New dentist summer 2016

THE #1 JOURNAL FOR NEW DENTISTS

THE

Debt-Free DENTIST

PLUS Treating Sleep Apnea Handpiece Help Posterior Composites SUMMER 2016

MacPractice Built In AES Encryption

Your Software?

?

Is your software protecting you and your patients?

MacPractice features advanced, easy-to-use charting, billing, Attachments, word processing, imaging, secure messaging, online services and everything you need to operate your practice with the lowest Total Cost of Ownership. With every feature and service integrated, MacPractice is designed to house your patient’s identity and ALL their health data (EPHI) and protect it with built-in AES encryption as required by HIPAA. Did you know that 35% of Americans’ health data was compromised in 2015 alone? And according to a recent survey, 50% of your patients will leave you if you are forced to notify them of a breach because you do not encrypt their data. And on top of that, HIPAA fines for non-compliance can reach $1.5M, with huge state fines as well.

Let MacPractice shield your patients and your practice!

Welcome to the future of dental software. Welcome to MacPractice.

Compare your software to MacPractice and see the difference

www.macpractice.com/security | (855) 679-0033 DOWNLOAD OUR FREE WHITEPAPER & LEARN MORE AT OUR ENCRYPTION WEBINAR

MacPractice Simplicity in practice

All Smiles. Every Step of the Way. From a first dental visit to hygiene, hygiene, orthodontics orthodontics and and implants, the CareCredit credit credit card card can can make make itit dad and and the the kids kids — — to to get get easier for families — mom, dad need it. it. And And CareCredit CareCredit care when they want and need resource they they can can use use again again gives them a financing resource becomes available. available. and again** as credit becomes

Help more more families families Help achieve healthy, healthy,happy happy achieve Formore moreways waysto tooptimize optimize smiles. For smiles.

CareCreditin inyour yourpractice, practice,contact contactyour your CareCredit PracticeDevelopment DevelopmentTeam Teamby bycalling calling Practice 800-859-9975,option option1, 1,then then6.

6.

800-859-9975, Notyet yetenrolled? enrolled?Call Call866-246-6401 866-246-6401 Not

Educational Audio Series Compliments of CareCredit SM

On this CD

Join Gary Takacs as he shares proven ideas and insights on how to create patients for life, focusing on providing patients with such a “remarkable” experience they can’t help but share positive remarks about the practice with their friends and family. Creating patients for life involves transitioning from a transaction practice, where the focus is primarily on the patient’s clinical needs, to a relationship-style practice, where both the clinical and relational needs of the patients are met.

Create Patients for Life with a Remarkable Patient Experience

YOU WILL LEARN HOW TO: ■ Make an incredible first impression with new patients ■ Create a practice tour that educates and excites patients about the dental services available to them ■ Use technology to actively engage patients in their oral health

featuring Gary Takacs, Practice Management Educator

Call Now Now for for aa Call FREE audio audio CD. CD. FREE

®

■ Initiate patient/doctor co-discovery ■ Have great financial conversations by choosing the most appropriate time and place www.carecredit.com/dental 800-300-3046 x4519 (new enrollment) 800-859-9975 (already enrolled) © 2014 All rights reserved. Duplication prohibited by law.

REV 9/9/14

Item # 851-948-00

*Subject to to credit credit approval. approval. *Subject

DE0515DA NEWD0516DA

countries have downloaded his Thriving Dentist Show. the most influential leaders in the dental profession. Dentists in 121 Show is a weekly internet radio show where Gary interviews some of audio podcast, the #1 dental podcast on iTunes. The Thriving Dentist environment. Gary is also the founder of the Thriving Dentist Show helped thousands of dental offices thrive in today’s changing business in-depth knowledge of the elements of a successful practice has ideal practice. Specializing in a patient-centered approach, his unique, Gary’s passion is helping dentists & team members develop their 602-321-1778 gary@takacslearningcenter.com

Gary Takacs, Practice Management Educator

FROM THE PUBLISHER’S DESK Dear Readers,

Advisory Board

Welcome to the Summer issue of The New Dentist™ magazine.

I

f you want to create a thriving dental practice, you not only have to attract new patients, you also have to keep them. Loyal patients who sing your praises to family and friends are vital to your practice’s success. As a new dentist, now is the time to focus on finding these loyal patients, patients who wouldn’t dream of going anywhere else for their dental care.

So how do you create a loyal patient base? Here are a few tips.

Start building rapport. Rather than just focusing on the dentistry, take the time to get to know your patients. Ask them about their jobs and their families, as well as their oral health goals.

Educate them about their condition. If you take the time to educate patients about the importance of maintaining their oral health, they’ll know you really care about their wellbeing—and will be more likely to go forward with any treatment you recommend.

Providing this education will help earn their trust and make them feel more connected to your practice.

Focus on customer service. Most patients don’t like going to the dentist and are uncomfortable as soon as they walk through the door. You and your team should do what you can to put them at ease. Train your team members to greet patients with a smile and to offer to help with any paperwork. Ask patients if they’d like coffee, tea or water as they wait and let them know they’re in good hands. This all goes a long way in enhancing the patient experience, and patients who have a positive experience will be happy to call your practice their dental home.

In this issue…

Our goal at The New Dentist™ magazine is to help you grow your patient base and your practice, and I’m excited to share what we have for you in this issue. If you’ve ever thought about treating sleep apnea in your practice, you’ll want to turn to page 14. Not sure what insurance you need as a new dentist? The article on page 6 will give you guidance.

Casey Hayes, Vice President of Sales for Hayes Handpiece Company, and a few of our advisory board members talk air-driven vs electric handpieces on page 22. On page 8, Dr. Dawn Durbin covers a topic that’s always on the new dentist’s mind: handling debt.

Dr. Michael DiTolla discusses the benefits of digital dentistry and lab communication on page 30, and you can learn about the latest trends in posterior composites on page 24.

Finally, Dr. Jordan Cooper gives advice on increasing productivity on page 18.

2 THENEWDENTIST.NET S U M M E R 2 0 1 6

Christopher Banks, DDS Inwood, WV WVU, 2011

Bryan Basom, DDS Columbus, OH Ohio State, 2007

Rebecca Berry, DMD Oakland, ME Tufts, 2011

Julie Boerger, DMD Patchogue, NY University of Montreal, 2010

Hal Cohen, DMD Haverford, PA Temple University, 2010

Larry Dougherty, DMD San Antonio, TX Nova Southeastern, 2008

Dennis Frazee, DDS Mooresville, IN Indiana University, 2012

Lindsay M. Goss, DMD, MPH Chandler, AZ ASDOH, 2010

Erica Haskett, DDS New York, NY NYU, 2008

Aaron Layton, DDS Fort Collins, CO Indiana University, 2010

Leah Massoud, DMD Morgan Hill, CA Tufts, 2009

Katie Montgomery, DDS Marysville, OH Ohio State, 2006

Michael Potter, DDS Quincy, WA University of Minnesota, 2014

Tyler Scott, DDS Loudonville, OH Ohio State, 2009

Mary Shields, DMD, MPH Louisville, KY University of Louisville, 2011

Matthew Silverstein, DMD, MPH West Hartford, CT University of Pittsburgh, 2012

Nicole Smith, DDS Newport Beach, CA NYU, 2009

Gregory Snevel, DDS Cleveland, OH Ohio State, 2011

Here to help,

Sally McKenzie, Publisher

$

TABLE OF CONTENTS

SUMMER 2016 S U M M E R 2 016 PUBLISHER

Sally McKenzie Sally@thenewdentist.net DESIGN AND PRODUCTION

Picante Creative www.picantecreative.com EDITOR

Renee Knight renee@thenewdentist.net SALES AND MARKETING

Jessica Mandrell, National Sales Manager jessica@thenewdentist.net For display advertising information, contact ads@thenewdentist.net or 877-777-6151. Visit our digital media book at www.thenewdentist.net/ mediabook.htm

14 FE AT U R ES Protecting Your Practice The Debt-Free Dentist

8

Treating Sleep Apnea

14

Happy Trails…As a New Dentist

6

18

4 Steps Every Dentist Can 20 Take to Serve Autistic Patients Handpiece Help

24

22

2 Publisher’s Message 32 Skinny on the Street

Choosing the Best 24 Posterior Composite Dr. Michael DiTolla on Digital Dentistry and Lab Communication

D E PARTMENTS

32 Index of Advertisers

30

4 THENEWDENTIST.NET S U M M E R 2 0 1 6

32

The New Dentist™ magazine is published quarterly by The McKenzie Company (3252 Holiday Court, Suite 110, La Jolla, CA 92037) on a controlled/complimentary basis to dentists in the first 10 years of practice in the United States. Single copies may be purchased for $8 U.S., $12 international (prepaid U.S. dollars only).

Copyright ©2016 The McKenzie Company.

All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, without permission in writing from the publisher. Authorization to photocopy items for internal or personal use is granted by The McKenzie Company for libraries and other users registered with the Copyright Clearance Center.

Disclaimer — The New Dentist™ does not verify any claims or other information appearing in any of the advertisements contained in the publication and cannot take responsibility for any losses or other damages incurred by readers’ reliance on such content. The New Dentist™ cannot be held responsible for the safekeeping or return of solicited or unsolicited articles, manuscripts, photographs, illustrations, or other materials. The opinions, beliefs, and viewpoints expressed by the various authors and contributors in this magazine or on the companion website, www.thenewdentist.net, do not necessarily reflect the opinions, beliefs, and viewpoints of The New Dentist™ magazine or The McKenzie Company.

Contact Us — Questions, comments, and letters to the editor should be sent to renee@thenewdentist.net. For advertising information, contact ads@thenewdentist.net or 877.777.6151. Visit our website at www. thenewdentist.net to download a media kit.

Our idea of traffic.

The road to a rewarding career opportunity awaits. As a dental health professional with the Indian Health Service (IHS) Division of Oral Health (DOH), you will experience a unique opportunity to deliver comprehensive care to an appreciative patient population within culturally diverse American Indian and Alaska Native communities nationwide.

IHS dentists enjoy an integrated, interdisciplinary team environment working within a collegial atmosphere. Combined with opportunities to be part of a rich, cultural tradition, you’ll also enjoy a structured, but flexible work schedule and have ample opportunity for recreational pursuits, all while living and working within some of the most beautiful areas of the country.

Professionally fulfilling and personally enriching — explore a world of opportunities in Indian health dental careers at www.ihs.gov/dentistry.

Opportunity. Adventure. Purpose.

The policy of the IHS is to provide absolute preference to qualified Indian applicants and employees who are suitable for federal employment in filling vacancies within the IHS. IHS is an equal opportunity employer.

Protecting your PRACTICE

By Renee Knight, Editor

A look at what insurance you really need as a new dentist.

Like most new dentists, Dr. Joe Wolski had plenty of debt and new expenses to worry about when he graduated from dental school. He also knew he needed insurance coverage before he started practicing, another expense and task to add to the growing list.

W

hile he didn’t learn much about the business side of practicing when he was in school, he did take advantage of the free Academy of General Dentistry membership—and that led him to his insurance carrier, the Dentist’s Advantage. Through the carrier’s partnership with the AGD, new dentists receive free professional liability insurance for the first year and then discounted rates for the next two years. This gave Dr. Wolski the coverage he needed without having to worry about the expense.

Most new dentists don’t know much about insurance when they graduate—they just know they need coverage in case something happens. Memberships at organizations like the AGD can help, but it’s also important to do your research and find a reputable carrier with a plan that meets your needs. Here’s a look at what insurance coverage you really should have those first few years and what to consider when choosing a carrier.

STARTING OUT When you begin your dental career, you need two types of insurance: professional liability and disability, said Chris Stafford, Vice President of Sales & Service for The Dentist’s Insurance Company. TDIC has a partnership with the California Dental Association and, like the Dentist’s Advantage, offers free and discounted insurance to new dentists seeking coverage.

“Malpractice protects your practice income and your assets from allegations you’ve done something wrong and disability insurance will protect your income in the event your health deteriorates and you can’t practice,” said Mark Buczko, Vice President of the Dentist’s Advantage program. “New dentists tend to have one focused goal, and that’s to pay off student debt. They also need to worry about what happens if they get sick and can’t practice and what happens if someone alleges they did something wrong.”

6 THENEWDENTIST.NET S U M M E R 2 0 1 6

There are other types of insurance you might want to consider investing in down the road, said Dan Miller, Senior Vice President of the Dentist’s Advantage program, but these are the two to focus on now. Most employers require you to have professional liability insurance, and disability insurance will protect you from losing income if you find yourself with an unexpected injury.

PROFESSIONAL LIABILITY INSURANCE: CLAIMS MADE VS OCCURRENCE When new dentists talk to Stafford about professional liability insurance, they typically have one question: what’s

the difference between a claims made and an occurrence policy. This is a key question, because buying the wrong policy could cost you big down the road.

So what is the difference? An occurrence policy protects you indefinitely into the future while claims made coverage keeps up with the increased cost of living throughout time.

Stafford sees claims made as more comprehensive coverage that offers better protection. With claims made, you have limits you renew every year, but with an occurrence policy you can’t buy those limits back.

Let’s say you missed an oral cancer diagnosis 15 years ago and the patient brought a claim against you today. If you have an occurrence policy, the money set aside for your claim is the amount of your limit 15 years ago—probably about $200,000, Stafford said. That won’t even cover your lawyer, let alone any money you might have to pay the patient. Claims based polices are retroactive, so the policy covers you for whatever your limit is today— which is usually $1 million per occurrence and $3 million aggregate.

“Dentists think when they buy an occurrence policy for a $1 million limit that it adds up year over year as long as they don’t have a claim, but that money is set aside just for events in that year and won’t roll over,” Stafford said. “In the case of the missed cancer diagnosis you would have to pay out of pocket for costs in excess of $200,000.”

Buczko says there are benefits to both policies and that an occurrence policy might be better for dentists who want a fixed price on their insurance coverage throughout their career. Claims based policies tend to be cheaper upfront, but dentists who choose this option might end up with a significant payment toward the end of their career to bring it in line with current policy costs.

Most insurance companies offer new dentists discounted rates, so you can expect to pay $0 to $500 for the first year with rates gradually going up over the next few years, Buczko said. After that, yearly rates range depending on the type of coverage you have and where you live, but most dentists can expect to pay about $2,000 a year for a $1 million limit.

DISABILITY COVERAGE Not convinced you need disability coverage? Think about it this way. You just invested hundreds of thousands of dollars into your education, and you need to protect yourself and your family from the loss of income an unexpected injury would bring.

With disability coverage, it comes down to the definition of what’s actually a disability, Stafford said. The policy must be specific and cover injuries that would keep you from doing your job as a dentist, not just any job. For example, a wrist injury might not be a big deal for most professionals, but losing fine motor skills means you can’t practice dentistry.

There are a number of different avenues you can take when buying disability coverage, but cost is typically based CONTINUED ON PAGE 28 >>

SUMMER 2016

THENEWDENTIST.NET

7

The

Living abnormally to gain financial security and freedom for your practice.

Debt-Free

By Dawn Durbin, DDS

Dentist

We are given owner’s manuals for our cars, our televisions and other significant life purchases. Unfortunately we are not given a step-by-step owner’s manual to life. Most of us make it through life doing the best we can with what we know.

W

hen it comes to managing money, most people deal with money as their parents did, which for some isn’t always a good thing.

Graduating dental students, young dentists, and even some who have been practicing dentistry for a long time too often carry enormous financial debt.

As if undergraduate and dental school debt weren’t enough, many of us continue to dig ourselves even further into debt because we have “doc-itis,” feeling we have sacrificed so much over the previous eight years that we deserve all the great things a dentist’s lifestyle has to offer.

I know how that feels; I felt like that, too.

My husband and I had business and personal debt in excess of $1.2 million at one point in our married life. Most of our debt accumulated as a result of my undergraduate and dental school loans, our home, the dental building, the dental equipment,the practice, a car, and some land—nothing out of the ordinary. Nothing frivolous. (In fact, my husband drove a 1985 Buick Park Avenue until a year ago—at first because he had to, but after that because he thought it was funny.)

For a few years, we were making minimum payments on everything, refinancing my school loans to lower my interest rates at every opportunity. And as time marched on, so did the debt that hung over our heads.

8 THENEWDENTIST.NET S U M M E R 2 0 1 6

My husband was always uncomfortable with debt and was never in debt until I came along. He lived simply to keep his head above water financially, because he knew what government cheese tasted like and didn’t want to taste it again. He was a factory worker and knew better than to live above his means. He was finally adamant that we get on the same page financially.

So, we did. We started working hard to get out of debt, and we did. It wasn’t easy, but boy was it worth it. I want to share with you, as a fellow colleague, how we claimed financial freedom, so you might do the same.

THE TURNING POINT I didn’t see the big deal. After all, everyone has debt—it’s normal! Right?

My husband had heard the Dave Ramsey radio show and knew he had found someone who thought like he did. Dave Ramsey, a nationally known financial expert and media personality, was coming to do his “Live Event” in Louisville,Kentucky, and my husband insisted I go with him. I reluctantly agreed to go. It was on a sunny Saturday spring morning. Great. Just how I wanted to spend the first sunny Saturday after a long winter… As Dave would say, “There were heel marks in the pavement” from being dragged in!

After the conference I saw that living in debt and only making minimum payments on everything was truly dragging us down. With this new realization of how

much joy debt was robbing from our lives, I had a fire burning inside.

I sat down in the quiet of my office on a weekend morning and began listing my school loan debts from the smallest amount owed to the largest amount, regardless of the interest rates. I devised a plan of action to pay each one in full. I also calculated a realistic time frame for paying off the debt. This was not going to be a microwave fix, but a crock pot fix. But I knew it was going to taste delicious when it was all done!

I went home and presented my husband with my plan to get rid of my school loans. He almost cried because he knew I had “gotten” it. He saw the fire in me. It was palpable. He knew we were finally a team.

CONTINUED ON PAGE 10 >>

Dawn Durbin, DDS, practices general dentistry in Corydon, Indiana. She is a member of the Indiana Dental Association, where she serves on the Council on Communications. Dr. Durbin lives in Corydon, Indiana, with her husband Kevin.

SUMMER 2016

THENEWDENTIST.NET

9

TOP 5 REASONS DENTISTS GET TRAPPED INTO DEBT

Debt

continued from page 9

Living a certain lifestyle to appear to be successful.

SMALL STEPS, BIG SACRIFICES The first debt we paid off was the toughest, not only because it was hard to change our whole approach to managing money, but also because any extra money we had went toward the debt— not toward new shoes! When the first loan was paid off, we combined the minimum payment we had been making on the second loan with the amount we had been paying on the first. Using this method we paid off the second loan, then the third, then the fourth. Dave Ramsey calls this the “Debt Snowball.” It is his second “baby step” in dumping debt.

It took us 10 years of hard work and, yes, more sacrifices, but we are now completely debtfree—even the house is paid for. We sold a bunch of stuff we didn’t want to sell, including our first house, the land, and my car. We agreed to incur no more debt for any reason. Ever. No matter what. In that spirit, it was easy to let go. It was just part of the journey. We rented and lived in a tiny 1920s house for three-and-a-half years after having lived in a “doctor-size house.” I drove an older car instead of a new one. We clawed and scratched our way out of debt and we saved and saved and saved.

In the meantime I had been tearing pages out of home magazines, carefully deciding exactly what I liked and what I wanted when it was time to look for another house. (I had to make sure my husband liked it too.) After all of my research, I even knew what the exercise room and the office would look like.

I taught myself that I had to know what I wanted before allowing myself to get it. I saw that, the clearer I was with myself and the more I wrote down, the more I ended up getting what I wanted.

We found a house in foreclosure that was almost exactly what we wanted, and we paid cash. For all of the interior features that weren’t exactly what we wanted, we paid cash to change them to our liking.

LESSONS LEARNED 1. Debt is “normal,” but “normal” is broke.

I am essentially trying to convince you to be weird. Strangely enough, it’s more shocking these days to be debt-free than to be broke.

CONTINUED ON PAGE 12 >>

10 THENEWDENTIST.NET S U M M E R 2 0 1 6

Most of us have been to Disney World. All of the facades seem so glamorous and magical—until you get close—only to find it’s a painted piece of wood or plastic. Don’t let the pressures of society and the dental community get to you. Be honest with yourself about your financial capabilities, and create a plan that works for you and your budget. You have to be happy, not your neighbors or colleagues whom you would like to impress. Leave the magical facades to Mickey.

Overspending on the latest dental technology. It’s exciting to think about purchasing all of the new dental gizmos constantly pitched by suppliers. You’ve heard those pitches: “Just think how much time you could save having digital radiography, or digital impressions,” or, “You can precisely find the pathologic lesion with CBCT imaging in your office.” Although all of those things would be true if you owned these devices, you must ask yourself if now is the right time. Could you send your patient to your colleague’s office or a university to have the CBCT? Sometimes a short-term solution will buy you some time while you save for the “must-haves,” or even the wants, on your wish list. Who knows, maybe someone will sell just what you want at a reduced price and you will be able to get the deal of a lifetime.

Expensive CE requiring several long-distance trips.

All of us need to keep our CE current so we don’t become stagnant.

We learn better techniques, more about occlusion, business, leadership, etc. Most of the “high-end” CE courses require a significant investment, including travel and substantial tuition. Borrowing money for CE does not always pay off. Shop for CE just like you shop for equipment: Do your research, decide which courses you really want to take, and buckle down for a time to pay for it with cash. You’ll be happy you did.

Replacing an expensive piece of equipment “unexpectedly.”

No dental equipment runs perfectly for the duration of your practice.

Making repairs along the way, however, can save big in the long run.

For example, when is the last time you changed the oil in your air compressor? Just like having an emergency fund at home, you need one at the office for situations when a piece of equipment dies. At the very least, have a month’s worth of all expenses set aside in the bank— not to be touched unless there is a true emergency. (An emergency can be defined as something you would have otherwise had to borrow money to pay for.) Expect emergencies, and be prepared for them. They will happen.

Buying a practice too soon, or a practice you can’t afford.

When I was in dental school, we were taught very little about running a business. This education is still lacking among today’s new dentists.

I’ve found it most helpful to seek advice on these matters to make more sound, beneficial business decisions. With all of today’s potential pitfalls in conducting business, we must become savvy business owners, eager students, and avid readers if we are going to succeed. Once you figure it out, it’s fun. If you are already caught in this trap, seek help immediately and save your practice (and sanity).

DO WHAT YOU CARE ABOUT MOST: HELP PATIENTS AS A U.S. ARMY DENTIST. You want to focus on what matters most — your patients. As a dentist on the U.S. Army health care team, you’re free to concentrate on your work, not operational issues like overhead costs and patient billing.

You’ll work with the most sophisticated modern technology, learn from extensive case diversity and benefit from educational opportunities that can help expand your skills. Plus, you may earn financial benefits, including a $75,000 sign-on bonus and up to $120,000 in student loan repayment.

To learn more, call us at 800-431-6712 or visit healthcare.goarmy.com/du42

©2016. Paid for by the United States Army. All rights reserved.

Debt

continued from page 10 My story proves there is no reason that people who are in significant debt have to accept debt as a lifestyle. There are straightforward, though sometimes painful, steps to achieving a life free from payments.

2. When you are depending on the patients in your chair to help you make your next debt repayment, they know it. You can’t help the vibe you convey to your patients, even with the best intentions. Can you imagine the difference between trying to convince patients to do something you think they should do, as opposed to taking them by the hand, showing them what you see, and asking them if it concerns them? If they say, “yes, it is a concern,” you present them with treatment options and walk together. It is much easier to be their coach and their guide, rather than trying to twist their arm into accepting a treatment they aren’t convinced they truly need. Now might not be the best time for them, but for a dentist in debt, now is always the best time. Since becoming debt free, I am able to be relaxed, and to thoroughly listen and explain things to patients before I recommend any treatment. Treatment acceptance dramatically increases and everybody feels good about it.

BABY STEPS Baby Step 1: Baby Emergency Fund

Get $1,000 in the bank as quickly as you can, not to be touched unless there is an emergency that you would have otherwise used a credit card for. If your transmission goes out on your car, for example, use this money to repair your car. Do not use a credit card. In fact, you should not own a credit card if you are serious about getting control of your debt. I have heard every excuse for needing one. You do not need one. I haven’t had one in over 10 years.

Baby Step 2: Debt Snowball

Pay off all your debts, smallest to largest, as quickly as you can. Pay no attention to the interest rates unless two of the debt amounts are the same. It is the only way to attain and maintain traction toward your goal. You will need to write a cash flow plan in order to accomplish this, also known as a budget. (Baby step two took us 10 long years once we got serious about it.) Drawing a line through your paid-off debts one by one yields a huge sense of accomplishment and spurs momentum.

Baby Step 3: Fully Funded Emergency Fund

Make sure you have three-to-six months of expenses in the bank in case something financially catastrophic happens.

There are a total of seven baby steps in the Dave Ramsey model for paying off debts. Find all seven at DaveRamsey.com.

12 THENEWDENTIST.NET S U M M E R 2 0 1 6

CASE STUDY Here is an example (one of many) of how doing my homework, being patient and working from a budget saved me big money on an equipment purchase: After becoming debt-free, I knew the first major purchase I wanted was digital radiography equipment. I started setting aside 10 percent of collections into a separate bank account to go into the practice emergency fund, and 10 percent to save for future equipment purchases, CE, team travel, etc.

I had researched all the different digital systems, asked colleagues for advice, talked with sales reps and decided on the one I wanted. There was a major problem: The investment I was going to have to pay was nowhere near what my budget allowed. So I decided to keep using film and keep saving. Because I told the sales representative that I had decided on her system, she kept me in mind. On New Year’s Eve of that year she called me. She said, “You are not going to believe this, but my company has decided to significantly cut the prices of both the software and the sensors, but you have to buy it today.”

Of course, I jumped at the offer. This was not an impulse decision. Because I had already done all the research, I knew exactly what I was getting. And after thinking about the previous price I had been quoted, I knew I was getting the deal of a lifetime. I was able to give her the routing number of my bank account. It was now within my budget, and I paid with cash.

Editor’s Note: This article originally appeared in the Spring 2012 issue of the Journal IDA.

Wells Fargo Practice Finance

Financing for your practice — and so much more

When you’re ready to purchase or start a practice, count on Wells Fargo Practice Finance to help you achieve your goals: · Up to 100% financing to help you acquire an existing practice or start one from scratch · Competitive fixed-rate loans with preferred pricing for ADA® members · Complimentary business planning tools, educational resources, and practice management consulting to help you successfully manage your transition to ownership

To get started, call 1-888-937-2321 or visit wellsfargo.com/thenewdentist to request your free Practice Starter Kit. Wells Fargo Practice Finance is the only practice lender selected especially for ADA® members and endorsed by ADA Business ResourcesSM.

All financing is subject to credit approval.

ADA® is a registered trademark of the American Dental Association. ADA Business ResourcesSM is a service mark of the American Dental Association.

ADA Business Resources is a program brought to you by ADA Business Enterprises, Inc., a wholly owned subsidiary of the American Dental Association. © 2016 Wells Fargo Bank, N.A. All rights reserved. Wells Fargo Practice Finance is a division of Wells Fargo Bank, N.A. 2846-0116-New Dentist Print Ad

Get the facts with a free Practice Starter Kit, including our latest issue of Strategies for Success, a New Dentist Planner, and an easy-to-use business plan template.

Treating

By Renee Knight, Editor

SLEEP APNEA Thinking about adding this service to your practice? Here’s what you need to know.

Last year, Dr. Nicole Chenet retired from general dentistry at the age of 40. She decided it was time to truly focus on what she’s most passionate about—treating patients with sleep apnea.

D

r. Chenet first began treating sleep apnea about six years ago and slowly grew her patient base over time. She worked hard to market her services and to build strong relationships with physicians in her community, earning their trust and their referrals. It wasn’t easy, but knowing she can help patients who suffer from all the symptoms that come with this condition, including migraines and facial pain, made it well worth the time and effort.

14 THENEWDENTIST.NET S U M M E R 2 0 1 6

“I recognized this isn’t something you can dabble in,” Dr. Chenet said. “It’s a science unto itself and takes a lot of time. I put my whole heart, soul and energy into becoming more of an exclusive sleep apnea practice, but it didn’t happen overnight.”

While you don’t have to give up general dentistry to provide sleep apnea treatment in your practice, you do have to realize it’s a commitment. It can be a great practice builder, but you must do it right. Here’s what you need to know.

IT STARTS WITH EDUCATION To treat sleep apnea, you need the proper education.

Taking a weekend course isn’t enough, said Dr. Kathleen Bennett, President of the American Academy of Dental Sleep Medicine. Learn about sleep apnea before implementing it into your practice. The AADSM is a great place to start. The organization offers a variety of courses as well as webinars and videos to give you the foundation you need.

“If you want to open an airway for a patient, you have to figure out how to do it the best way,” Dr. Bennett said. “You need to learn the skills of bringing the jaw forward and how to maximize the airway.”

WORKING WITH PHYSICIANS Last year, the American Academy of Dental Sleep Medicine and the American Academy of Sleep Medicine released joint sleep apnea guidelines for the first time. Through these guidelines, both organizations recommended oral appliance therapy to treat adult patients with obstructive sleep apnea who couldn’t tolerate continuous positive airway pressure (CPAP) therapy or who prefer alternate therapy—supporting increased teamwork between both the dentists and the doctors who treat these patients.

When working with a sleep apnea case, the physician makes the diagnosis, prescribes an oral appliance and then refers the patient to a trusted dentist, Dr. Bennett said. The dentist makes the oral appliance and then follows up with the patient before referring back to the physician.

It’s important to remember dentists aren’t there to diagnose sleep apnea cases; that comes from the physicians, said Dr. Chenet, who uses oral appliances from Respire Medical. You can’t diagnose and treat these patients on your own. To be successful, you need to develop strong relationships with physicians in your area and constantly communicate with them for the best possible outcomes.

“The misconception with dentists getting into this is they’re just treating snoring and snoring issues. They think they can give patients a mouthpiece and hope it works out,” said David Walton, Co-Founder and CEO of Respire Medical. “It’s much more multifaceted than that. It’s not just a mouthpiece. This is a life threatening condition and it should be respected that way.”

IMPLEMENTING THIS TREATMENT INTO YOUR PRACTICE Once you get the education and establish the relationships, it’s time to develop protocols. Dr. Bennett suggests you start by screening patients to see if they suffer from sleep apnea.

Use a questionnaire to identify patients at high risk. Ask them if they snore or have trouble sleeping. From there, evaluate the airway. If the airway is obstructed, refer the patient to a sleep physician.

The new guidelines from the American Academy of Dental Sleep Medicine and the American Academy of Sleep Medicine: 1 We recommend that sleep physicians prescribe oral appliances, rather than no therapy, for adult patients who request treatment of primary snoring (without obstructive sleep apnea). (STANDARD) 2 When oral appliance therapy is prescribed by a sleep physician for an adult patient with obstructive sleep apnea, we suggest that a qualified dentist use a custom, titratable appliance over non-custom oral devices.

(GUIDELINE) 3 We recommend that sleep physicians consider prescription of oral appliances, rather than no treatment, for adult patients with obstructive sleep apnea who are intolerant of CPAP therapy or prefer alternate therapy. (STANDARD) 4 We suggest that qualified dentists provide oversight—rather than no follow-up—of oral appliance therapy in adult patients with obstructive sleep apnea, to survey for dental-related side effects or occlusal changes and reduce their incidence. (GUIDELINE) 5 We suggest that sleep physicians conduct follow-up sleep testing to improve or confirm treatment efficacy, rather than conduct follow-up without sleep testing, for patients fitted with oral appliances. (GUIDELINE) 6 We suggest that sleep physicians and qualified dentists instruct adult patients treated with oral appliances for obstructive sleep apnea to return for periodic office visits—as opposed to no follow-up—with a qualified dentist and a sleep physician. (GUIDELINE) Want more?

Visit the American Academy of Dental Sleep Medicine at aadsm.org for more information on what it takes to treat sleep apnea in your practice.

SUMMER 2016

THENEWDENTIST.NET

15

PHOTO COURTESY OF THE AMERICAN ACADEMY OF DENTAL SLEEP MEDICINE

That’s how Dr. Mary Anne Baysac, who has treated sleep apnea for about three years, identifies high risk patients in her practice. She really started marketing sleep apnea as one of her services last year and says building close relationships with sleep physicians is vital. Not only are they the ones making the final diagnosis, they also understand medical billing and can help you with claims.

This truly requires a team approach if you’re going to get the best results for your patients and your practice.

Now Dr. Baysac is working to develop a protocol that streamlines the process, from screening patients, to billing medical insurance to following up with patients throughout and after treatment. She also understands how important it is to get her team involved. They have meetings to discuss sleep apnea and how to properly fill out paperwork.

“We can’t write like dentists when we take notes,” said Dr. Baysac, who uses oral appliances from SomnoMed. “We have to write like physicians and use their language. I’m training my team to be more efficient and I’ve designated someone to be our sleep coordinator. We have a centralized location for sleep apnea. We have a sleep apnea binder and sleep apnea forms. We have separate charts and use Dentrix so we can identify medical billing patients.”

Dr. Chenet also has developed protocols and said she won’t treat patients unless they’ve had a sleep study and an appropriate diagnosis. After she takes an impression for an oral appliance, she communicates with the patient’s physician and the general dentist. She schedules follow-up visits and a follow-up sleep study with the oral appliance in place.

“You have to take it very seriously, but once you do your sleep apnea practice will grow,” Dr. Chenet said. “It will grow slowly, but at a pace where you’re establishing

CAREER OPPORTUNITIES WORTH

ABOUT NATIONWIDE

UP TO $25K S BONU

Compensation » Average annual compensation of full-time dentists in excess of $230,000 Benefits » Health & Malpractice Insurance » Continuing Education » Dental coverage for associates and immediate family members » Three weeks’ vacation » Visa and permanent residency sponsorship Clinical Practice » Complete freedom over treatment planning » Friendly and efficient staff » Paperless offices and state of the art equipment and supplies » Discretion over dental supplies and instruments

Make Dental Dreams a reality for you. Please contact us to learn more about rewarding associate dentist opportunities.

We offer full-time, part-time, and Saturday only schedules. New grads and residents are encouraged to apply.

IL, MI & SC: Contact Kari Thompson @ 312.274.4530 or kthompson@kosservices.com MA, PA, VA, DC, MD, LA, TX & NM: Contact Juliette Boyce @ 312.274.4520 or jboyce@kosservices.com

16 THENEWDENTIST.NET S U M M E R 2 0 1 6

“

The risks of untreated sleep apnea are great, including heart attack and stroke. As you develop your skills, it’s a value that’s added to your practice.

JOIN OVER

3,000 dentists

who are helping to treat the millions of people who have obstructive sleep apnea.

”

— Dr. Kathleen Bennett, President of the American Academy of Dental Sleep Medicine relationships with doctors and doctors are respecting what you do because you’re following the appropriate protocols.”

GAINING POPULARITY As more dentists become interested in sleep apnea, Dr. Chenet cautions new dentists to be wary of manufacturers that claim you can treat 50 patients a day with their system—without collaborating with a sleep physician. That isn’t reality, and it isn’t how to build a practice.

Even if you decide treating sleep apnea isn’t a good fit for you, at least not yet, you can still look for the condition in patients, Dr. Chenet said. When you see the tongue obstructing the soft pallet during hygiene exams, ask patients if they snore or if they often wake up with headaches. Look for signs and bring awareness to your community. And when you find a patient you think might have the condition, refer that patient to a sleep doctor.

For dentists who do want to make the commitment, start building those relationships and get the education you need to be successful.

“It’s a great way to care for patients,” Dr. Bennett said.

“The risks of untreated sleep apnea are great, including heart attack and stroke. As you develop your skills, it’s a value that’s added to your practice. You can become one of the primary dentists in your area who does this. It certainly fills a need in society with so many patients with untreated sleep apnea.”

New Dentist

Blog

Visit aadsm.org/member.aspx to learn more about membership with the American Academy of Dental Sleep Medicine.

www.thenewdentist.net/Blog

SUMMER 2016

THENEWDENTIST.NET

17

Happy Trails …

AS A NEW DENTIST Advice from a clinician who marks 10 years as a dentist this summer.

By Jordan Cooper, DDS PA

It’s a bittersweet statement to make, but I guess this will be the last article I write as a “New Dentist.” I will have completed my tenth year of practicing the profession I love in June. During these years, our practice has grown from one location to seven. We have added several associate doctors and every month we meet to go over protocols and procedures.

A

s I was planning the agenda for our meeting this month, it occurred to me that, maybe, I could share a little of what I’ve learned over the past 10 years with dentists just starting out. I’ve put together five tips to help you boost production and grow your practice.

1. MAKE POST-OPERATIVE CALLS Post-op calls are helpful for multiple reasons. First of all, they allow you to check for procedure complications.

If something has gone wrong or the patient had a bad experience, you have the opportunity to address the issue with your patient first, as well as learn from the experience and rectify the situation.

These calls also endear you to your patients. It shows patients you care, confirming the trust they have in you and your practice. As your practice grows, I recommend delegating this function to the dental assistant who sat chairside during that patient’s most recent procedure.

2. DO A TREATMENT PLAN COMPLETE CHECK This sounds obvious, but you might be surprised by how many dentists don’t do this. Many times a patient comes into your office with a complex treatment plan that may evolve 18 THENEWDENTIST.NET S U M M E R 2 0 1 6

PHOTO COURTESY OF DR. JORDAN COOPE R.

over months or even a year. Upon completing treatment, you scratch off everything on your original list or mark it complete in your software. It now appears all treatment is complete, or is it?

After several appointments over time, treatment can change. By doing another check, you may find a new cavity or treatment that was overlooked because of the original severity of the case. Always check the patient’s current oral health with the treatment plan. This last check will benefit both the patient’s health and your practice.

CONTINUED ON PAGE 31 >>

Dr. Jordan Cooper is from Jacksonville, AR. He graduated from the University of Arkansas with a Bachelor of Arts in Spanish and in 2006 graduated from the University of Tennessee College of Dentistry. After dental school, Dr. Cooper joined his father in practice in Jacksonville. Cooper Family Dentistry has now grown to include 5 other practices with locations in Jacksonville, Conway, Lonoke and Little Rock. Dr. Cooper is also the Continuing Education Chair for the State of Arkansas and is the author of the International Best Seller “Chasing the Blue Marlin.”

ADVERTORIAL

4 Steps Every Dentist Can Take To Serve Autistic Patients In dental school we’re taught how to fix teeth, identify pathologies, and treatment plan people’s long term oral care. However, with all of our training and practice, we may not feel comfortable seeing patients with autism. As general practice dentists, we often believe only pediatric specialists are qualified and Jacob Dent, DDS trained to handle autistic patients.

For me, the major turning point came in both my personal and professional life when my son was diagnosed with autism. Overcome with emotions of anger, helplessness and devastation, I decided to educate myself about autistic developmental disorders and how to manage the associated challenges.

Living with an autistic child over the past 12 years, there has been much learning from daily devotion and trial and error. Every person with autism is unique. Some are high functioning and some are low functioning. Not all people with autism are savants, nor are they intellectually disabled. This uniqueness is what makes treating patients with autism both challenging and rewarding. Based on my personal experience and learnings, there are four simple steps every dentist can take to prepare themselves to treat autistic patients.

1

Use the parents/caregivers as a resource Ask the parents/caregivers to fill out a health history intake form specific for autism (samples available in the Autism Speaks® toolkit for dental providers1), and discuss their concerns and expectations. Parents/caregivers are your best resources in helping the patient have a good dental visit.

Always allow parents to come into the operatory with the patient. If only one parent can make the appointment, request the one who is involved with brushing at home. This allows you to ask about their routine at home and provide feedback on how to improve their daily brushing and flossing.

At every first visit, I have parents demonstrate their normal home care routine either in the dental chair or standing in front of the bathroom mirror. Patients may be uncomfortable in a new environment and uncooperative at first. Allow the parent to sit in your chair to help acclimate the patient for you. Desensitizing patients to your office takes time. Do not force the patient to do something he/she is not ready for. It is important to push for progress, but going too far can undo any progress already made. Parents are the best resource to inform you of how far you can push.

20 THENEWDENTIST.NET S U M M E R 2 0 1 6

2 3 4

Be intentional with scheduling Autistic patients are best scheduled for the first appointment in the morning or the first appointment after lunch. This ensures they won’t have to wait and the number of people in the waiting room will be minimal. Appointments should be no longer than 30 minutes. Multiple appointments may be necessary to build trust and comfort with the patient.

Create a social story Use pictures personalized to yourself and your office to create a social story. This can be as simple as 5-10 pictures and should show patients a step by step example of what will occur during their visit. Social story samples are available in the Autism Speaks toolkit, but making one with pictures of your own office and staff will help to improve familiarity. Give these to autistic patients a week or two before their visit.

Take one small step at a time Start small and do not expect every visit to be a win. You may accomplish everything or nothing depending on how the patient is doing that day. The key to success is routine and repetition. This will help gain the patient’s trust. To achieve this, follow the same process each time. Use the same room, same dental assistant and dental hygienist if possible, and the same positive reinforcements, such as a toy or movie the patient gets only for good behavior.

The social story also can be used as a guide for patients, parents and doctors on what will be done at each visit and what will be worked on at the next visit.

Treating patients with autism no longer needs to be something we avoid or only refer to a specialist. As dentists, we thrive on doing things in a timely, organized, and methodical order that can help deliver predictable, quality results. Applying this theory to treating autistic patients will help set us up for success.

References 1. ATN/AIR-P Dental Professionals’ Tool Kit. 2015. https://www. autismspeaks.org/science/resources-programs/autism-treatment-network/ tools-you-can-use/dental. Accessed on December 15, 2015.

Dr. Jacob Dent is a graduate of Louisiana State University School of Dentistry and has been a practicing general dentist since 2003.

He is the owner dentist of Sugar Land Modern Dentistry and Orthodontics, a practice supported by Pacific Dental Services® in Sugar Land, Texas. Dr. Dent is also a faculty member of the PDS Institute® as a subject matter expert in special needs dentistry. The father of a 12-year-old autistic child, Dr. Dent serves as an advisory board member for several autism advocacy groups. He can be reached at dentj@pacden.com.

Handpiece Help Not sure how to find the right handpiece?

Hayes Handpiece offers some advice.

CASEY HAYES, VICE PRESIDENT OF SALES FOR HAYES HANDPIECE

Choosing the right handpiece for your practice can be a bit overwhelming. There are plenty of options in both air-driven and electric styles, but what’s best for you?

We recently talked with Casey Hayes, Vice President of Sales for Hayes Handpiece Company, about how to choose the right handpiece and then properly maintain it.

Here’s what he had to say.

Q: WHAT SHOULD A DENTIST LOOK FOR WHEN CHOOSING A HANDPIECE? A: Dentists have many choices when selecting a handpiece. Choosing a handpiece that is comfortable for both the patient and the doctor is very important. The main elements to consider are head size, angle, weight, torque and noise. Torque is very important so the doctor can cut efficiently and quickly. Acceptable access based on head size is also very important.

I recommend trying out several handpieces prior to purchase to make an informed decision on your investment.

Q: WHAT IS THE DIFFERENCE BETWEEN ELECTRIC AND AIR-DRIVEN HANDPIECES? A: Electric handpieces are one of the fastest growing segments in the U.S. dental market. It is estimated the U.S. handpiece market is between 30 and 40% electric. In Europe and Asia, the market is estimated to be about 80% electric. The U.S. market will continue to grow as we are seeing more dental schools add electrics for training.

22 THENEWDENTIST.NET S U M M E R 2 0 1 6

The major differences between air-driven and electrics is electrics have substantially more torque and less noise. Electrics have up to 60 watts of power where the air-driven have approximately 16 watts of power with a max up to 30 watts.

The noise is considerably less with electric handpieces because they have a drive shaft and gears as opposed to air flowing through the handpiece to the air turbine. The electric highspeeds reach a maximum rpm of 200,000 with little or no drop in rpm while contacting the tooth. The air-driven handpieces run between 350,000 and 400,000 rpm with a reduction of rpms in excess of 100,000 when contacting the tooth.

This causes the dentist to “feather” while cutting to regain the rpms. With electrics, the dentist can cut continuously, allowing for more accuracy.

Q: WHAT ARE THE PROS AND CONS OF INVESTING IN AN ELECTRIC HANDPIECE? A: The major initial complaints we receive on the electrics is they are too bulky and heavy. The major electric manufacturers have made great strides

in developing smaller, lighter and more efficient electric handpieces. All of the new electric motors are brushless systems, making them much more reliable.

Electric handpieces are also a nice time saver and more accurate because of the superior torque. Electrics have less vibration, cut quicker and are quieter—all pluses for the patient and the dentist. If not serviced or used properly, electric handpieces can get hot and burn patients. Don’t try to save money by having an unauthorized repair center service your electrics.

Air-driven handpieces are generally smaller and lighter, which some dentists still prefer. They are also less expensive to service.

Q: HOW CAN DENTISTS MAKE SURE THEY PROPERLY MAINTAIN THEIR HANDPIECES? A: There are two ways to maintain handpieces—man or machine.

The U.S. market has seen a big increase in the number of automatic lube stations, which lubricate and flush

PHOTO COURTESY OF NSK

the handpieces automatically, helping eliminate staff error.

If the dentist chooses not to invest in a lube station, then proper staff training is essential. Hayes offers convenient in-office maintenance classes to properly train dental staff on handpiece maintenance—for lowspeeds and highspeeds.

The key components to maintenance are rotation (how many handpieces does your office have?), lubrication and sterilization. Offices should use a high-grade handpiece lubricant and avoid inexpensive, inadequate lubricant.

The handpieces should always go through the drying cycle; if they don’t they’ll develop internal and external rust, dramatically decreasing their life.

Q: DO YOU HAVE ANY OTHER ADVICE FOR NEW DENTISTS? A: I recommend new dentists align themselves with a handpiece specialist they can go to for training and advice.

Choosing the correct handpieces and properly maintaining them will result in substantial time and money savings throughout a dentist’s career.

THOUGHTS FROM OUR ADVISORY BOARD “I use electric because I prefer the torque, or the ability of the handpiece to cut at a consistent force regardless of the material applied to the bur. However, the electric is much heavier and less ergonomic so there is a tradeoff. I personally find electric to be far superior in cutting power so it’s worth the tradeoff of adding bulk.”

—Dr. Christopher Banks, who uses the KaVo Electric handpiece and the KaVo QuatroCare Maintenance System.

What he likes most about his handpiece: The excellent cutting efficiency and quieter operation when compared to air-driven/other models.

“The light allows for easy view.

I prefer electric handpieces because they are more stable. They stop when I release the rheostat.”

—Dr. Lindsay Goss on the KaVo Electric Fiber Optic handpiece What she looks for in a handpiece: Something electric and lightweight for good ergonomics.

“I use both electric and air-driven.

I like the electric handpiece the best. It cuts crowns very efficiently.” ­—Dr. Rebecca Berry How she maintains her handpieces: Lubrication before sterilization “I use the Assistina (handpiece maintenance system) day to day for maintenance, and one time every 2 years I have a service come into the office to check each handpiece and service as needed.”

—Dr. Aaron Layton, who uses an air-driven from W&H Synea and an electric from KaVo What he likes about the air-driven: Size and reliability. He prefers this handpiece for simple fillings.

What he likes about the electric: Power.

He prefers it for crown and bridge work.

“It has a fiber optic and cuts more efficiently than most air-driven highspeeds.”

—Dr. Hal Cohen, who uses an NSK handpiece How he maintains his handpiece: His assistant lubricates it after each use.

CONTINUE YOUR

FREE SUBSCRIPTION TODAY! THE #1 JOU RNAL FOR NEW DENTISTS

EQUIPPING

THE NEW DENTAL PRACTICE

PLUS

Leasing vs. Buy ing Maximize You r Dental Assistant Digital Radiogr aphy in Your Practice SPRING 2015

URNA THE #1 JO

TS W DENTIS L FOR NE

R SALE DentisWhattrMyakFesOa PaentitenPltanBu?y Into a Treatm

PLUS tein on Dr. Feuers Haves MustTechnology Leave Maternity for g rin Prepa ect an How to Sel nity portu Op ate Associ ER 2015 SUMM

SIGN UP NOW AT The New Dentist – New Dentist Resources, New ...

http://www.thenewdentist.net/subscribe.php

thenewdentist.net/subscribe.php

http://kaywa.me/8pTxQ

877.777.6151 Download the Kaywa QR Code Reader (App Store &Android Market) and scan your code!

SUMMER 2016

THENEWDENTIST.NET

23

Choosing the best posterior composite

By Renee Knight, Editor

The thought of choosing a posterior composite can be a bit overwhelming. There are a variety of options on the market, but how do you know what will work best for your patients and your practice? Because of this, many new dentists stick with what they used in dental school. If that describes you, you could be missing out on even better options that are available today.

To help make the decision a little easier, we recently spoke with a few dentists—both experienced and new—about what they look for in a posterior composite and what they use in their practices.

Dr. Steve Melonakos, Plantation Dental Dr. Steve Melonakos has used a variety of posterior composites in his short dental career. Before becoming a dentist he worked with Gordon Christensen at CRA, where he had the opportunity to handle and learn about many different materials. He’s found that, these days, most posterior composites offer low shrinkage and marginal adaptation, but finding a material that’s easy to handle is a little more challenging.

About four years ago, Dr. Melonakos began using materials from Shofu.

For just about every posterior composite he places, he lines the prep with Beautifil Flow Plus and then uses the packable Beautifil II. “In my mind, it’s how it works in your hands. It’s such an individual thing,” said Dr. Melonakos, who’s been practicing for about six years. “Beautifil is not sticky at all. It’s very moldable and it stays where you put it. The handling characteristics are superb and I like the availability of many different shades.”

When Dr. Melonakos first switched to the Shofu products, he was working at a high volume, mostly Medicaid office, he said. Because both the flowable and packable are so easy to use, he soon found he was spending less time adapting material—and shaving those few seconds off the procedure time was a huge help during his busy days.

“It saves time because it stays where I put it and I can get the shape I want faster,” Dr. Melonakos said, noting the material also dispenses and polishes well.

“The shades being what they are and my own familiarity with the products allows me to make the procedure a smooth experience for my patients.”

Dr. Melonakos also likes the fact he can use the material for cases beyond posterior composites. This simplifies his system, saving him time and money.

CONTINUED ON PAGE 26 >>

24 THENEWDENTIST.NET S U M M E R 2 0 1 6

Occlusal pre-op.

The prepped restoration.

The final result.

Dr. Steven Melonkas used Shofu’s Beautifil Flow Plus, Beautifil II and BeautiBond bonding agent for this posterior restoration.

Photos courtesy of Dr. Steven Melonkas.

Evolve.

GIOMER TECHNOLOGY taking dentistry to the next level NOW IN TIPS!

Beautifil-Bulk

Flowable & Restorative

Beautifil Flow Plus Beautifil II ®

®

BeautiSealant

BeautiBond

®

BeautiCem

F00 Zero Flow Stackable

F03 Low Flow Self-leveling

Visit www.shofu.com or call 800.827.4638

Key Features of Giomer Materials S-PRG filler material clinically: ■ Recharges fluoride when treated with fluoridated products ■ Decreases acid production of cariogenic bacteria ■ Demonstrates an anti-plaque effect

Shofu Dental Corporation • San Marcos, CA

Scan here for more information on Giomer Technology & watch the Acid Neutralization video.

SNBBG-0814

■ Neutralizes acid on contact

Posterior Composites continued from page 24 His assistant knows what material he’s using for a vast majority of cases, making the ordering process quick and easy.

While you might be more comfortable placing the material you used in dental school, Dr. Melonakos encourages

new dentists to get out of their comfort zone. He was happy with the material he was using before, but after giving Shofu Beautifil Flow Plus and Beautifil II a try, he found these materials were a better fit for him and his practice. Talk with colleagues, read dental magazines you trust and do your research. This might lead you to a product that provides even better results for your patients.

Dr. Michael Sesemann, Nebraska Institute of Comprehensive Dentistry When Dr. Michael Sesemann began placing posterior composites about 20 years ago, he relied on the incremental fill technique and fourth generation adhesive bonding. This was time consuming and complicated, and he was always eager to find a less arduous, more patient friendly and financially feasible option—and he got it about seven years ago when Ivoclar Vivadent released Tetric EvoCeram Bulk Fill.

“I’m envious of dentists now a days who never had to experience that,” Dr. Sesemann said of the challenges that come with the incremental fill technique. “When we first started using the bulk fill we knew immediately it was something that was going to change our lives and the lives of our patients.

We have never looked back at the old protocol because this product was so revolutionary and so immediately out-of-the-box good for us.”

Tetric EvoCeram Bulk Fill features Ivocerin, a germanium-based lightinitiator, Dr. Sesemann said. This means that, unlike other bulk fill materials, it doesn’t take much light to activate the polymerization process. Rather than making the composite translucent, it changes the chemistry so the chemical reaction is more sensitive to light. There’s also a light sensitivity filter to ensure the material doesn’t react to operatory lights and start curing before you’re ready.

Dr. Sesemann also appreciates the filler technology. With older composites, polymerization shrinkage was more than 5 percent at times. Some studies put this composite’s shrinkage stress at 1.9 percent, or less than half, he said, which offers huge benefits for patients and clinicians.

“When you cure a big block of composite it’s not shrinking so much it pulls away from the margins, giving clinicians the white line they really hate to see at the completion of their restorative procedure,” Dr. Sesemann said. “If I don’t have that shrinkage it makes for a better interproximal contact, which used to be hard to achieve when doing posterior composites.”

Dr. Sesemann completes 80 percent of his posterior cases with Tetric EvoCeram, meaning he carries less inventory. He doesn’t have to store multiple materials like he did in the past, or worry about those materials going bad if he doesn’t use them before they expire. He has a product that offers predictable curing at 4 mm, has less polymerization shrinkage, doesn’t react to light until he’s ready to cure it and that polishes to a nice luster.

“You save a lot of chair time and that benefits the patient,” Dr. Sesemann said. “You have better marginal stability, which makes the composite last longer.

You have better interproximal contacts so there’s less food catching, less chance for recurrent decay and less chance of having to do the filling over again.”

26 THENEWDENTIST.NET S U M M E R 2 0 1 6

BEFORE

AFTER

BEFORE

AFTER Before and after images of cases completed by Dr. Michael Sesemann using Tetric EvoCeram from Ivoclar Vivadent.

Photos courtesy of Dr. Michael Sesemann

Dr. Kendalyn Lutz-Craver, Cornerstone Dental Associates Dr. Kendalyn Lutz-Craver works in a practice with two other dentists and they all use x-tra fil bulk fill posterior composite from VOCO. They wanted a simple shaded bulk fill posterior composite and that’s exactly what this material gives them.

“Being able to bulk fill is huge,” Dr. Lutz-Craver said. “All the incremental layering bogs me down. I don’t have the patience for it.”

The material offers benefits for patients as well, she said, including shade. It blends well to almost everyone’s teeth. Patients also don’t have to deal with shrinkage or sensitivity that other materials might cause.

For dentists starting out, Dr. Lutz-Craver recommends looking for a material that’s easy to use and predictable. It’s also a good idea to find a material that doesn’t require you to purchase 12 different shades. Find a system that enables you to keep your inventory small, a benefit of VOCO’s x-tra fil that Dr. Lutz-Craver really appreciates.

“I didn’t realize universal shading was an option when I came out of school,” Dr. Lutz-Craver said. “And I was

Before and after images of a case completed by Dr. Kendalyn Lutz-Craver using x-tra fil bulk fill from VOCO. Photo courtesy of Dr. Kendalyn Lutz-Craver.

taught to layer the materials every couple millimeters, then cure and then add on and then add on. This material can be added in 4 mm increments, which is a pretty hefty amount. Using the bulk fill material instead CONTINUED ON PAGE 28 >>

FREE Online Dental CE Earn live interactive and self-study credits from the comfort of your home or office • ADA CERP Provider • World-respected Speakers • Instant CE Certification

www.vivalearning.com

SUMMER 2016

THENEWDENTIST.NET

27

Posterior Composites continued from page 27

Insurance continued from page 7 on age and goes up over time. You can also buy a product that allows you to pay the same amount over the course of your career. Stafford recommends getting a policy for up to 60 percent of your annual income. That amount is paid to you after taxes so it matches the income you’re losing.

More before and after images of a case completed by Dr. Kendalyn Lutz-Craver using x-tra fil bulk fill from VOCO. Photo courtesy of Dr. Kendalyn Lutz-Craver.

definitely saves time. Not having to pick out a shade saves you time and not having to place layer on layer and cure and re-cure saves time.”

HOW TO CHOOSE THE RIGHT COMPANY While there are many insurance companies, it’s important to find one that’s reliable and financially stable, Miller said. Look for respected companies endorsed by other organizations.

All three suggest looking at A.M. Best ratings and choosing an insurance company the ratings agency gives at least an A. The business should have a good reputation for handling claims and provide the coverage you need at a reasonable cost. And of course, it’s always best to go with a company that specializes in dentistry.

“Pick one that has a good reputation and that understands dentistry,” Stafford said. “If you ever end up in a professional liability suit where a patient says you did something wrong, you want to make sure your legal representative understands dentistry and defending dental-related lawsuits.”

Check out our

New Website New Dentist Blog | New Dentist Article Library | New Dentist Magazine Library New Dentist FREE Podcasts | New Dentist Bookstore | New Dentist Resources W W W.T H E N E W D E N T I S T. N E T

28 THENEWDENTIST.NET S U M M E R 2 0 1 6

WELCOME TO THE

SUITE LIFE

Your All-Inclusive Software Solution Our dental software suite creates a worry-free mobile and tablet friendly workflow, providing your team the tools they need to make your practice most profitable. www.xldent.com/newdentist

Call to learn more. 800.328.2925 or 763.479.6166

BEEN THERE, Done That

Key Opinion Leader Dr. Michael DiTolla on digital dentistry and lab communication.

D

r. Michael DiTolla first became interested in dentistry because of the lifestyle it offered. His dad was a dentist, and although he didn’t know much about what it took to succeed as a clinician at the time, Dr. DiTolla knew the career offered flexibility that enabled his dad to spend more time with his family.

“My dad was my inspiration to go to dental school and I had the opportunity to practice with him for two years before he retired,” Dr. DiTolla said. “He taught me things he learned in his 30 years of being a dentist that they just couldn’t teach you in school.”

Today, Dr. DiTolla is the Director of Clinical Affairs for Sirona after serving as the Director of Clinical Education for Glidewell Labs for nearly 15 years. His advice to young dentists? Keep up with continuing education, invest in digital dentistry when you can and work on building strong relationships with your lab.

Continuing Education Dr. DiTolla always has been interested in CE, and said it’s important to make it a priority as soon as you graduate from dental school. He became an Academy of General Dentistry Fellow right away and would recommend today’s new dentists do the same.

“Even though you’ve already spent a lot of money toward your education, CE is a great way to make sure you stay current on what’s happening in dentistry,” he said. “There are a lot of advancements. Much more than when I graduated in 1988.”

Going Digital When you first begin practicing, it’s important to find ways to enhance your clinical skills. While this will come with time, Dr. DiTolla said investing in digital dentistry, particularly digital impressions, is one of the best ways to quickly improve. You’ll find you take much better impressions, leading to better clinical outcomes.

“It also allows your technician to see your prep while your patient is still in the chair so you can make changes to the prep and clean up the impression,” he said. “It really opens up your eyes to what your preps and impressions look like in a way you couldn’t without this technology.”

30 THENEWDENTIST.NET S U M M E R 2 0 1 6

Many new dentists are hesitant to purchase a digital impression system right away because of the cost. Even if you don’t make this investment until sometime down the road, Dr. DiTolla suggests getting experience with it now so you can decide if it’s right for your practice.

For instance, you could opt to practice at a corporate dental group like Pacific Dental Services. This would give you the opportunity to use various technologies without the upfront cost, and help you decide if you want to implement them once you open a practice of your own.

“I’m not sure a recent grad can go to a dental convention, try this equipment once and say I’m going to invest $40,000 in this system,” Dr. DiTolla said. “I suggest they use it clinically on a variety of patients first.”

Looking for other products to invest in? Dr. DiTolla also likes the burs from Axis Dental for reverse crown preps and zirconia crowns.

Lab Communication While digital impressions certainly help improve lab communication, there are other ways you can strengthen this relationship. The best method? Taking digital photos, Dr. DiTolla said.

This is especially important when you’re placing an anterior crown. It’s not enough to tell your technician you’re preparing a crown on tooth No. 9 and you need to match it to tooth No. 8’s A2 natural shade. If you don’t send a photo of the tooth along with a shade tab, the lab tech might as well be working with a blind fold on, Dr. DiTolla said.

“It would be like asking a dentist to put composite on a central incisor to match the tooth next to it without letting the dentist see what that tooth looks like. Most dentists wouldn’t do it,” he said. “The reality is that’s how most dental technicians are asked to fabricate crowns.”

Sending your lab digital photos not only gives them more information, they’ll appreciate your efforts and work harder on the case, Dr. DiTolla said. They’ll know you have higher expectations, and that will lead to better results for your patient.

It’s also a good idea to send photos after the case is complete.

“They usually only hear from dentists at the end of a case if the doctor is angry,” he said. “A photo of the crown in the mouth with a note saying how much the patient liked it goes a long way in getting technicians to give you their best work and to spend the most amount of time on your cases.”

Dr. Michael DiTolla is Director of Clinical Affairs for Sirona, after being the Director of Clinical Education for Glidewell Labs from 2001-2015.

In 2011 he received the “Most Effective Dentist Educator” award in a nationwide survey of dentists. Dr. DiTolla can be reached at mike.ditolla@sirona.com, through his website at drditolla.com or through his podcast Accidental Geniuses at accidentalgeniusespod.com.

Happy Trails continued from page 18

3. USE INTRAORAL CAMERAS We all know cameras are great, but have you considered all the ways they can be used? You can use intraoral cameras for several patient education experiences.

When a cavity is very large and close to the pulp, for example, I stop and take a picture. This allows patients to see and understand the tooth may need more extensive treatment. When there is a large fracture or crack in a tooth surface, I show the patient a picture and recommend a crown. A tooth may be asymptomatic, but when patients actually see the problem, they are less likely to be suspicious of your motives.

Taking these pictures has not only helped me avoid misunderstandings, it also has generated extra revenue for my practice. Remember: A picture is worth a thousand words!

4. REVIEW X-RAYS WITH YOUR PATIENTS Patients might not be qualified to read radiographs, but if you see a large cavity on an x-ray, you can enlarge that

image on the computer screen to show them the proximity of the cavity to the nerve tissue. Patients can see and understand that image.

I do the same for bone loss, dental abscesses, impacted wisdom teeth and several other conditions. Patients feel involved and respected when you talk to them as equals, and are much more compliant and trusting with the treatment you are recommending.

5. DRESS FOR SUCCESS When I started out in 2006, I wore scrubs. Sometimes they were a little wrinkled. I then graduated to khakis and a polo shirt. I now wear a nice pressed shirt and a white coat that represents the quality of doctor I am.

I firmly believe you must exude confidence to have a high level of treatment plan acceptance. This starts with your appearance from head to toe. People notice that you take care of yourself and will then know you will take care of them. How can you expect a patient to trust you to do excellent dental work if you cannot even dress appropriately?

These five tips have helped me grow over the last 10 years. I hope they can help you do the same.

there are

100 89% 74% 78% social media billion for purchase searches of consumers use

search engines

per month on Google

decisions

of consumers rely on IN MAKING A

buying decision

of people said that

social media posts

of companies INFLUENCE

their buying decisions

The statistics are overwhelming - to command your market share of new patient spending, you must be online. And even more importantly, you must be FOUND online.

Simply having a website is not enough.

BUILD YOUR ONLINE PRESENCE AND GET 3 MONTHS FREE WHEN YOU COMBINE SEARCH ENGINE OPTIMIZATION AND SOCIAL MEDIA SOLUTIONS *New agreements only - restrictions apply. Cannot be combined with any other discount or offer.

Start Now! 866.961.4412

www.affordableimage.com

SUMMER 2016

THENEWDENTIST.NET

31

SKINNY

on the Street

The latest news on products and services for new dentists and their practices

Jiffy Universal Ceramic Finishing System Ultradent Products Inc.’s Jiffy® Universal Ceramic Finishing System is described as the only universal finishing system for high-strength ceramics. All of the system’s adjustors and polishers work interchangeably on porcelain, lithium disilicate and zirconia. Each convenient kit (extraoral or intraoral) includes everything the dentist needs, eliminating the need to purchase unnecessary or multiple components and allowing the clinician to create a truly smooth, beautiful, high-gloss finish on all ceramic restorations. Jiffy Universal allows for universal application, eliminating the need for multiple grinders and polishers, saving the clinician time and money.

For more information call 800-552-5512 or visit ultradent.com.

PHOTO COURTESY OF ULTRADENT DENTAL PRODUCTS

NiteBite

BurButler

NiteBite® prevents pain and damage from bruxism, tension and TMJ/D. Incisal contact is proprioceptively sensed as the mandible closes toward the NiteBite, opens rests and relaxes. With use the teeth do not contact NiteBite or each other. Other devices act only as barriers forcing the mandible open beyond physiologic rest position. NiteBite fits during a single 10 minute appointment requiring no impressions or lab expense. NiteBite brings immediate relief with superior efficacy and comfort. Increased profitability, low cost and success will be realized for your practice. NiteBite is the first occlusal appliance patented for function entirely within the freeway space.

For free ADA/CERP “Occlusal Appliance” course or more information visit NiteBite.us.

Shofu has extended its BurButler product line, the unique silicone bur block that grips all burs securely in place, eliminating the risk of spilling. BurButler now includes a 5, 10 and 25-hole base configuration. The 25-hole base features the option of a standard or a tall clear lid.

Mix and match FG, CA, HP (tall lid only), and short shank burs to suit clinical or laboratory needs.

The autoclavable high temperature resistant silicone base is durable and retains integrity, even after repeated sterilization. There are no replacement plugs or moving parts and the burs won’t magnetize or rust. The patented starburst hole design with reverse fluting allows for easy bur insertion and removal. The secure clear lid offers easy viewing and safety and can be removed with one hand.

The BurButler configurations are available in five colors.

For more information visit shofu.com or call 800-827-4638.

PHOTO COURTESY OF RANDMARK DENTAL PRODUCTS

PHOTO COURTESY OF SHOFU DENTAL

INDEX O F A D V E R T I S E R S Advertisers in this issue of The New Dentist™ have made it possible for you to receive this publication free of charge. Please support these companies. Contact information can be found below, or visit The New Dentist™ Resources at www.thenewdentist.net to receive information from more than one company.

Affordable Image.................... 31 affordableimage.com 866-961-4412

CareCredit.................................. 1 carecredit.com 866-246-6401

MacPractice............................ IFC macpractice.com/dds 855-679-0033

US Army.....................................11 heatlthcare.goarmy.com/du42 800-431-6712

American Academy of Dental Sleep Medicine.........................17 aadsm.org 630-737-9705

ClearCorrect............................... 3 clearcorrect.com 888- 331-3323

McKenzie Management..........BC mckenziemgmt.com 877-777-6151

Viva Learning........................... 27 vivalearning.com

Dental Dreams..........................16 Juliette Boyce, 312-274-4520 Kari Thompson, 312-274-4530

New Dentist Website............... 28 thenewentist.net Jessica@thenewdentist.net

Henry Schein Professional Practice Transitions................IBC henryscheinppt.com 800-988-5674

Pacific Dental Services............ 21 Pacificdentalservices.com 855-JOIN-PDS joinpds@pacden.com

Indian Health Service............... 5 ihs.gov/dentistry 800-447-3368

SHOFU...................................... 25 shofu.com 800-827-4638

Arrowhead Dental Laboratory................................19 arrowheaddental.com 877-358-0285 Aspen Dental............................. 7 aspendentaljobs.com/weagree 866-529-2361 Bank of America........................ 9 bankofamerica.com/ practicesolutions Ali Karjoo, 614-403-8295

Wells Fargo Practice Finance..................................... 13 wellsfargo.com/thenewdentist 888-937-2321 XLDent...................................... 29 xldent.com/newdentist 800-328-2925

The New Dentist – New Dentist Resources, New ... http://www.thenewdentist.net/resources.htm

Scan the code with your mobile device to receive more information from these advertisers.

Or visit www.thenewdentist.net/resources.htm http://kaywa.me/b4u2c

32 THENEWDENTIST.NET S U M M E R 2 0 1 6

Download the Kaywa QR Code Reader (App Store &Android Market) and scan your code!

We have a high rate of success placing all types of Dental Associates.

No kidding!

Henry Schein Nationwide Dental Opportunities has a great track record of matching Associates with the right position.

Our experienced staff achieves win-win situations every day.

There's no fee to the Associate and all information is strictly confidential. So, give us a call today.

1-866-409-3001

www.dentalopportunities.com

Henry Schein may receive a marketing fee from the vendor for products/services purchased. Š 2016 Henry Schein, Inc. No copying without permission. Not responsible for typographical errors.