe current and emerging issues related to infection prevention and safety in oral healthcare settings.

• List new resources, tools and networks to optimize compliance.

• Identify important attributes to develop and enhance global leadership for the optimal delivery of infection prevention and safety.

Continuing dental education OSAP is an ADA Continuing Education Recognition Program (CERP) Provider. ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education.

ADA CERP does not approve or endorse individual courses

or instructors, nor does it imply acceptance of credit hours by boards of dentistry.

Participants requesting professional continuing education credits will receive a CE verification form to record the CE numbers for the specific courses they attend. To receive continuing education credit, participants must sign in at the conference, attend the sessions, record the assigned CE number for each lecture attended (note: CE verification numbers are announced at the end of each session), and complete the required evaluation forms. Attendees maintain their CE verification form as proof of participation in the educational programming.

For more information about the 2019 OSAP Annual Conference, email Office@OSAP.org or call +1 (410) 571-0003 | US & Canada: +1 (800) 298-6727.

Editor’s note: OSAP focuses on strategies to improve compliance with safe practices and on building a strong network of recognized infection control experts. The organization offers an online collection of resources, publications, FAQs, checklists and toolkits that help dental professionals deliver the Safest Dental Visit for their patients. Plus, online and live courses help advance the level of knowledge and skill for every member of the dental team. For additional information, visit www.osap.org.

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SURGICAL ADVANCES

BY LAURA THILL

Faster, Easier, Better Cone beam technology and 3D printing continue to be game-changers for dentists and patients alike.

In nearly the time it takes to make a pot of coffee and retrieve the morning

there’s one thing that has made my patients’ life better – and my life easier – it paper from the driveway, some dentists can place an implant. While there’s no way has been cone beam technology, or 3D cat to guarantee a perfect cup of coffee, however, that implant’s going to be darn close scans,” he says. “That combined with my to perfect, if not spot-on.

CEREC CAD/CAM technology, procedures have gotten easier and less expensive, with better results.”

Cosmetic and reconstructive Fulbright, in fact, had just completed an implant procedure specialist Michael Fulbright, DDS, shortly before taking time to discuss surgical advances that have owner of Fulbright Cosmetic and changed the dental industry for the better. “With my Gallileos Reconstructive Dentistry, Redondo cone beam and CEREC, I was able to plan this morning’s surgery Beach, California, spends much ahead of time and place the implant exactly where it needed to of his day in surgery. His services be using a surgical guide fabricated right in my office.” Not long range from implants and full-mouth ago, it would have been impossible to get an unobstructed view rehabilitation to porcelain veneers, to determine whether the patient had enough bone height to periodontal care and treatment for Michael Fulbright avoid the mandibular nerve, he points out. Not so today.

TMJ disorders and sleep apnea. “If

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“In the old days, using 2D X-ray technology, I would have to place implants freehand. Although I have placed many freehand implants successfully, the predictability and precision of guided implants has given us more confidence and has made the procedure more efficient. The patient experience and case acceptance have increased dramatically with the patient being able to visualize and be a part of the planning process. With regard to our digital scanning technology (CEREC) to take impressions versus the old putty impressions, there really is no comparison. Patients love the fact that they don’t have to have a goopy, gaggy impression made, and the accuracy of the impression and fit of the subsequent crown is superior.”

“Today, I approach the procedure using reverse engineering, first planning the ideal crown and then planning the implant. Next, using a surgical guide sleeve over the missing tooth, I position the drill in the sleeve and can get within microns of the mandibular nerve or sinus, confident I won’t hit it.”

Surgical times have been reduced from an hour to about 10 or 15 minutes, he adds. His practice runs more efficiently and his patients and dental team are happier.

Furthermore, even smaller dental offices are able to accommodate cone beam equipment. “The cone beam foot print is small enough that it should fit in most dental offices,” he says.

A window to the future If cone beam has changed the face of dental surgery, 3D printing has opened a window to the future. “3D printing definitely has changed – and will continue to improve – the way I work,” says Fulbright. “My CEREC digital scanner ensures I get the most accurate impression possible, which I can send to a lab or print a

“ If there’s one thing that has made my patients’ life better – and my life easier – it has been cone beam technology, or 3D cat scans.

That combined with my CEREC CAD/CAM technology, procedures have gotten easier and less expensive, with better results.” model in-office with my 3D printer. I believe this is where every dental practice is headed. I use my printer to print models for Invisalign-type aligners, sleep apnea appliances and nightguards.

“3D printers have come down in price tremendously,” he continues. And, because he is able to work more accurately and efficiently, his printer has practically paid for itself, he notes. “So, I don’t need to raise my fees to reflect the cost of the equipment.

I don’t pass that cost on to my patients.”

3D printing is still relatively new, according to Fulbright. “It’s really just getting started,” he says. “Today, we only basically print plastic. As the materials catch up to the technology, I expect we’ll eventually move away from milling and start printing porcelain crowns and implant abutments. The sky is the limit”

Expanding roles Advances in surgical technology have led to new and expanding roles for dental assistants. Indeed, as more and more can be accomplished in the dental office, dental assistants no longer take a back-seat to the rest of the team. “Dental assistants’ jobs have changed tremendously,” says Michael Fulbright, DDS, owner of Fulbright Cosmetic and Reconstructive Dentistry, Redondo Beach, California. “The dental assistants are the ones who are learning the software involved in milling, planning and 3D printing. I always complete the training with my team, but it’s my dental assistants who are using these machines day in and day out!”

And this is a good thing, he adds. “Patients know and trust their dental assistants – often more so than their dentist. For patients, this technology means shorter chair times and less re-dos.”

Editor’s note: Michael Fulbright, DDS, owner of Fulbright Cosmetic and Reconstructive Dentistry (Redondo Beach, CA), offers restorative options such as dental implants and full-mouth rehabilitation, as well as a full range of general and cosmetic dentistry procedures. In addition, he is dedicated to helping individuals who suffer from obstructive sleep apnea. Dr. Fulbright is also very involved in giving back to his community. He has helped restore the lives of domestically abused men and women through the Give Back a Smile Foundation, as well as volunteered through Remote Area Medical (RAM), the Beacon House and various community causes. www.firstimpressionsmag.com

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SURGICAL ADVANCES

BY THOMAS HIRSCH, DDS, THE OWNER OF A MALIBU, CALIFORNIA-BASED DENTAL PRACTICE AND FOUNDER OF ISOLITE SYSTEMS, CURRENTLY ZYRIS

Dental Implants

By Thomas Hirsch

Newer technology has made implants simpler and more accurate.

Dental implants date

back to 2500 BC, when the ancient Egyptians tried to stabilize teeth with gold ligature wire. Today, researchers are exploring ways to grow a new tooth in a human adult – something that could take root, so to speak, in the next 10 years or so.

Recently, a Tufts University team constructed a cellular matrix that allows successful implantation of a tooth bud into a pig’s jaw. Under their design, early adult-stage teeth develop within five months. Researchers project that humans won’t profit from these developments for another ten years. The exciting progress hints at options once believed to be impossible.

For now, dental implants are the closest alternative to growing new teeth. Research has brought major benefits to implant technology as well.

A higher standard of care It was debated several years back that if dentists had a CT scanner in their office, they would be held to a higher standard of care. And, in fact, they were.

“Medical professionals who are liable for non-diagnosis of any abnormality on the CBCT scan include the dentist who orders the CBCT scan and likely any other professional who uses the CBCT for diagnosis or treatment planning. Dentists must possess the requisite standard of care when diagnosing and treating patients. This standard is normally stated as the level of knowledge, skill and care of a reasonable dentist. To meet this standard when using CBCT, dentists should use CBCT’s full capabilities to obtain maximum diagnostic accuracy. The standard of care must be met whether or not the dentist received specialized training on CBCT imaging because dentists are required to stay current in the areas in which they actively practice by enrolling in continuing education courses. There is even argument that

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dentists who use CBCT should be held to the higher standard of a board-certified oral and maxillofacial radiologist.”1 Stuart J. Oberman, Esq. Dental Tribune U.S. Edition, Vol. 6 No. 18, December 2011.

So how do dentists integrate a CBCT into their treatment planning and execution of dental implant procedures? Plan, plan, plan. It’s actually quite simple. First, patients should be medically evaluated before any implant surgery is scheduled. Patients either must have enough bone to support the implant, or be good candidates for surgery to build up the bone where the implant will be placed. Chronic illnesses, such as diabetes or leukemia, may interfere with healing after surgery. Patients that have taken bisphosphonates can have osteonecrosis of the surgical site. Using tobacco can also slow healing.

Another great advance, although it’s no longer considered new, is CADCAM technology. CADCAM, combined with CBCT technology, allows dentists to virtually plan the final result. So, the next step in this journey is to take physical or digital impressions of the patient’s maxillary and mandibular arches. Once the arches are scanned and the vital structures are identified (in this example, that includes the adjacent teeth and the mandibular nerve, as well as the mental foramen) a virtual final restoration can be designed.

With the proper size and shape of the final virtual restoration, the implant of choice can be positioned.

It’s vitally important to determine the path of insertion of the implant relative to the occlusal surface of the crown, lest the screw access hole exits out of the buccal or lingual! Now it’s clear where the implant should be placed, but how does the dentist ensure it gets there? Neophytes in implant placement would do well to take beginning and advanced surgical dental implant courses. But even the best laid plans can fall short when using

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steady hands to place implants in the genesis, which is why the surgical guide has become so important. Dentists can construct and print their own guide, mill it and have their laboratory fabricate one, or they can work with a third party. Whether the procedure involves a single implant or multiple implants, the surgical guide ensures it runs smoother, with fewer complications.

of precision and accuracy, it makes the final crown restoration a simple one.

Thanks to directly visible surgical conditions, implantation is not only safer, it’s also minimally invasive. What’s more, dentists can save time during patient consultations since their patients understand the 3D visualization more easily.

The surgery

Maximum efficiency

Now comes the fun part: the surgery. For this, dentists must trust in their planning and clinical abilities, since they cannot actually see under the patient’s bone, and proceed as follows: • Review patient’s medical history.

• Review treatment, options, risks, complications, alternatives and fees.

• Verify surgical guide fit.

• Treat in accordance to surgical protocol.

• Lay a flap or go flapless (tissue punch).

• Place the implant.

• Place the cover screw or healing abutment.

• Close the surgical site.

All of this great CADCAM and CBCT technology has allowed me to design my operatories for maximum efficiency. We have placed treatment centers in all of our rooms. Our chairs are integrated with surgical motors built into the dental unit, and there is a pump for sterile saline. We always have a surgical handpiece ready to go.

It has become very convenient to remove a cover screw, healing cap, abutment or implant crown. Sure, this has involved an investment in technology, but the returns have been fantastic. My front desk assistant has been crossed-trained to determine how long the procedures will take and to schedule a shorter amount of time to accommodate them.

My hygienist can recommend treatment with a great deal of confidence, knowing that guided dental implant procedures are much easier for the patient and entire team, and my dental assistant essentially has an extra pair of hands during surgery.

And as for me: dental surgery has become more like a hobby than work. I do it for the love of it.

At my dental office, the surgical time to place a simple implant, a healing abutment and to close the surgical site can be a short as 10 minutes. Much depends on the implant method selected. In the end, when the implant is placed with a high degree

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HAND INSTRUMENTS

To the Point

When instruments stay sharp longer, hygienists can work faster, with better results.

Hygienists rely on sharp scalers and curettes to deliver the best quality

care and a great patient experience – both of which are integral to the success of a dental practice. “When it comes to hand instruments, dental customers have a few categories from which to choose,” says Tim Irwin, vice president of sales, Nordent Mfg. Co. These include: • Low-cost instruments, which typically are imported and do not last long.

• Quality brand name instruments, which are considered the standard.

• Instruments with coated stainless-steel tips that cannot be sharpened and must be disposed of when dull.

• New, stainless steel instruments, which are designed to stay sharp longer and can be sharpened.

“The scalers and curettes hygienists use to scrape away calculus get a little duller with each stroke, so in order for the practice to get the most from its investment, instruments should be able to be sharpened,” he adds.

That hand instruments can stay sharp longer – and that companies now provide sharpening services to keep these instruments sharp and prolong their life – not only eliminates the need for in-office sharpening, it allows team members to focus on patient care, says Irwin. “And when hygienists consistently use sharp instruments, dental procedures are accomplished more quickly and efficiently, and stain and calculus are cleanly removed, elevating the level of care and patient outcomes,” he points out.

In addition, increased attention on the risk of cross-contamination has led to improvements in sterilization, making hand instruments increasingly safer, says Irwin. “The recent focus has

been on how the sterile instrument pack is presented to the patient and the safety and efficiency of the sterilization process,” he explains. “As dental offices face more and more competition, and the public’s expectations of the patient experience continue to increase, it becomes more important for clinicians to open an obviously sterile instrument pack in front of the patient, ideally with instruments neatly organized in a sterilization cassette. Additionally, sterilization cassettes protect dental team members from sharps injuries and potential exposure to bloodborne pathogens, and they eliminate the need for staff to disassemble and reassemble instrument kits.

“When discussing the benefits of sterilization cassettes with their customers, distributor sales reps should point out the opportunity to provide a better patient experience, as well as protect dental team members from sharps injuries. Cassettes offer a substantial time savings during sterilization,

Start a discussion To better gauge their customers’ needs, Tim Irwin, vice president of sales, Nordent Mfg. Co., recommends that distributor sales reps ask a few probing questions: • “Doctor, the hygiene appointment accounts for 30 percent of production and 75-80 percent of the dentistry you do. That said, don’t you want your patients to have the best possible experience in the hygiene chair?”

• “Your new patients’ first appointment almost always includes an exam and cleaning. Wouldn’t you agree that a great first-time experience would encourage them to return for future appointments?”

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• “Are you aware that the most common reason patients leave a hygienist is because he/she is too rough? This rarely has anything to do with the hygienist’s skill level and almost always is due to dull, inefficient instruments he/she is using.”

“When instruments are dull and in poor condition, hygienists must press harder to remove stain and calculus,” says Irwin. “Patients feel this pressure and experience discomfort during the procedure, leaving them with a negative feeling about the quality of care they received.”

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XDURA® Scalers and Curettes When hygienists use sharp instruments, it dramatically improves the patient experience, increasing production at the dental practice. Sharp instruments make procedures go faster and elevate the level of care delivered.

Nordent Mfg. Co. knows that the majority of offices do not sharpen instruments with any kind of regularity. That’s why we offer XDURA® scalers and curettes. They are harder, stay sharp longer and come with free, unlimited professional sharpening for 48 cents per patient. Everyone benefits when each patient is treated with a sharp instrument!

leading to increased productivity and profitability.” And the additional safety precautions come with certain OSHA benefits, he adds.

An investment in quality Investing in higher quality instruments can quickly pay off for a dental practice, says Irwin. As attractive as it may be to keep upfront spending to a minimum, cheaper instruments will dull and fall into disrepair more quickly, preventing clinicians from working efficiently and effectively.

“High quality instrument companies use the best stainless steels, cryogenic hardening processes and skilled, experienced craftsmen to provide products that last as long as possible,” Irwin points out. “Each of these components represents a significant portion of the cost of manufacturing an instrument. In order to achieve a price point, inexpensive instrument companies tend to use cheaper grades of steel and rely on lower-cost processes

and labor.” While this can affect the quality of all instruments, it especially impacts the scalers and curettes used by hygienists and the surgical instruments that dentists rely on, he adds, noting that distributor reps who focus on higher quality instruments will do their customers a huge service.

For starters, reps should help the dental office compare the instruments they currently use with new available options, he explains. “In addition, they should educate their customers on the impact high-quality, well-maintained instruments have on the productivity and production of a practice and show them how low the cost-per-patient actually is.” For example, when hygienists use new instruments that stay sharper longer and can be re-sharpened when necessary, they work more efficiently and the cost-per-patient is as low as 48 cents.

Editor’s note: Provided by Nordent Mfg. Co.

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HAND INSTRUMENTS

Greater Efficiency, Better Care When sales reps truly understand the needs of their customers, they can provide the right hand instrument solutions to ensure best results.

Dental teams have a growing number of options for providing the best

possible care to patients, making it especially important for distributor sales reps to offer solutions that meet the needs of the practice and best serve their patients. “With so many options available, it is more important than ever before for distributor sales reps to sell strategically, yet still maintain that level of trust with the customer,� says Stacie Barth, senior director, Preventive Strategic Business Unit, Hu-Friedy Mfg. Co.

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Hand instruments are a prime example, she notes. “Not only are they used every single day on patients, but the evolution of hand instruments greatly impacts the efficiency of a practice and increases effectiveness in deposit removal. Distributor sales reps need that knowledge of the

ever-changing landscape of product improvements, so they can Building trust share these value-adds with their customers. For example, HuBuilding customer trust is essential, notes Barth, and the more Friedy has made substantial investments in manufacturing equipsales reps know about a dental practice’s hand instruments – and ment that allows the consistent production of sharp instruments what the practice is doing to extend or diminish the life of those that maintain their sharp edges over time. When it comes to hand instruments – the more likely they are to provide the best posinstrumentation, sharpness and edge retention are the two most sible solution. “The longevity of hand instruments is of utmost imimportant factors that end users look for and care about. Putting portance,” she says. “Often, practices do not replace their hand the end user’s pain points and concerns first, and then sharing instruments and may be using a product that is two or three years product knowledge that can be their perfect solution, is key.”

“However, the story and opportunities around instrumentation actually go much deeper than that,” says Andy Xilas, senior vice president – Global SBUGP/Specialty & Surgical, Hu-Friedy. “The secret weapon that dealer reps need to tap into more are those surrounding technique-specific instruments in the fields of surgical, orthodontic, endodontic and restorative specialties. Why? – Stacie Barth, senior director, Preventive Strategic Business Unit, Hu-Friedy Mfg. Co. Simply because in addition to the doctors who already work in these areas, many general practitioners are also keeping more and more old and not well maintained. Dull and worn-down scalers can lead cases in-house. This is creating additional conversation opto burnished deposit and can cause clinicians to increase hand portunities and sales paths for the dealer rep to capitalize on. pressure when scaling, in turn decreasing comfort for both the cliEspecially in the area of implantology, since the market has nician and the patient.” Dealer reps can learn a lot about a dental expanded so much, there has also been an increase in opporpractice – and in turn offer their customers some helpful feedtunities for specialty instrumentation.” back – by taking an instrument audit, she adds. “Another strategy

“ With so many options available, it is more important than ever before for distributor sales reps to sell strategically, yet still maintain that level of trust with the customer.”

The EverEdge 2.0 Dealer reps already know that having the best quality and most effective instruments is crucial for any practice.

Due to advancements in technology, metallurgy and HuFriedy’s investment in advanced manufacturing processes, EverEdge 2.0 is the sharpest and longest-lasting scaler on the market. Hu-Friedy EverEdge 2.0 scalers are 72 percent sharper out of the box than the next closest competitor.

Hu-Friedy’s new, optimized heat-control process, paired with several manufacturing intricacies, enables EverEdge 2.0 blades to remain sharper longer than any competitor’s scaler. This means you won’t have to sharpen as often.

Or, you can choose not to sharpen at all and simply open a new scaler package. Either way, investing in Hu-Friedy

hand instruments is the best economical choice for a dental practice.

Having the correct instruments is only step one. Step two is carefully choosing the products to clean and care for those instruments, from their ultrasonic detergent to instrument lubricant. When used properly, the lifespan of these products will be significantly improved. For example, Hu-Friedy’s Enzymax® and Enzymax Earth™ Ultrasonic Detergents include both a protease enzyme (breaks down proteins in blood and saliva) and an amylase enzyme (breaks down carbohydrates and starches). In addition, Steelgard™ agents protect instruments from harmful minerals found in water, which contribute to buildup, spotting and corrosion.

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HAND INSTRUMENTS would be for the rep to give the practice a wear guide, which can help them determine the status of their own instrumentation.”

Hu-Friedy takes the longevity of its hand instruments seriously, according to Barth. “Hu-Friedy’s EverEdge 2.0 is the sharpest and longest lasting scaler on the market,” she says. “Because there is no coating on the instrument, at any point, clinicians can sharpen the blade of the instrument to the same sharpness level as when it was delivered in its original packaging.”

Infection prevention is another equally important concern for dental teams. “The recent news of infection control breaches throughout the country has raised awareness of the importance of infection prevention for both patients and practitioners,” says Barth. “When distributor reps speak with practices about instrument reprocessing, education is key. There are many ways for dental practices to monitor and improve their instrument reprocessing to be more effective and protect the investment they make in instruments.” In fact, using products correctly is as essential to successful treatment as is using the correct products, she points out.

“Cassettes are known for helping practices keep their instruments protected and organized,” says Barth. “At the same

contaminated instruments and reduces the risk of injury and exposure to blood-borne pathogens.”

Connecting with the customer The best – and only – way for distributor sales reps to truly understand the needs of their dental customers is to ask questions, Barth points out. “The more a distributor sales rep knows about the practice and their everyday happenings, the easier it will be to diagnose their problems and supply the best solution,” she explains.

Some good probing questions include: • “Doctor, how often are your instruments sharpened?”

• “How often are your instruments replaced?”

• “How much do you spend per year on caring for and servicing your hand instruments?”

• “What kind of feedback are you getting from your patients with regard to their comfort during visits?”

“Sales reps can also dig a little deeper into the practice’s concerns,” she continues. “Does the staff at the dental practice find sharpening to be burdensome? How many more patients could they care for if they didn’t have to sharpen at all? The reality is, there is no such thing as the sharpen-free scaler.

That is why Hu-Friedy has created the EverCare Scaler Sharpening Service, a subscription-based service with a variety of flexible membership options. With EverCare, members can have their instrument professionally sharpened with a timely turnaround, free shipping and other exclusive membership benefits.

– Barth Practices will spend less time sharpening and more time caring for their patients.”

That said, some dentists may question the need to spend a premium price for a premium instrument. Sales reps should remind them that dental hand instruments are an investment, not only for their clinicians, but for their patients as well. “High quality, sharp instruments that maintain their edges over time increase practice efficiency and create the best patient outcomes,” says Barth.

“Less expensive instruments may seem like a good investment in the short term, but offices soon realize that these instruments need to be replaced more often, can cause burnished calculus and, in time, end up costing the office more money. Making that investment now will, in turn, save the practice more in the long run.”

“ The longevity of hand instruments is of utmost importance. Often, practices do not replace their hand instruments and may be using a product that is two or three years old and not well maintained.” time, they help keep instruments spaced apart from each other to ensure they are properly cleaned and sterilized.” Opening the sterile packaging of a cassette in front of the patient assures them that instruments are clean and that the practice is commited to safety and sterility, she adds.

‘A distributor rep’s job is to sell, but at the same time they are also a trusted advisor maintaining the practice’s best interests. For instance, do your customers know sharps injuries can cost a practice up to $3,000 per incident? Cassettes reduce that risk dramatically; the only time staff members have direct contact with any instrument is in the operatory with patients.

During transportation and reprocessing, the instruments are contained within the cassette. This minimizes the handling of

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Editor’s note: Provided by Hu-Friedy Mfg. Co.

SALES FOCUS

A New Standard of Care Newer dental materials combine the benefits of composites, glass ionomers and RMGIs without their disadvantages.

Traditionally, dentists have

depended on restorative materials to provide great esthetic and physical properties or bioactivity. Until recently, though, they could not count on a single product to offer all of these benefits.

But today, bioactive materials that behave favorably in a moist oral environment, neutralize conditions that cause dental caries, provide preventive benefits and maximize the potential for remineralization are quickly becoming the new standard of dental care.

Pulpdent’s® ACTIVA BioACTIVE products are the first dental resins with a bioactive ionic resin matrix, shock-absorbing rubberized resin component, and reactive ionomer glass fillers that mimic the physical and chemical properties of natural teeth.

These bioactive materials actively participate in the cycles of ionic exchange that regulate the natural chemistry of our teeth and saliva and contribute to the maintenance of tooth structure and oral health.

Bioactive materials Bioactive materials that are strong, esthetic and long-lasting offer an alternative to traditional composites, which are strong and esthetic but are passive, and to glass ionomers, which are bioactive but have poor esthetics and undesirable physical properties.

These materials imitate nature and participate in the oral cavity’s dynamic ionic exchange.

In the oral cavity, saliva is rich with water, proteins and ionic components, making it a natural caries protection agent. It contains the minerals that maintain the integrity of the enamel surface, enabling it to help maintain the health of hard and soft tissues, remove waste and offer a first line of defense against microbial invasion.

The oral environment is exposed to continuous pH cycles, and saliva and tooth structure participate in an endless cycle of mineral exchange. When the pH is low, the demineralization process releases calcium and phosphate ions from the tooth surface. As the pH rises, these ions are available to interact with fluoride ions in the saliva.

Bioactive materials are water-based, or contain zones or phases of water, and continuously release and recharge their ionic components. They react to the changes in the oral environment to bring about advantageous changes in the properties of saliva and the materials themselves.

Ionic resin Moisture-friendly ionic resin exhibits exceptional marginal integrity, sealing ability against microleakage, and intimate adaptation to tooth structure. It releases a great amount of phosphate, significantly recharges with fluoride and contains an acidic monomer that improves the interaction between the resin component and the glass ionomer and enhances the interaction with tooth structure.

The ionic resin contains phosphate acid groups. Through an ionization process that is dependent upon water, hydrogen ions break off from these groups and are replaced by calcium in tooth structure. This ionic interaction binds the resin to the minerals in the tooth, forming a strong resin-hydroxyapatite complex and a positive seal against microleakage.

Editor’s note: First Impressions would like to thank Pulpdent® for providing the above information. www.firstimpressionsmag.com

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SALES FOCUS

A Clean Finish

A high quality prophy paste leaves patients with a clean, polished feeling

Patients desire the fresh, clean feel of polished teeth. Indeed, a bitter aftertaste may be all it takes to deter them from returning for their next cleaning!

With the right prophy paste, dental professionals can deliver the experience and results their patients expect.

a less-than-positive experience for both the clinician and patient.

Less mess, better feel, greater variety

Prophy pastes today are designed to enhance the dental experience – both for hygienists and their Research supports that keeping teeth free of plaque and patients. Manufacturers, for instance, have added a variety calculus is one of the best ways to prevent periodontal disof new flavors in addition to traditional mint and bubblegum. ease. A regular professional prophylaxis – or cleaning – usYounger patients in particular can enjoy the wide selection, ing a polishing paste containing an abrasive, such as flour of leaving them with a positive feeling about their dental visits for pumice, to remove dental biofilm and extrinsic stains from many years to come. the coronal surfaces is an important component of a healthy oral hygiene regimen.

But, not all prophy pastes are the same, according to experts. The handling characteristics, consistency and A box of prophy paste can range from $15 to $65 for a box of 200 cups – the flavor quality of the paste can influence equivalent of paying just 7 to 37 cents for a 2-gram cup. But, saving a few both professional and patient acceppennies up front may not benefit the dental practice in the long run. While all tance. Hygienists seek a low-splatter, prophy pastes contain the same active ingredients, the packaging, functionality, flash-rinsing paste that leaves a clean handling and flavor quality of lower grade products are often less than satisfacsurface, while patients look for a fresh, tory for both professionals and their patients. One of the last things patients clean, smooth mouth feel, a pleasant experience before leaving their dental visit – and scheduling their next appointtaste experience and shiny, stain-free ment – is the taste and clean mouth feel of the prophy paste. A pleasant taste teeth. While most products make these and a good feeling are much more likely to bring them back for a return visit. claims, not all deliver, often resulting in

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Manufacturers have also worked to deliver prophy pastes less prone to splatter and grittiness. In the past, excessive splatter has made for a messier prophylaxis, as well as increased the risk of cross contamination and resulted in longer cleaning and preparation time between patients. And, patients have been known to complain of excessive grittiness, often due to poor rinse ability, which can be deflating for hygienists striving to provide the best possible experience. Indeed, an easy chair experience and a smiling, satisfied patient can be the greatest validation of a job well done.

In recent years, many manufacturers have also placed additives, such as xylitol and calcium phosphate, in their paste to redeposit the building blocks of the tooth enamel. While many experts agree these are desirable ingredients, clinical studies have yet to support their therapeutic benefit. (Until such studies are performed, the FDA prohibits prophy paste manufacturers from making any therapeutic claims.)

Experts recommend that dental professionals sample products prior to purchasing them. Experiencing the paste’s performance in their hands and taking time to assess their patients’ reaction to the taste and feel of the paste can be key to providing predictable and desirable clinical outcomes.

3/4/2019 11:14:21 AM

Engage your customers When initiating a discussion about prophy pastes with dental customers, it’s important to discover what brand of paste they currently are using. From there, sales reps should ask several probing questions, such as: • How long have you been using this particular brand of prophy paste?”

• “What do you like about it, and what would you like to improve?”

• “How often do you purchase new pastes?” (This will help determine whether your customers would like to take advantage of a quantity discount.)

• “Do you offer flavor choices for both adult and child patients?” (Your customers may wish to purchase more flavor varieties to enhance their patients’ prophy experience.)

• “How do your patients respond during treatment?

Do they remark about their clean, fresh mouth feel or complain about a gritty feel and a bitter aftertaste?”

Editor’s note: First Impressions would like to thank Preventive Technologies, Inc. for its assistance with this article. www.firstimpressionsmag.com

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DISTRIBUTION

Proof Positive Burkhart’s Proven Solutions Center helps dental practices make the right equipment decisions.

Dental teams today have more and more solutions available to address

patient care and practice management. That means finding new ways to integrate multiple devices, systems and software. For some practices, this is easier said than done.

Burkhart recognizes technology integration can sometimes be disruptive to the dental practice and recently created a digital equipment testing and evaluation center in its Tacoma, Washington corporate office called the Proven Solutions Center. In partnership with manufacturers, They test and evaluate digital dental equipment using key performance indicators. Helping their clients make more informed equipment purchase decisions – including the equipment’s ability to interface with other systems – gives them peace-of-mind, reduces their downtime and supports their success.

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Solutions Center goals With the Proven Solutions Center, Burkhart accomplishes three goals: • Helps clients determine whether certain types of equipment integrate well with other equipment and/or software.

• Expands the knowledge and skills of Burkhart associates to be able to provide better client service.

• Works with manufacturers to develop a remote platform to resolve clients’ equipment issues in a more timely and cost-effective manner.

More informed decisions One of the many benefits the Proven Solutions Center offers is to provide clients with more informed product purchases. “The Proven Solutions Center serves as a quality assurance function that supports our clients to ensure the quality and consistency of dental equipment we offer,” says Michael Norton, director of equipment and technology sales at Burkhart. “We expect this will make practices more efficient and profitable and help doctors deliver a better patient experience,” he adds.

“Over the last couple years, the Proven Solutions Center has tested, evaluated and supported the launch of new technology products, as well as certified existing technology solutions, to ensure our clients have a positive practice experience with their technology purchase,” Norton continues. Since its inception, the Proven Solutions Center has tested and evaluated digital

“ The whole process of getting our product to the PSC, setting it up, evaluating and testing with Burkhart was a breeze,” he says. “During the process, we learned what they liked and received suggestions as to what the market needs and wants. As a result, we were able to collaborate and work with Burkhart to make our product that much better and ready to launch.” equipment and technology for a variety of products such as 3D cone beams, CAD/CAM systems, air compressors, sterilizers and 3D printers.

“Not only do we test manufacturers’ equipment for our clients, we also evaluate the equipment software and occasionally test how the software interfaces with other thirdparty software,” says Chuck Greenfield, corporate service support manager at Burkhart. “We even determine what kind of support the manufacturers provide for a specific product. We call them with product questions because we want to make sure there is a good support structure in place for our clients.”

Burkhart’s director of technical services, Shannon Bruil, likens the Proven Solutions Center to providing a Consumer Report-like service to dental clients. “To help our clients, we have taken the Consumer Reports concept and applied it to our test center,” he says. “We have come up with report cards on various products and how they perform.”

No more costly downtime “We are excited to be working with manufacturers who are developing software and embedded sensors for their equipment to communicate and exchange data through the internet,” says

One proven solution “My experience working with the Burkhart team at the Proven Solutions Center was nothing short of amazing,” says Keith Huang, vice president, operations, PreXion Inc. “As a manufacturer, we worked with the PSC to make sure our product met Burkhart’s expectations so there would be no surprises down the road for our future mutual customers.

“The whole process of getting our product to the PSC, setting it up, evaluating and testing with Burkhart was a breeze,” he says. “During the process, we learned what they liked and received suggestions as to what the market needs and wants. As a result, we were able to collaborate and work with Burkhart to make our product that much better and ready to launch.”

Norton. Burkhart sees the opportunity to eventually serve clients remotely as the technology develops. “With this rapidly growing technology, we want to be able to better service equipment in a more predictable way for our clients. This will enable our service technicians to consistently show up with the right part at the right time, which will help our clients avoid costly and disruptive downtime.”

An exceptional client experience One of Burkhart’s goals is to consistently provide an Exceptional Client Experience, which means consistently delivering service that is impactful and valuable to clients. They will continue to expand their reach by testing and evaluating equipment and technology their clients purchase to help them make more informed purchase decisions that will ultimately support their continued success.

Certified products Burkhart has partnered with a handful of manufacturers to test their equipment. Evaluation typically takes 3-6 months. Examples of manufacturers with products that have been certified include: Planmeca (Emerald Scanner and PlanMill 40 S), Kavo Kerr (OP300 Panoramic CBCT), 3M (True Definition Scanner), PreXion (3D Excelsior CBCT), and SciCan (Statim G4).

Editor’s note: Provided by Burkhart Dental

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WHAT YOU MAY DISTRIBUTION HAVE MISSED

BY ANTHONY STEFANOU, DMD, FOUNDER, DENTAL SALES ACADEMY

A Successful NDC Dental Forum in Sunny Florida The NDC Dental

Forum 2019: Power of Partnership brought 230 people together from 38 dealer and 72 vendor companies. The annual event delivered powerful networking opportunities, face-to-face strategic meetings, educational sessions, a product fair and awards ceremony. Held in January at the Loews Royal Pacific Resort in Orlando, the Forum provided a setting for vendors and dealers to develop strong sales strategies for the coming year.

A Rapt Audience at the Opening General Session

Keynote Speaker, Perrin DesPortes

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NDC President & CEO, Mark Seitz, shared with Forum attendees the investments the company is making to elevate support for customers, including: an improved contract processing platform, a renewed focus on operational efficiencies, access to pharmaceutical products and price-saving programs through NDC’s proprietary GPO, NuEdge Alliance, LLC. “Independent dealers continue to gain market share,” remarked Lori Paulson, NDC’s Chief Commercial Officer, Dental & Specialty Markets, during the opening session. She continued, “In 2018, NDC dental members’ collective business grew slightly more than industry reports for the overall dental market. Additionally, merchandise consumables grew versus prior year, despite flat equipment sales.”

The keynote presentation, “Group Practice Fundamentals & Selling Tactics to Compete in the Space,” was delivered by Perrin DesPortes of TUSK Partners. DesPortes discussed why doctor-founded and debt-funded group practices are the fastest-growing segment in the entire dental industry. He took the audience for a deep dive into consolidation of practices, mid-tier group formation and the roles played by private equity groups and enterprise-level dental service organizations (DSOs). Both dealers and vendors walked away with insights to build a better value proposition when engaging with special markets.

The Forum also featured a product fair, allowing vendors to showcase products and give hands-on demonstrations of new products. This event gave vendors a chance to discuss the unique products and services they can offer dealers.

Manufacturer of the Year: Medicom

Dental Member of the Year (Full Service): Midway Dental

Dental Member of the Year (Merchandise): Top Quality Manufacturing

Attendees at the Awards Reception

Face-to-Face Strategy Sessions

Vendor Product Fair

Additionally, a fun challenge was posed to the dealer group this year for a Floss Dance Video Contest. The winner of the contest was awarded $500 and a 1-year supply of floss. A group from IQ Dental Supply won the contest, and the President of IQ Dental Supply, Sergey Kunin, announced that the prize will be donated to America’s ToothFairy, an organization that provides dental care to underserved children.

At the annual awards event, NDC recognized new members, including: • AMAX Health (St. Catharines, Ontario, Canada) • Best Buy Dental Supply (Harrison, Ohio) • Newark Dental-Pemco (Springfield, New Jersey) • Preferred MedSurg (Columbia, South Carolina) The awards ceremony was an exciting celebration of top-performers from the previous year. The 2018 award winners are as follows: DENTAL MEMBERS OF THE YEAR: • Full Service: Midway Dental • Merchandise: Top Quality Manufacturing MANUFACTURER OF THE YEAR: • Medicom

NDC BRAND PERFORMANCE AWARD: • DDS Dental Supplies QUALA TRENDSETTER AWARD: • J&L Dental WAREHOUSE PERFORMANCE AWARD: • Midway Dental WAREHOUSE VENDOR OF THE YEAR: • Southern Dental Industries (SDI) MULTI-MILLION DOLLAR CLUB: • AM-Touch Dental • Burkhart Dental • Dental City • Dental Health Products, Inc. • IQ Dental • Midwest Dental Equipment & Supply • Top Quality Manufacturing MILLION DOLLAR CLUB: • DDS Dental Supplies • Parkway Dental • Scott’s Dental Supply

www.firstimpressionsmag.com

• Atlanta Dental • DC Dental • Dental Distributors, Inc. • Goetze Dental • Midway Dental • Nashville Dental • Safco Dental Supply • Ultimate Dental

• Healthcare Supply Service • PureLife Dental

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INFECTION CONTROL

Bootcamp 101!

Personal Protective Equipment Infection control and the correct use of personal protective equipment should be top concerns for your dental customers.

BY DR. KATHERINE SCHRUBBE, RDH, BS, M.ED, PHD.

Most of us

associate the term boot camp with the military. It is described as a basic training that prepares recruits for all elements of service: physical, mental and emotional. It is also labeled as an intense experience that gives service members the basic tools necessary to perform the roles that will be asked of them. The purpose of this training is not to break recruits; in fact, the combination of physical training, field exercises and classroom time makes individuals strong and capable. It’s a tough process, but a rewarding one that many service members value for life.1 In dentistry, where there is a constant pursuit to provide patients with an infection free, safe dental visit, there exists another kind of boot camp. This one isn’t provided by the military, but rather by the dental industry’s Organization for Safety, Asepsis and Prevention (OSAP). This year’s Boot Camp, which took place in January, was themed, Safety Strong. Like military boot camp, it included three intense days of training designed to prepare new and existing dental team members responsible for infection control on the basic

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tools necessary to perform their roles.

Although there was no formal physical training, each day began at 7:30 a.m. sharp and closed around 5 p.m., and included a full schedule of lectures and interactive field exercises, called “boots-on-the-ground” sessions. Interestingly, the completion of OSAP Boot Camp has the same goal as military boot camp: to make dental team members strong and capable of carrying out OSHA standards and CDC best practices for infection control in their dental settings.

This year, I had the honor of being invited to speak at the OSAP Boot Camp conference. One of my assigned topic areas was personal protective equipment (PPE), and there were two objectives to my presentation: First, to define the elements and use of personal protective equipment (PPE) as required by OSHA and CDC recommendations that meet Standard Precautions.

Second, to understand the rationale for compliance to standards, regulations, guidelines and best practices. PPE is sometimes an area of compliance that is taken for granted, so this may be a good time for a brief review and reminder on standards related to its importance and use.

Why comply with PPE? The Occupational Safety and Health Administration (OSHA) is part of the US Department of Labor, and therefore a federal law. OSHA’s mission is to assure safe and healthful working conditions for working men and women by setting and enforcing standards and by providing training, outreach, education and assistance.2 OSHA is there to protect workers from hazards on the job and in healthcare. Dental team members are exposed to a variety of such hazards, such as infectious agents from patients and contaminated equipment, as well as chemicals.

The use of PPE is mandated by OSHA with varying specifications. For dental healthcare workers, the Bloodborne Pathogens standard 1910.1030 clearly states, “when there is occupational exposure, the employer shall provide, at no cost to the employee, appropriate personal protective equipment such as, but not limited to, gloves, gowns, laboratory coats, face shields or masks and eye protection, and mouthpieces, resuscitation bags, pocket masks, or other ventilation devices. Personal protective equipment will be considered appropriate only if it does not permit blood or other potentially infectious materials (OPIM) to pass through to or reach the employee’s work clothes, street clothes, undergarments, skin, eyes, mouth, or other mucous membranes under normal conditions of use and for the duration of time which the protective equipment will be used”.3 In dentistry, PPE act as an efficient barrier to prevent contact with infectious agents and hazardous chemicals.

Training Dental employers have a responsibility and obligation to train team members on PPE. During and after training sessions, there should always be time allotted for team members to ask questions and verify expectations. OSHA 1910.132 states that the employer shall provide training about: • When PPE is necessary.

• What types of PPE are necessary.

• How to properly don, doff, adjust and wear PPE. • The limitations of PPE. • The proper care, maintenance, useful life and disposal of the PPE.4

Dental employers have a responsibility and obligation to train team members on PPE. During and after training sessions, there should always be time allotted for team members to ask questions and verify expectations.

Another OSHA standard – one which is sometimes overlooked in dental practices, but which must be carried out – is Standard 1910.132, Personal Protective Equipment. It provides additional guidance on employer responsibilities and training related to PPE, stating that employers shall: • Provide PPE in appropriate sizes.

• Clean, launder and dispose of PPE. • Repair/replace PPE as needed.

• Ensure PPE is removed before leaving the work area.

• Train employees on proper use.4

Also, the standard states that the team member shall demonstrate an understanding of the training and the ability to use PPE properly, before being allowed to perform work requiring the use of PPE.4 No dental team member should be permitted to perform duties with occupational exposure without being properly trained. If team members are not utilizing PPE appropriately, constructive corrections should be made immediately. OSHA 1910.132 states, “retrain when the employer has reason to believe that any employee who has already been trained does not have the understanding and skill required.”4 Dental team members should not be permitted to continue to act inappropriately, as it puts them at greater risk for occupational exposure and injury. Training should always be documented in writing to create a permanent record.

Although not a regulatory agency, the Centers for Disease Control and Prevention (CDC) provides key recommendations for PPE that are consistent with OSHA standards as indicated below. Guidelines from the CDC should be strictly followed to reduce the risk of disease transmission to both patients and dental team members.

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INFECTION CONTROL Protective clothing Protective clothing, such as clinic gowns, can be reusable or disposable. They are used to protect the wearer from the spread of infection or illness should the wearer come in contact with potentially infectious liquid and solid material; gowns are considered one part of an infection-control strategy.5,6 OSHA requires long sleeves to protect forearms and clinic attire when spray/ spatter of blood, saliva or OPIM is anticipated; also based on the information in 1910.1030, the desirable features of a clinic gown are tight cuffs, a high neck and fluid resistancy. Gowns must be changed when visibly soiled, at end of work-shift or whichever comes first, and team members must remove all PPE when leaving the treatment area.3 Therefore, gowns are not permitted in non-clinical areas, such as offices, food areas or outside. Often, there are team members who state they take their gown home to launder. This practice is strictly against OSHA; the standard states that laundering is the responsibility of the employer at the office or through contact with a commercial service. “Employees

Key Recommendations for PERSONAL PROTECTIVE EQUIPMENT (PPE) in Dental Settings 1. Provide sufficient and appropriate PPE and ensure it is accessible to DHCP. 2. Educate all DHCP on proper selection and use of PPE. 3. Wear gloves whenever there is potential for contact with blood, body fluids, mucous membranes, nonintact skin or contaminated equipment. a. Do not wear the same pair of gloves for the care of more than one patient. b. Do not wash gloves. Gloves cannot be reused. c. Perform hand hygiene immediately after removing gloves.

4. Wear protective clothing that covers skin and personal clothing during procedures or activities where contact with blood, saliva, or OPI is anticipated.

5. Wear mouth, nose and eye protection during procedures that are likely to generate splashes or spattering of blood or other body fluids.

6. Remove PPE before leaving the work area.

5. S ummary of Infection Prevention Practices in Dental Settings: Basic Expectations for Safe Care, 2016.

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are not permitted to take contaminated gowns or lab coats home for laundering; when removed, they are to be placed in a designated area or container for storage, washing, decontamination or disposal.”3 If there are no laundering facilities on-site and no commercial contract for professional laundering, then disposable gowns should be utilized in the practice.

Face masks Face masks are a medical device labeled by the FDA and used to protect the mucous membranes of the nose and mouth from contact with sprays/spatter of oral fluids from the patient or items contaminated with patient fluid.5,7 Masks should be worn during any patient care activity, in the lab during grinding or polishing, when using chemical agents and during instrument reprocessing.3,5,7 As a strong reminder, face masks are single-use devices: one mask for each patient. The FDA labels face mask boxes with the universal symbol for a single-use item to ensure there is no question:8 Face masks also are made in a variety of protective levels, and testing is mandatory to determine which of these levels is provided by the American Society of Testing Materials (ASTM).9 The organization develops over 12,500 voluntary consensus standards, but for face masks, the current standard ASTM F2100-11 (2011) specifies the performance requirements for medical face masks with five basic criteria: • BFE (bacterial filtration efficiency). BFE measures how well the medical face mask filters out bacteria when challenged with a bacteria-containing aerosol. ASTM specifies testing with a droplet size of 3.0 microns containing Staph. Aureus. In order to be called a medical/surgical mask, a minimum 95 percent filtration rate is required. Moderate and high-protection masks must have bacterial filtration rates greater than 98 percent.

• PFE (particulate filtration efficiency). PFE measures how well a hospital mask filters sub-micron particles with the expectation that viruses will be filtered in a similar manner. The higher the percentage, the better the mask filtration. Although testing is available using a particle size from 0.1 to 5.0 microns, ASTM F2100-11 specifies that a particle size of 0.1 micron be used.

• Fluid resistance. Fluid resistance reflects the surgical mask’s ability to minimize the amount of fluid that could transfer from the outer layers to the inner layer as the result of a splash or spray. ASTM specifies testing with synthetic blood at pressures of 80 mm, 120 mm or 160 mm Hg to qualify for low, medium or high fluid resistance.

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•D elta P (pressure differential). Delta P measures the air flow resistance of the medical mask and is an objective measure of breathability. The Delta P is measured in units of mm H2O/cm2, and the lower the value the more breathable the mask feels. The ASTM standard requires that masks have a Delta P of less than 5.0 for moderate and high barrier masks, while low barrier masks must have a Delta P of less than 4.0.

• F lame spread. As healthcare facilities contain sources of oxygen, heat and fuel, the ASTM F210011 standards include testing for flame resistance.

Testing dictates that all hospital masks must withstand exposure to a burning flame (within a specified distance) for three seconds.9 Given the possibility of a high amount of spray and spatter of oral fluids, team members should choose a face mask with higher filtration and fluid resistance; sometimes a Level 2 is adequate, however a Level 3 will provide the best protection.

For tasks such as patient exams, lab work, taking impressions or operatory processing, a Level 1 mask will suffice.

Dental team members should check the information on the mask box to verify its protective level.

Eye protection Dental team members should wear eye protection with solid side shield to prevent ocular exposure and injury that may occur due to flying objects, spray/spatter of oral fluids and/or aerosols, and hazardous chemicals.3.5 Safety glasses or goggles must also comply with American National Standards Institute (ANSI) Z87.1-2010 to ensure a high level of impact resistancy.10 Every team member must be a part of the infection prevention and safety program and help each other remember to utilize eye protection.

Gloves Patient care gloves should be worn whenever there is the potential for contact with blood, saliva, mucous membranes, hazardous or infectious wastes or chemical agents.3,5,11,12 Patient care gloves are single-use items; they should always be donned on aseptically clean hands and inspected for tears or holes. They should never be washed or disinfected. In addition, it’s important that dental team members wear the correct size gloves and that they remove them before leaving the treatment area. Both patient care gloves and surgical gloves are regulated by the FDA, however, the non-medical utility gloves are not.12 Utility gloves, which are puncture- and chemical-resistant, should be worn when processing instruments and during housekeeping tasks that involve contact with blood, OPIM or chemical disinfectants.3,5,11 Utility gloves are available both as

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INFECTION CONTROL reusable and disposable. They are highly underutilized, but so very important for the protection of dental team members.

Personal protective equipment is mandated to protect the dental team at the workplace, and not meant to be overwhelming, inconvenient or difficult.

Just like boot camp, this material was intended to provide a review of the basic elements and current information

on PPE to prepare new and existing dental team members and those responsible for infection control to perform the roles that will be asked of them. Infection prevention is a team sport and requires team effort in each and every dental setting. It is always a good idea to review the basics, but even a better idea to put them into practice and consistently exercise them.

ASTM F2100-11 (2011) requirements for medical face masks LEVEL 1 (LOW) BARRIER: LEVEL 2 (MODERATE) BARRIER: LEVEL 3 (HIGH) BARRIER: 80 mm Hg 120 mm Hg 160 mm Hg

Test BFE (Bacterial Filtration Efficiency) at 3.0 micron ASTM F2101

≥ 95%

≥ 98%

≥ 98%

PFE (Particulate Filtration Efficiency) at 0.1 micron ASTM F2299

≥ 95%

≥ 98%

≥ 98%

Delta P (Differntial Pressure) MIL-M-36954C, mm H2O/CM2

< 4.0

< 5.0

< 5.0

80

120

160

Class 1

Class 1

Class 1

Fluid Resistance to Synthetic Blood ASTM 1862, mm Hg Flame Spread 16 CFR part 1610

ASTM F2100-11 (2011) REQUIREMENTS FOR MEDICAL FACE MASKS9

References:

1. Today’s Military. Boot camp. Available at https://www.todaysmilitary.com/training/boot-camp. Accessed February 2, 2019.

2. U.S. Department of Labor. Occupational Safety and Health Administration. Available at https://www.osha.gov/about.html. Accessed February 2, 2019.

3. U .S. Department of Labor. Occupational Safety and Health Administration. Available at https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_id=10051&p_ table=STANDARDS. Accessed February 2, 2019.

4. U .S. Department of Labor. Occupational Safety and Health Administration.https://www.osha.gov/pls/oshaweb/owadisp.show_document?p_id=9777&p_table=STANDARDS. Accessed February 2, 2019.

5. C enters for Disease Control and Prevention. Summary of Infection Prevention Practices in Dental Settings: Basic Expectations for Safe Care. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Oral Health, March 2016.

6. U .S. Food and Drug Administration. Medical gowns. Available at https://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/GeneralHospitalDevicesandSupplies/ PersonalProtectiveEquipment/ucm452775.htm. Accessed February 3, 2019.

7. U .S. Food and Drug Administration. Medical devices; Masks and N95 respirators. Available at https://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ GeneralHospitalDevicesandSupplies/PersonalProtectiveEquipment/ucm055977.htm. Accessed February 3, 2019.

8. U .S. Food and Drug Administration. Medical devices; device labeling. Available at https://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/Overview/DeviceLabeling/ default.htm. Accessed February 3, 2019.

9. American Society for Testing and Materials. ASTM Mask Protection Standards & FAQ. Available at https://www.primed.ca/clinical-resources/astm-mask-protection-standards/.

Accessed on February 3, 2019.

10. American National Standards Institute. Available at https://www.ansi.org/. Accessed February 3, 2019.

11. OSAP. OSHA and CDC Guidelines. Interact training system self-instructional workbook. 2017, section 3.

12. U.S. Food and Drug Administration. Medical devices; medical gloves. Available at https://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/ GeneralHospitalDevicesandSupplies/PersonalProtectiveEquipment/ucm056077.htm. Accessed February 3, 2019.

Editor’s note: Dr. Katherine Schrubbe, RDH, BS, M.Ed, PhD, is an independent compliance consultant with expertise in OSHA, dental infection control, quality assurance and risk management. She is an invited speaker for continuing education and training programs for local and national dental organizations, schools of dentistry and private dental groups. She has held positions in corporate as well as academic dentistry and continues to contribute to the scientific literature. Dr. Schrubbe can be reached at kathy@schrubbecompliance.com.

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TRENDS

Oral Arguments As researchers continue to make a connection between oral health and chronic disease, the question begs: What will this mean for dental professionals?

Researchers continue to connect the dots between oral health (par-

ticularly periodontal disease) and other chronic conditions, such as diabetes, heart disease and asthma. Payers, regulators and providers are getting the message.

Here’s what’s happened in dental/medical research in the last year and a half.

• Oct 2018: Dominion National, a dental insurer and administrator of dental and vision benefits headquartered in Arlington, Virginia, released a study indicating people with chronic health conditions such as asthma, diabetes and heart disease who received preventive dental care covered by Capital BlueCross’ BlueCross DentalSM benefits had fewer emergency room visits and hospital stays.

• F ebruary 2018: After reviewing meta-analyses of clinical trials, researchers from the University of Athens (Greece) School of Dentistry reported in the Journal of Clinical Periodontology that periodontal treatment improves glycemic control in people with diabetes. Patients who underwent periodontal treatment had about half a percent lower HbA1c levels three months after treatment than those who did not receive periodontal therapy.

• November 2017: Data from a Medical Expenditure Panel Survey (MEPS) revealed that when a preventive dental benefit was provided for adult Medicaid recipients, medical costs for people with chronic conditions were lowered from 31 to 67 percent.

• September 2017: Dental insurer United Concordia released a study examining the medical benefit when an individual absent a chronic medical condition regularly sees their dentist two times a year for checkups and cleanings, compared to those who do not.

More covered mouths More people than ever are covered by dental insurance, reports the National Association of Dental Plans. The percentage of the population with dental insurance – either commercial or public (Medicare, Medicaid, and the Children’s Health Insurance Plan, or CHIP) has increased from 58 percent in 2008 to 78 percent in 2017.

“The public sector is the big news,” says Evelyn Ireland, executive director, NADP. Due to expansion of the number of adults covered by Medicaid, and growing participation in Medicare Advantage (which frequently includes dental coverage), the number of Medicaid and Medicare recipients receiving dental coverage grew from about 36.6 million in 2014 to 87.8 million in 2017. (Meanwhile, the number of people with commercial dental insurance grew steadily during that same period, from 155.9 million in 2014 to 166.2 million in 2017.)

In 2016, Washington, D.C.-based consulting firm Avalere Health released a study conducted on behalf of Pacific Dental Services Foundation indicating that by adding a periodontal benefit to Medicare Part B, the Medicare program would save $63.5 billion over the period 2016 to 2025 in reduced hospitalizations and emergency room visits by individuals with periodontal (gum) disease and medical conditions, e.g., diabetes, coronary artery disease and cerebrovascular disease.

“Research is ongoing and results continue to solidify the evidence of a biological link between periodontitis and [diabetes, coronary artery disease and cerebrovascular disease],” reported Avalere.

“While much about these links remains unknown due to biological complexity and the limitations of research design and resources, data suggest that improving periodontal health may have a positive impact on health outcomes….”

Approximately 45 percent of adults aged 30 years and older – and an estimated 66 percent of adults 65 years and older – have some form of periodontal disease, Avalere pointed out, citing research published in the Journal of Periodontology.

Medical cost savings In November 2017, Avalere’s findings for Medicare were replicated in the Medicaid program by a Medical Expenditure Panel

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TRENDS

Survey (MEPS) conducted by researchers at the Department of Public Health, University of Maryland School of Dentistry, on behalf of the National Association of Dental Plans.

Researchers studied the relationship between the cost of medical care when Medicaid recipients (ages 25-64) with chronic conditions received preventive dental care. “It’s a good indication that dental benefits keep medical costs down and help manage overall costs,” says Ireland.

The research showed that health expenditures for recipients who received preventive dental care were lower than those who did not: • Coronary heart disease: 67 percent lower.

• Diabetes: 36 percent lower.

• High blood pressure: 31 percent lower.

• Heart attack: 36 percent lower.

• Stroke: 52 percent lower.

• Angina: 45 percent lower.

• Other heart disease: 45 percent lower.

• Cancer: 67 percent lower.

• High cholesterol: 43 percent lower.

• Asthma: 37 percent lower.

Private pay Commercial insurers are studying the medical/dental connection closely.

The Dominion National study was conducted over a two-year period in partnership with Capital BlueCross and Geneia.® The study analyzed paid claims between July 2015 and June 2017 for individuals with and without BlueCross DentalSM coverage who had a diagnosis of one or more of the following conditions: asthma, cerebrovascular disease, chronic obstructive pulmonary disease, coronary artery disease, congestive heart failure, diabetes, maternity, osteoporosis, renal failure and rheumatoid arthritis.

The research compared medical costs and utilization of Capital BlueCross members with chronic conditions and BlueCross Dental coverage who received preventive dental services, versus those who did not receive preventive dental services. It found: • People with chronic conditions – but no BlueCross Dental coverage – had a 7 percent higher incidence rate of inpatient hospital stays than those with BlueCross Dental coverage who received a preventive dental service.

• Those who had BlueCross Dental coverage – but did not receive preventive dental services – had a 19 percent higher incidence rate of emergency department visits than those with BlueCross Dental coverage who received preventive dental services.

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Dental insurance facts • Twenty-two percent of Americans have no dental benefits.

• Thirty-five percent of the uninsured are over 65.

• Most of the remaining uninsured are employed in businesses that do not offer dental coverage.

• A small fraction of the population has access to dental benefits but do not purchase coverage.

• A little more than half of the population gets dental benefits in the private market – through employers or by purchasing as an individual.

• Less than 4 percent of the population has individual coverage for dental services.

• Just over a quarter of the population gets dental benefits through a public program, i.e. Medicaid, CHIP, Medicare Advantage, or other public programs like Indian Health Services.

• A segment of the senior population has maintained coverage from prior employment, and some purchase dental benefits as individuals outside of Medicare Advantage plans Source: NADP 2018 Dental Benefits Report: Enrollment, October 2018

“The findings of this study reinforce how integrating medical and dental coverage and care can be associated with improved health and lower costs for those dealing with chronic medical issues,” Capital BlueCross President and CEO Gary St. Hilaire was quoted as saying.

“The dental/medical connection has picked up momentum in the past two decades,” says Dominion National Vice President of Marketing Jeff Schwab. The company is in a unique position to study and act on that connection, as it not only provides dental and vision benefits, but administers dental benefits on the part of medical insurance providers.

“We’re eager to work with our health plan partners to provide outreach to these high-risk individuals to seek preventive, necessary dental care and improve health outcomes,” says Schwab. For example, Dominion National can identify high-risk members (that is, those with a chronic condition) who might benefit from a dental checkup. “We can also help them find a dental home, and ensure they receive information that emphasizes the importance of oral health.”

If there is one obstacle in connecting oral health and systemic health, it is the lack of integration between electronic medical records and electronic dental records, says Schwab.

“Overall, oral health professionals and physicians recognize the benefit of closing the information gap between them,” he says.

Short of sharing patient records, primary care providers – particularly pediatricians – can continue to promote dental care to their patients; meanwhile, dentists can discuss the oral/medical connection to their patients, help detect signs of several chronic health conditions through oral exams, and refer patients to the appropriate healthcare provider.

“Sharing data is a critical key to success in integrating dental and medical care.”

The right direction In 2014, United Concordia Dental published a study in the American Journal of Preventive Medicine showing reduced hospitalizations are possible when individuals with a chronic medical condition, such as diabetes or heart disease, seek and maintain treatment for gum disease. The company followed up that study with another to determine the medical value of visiting the dentist regularly, even for people without a chronic condition.

The study population included more than 489,000 United Concordia and Highmark Inc. members with both medical and dental coverage between the ages of 4 and 64. (United Concordia is a subsidiary of Highmark.)

Study participants who visited the dentist routinely (defined as two checkups a year that include an oral evaluation, and a cleaning

or periodontal maintenance) for three consecutive years saw medical cost savings of $68 per person annually as compared to those who did not see the dentist at all. The savings rose to $157 annually over a three-year period for those who went to the dentist regularly versus those who did so intermittently; $134 for kids ages 4-18; and $219 for adults aged 45 to 64.

“We’ve done a lot of research on oral health and people with chronic disease and without chronic disease, as well as the association between periodontal disease and overall health,” says United Concordia Chief Dental Officer Quinn Dufurrena, DDS, JD. At press time, United Concordia was engaged in research on the association between dental care and respiratory or ear infections, as well as the association between dementia and tooth loss.

“Studies point to an association between oral health and systemic health, but we can’t say there’s causation, and that’s an important distinction,” he says. “The research we – and others – are doing points to the fact that we’re shining a light on something interesting and important. As time goes on, we’ll make more connections.”

In the meantime, exciting developments continue to occur, says Dufurrena. For example, the Harvard School of Dental Medicine’s Initiative to Integrate Oral Health and Medicine is working with partners in academia and healthcare to develop ideas and conduct research around the integration of oral health and primary care. Many medical and dental schools are combining curricula, he adds.

“It’s a direction that makes sense.”

The commercial market Given the association between oral health and systemic health, combining medical and dental insurance coverage makes sense. But just how – and when – that will take place remains to be seen.

“Standalone dental benefits aren’t going anywhere,” says Jeff Schwab, Dominion National’s vice president of marketing. “Health plans recognize the need for a strong dental component, and a lot of them will look to standalone dental partners to administer their dental plan. It comes down to the bandwidth and resources of the carrier.”

A survey published by Chicago-based consulting firm West Monroe Partners in January 2018 found that 96 percent of insurance executives believe the embedding of dental benefits into medical plans is already happening, or will

happen. Today, 99 percent of commercial dental insurance plans are purchased through standalone dental insurers.

“Competitive margins and profitability, relative benefit simplicity, customer retention, and the increasing proof of correlation between oral health and overall health are driving more health insurers to experiment and invest in adding dental benefits to their plans,” the company said. “Convergence opportunities exist between health and dental insurers, especially as both face significant technical investments necessary to modernize core platforms and address consumer demands. As such, standalone dental insurance plans are attractive targets for health plans – either for acquisition or partnership. In fact, 100 percent of surveyed health plan executives whose companies don’t already offer dental benefits plan to do so in the near future.”

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First Impressions

April 2019

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REP CORNER

Making a Difference After 38 years, Monetta Reyes continues to impact the lives of dentists and patients for the better.

One of her earliest experiences in the dental chair – having four premolars

and Select Markets, it has become a privilege to offer the same superior level extracted prior to orthodontic treatment – was not her fondest, recalls Monetta of support to solo practitioners and help Reyes, Henry Schein Dental sales consultant, Houston, Texas, region. But, if dental them increase profits and minimize risk. visits made her anxious as a child, she certainly turned that attitude around in the I consider myself fortunate to work for a years to come. distributor like Henry Schein Dental, who has been known for trail blazing.”

By age 14, she already knew her fuAfter contributing to volume 4 of ture lay in dentistry. “In time, I recognized author Michelle Prince’s “Dare to be a the significant role dentists can play to Difference Maker,” a collection of stories ensure the delivery of quality care, while from people working to make a differmaking their patients as comfortable as ence, Reyes felt she was able to impact possible. I became interested in the writthe dental community more than ever ings of Linda Miles, the ‘godmother of denbefore. “I have loved making a difference tistry.’ She inspired me to enter a field that in the lives of others and surrounding does so much to not just improve people’s myself with like-minded people who are oral health, but their overall health.” Today, truly concerned about their own potential in fact, the two are friends. impact and life legacy,” she says.

“After attending The University of “When we are committed to a viAlabama at Birmingham Dental Assistsion, our goals help guide us in making ing and Dental Hygiene Preceptorship the right decisions,” she continues. “I Programs, I discovered opportunities in find the human spirit fascinating. Often, both private practice and corporate denI see the very gift of compassion – which tistry,” Reyes continues. While commitMonetta Reyes is essential to being a great dentist – as ted to dentistry and exceptional patient essential to conflict resolution. For example, team challenges care, she felt that working as a hygienist and assistant “limited are the practice owner’s number one challenge 99.9 percent my influence.” After 15 years of clinical experience, she made of the time. “ the decision to transition into dental distribution, and immediFor a long time, Reyes envisioned a place “where others can ately discovered how different it is from the clinical side. But, it learn, share and examine the building blocks necessary for them felt right. “Having worked with four distributors, I have gained to accomplish their dreams.” Then a few years ago, she and her relevant and valuable insight into how best to support dentists husband purchased a ranch, which they named Reindeer Ranch and their teams, and the importance of good leadership and at Round Top. The Reyes welcome dental teams to visit their organizational vision. In distribution, I feel my biggest responranch. “It’s a place where they can work on the practice, not in sibility is to provide a mirrored reflection to the dentists and it,” she says, noting that she benefits as much as her guests do. teams that I serve.

“Many dental professionals enjoy being able to get away from “Over the years, I have enjoyed designing, branding and the city and relax, and I enjoy being with others who have a pasassisting dental teams with systems and capacity challenges,” sionate entrepreneurial spirit,” she explains. “Reindeer Ranch at she explains. “My role as a field sales consultant with Henry Round Top is meant to be a special place where every day is Schein allows me to reach many providers with unmatched soChristmas,” she adds. lutions. Our leadership is phenomenal! With the growth of DSO

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Women in dentistry

“Over the years, I have enjoyed designing, branding and assisting dental teams with systems and capacity challenges.”

syndrome and delayed speech and development. According to his mother, he could When Reyes joined the dental industry 38 only pronounce the beginning of words years ago, the majority of dentists were and spoke at the level of a 1-year-old. male. Although more and more women Following his treatment with Luedemannwere choosing careers as dentists in the Lazar, he was able to speak at a 4-year-old 1980s, they would remain in the minorlevel and is expected to catch up to his ity for decades to come. After changing peers by the time he is 13. careers from hygienist/assistant to a disInterestingly, Reyes was able to help tributor sales representative, Reyes could this same dentist envision a new pediatric see a similar trend. “There were very few office – all on the back of a paper napkin! women in dental distribution sales at that “Dr. Luedemann-Lazar and I met several time,” Reyes points out. “I decided I could times with the purpose of understanding do anything that I wanted to do and that – Monetta Reyes, sales consultant, how she wished to communicate her fuwas to become the number one female in Henry Schein Dental, Houston, ture vision to her patients. We sketched a distribution in Houston, Texas!” She never Texas region floor plan on the napkin at the restaurant veered from her goal and 23 years later, table and then took it to the next level with CAD/CAM. In time, in 2018, she became Houston’s top saleswoman. “I believe one beautifully unique floor plan designs began to take shape. of the most important keys to success is being steadfast and “Amy and I have had many challenges along the way,” resilient,” she says. That means ignoring those who are less than says Reyes. “But we have worked together to overcome supportive, she adds. them, through open and straightforward discussions. I have While the dental industry has come to embrace women, learned that the greater the challenge, the bigger the reward. that’s not to say it’s become easy to be female in a still-mostlyWe continue to grow and will soon expand her practice for male arena. Career advancement comes with its challenges, she the third time. By keeping our eyes on the mission/vision and notes. “You must learn to become your biggest fan and not wait continuing to review and write goals, we are achieving them. for others to acknowledge your efforts,” she says. “Confidence Today, Amy has parents calling from around the country asking is the most attractive character trait in others, and women who if she can see their child as a patient.” embrace conflict as a part of their growth are in a position of power. Learning how to speak difficult words with truth and love are important qualities in great leaders.”

The Gateway Indeed, a gender-balanced dental industry is better and Reyes feels fortunate to get to work with dental professionals stronger, according to Reyes. “I have discussed this with key who, like her, believe the mouth is the gateway to the body. opinion leaders around the world,” she says. The consensus is “Dentists today hold the medical keys to the future,” she says. that professional women tend to be very empathetic and are “The ability to diagnose total body health with the assistance of good listeners, she points out. “Being able to help others – 3D and other technologies, or to proactively treat microscopic whether a patient or a dental team member – requires great challenges, enables dentists to position themselves as the ultiempathy and excellent communication skills.” mate health quarterback.

“Every practitioner gets to determine their own standard of care, and we must take this seriously,” she continues. “Dentists Giving voice have the opportunity to notice, find and observe things that phyWith nearly four decades of experience in the dental industry, sicians never get the chance to see. This is a big responsibility.

Reyes has met her share of talented and interesting figures. Most I want to help remove the barriers that cause patients to delay recently, she was introduced to Dr. Amy Luedemann-Lazar, a peor postpone treatment, often resulting in a snowballing impact diatric dentist and owner of Kidstown Dental, Katy, Texas. Luedeto their health. Neglect is more than expensive. If our mouth isn’t mann-Lazar made national news when, in 2018, she performed healthy, our entire body and mind are impacted.” several procedures on a 6-year-old boy who struggled with Sotos Editor’s note: For more information about Monetta Reyes the author, or about Reindeer Ranch at Roundtop, visit www.monettareyes.com or www.reindeerranchatroundtop.com. www.firstimpressionsmag.com

First Impressions

April 2019

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REP CORNER

BY LAURA THILL

Striking a Balance Benco sales consultant Ian Pryor thrives on a fulfilling career and a healthy lifestyle.

For Ian Pryor, his attraction to the dental industry has always been about the opportunity to help others. A biology major in college, he originally considered becoming a dentist. He soon realized that sales – rather than actually practicing dentistry – was more to his liking. But he never veered from his original goal: “Today, I help doctors build dental practices,” he says.

Ironically, nearly 10 years out of college, while focusing on a career in healthcare, Pryor lost track of his own wellbeing.

“When I turned 30, my doctor wanted to put me on medication for basic health issues, which I knew I could control through a healthy diet and exercise,” he recalls. “I knew I couldn’t approach this with some half-hearted changes. I had some big goals to achieve.” From fitness to CrossFit, he learned that taking care of himself could be as rewarding as his career.

Transitioning into sales Convinced he wanted to pursue a career as a dentist, Pryor interned as a researcher for Ian Pryor Dentsply Caulk while in college. Although he enjoyed the company, he found that research wasn’t his calling. A friend suggested he might find sales to be a more creative alternative, so following his graduation, he accepted an inside sales position at Dentsply Caulk. “I loved sales, but not the phone work,” he recalls. Something was missing, and it didn’t take him long to realize that something was the face-to-face contact with the people he was helping.

“In 2006, I took a position with Brasseler USA®, where I stayed for six years,” he says. “I started out with a small territory in Delaware, eventually becoming a key account manager.” His new position involved calling on larger groups of decisionmakers at universities. Interesting as the work was, he missed interacting with small dental business owners, where he felt he could make a greater impact.

“I discovered Benco Dental through professional connections,” says Pryor. “At the time, I knew very little about the company and applied online. Although they had no openings, they brought me in to see their corporate headquarters and showroom in Scranton, Pennsylvania, and I immediately knew this was the company for me!

“I could see that Benco is all about giving the customers choices and ensuring their best interests are met,” he continues. Pryor remained engaged with the company for about six months, at which time they were able to piece together a territory for him in Delaware, and he officially joined Benco in January 2012.

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In his 20 years working in the dental industry, he’s covered a lot of ground. “At Dentsply Caulk, I focused on the dentists’ restorative needs,” he says. “At Benco, I focus not only on my customers’ clinical needs, but a number of other issues as well, such as office setup, insurance, hiring, etc. I help them build their dental practice.” Often, this involves helping them navigate a constant series of

“When I turned 30, my doctor wanted to put me on medication for basic health issues, which I knew I could control through a healthy diet and exercise. I knew I couldn’t approach this with some half-hearted changes. I had some big goals to achieve.” changes and new developments. “Keeping up with new technology will always be a concern for my customers – especially for the older dentists nearing retirement who plan to sell their practice in the next five years.”

Raising the bar As confident as he was about the direction in which his career was heading, at some point, Pryor realized he didn’t feel great. As his personal physician pointed out, given his subpar health, how could

he? In an attempt to avoid unnecessary medications and longterm health issues, he was determined to jumpstart his lifestyle.

Armed with a p90x workout video, organic fruits and vegetables and a slew of other healthy choices, Pryor set a new course. “As I got more involved with my fitness program, I realized how beneficial it would be to work with a coach,” he says.

“That’s when I discovered CrossFit. It was similar to my own workout, but would require a coach, so I joined the local CrossFit Wheelhouse.” As it turned out, the two workouts were less similar than he supposed.

“Joining a CrossFit program turned out to be a humbling experience,” he says. “For one, I realized hadn’t been following the video workout routine correctly. At the end of my first class of box jumps, dead lifts and running, I was a mess!” At the same time, he was hooked. “Eventually, I registered for a competition for men in the 30-to-39-year age range. I was one of the younger men and expected to perform very well.” It didn’t quite work out that way, he notes. But, a less-than-stellar performance didn’t deter him from entering future competitions.

Pryor has continued to enter about one CrossFit competition each year, which means he’s training year-round. “You are always competition-ready,” he explains. “It’s important to keep up with training in order to be at peak strength on the day of the competition.

“The CrossFit model involves constant, varied movements,” he continues. “In a given competition, you may have to lift the heaviest weights you can in the clean-and-jerk event. And, you may have to exceed your maximum lifting weight by five or 10 pounds, based on who else is competing. About eight weeks prior to the competition, the coach or class instructor provides specific exercises to help you with this. Like any sport, there is a good deal of strategy involved.”

You can’t give up Not only has CrossFit training made Pryor a stronger person, it has made him a stronger sales consultant. “I exercise six days a week, and I don’t let my off days bring me down,” he says.

The same goes for work. “Sales consultants must be organized,” he points out.

“They must understand their strengths and weaknesses, and they can’t give up when they hit a roadblock.” It’s a perspective he shares with his customers, as well, he adds. “A new customer of mine recently opened a dental practice

and felt like she was in over her head. I reminded her that, in time, everything would fall into place. Even when it seems like nothing is working out, you can’t give up.”

Indeed, when Pryor helps his dental customers stay the course and realize their dreams, he can be confident he has succeeded as their sales consultant. “This is about their goals, not mine,” he says. “Just as my CrossFit trainer becomes better at what he does by helping me succeed, when my customers are successful, so am I.”

CrossFit CrossFit is a branded fitness regimen created by Greg Glassman, and is a registered trademark of CrossFit, Inc., which was founded by Glassman and Lauren Jenai in 2000. A strength and conditioning program, CrossFit incorporates a mix of aerobics, calisthenics and Olympic weightlifting and involves constantly varied and intense movements.

Source: Wikipedia. For more information visit https://en.wikipedia.org/wiki/CrossFit.

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April 2019

47

NEWS

Industry News Christian Brutzer named President of Ivoclar Vivadent North America Ivoclar Vivadent announced that Christian Brutzer has been appointed President of Ivoclar Vivadent North America, effective July 1, 2019. Currently a Vice President of Ivoclar Vivadent N.A., Brutzer will be responsible for leading the North American subsidiaries (US and Canada).

Brutzer joined Ivoclar Vivadent Christian Brutzer AG in 2006 as Director of Sales for the Asia/Pacific Global Region, and Vice President of Alloy Sales for North America. He was appointed to the Ivoclar Vivadent AG Corporate Management Board in 2011. Until July 1st, Mr. Brutzer will continue in his current role in North American operations and work with current Ivoclar Vivadent President and CEO, Robert Ganley, toward an effective and seamless transition.

He will also maintain his position on the Corporate Management Board responsible for the Asia/Pacific Global Region.

“Mr. Ganley has enjoyed a storied career with Ivoclar Vivadent,” said Brutzer. “Under his leadership, the company has experienced tremendous growth. He was responsible for jumpstarting the Esthetic Revolution and many of his accomplishments still serve as industry benchmarks. In this position, I look forward to continuing his legacy.”

Darby to host 18th Annual SmartScramble Charity Golf Outing to benefit Give Kids a Smile Darby Dental Supply, LLC, is gearing up to host the 18th Annual SmartScramble Charity Golf Outing to support the

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Arizona Dental Association’s Give Kids a Smile. The outing will take place April 12, 2019 in Paradise Valley, Arizona, located at the CW Marriot Camelback Golf Club. Founded in 2002 by Phoenix-based SmartPractice, the annual SmartScramble golf tournament supports charitable organizations in Phoenix and surrounding communities. Re-named the Darby SmartScramble in 2018 after Darby acquired the dental supply division of SmartPractice, this year’s event marks Darby’s first time hosting this event. Last year’s event was the most successful to date, raising $85,000 for Give Kids a Smile. Darby, along with their generous list of sponsors and participants are set to surpass that number this year. For more information on how to participate or donate, please visit darbysmartscramble.com

Solmetex names Kevin Danahy as Solmetex President Solmetex, LLC announced that Kevin Danahy has been named as President, a new position at Solmetex, reporting directly to CEO, Nick Mozzicato. Danahy most recently served as Vice President of Global Emerging Technologies and Specialty Sales at Zimmer BIOMET, and before that served as Vice Kevin Danahy President of Global Robotics Clinical & Technical Sales. Danahy brings more than 17 years of senior management experience in accelerating revenue growth and building high performance teams to drive long-term success.

NEWS

Benco Dental New Appointees Theodore Austin, Territory Representative Benco Dental is pleased to welcome Theodore â&#x20AC;&#x153;Tedâ&#x20AC;? Austin to the Northstar region. Austin, a Certified Dental Assistant, brings eight years of industry experience to the Benco family.

Sofia Mata, Territory Representative Sofia Mata joins Benco Dental in the Dallas region.

Mata, a Registered Dental Assistant, brings five years of sales experience to Benco customers in her region.

Gerry Farmer, Territory Representative The Benco Dental team in the Carolinas region welcomes Gerry Farmer. Farmer earned a degree in commercial recreation from the University of North Carolina at Greensboro. He brings six years of industry experience to the Benco family.

Aaron Miskovich, Territory Representative Benco Dental is pleased to welcome Aaron Miskovich to the Northstar region. Miskovich earned a degree in business from the University of Minnesota.

Chandler Mitchell Hamaker, Territory Representative Benco Dental is pleased to welcome Chandler Mitchell Hamaker to its Dixie region. Hamaker earned a degree in kinesiology from the University of Tennessee-Knoxville. She brings three years of sales experience to Benco customers in his region.

Chelsea Hower, Territory Representative Chelsea Hower joins Benco Dental in the Derby region. Hower earned a bachelorâ&#x20AC;&#x2122;s degree in business at Saint Louis University. She brings four years of experience to Benco customers.

Andrew Kim, Territory Representative The Benco Dental team in the Chesapeake region welcomes Andrew Kim. Kim earned degrees in chemistry from University of Maryland, Baltimore County and in pre-pharmacy from the University of Maryland. A paramedic, Kim brings five years of industry experience to Benco.

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Lindsay Mock, Territory Representative Lindsay Mock joins Benco Dental in the Cascade region. Mock graduated from Washington State University with a degree in biology. Mock brings eight years of sales experience to Benco.

Kristeena Robinson, Territory Representative The Benco Dental team in the Cascade region welcomes Teena Robinson. She brings nine years of sales experience to the Benco family.

Annie Thompson, Territory Representative Annie Thompson joins Benco Dental in the Cascade region. Thompson attended Illinois Central College and brings three years of sales experience to Benco.

Burkhart Dental New Appointees Burkhart Dental Supply welcomes Sandra M. Vestal as an Account Manager in its Oklahoma City office.

Vestal brings 16 years of experience in the dental industry to Burkhart. Prior to joining Burkhart, Vestal was a Territory Representative for another distributor. She graduated from Drury University in Springfield, Missouri, with a bachelor of science degree in business administration.

Burkhart Dental Supply announced the hiring of Paul A. Kasperbauer as an Account Manager in its Houston office. Prior to joining Burkhart, he was in sales with KB Home and prior to that was Territory Manager for another distributor. Kasperbauer is a graduate of the University of Kentucky with a bachelor’s of arts degree.

Burkhart Dental Supply welcomes Shawn R. Gardner to its Salt Lake City office as an Account Manager. Prior to joining Burkhart, he was a District Manager for Dentsply Sirona throughout Utah.

Gardner is a graduate of Utah Valley University and is working toward a bachelor’s degree in business communications from the University of Phoenix.

Burkhart Dental Supply welcomes Ric Vordermark as an Equipment Specialist working out of its Portland and Eugene offices. A Western Illinois University graduate, Vordermark brings over 18 years of dental experience to Burkhart and its clients. Prior to joining Burkhart, he was Senior Director of Sales for DentalEZ in Malvern, PA. Burkhart Dental Supply welcomes Brett M. Miller as an Account Manager in its Tulsa, Oklahoma, office. Miller has over ten years of experience in the dental industry. Prior to joining Burkhart, Miller was a Territory Representative for another distributor. He graduated from Rogers State University with an associate’s degree in business management and from Oklahoma University with a bachelor of science degree in information technology.

Miller is a former CEREC (ceramic reconstruction) Specialist with expertise in building relationships and information technology.

Burkhart Dental Supply welcomes Derek A. McCosh as an Account Manager in its Tulsa, Oklahoma, office. McCosh has nearly five years of experience in the dental industry. Prior to joining Burkhart, McCosh was a Territory Representative for another distributor. He graduated from the University of Missouri with a bachelor of science in corporate fitness and a minor in business management. His areas of expertise include creating high performance teams that focus on providing a customer-centric environment helping clients to reach their professional and growth goals.

Burkhart Dental Supply welcomes Mark Tams as an Account Manager in its Tulsa, Oklahoma, office.

Tams has over 12 years of experience in the dental industry. Prior to joining Burkhart, Tams was a Territory Manager for another distributor. He graduated from the PGA Business School in Palm Beach Gardens, Florida, with a business management degree.

His areas of expertise include client relations and logistical management.

Burkhart Dental Supply is pleased to announce the hiring of Trevor W. Kumakura as an Account Manager in its Western Washington Region location.

Kumakura has five years of sales experience in the dental industry. Prior to joining Burkhart, he was an Account Manager for Ultradent in South Seattle.

Kumakura is a graduate of Eastern Washington University with a degree in business administration.

Burkhart Dental Supply welcomes Craig A. Roberts as an Equipment Specialist in its Irving, Texas, office. Roberts has eight years of sales experience in the dental industry. Prior to joining Burkhart, he was a Midwest Specialist for Dentsply Sirona, a dental equipment and supplies manufacturer. Roberts graduated from Baylor University in Waco, Texas, with a bachelor of science degree.

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April 2019

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NEWS

Patterson New Appointees

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Misty Adams

Gabriel Anaya

Haylie Davis

Collin Fabian

Katie Fontenot

Amy Fuller

Eric Gonzalez

David Graziano

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Chris Hale

Cody Hall

Marry Happel

Josh Haydel

Adam Hill

Sean Jiang

Chris Klein

Robert Pobjecky

Jane Rossell

Kody Souers

Ashlie Strevig

Ryan Taylor

Amy Thompson

Clayton Wilson www.firstimpressionsmag.com

First Impressions

April 2019

53

WHAT YOU MAY EDITOR’S NOTE HAVE MISSED

BY ANTHONY LAURA THILL STEFANOU, DMD, FOUNDER, DENTAL SALES ACADEMY

Forging Ahead Technology is better than ever, and new surgical treatments are always on the horizon.

At the same time, dental teams can also expect much more from their everyday tools.

More and more dentists are taking advantage of cone beam and CAD/CAM, which means shorter chair times for patients and more precise results. And, while 3D printing is still relatively new, some dentists believe it could eventually make milling obsolete. “Today, we only print plastic,” says Michael Fulbright, DDS, owner of Fulbright Cosmetic and Reconstructive Dentistry, Redondo Beach, California.

“As the materials catch up to the technology, I expect we’ll eventually move away from milling and start printing porcelain crowns and implants.”

And that’s only the beginning. Recently, a Tufts University team constructed a cellular matrix that allows successful implantation of a tooth bud into a pig’s jaw, according to Thomas Hirsch, DDS, the owner of a Malibu, California-based dental practice and founder of Isolite Systems, currently Zyris. “Under their design, early adult-stage teeth develop within five months,” he says. “Researchers project that humans won’t profit from these developments for another ten years. But, the exciting progress hints at options once believed to be impossible.”

Indeed, the future holds some unique possibilities. So, in fact, does the present. If you aren’t giving serious thought to hand instruments, think again!

Day after day, hygienists depend on reliable instruments to properly care for their patients. Thanks to recent advances, today’s hand instruments can stay sharp longer. In addition, companies now provide sharpening services to keep these instruments sharp and prolong their life, permitting team members to focus on patient care. “When hygienists consistently use sharp instruments, dental procedures are accomplished more quickly and efficiently, and stain and calculus are cleanly removed, elevating the level of care and patient outcomes,” notes Tim Irwin, vice president of sales, Nordent Mfg. Co. With so many instrument options available to dental teams, however, it is especially important for distributor sales reps to offer solutions that meet the needs of the practice and best serve their patients.

“With so many options available, it is more important than ever before for distributor sales reps to sell strategically, yet still maintain that level of trust with the customer,” says Stacie Barth, senior director, Preventive Strategic Business Unit, Hu-Friedy Mfg. Co. The evolution of hand instruments has greatly impacted the efficiency of the dental practice, as well as increased the effectiveness of deposit removal, she continues. “Distributor sales reps need that knowledge of the ever-changing landscape of product improvements, so they can share these values adds with their customers.”

Important advances have taken hold, and even bigger changes are on the horizon. When it comes to great patient care, the only direction in which to move is forward.

Important advances have taken hold, and even bigger changes are on the horizon.

54

April 2019

First Impressions

www.firstimpressionsmag.com

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