THE #1 JOURNAL FOR NEW DENTISTS
Patient Communication Systems
PLUS Caries detection Clinical photography Numbers to watch WINTER 2016
cloud vs. Mac OS X client server
These numbers don’t lie. It’s no surprise the cloud has received attention in the past few years. But what is surprising is that more dentists blindly consider the cloud without knowing more about who has their data and if it’s safe. On the other hand, Mac OS X client server is tried and true and SAFE. As a matter of fact, while there was a 1 incident of Ransomware on Mac from January 2015 to April 2016, there were 1,500,000 on Windows* and others. MacPractice DDS is the most advanced, robust dental software and safely runs on a non-dedicated Mac server in your office with best of class practice management and clinical features in an all-in-one design.
MacPractice is Certified and protects patients from hacking and dental practices from millions in HIPAA and state fines with built-in AES encryption; integrated HIPAA compliant secure messaging, network faxing, online registration, online scheduling, reputation marketing that works, automatedin reminders and marketing, and more. Simplicity practice Welcome to the future of dental software. Welcome to MacPractice.
MacPractice Simplicity in practice
Compare your software to MacPractice and see the difference www.macpractice.com/dds | (855) 679-0033 * Source: Symantec, Gemalto
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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 planning resources and professional support to help your practice thrive To get started, call 1-888-937-2321 or visit wellsfargo.com/thenewdentist to request your free Preparing for Ownership workbook. 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. 3030-0816-PF-The-New-Dentist-Ad
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FROM THE PUBLISHER’S DESK Dear Readers,
Welcome to the Winter issue of The New Dentist™ magazine. s we come upon the holiday season, this is the time to focus on our families and the joy they bring us. But for many new dentists, family members aren’t just part of their lives outside the practice—they’re also vital to the success of their business. While family-run practices are fairly common, they’re also complex business arrangements that could turn ugly if not handled properly. But when done right, they have the potential to be very successful. Interested in making your new practice a family business? Follow these tips. Remember the practice is a business first and a family operation second. Deal with practice issues as partners, not as a family. Create detailed job descriptions. Just like your other employees, every family member working in the practice needs guidance. Family members often think they can get away with more, and that becomes even easier if they don’t know what they’re accountable for. Make that clear through job descriptions. Make sure they can do the job. Your brother might be a good guy, but that doesn’t mean he has what it takes to be a successful Office Manager. Before asking any family members to join your team, find out if they have the necessary skill set and temperament to excel. Develop a system for giving out raises. Make it clear how performance will be measured and under what circumstances raises will be given. If family members ask for a bump in pay, don’t give in unless they’ve actually earned it. Those few extra dollars an hour could send overhead costs skyrocketing. Align your goals. Ask questions to ensure they share your practice philosophy, vision and goals. In this issue… Whether you plan to open a family-run practice or to go out on your own, there’s plenty of advice in this issue to help you succeed. On page 18, learn how clinical photography can grow your practice and find out how patient communication systems can increase revenues on page 12. Ever thought about incorporating a caries detection device into your practice? Read about the benefits on page 14, and learn how lasers can be used to treat periodontal disease on page 6. Dr. Daniel Domingue outlines the benefits of placing implants on page 24 and I tell you what numbers to monitor to keep your practice healthy on page 10. Finally, Dr. Michael Miyasaki gives advice on how to grow as a dentist on page 27.
2 THENEWDENTIST.NET W I N T 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
WINTER 2016 W I N T E R 2 016 PUBLISHER
Sally McKenzie Sally@thenewdentist.net DESIGN AND PRODUCTION
Picante Creative www.picantecreative.com EDITOR
Renee Knight firstname.lastname@example.org SALES AND MARKETING
Jessica Mandrell, National Sales Manager email@example.com For display advertising information, contact firstname.lastname@example.org or 877-777-6151. Visit our digital media book at www.thenewdentist.net/ mediabook.htm
14 FE AT U R ES Treating Perio with Lasers Numbers to Watch
Copyright ©2016 The McKenzie Management Company, LLC. 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 Management Company, LLC for libraries and other users registered with the Copyright Clearance Center.
Improve Communication, Increase Practice Profits
Take the Guessing Out of Caries Detection
Use Clinical Photography to Grow Your Practice
Adding Implants to Your Practice
Dr. Michael Miyasaki on Growth
24 D E PARTMENTS 2 Publisher’s Message 28 Skinny on the Street 28 Index of Advertisers
4 THENEWDENTIST.NET W I N T E R 2 0 1 6
The New Dentist™ magazine is published quarterly by The McKenzie Management Company, LLC (302 N. Chestnut St., Barnesville, OH 43713) 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).
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 Management Company, LLC. Contact Us — Questions, comments, and letters to the editor should be sent to email@example.com. For advertising information, contact firstname.lastname@example.org or 877.777.6151. Visit our website at www. thenewdentist.net to download a media kit.
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TREATING PERIO WITH
By Renee Knight, Editor
Lasers can make periodontal procedures and other treatments more comfortable for your patients. Here’s what you need to know about treating this disease and incorporating lasers into your practice. hen Dr. Blake Cameron first invested in a laser three years ago, he wanted to provide a more minimally invasive experience for his patients. His goal was to reduce the need for anesthetics, decrease pain during and after treatment, and ultimately alleviate some of the anxiety many patients deal with before a procedure. Since then, he’s found many other uses for his lasers—the LightWalker all-tissue laser from Fotona and the ezlase diode laser from Biolase—including treating periodontal disease. “When you do scaling and root planing to treat perio, patients often have continued pockets with bleeding that are resistant to healing,” Dr. Cameron said. “Lasers help in 6 THENEWDENTIST.NET W I N T E R 2 0 1 6
reducing the bacterial load and make it more comfortable for the patient. You tend to get faster and more uneventful healing.” Whether using them to treat periodontal disease or in other procedures, lasers provide a host of benefits for both your patients and your practice. The key is choosing the right laser and getting the proper training. Here’s how to make it happen in your practice.
DETERMINE WHICH TYPE OF LASER WORKS BEST FOR YOU There are three types of lasers that can be used to treat periodontal disease—diodes, CO2 lasers and Nd:YAGs. The less expensive diodes are designed to treat just soft tissue and
are used in conservative periodontal procedures, while the allDr. Cameron said. “It shows you’re really going to take care of tissue CO2 and Nd:YAG lasers are equipped for more difficult them. And if the dentist believes in it and is passionate about periodontal procedures that involve root and bone, said Dr. Sam it, that excitement will naturally transition to the patient.” Low, a periodontist who’s taught laser dentistry and primarily Dr. Josh Weintraub sees many patients who could uses the all-tissue Waterlase iPlus from Biolase, which offers a benefit from periodontal treatment but who refuse to go to a minimally invasive protocol for periodontal management. specialist to get that treatment. Since he invested in the Solea All-tissue lasers give clinicians more versatility, Dr. Low from Convergent Dental, a 9.3 μm all-tissue CO2 laser, they said, but choosing which laser works best for your practice don’t have to. He’s able to provide them with a minimally depends on what new services you want to offer and how you invasive procedure, less bleeding and quicker healing with a want to enhance existing services. If you only plan to perform laser that he says keeps him on the cutting edge, regardless of non-surgical perio procedures and other soft tissue treatment the procedure he’s performing. then, at least for now, a diode might be your best option. “CO2 lasers are known to be the gold standard for soft “Know what you want to do and tissue,” Dr. Weintraub said. “The Solea how much a part of your practice you cuts smoothly and cleanly and with little “Lasers have the ability to reduce want this to be,” Dr. Cameron said. “You to no bleeding. It offers rapid healing biofilm and kill bacteria. Depending can invest quite a bit of money into and less need for local anesthetic. It’s a on the laser utilized lasers pose a lasers. You want to make sure you do better patient experience.” tremendous advantage over other your research and know what you’re methods for controlling disease looking for.” GET THE PROPER TRAINING and in many instances for treating No matter which laser you invest in, you THE BENEFITS OF USING have to get the proper training before periodontal disease.” you can incorporate it into your practice, LASERS TO TREAT PERIO — Dr. Ron Kaminer, who uses Picasso+ said Gail Siminovsky, Executive Director and LiteTouch from AMD Lasers. Effectively treating periodontal disease for the Academy of Laser Dentistry. Take is important to keeping patients healthy, an unbiased laser course and actually especially when you factor in the oraluse the lasers you’re considering in systemic link, said Alan Miller, Founder your practice for a few days. Most new of AMD Lasers, the company that dentists don’t have much exposure manufactures the Picasso lasers. to lasers during school, so taking a “Lasers are an adjunct tool used variety of courses and gaining hands-on regularly for LAPT (Laser Assisted experience is key to understanding Periodontal Treatment) and LBR (Laser how lasers can be part of your everyday Bacterial Reduction),” Miller said. practice, whether you’re using them “Because our Picasso line of soft tissue for perio treatment or various other lasers have a very good wavelength that procedures from crown preps to is highly absorbed into dark targets such gingivectomies. as pigment, melanin, hemoglobin and The ALD offers information on are even more absorbed into necrotic its website, laserdentistry.org, as well as courses for dentists tissue, it’s easy to perform removal of diseased tissue and interested in laser dentistry. Siminovsky recommends the destruction of bacterium.” ALD’s certification program for any dentists serious about Using lasers to kill bacteria reduces bleeding and promotes incorporating lasers into their practice. faster healing, Dr. Cameron said, and only adds a few extra “Training is essential,” said Dr. Low, who also minutes to the appointment—time well spent for both you and recommends taking courses from the ALD. “And it needs your patients. to be beyond watching a webinar or watching videos Knowing that you’re using a minimally invasive tool to on YouTube. If you’re going to use a laser and use it treat periodontal disease will make patients more likely to appropriately, you should have some basic knowledge of accept treatment, Dr. Low said. Many patients opt to forego the physics and, more importantly, how a laser works, periodontal therapy because they’ve heard horror stories about specifically the one you purchase.” the pain caused by traditional methods, or have already had a bad experience themselves. If they know you’re using a technique that reduces bleeding, decreases their discomfort TALKING WITH PATIENTS and promotes faster healing, they’ll be much more likely to get While most patients find laser dentistry exciting, some the care they need. might be a little leery of the technology. Dr. Low suggests “There’s the added value that we’re going to use this comparing laser dentistry with something they’re already awesome technology and it’s not going to cost them any extra,” familiar with, like LASIK that’s used to enhance vision.
Let patients know lasers are safe and when have to deal with the discomfort and healing advisory explaining how they work, never say cut or times that come with traditional methods, and board burn. Use the word vaporization instead, which they’ll be impressed that you’re willing to invest Dr. Hal Cohen uses the is how most lasers work. in the technology that makes that possible. Picasso Lite from AMD “They vaporize tissue that we don’t want Dr. Low describes lasers as an “incredible Lasers to treat periodontal and at the same time they energize tissue we do technology” for new dentists that will help disease in his practice and want to create wound healing,” Dr. Low said. them stand out in their communities and says the main benefits are “Many people think lasers just cut through ultimately grow their practices—not to the ability to manicure tissue. What they don’t appreciate is the mention make dentistry more fun. gingiva, the ability to incredible light energy that enhances wound “No one brags to their buddy that they achieve excellent tissue healing, which is a subject we don’t emphasize had scaling and root planing done and it was retraction around finish enough. Lasers facilitate the body to heal itself.” awesome. You’ll never hear that,” Dr. Cameron lines and the ability to When treating perio, let patients know the said. “A patient might tell his buddy his dentist remove overgrown gingiva laser will kill the bacteria causing the problem used a laser to treat gum disease and it was for recements. with less discomfort and post-op pain than awesome. That conversation happens. I have traditional methods, said Dr. Cameron, who is a plenty of patients who come to me because member of the ALD. Patients will be wowed by the technology they heard about the lasers. It definitely increases word of and more likely to accept treatment. mouth referrals and generates excitement. It’s a great way to help your practice grow if you implement it properly.”
THE BENEFITS FOR A NEW DENTIST Incorporating laser dentistry into your practice will increase case acceptance, attract new patients, enhance the care you provide and allow you to offer additional services. When it comes to perio, more patients will accept treatment and they’ll have a much better experience while in the chair. They won’t
Interested in incorporating laser dentistry into your practice? Visit laserdentistry.org for more information on what to consider before choosing a laser and on courses that can prepare you to be a successful laser dentist.
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
8 THENEWDENTIST.NET W I N T E R 2 0 1 6
She needs care. She wants care. But she’s going to delay care.
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NUMBERS TO WATCH By Sally McKenzie, CEO of McKenzie Management
The six systems you should track to make sure your practice stays healthy and productive.
s a dental consultant and owner of McKenzie Management for more than 30 years, I’ve seen a lot of struggling practices. The dentists behind them just can’t seem to find success no matter how hard they work, leading to a lot of frustration and stress. I don’t want to see this happen to you. There are ways to help ensure your practice stays healthy and productive, and it starts with monitoring six key practice systems for signs they’re struggling. What systems, you ask? Patient volume, treatment presented/accepted, collections, scheduling, hygiene volume and cost, and overhead. When these systems are on track, so is your practice. Here’s a look at the numbers to watch to keep your practice healthy and changes you can make if you see symptoms that indicate a struggling practice.
1. Patient volume. The sad truth is, 80% of dental practices lose more patients than they bring in. Ask yourself these questions to determine if this is happening to you: • How many inactive patient records do I have? • Am I converting 85% of emergency patients to comprehensive exams? • Have I increased hygiene days per week in the last year? • Is my hygienist’s salary more than 33% of what he/she produces? If the number of inactive patient records or past due recall patients is enough to open a second practice or if
10 THENEWDENTIST.NET W I N T E R 2 0 1 6
you answered “no” to question two and three and “yes” to question four, your patient retention is weak—and that’s probably because you have an ineffective recall system that it’s time to revamp. OK, so how exactly do you do that? I suggest you start by hiring a Patient Coordinator to focus on recall. Generate a report of all patients past due for recall appointments in the past year, then task your Patient Coordinator with calling and scheduling a specific number of past due patients a day, scheduling so the hygienist achieves a specific daily or weekly financial goal, managing a specific number of unscheduled time units in hygiene each day, and monitoring and reporting on recall once a month. Remember, it costs five times as much to attract new patients as it does to keep the ones you already have. Reach out to current patients and focus on building loyalty. Send out e-newsletters, call patients after a procedure and provide the
best customer service possible. This will show patients you care, and that will help boost your patient retention rates and grow your practice.
2. Treatment presented/accepted. Patients should accept 85% of the treatment you present, but that isn’t the case at most practices—and that’s often because of how dentists present treatment. Never assume patients can’t afford treatment or that they just won’t be interested. Take the time to educate them about all their options. Listen to their concerns and their objections, and then address them. Here’s an example. You just presented a treatment plan for a three-unit bridge. The patient, Mr. Taylor, tells you he’ll just chew on the other side for now. You know this is a bad idea, but Mr. Taylor doesn’t. Here’s what you can say to educate him: “Mr. Taylor, the bridge will restore your ability to chew normally. Chewing on one side of your mouth will cause stress on your jaw, and that could result in further breakdown of the teeth and possibly jaw pain related to the joint being overstressed. Waiting will not lower the cost and will cause undo damage to the teeth on the other side. Let’s not wait for that to happen.” This tells Mr. Taylor the benefit of going forward with treatment and what could happen if he decides to wait— making him far more likely to say yes.
3. Collections. Your accounts receivable should be less than one month of net production. If the percentage of accounts receivable over 90 days past due exceeds 10%, that’s a huge problem. Daily collections should be no less than 45% of daily production if you accept assignment of insurance. Not meeting industry standards? One of these reasons could be why: • You don’t have a written financial policy. • There is no expectation that patients are to pay. • Team members don’t know how to collect from patients. • You have no measurements in place to monitor collections. To help improve collections, make it clear in your policy that patients are expected to pay for procedures that are $200 or less at the time of service. For more costly procedures, provide convenient payment options. If you must bill patients, bill on a daily basis and always include the due date on the statement as well as a delinquent message for any overdue balance. Don’t be shy or feel bad asking patients for the money they owe you. Another tip? Electronically submit insurance claims the day the service is performed and collect the patient’s portion after the appointment. Run a weekly delinquent insurance claim report and group it by carrier. Then you can make one call to each carrier to check claims 30 days delinquent.
4. Scheduling. Your practice should have no more than three unscheduled 10-minute units per day. That’s right,
three. Some practices have more than that while others have fewer; either way it’s causing you trouble. If you have too much time to fill, it’s likely because you have a weak recall system and no real marketing plan. On the other hand, practices constantly running behind are probably pre-scheduling entire treatment plans and not fully using their clinical assistants. Inefficiencies also could be to blame. How do you fix this? Schedule to meet production goals. Schedule and track every failed or cancelled appointment as well as any unscheduled treatment, and don’t book entire treatment plans. Instead, limit it to just one or two appointments at a time. And if your state allows expanded functions for assistants, implement them. Overlap patients during the first and last 10 minutes of each appointment. Set aside time during every daily huddle to discuss the schedule for the next two days. Use this time to identify possible problems, ensure producers are scheduled to meet daily production goals, and to determine where emergency patients will be placed.
5. Hygiene volume and cost. There are a few ways to tell if this system is sick, including no increase in the number of hygiene days in the last two years, a hygienist’s salary that’s more than 33% of net production, and not being able to accommodate hygiene patients due this month until next month. When looking at hygiene, I suggest you follow the rule of 33. Hygiene services should account for 33% of total practice production, periodontal therapy should account for 33% of hygiene production and the hygienist’s salary should be about 33% of her/his net production. You can reach these benchmarks through careful monitoring, scheduling to meet production goals, and at least considering doing away with six-month pre-appointing. Here are other ways to improve your hygiene numbers: • Review the hygiene schedule to determine the number of cancellations and failed appointments that are the result of pre-scheduling recall patients. • Measure patient retention by dividing the number of patients due for prophies in a given month by the number of recall prophies actually performed for the month. • Establish the number of hygiene days to match the demand for hygiene appointments. • Implement a recall system that conveys the value of the oral hygiene appointment. • Regularly evaluate fees and hygiene hours. • Customize the time per patient based on patient need, not on standard one-hour allocations. CONTINUED ON PAGE 23 >>
Sally McKenzie is CEO of McKenzie Management, a nationwide dental coaching company, and the Publisher of The New Dentist™ magazine. She can be reached at email@example.com or 877-777-6151.
IMPROVE communication, INCREASE practice profits A look at how patient communication systems can help your practice grow. By Renee Knight, Editor
aking and keeping dental appointments usually isn’t a top priority for your patients— as much as you might wish it was. They’re busy people with hectic work schedules and demanding social lives, and oftentimes dental appointments get knocked down to the bottom of their to-do list. To help keep dentistry top of mind, you might want to consider investing in a patient communication system. There are a variety of communication systems on the market, all designed to keep patients coming back to your practice while attracting new patients as well. Patient communication systems make it easy to automatically send out appointment reminders or to remind past due patients it’s time for their hygiene exam, freeing up your team members to focus on other, more important tasks. And it all can be done via text, email, phone call or postcards, or a combination of all four, depending on what each patient prefers. “Your patients deserve it,” Demandforce National Sales Manager Jonathan Tucker said of why new dentists should invest in a patient communication system. “This is an expectation that patients have, not a luxury. It’s all about convenience. A lot of times this type of convenience is why patients choose to go to one practice over another.” 12 THENEWDENTIST.NET W I N T E R 2 0 1 6
KNOW WHEN YOU’RE READY As a new dentist, it’s important to make sure your practice is ready for a patient communication system to ensure you get the best return on your investment, Tucker said. He suggests waiting until you have between 300 and 400 emails in your database. Mobile phones should be entered in the proper fields in your practice management system so companies like Demandforce can automate those communications. “Demandforce automatically reads into your practice management system every five minutes to pull accurate data so we can reach out to the right customer with the proper communication,” Tucker said. “If your practice management system isn’t established yet, Demandforce won’t be able to work with your office.” ADDED EFFICIENCIES Once your office is ready, adding a patient communication system certainly will help improve efficiencies—something Rae
Scruggs learned soon after incorporating Solutionreach into her practice. When she first started her job as Office Manager at Scruggs Family Dentistry a few months ago, the practice handled recall by printing out a past due report and calling every patient on the list. Before she came on, no one had time to make those calls and that left hygiene struggling. She spent her first three days trying to make a dent in the list, which had 364 patients on it, without very promising results. Most patients didn’t answer or simply didn’t want to schedule, and she knew if she was going to get more hygiene patients in the chair, she was going to have to find a better way of contacting patients. Since implementing Solutionreach, more patients have scheduled appointments and she has more time to focus on other tasks, such as getting treatment plans started, Scruggs said. It’s also helped jump start other changes in the practice like going paperless and using iPads to check patients in. “It’s made our practice so much more up-to-date and modern,” Scruggs said. “I have patients who say they love getting text messages. They hated calling us back; it was just so inconvenient.” Purchasing a truly automated system will also save practices time, PracticeMojo Product Manager Jonathan Coffey said. Postcards, texts, emails and phone calls all go out when they should, automatically, without you or your team members needing to do a thing.
Cisneros really loves. Her practice, MajorSmiles, began using the system earlier this year and Cisneros said it has helped them improve recall and grow their practice. Patients who haven’t been in for a while are suddenly making appointments, Cisneros said, and more of them are actually responding to appointment confirmations. Part of the reason is Cisneros now has the ability to customize communications. She can change the message on a text message or an email to sound like something the doctor or one of the team members would actually say. The fact they use a mix of communication—text, email, phone call and postcard—has also made a huge difference, she said. While they have a lot of patients who prefer to confirm appointments via text or email, some are older and are more comfortable receiving a postcard and then calling the practice. “We want to help dental practices grow,” Coffey said. “As a new dentist, if you just bought a new practice you want to make sure you’re generating cash flow so you can pay your bills. That’s absolutely key. You need to get hygiene patients in the chair as fast as you can, and that happens through recall and activation.”
ATTRACT NEW PATIENTS WITH REVIEWS Cisneros has noticed an increase in reviews since the office started using PracticeMojo—and in new patient phone calls. Patients can easily write a practice review via a link they receive after each appointment. Once the practice INCREASE RECALL approves them, reviews are posted to the website. And The team at Scruggs Family Dentistry has seen more when potential new patients see positive reviews, they’re hygiene patients since they implemented Solutionreach, more likely to make an appointment. Scruggs said, and it’s because patients Through Solutionreach, patients are much more responsive to their receive a survey that prompts them to communication attempts. From our advisory board complete a review, Scruggs said. The “No one was scheduling when I practice can manage the reviews from one called them, but when I started texting platform and the system notifies them they would find time to email me, text when a review comes in that’s less than me or even call,” Scruggs said. “I got a 3 stars. The practice went years without call this morning from a gentleman who any online patient reviews, but that has hasn’t been here in two years. He got changed since investing in Solutionreach. three text messages over the last month Reviews serve as a great tool to and knew he really needed to schedule. help your practice grow, Tucker said. “It allows us to contact patients to confirm their We got him scheduled for tomorrow.” He recently worked with a practice in appointment and share One of the main benefits of a patient Orange County that needed to attract information about communication system is getting more new patients. Demandforce sent out a their appointment in the recall patients in the chair, Coffey said. newsletter to all patients asking them to manner they choose, PracticeMojo contacts patients as far post a review on Google, and the response whether it is text, email or back as two years, which is one of the was pretty impressive. a phone reminder.” CONTINUED ON PAGE 23 >> features Front Desk Administrator Ashley —Dr. Lindsay Goss on Patient Activator
Take the guessing out of
caries detection How caries detection devices can help improve diagnosis and increase case acceptance.
he earlier you find lesions, the better off your patients will be. But if you’re only relying on explorers and radiographs for caries detection, chances are you’re missing the small, early-stage lesions hiding under the surface. Caries detection devices can help you diagnose caries earlier and provide patients with the treatment they need before the problem becomes worse. There are a variety of devices on the market, all designed to make caries detection as seamless and as minimally invasive as possible.
14 THENEWDENTIST.NET W I N T E R 2 0 1 6
By Renee Knight, Editor
“It makes me a better clinician. It allows me to make better decisions,” said Prosthodontist Dr. Pamela Maragliano-Muniz, who uses the Canary System. “It also improves patient engagement and allows them to see what’s going on.” Thinking about investing in a caries detection device? Here’s why you should.
THE CASE FOR CARIES DETECTION DEVICES The truth is, dentists simply aren’t as good at finding caries as they think they are, said Dr. Jeff Price, Clinical Associate
Professor & Director of Oral & Maxillofacial Radiology at the University of Maryland School of Dentistry. They tend to overestimate their ability and rely on radiographs, and that means they’re not finding caries as early as they could—so cavities get bigger and more complicated to treat. Radiographs just don’t provide all the detailed information dentists need, making caries detection devices valuable adjunctive diagnostic tools. And because they tend to use fluorescence to activate the bacteria found within caries, they’re also a nice option for patients who are leery of radiation exposure, Dr. Price said. “We’re able to be more thorough in our exams. If we don’t get a clear x-ray or there’s an overlap, it can be difficult to really distinguish if we’re looking at a cavity or not,” said Dr. Jordan Peterschmidt, who uses the CariVu from DEXIS. “If it’s truly an incipient lesion you’re not guessing or just using your best judgement. You’re also not exposing patients to radiation when you don’t have to, and patients appreciate that.” The CariVu makes it easy for Dr. Peterschmidt to detect interproximal caries he wouldn’t otherwise be able to spot, while also offering a nice alternative to radiographs for his pediatric patients or adult patients who are prone to gagging during bitewings. Using caries detection devices leads to a paradigm shift from managing caries to preventing caries, said Dr. Stephen Abrams, President and Founder of Quantum Dental Technologies, manufacturer of the Canary System, which measures the crystal structure of the tooth to detect caries beneath intact restorations, crown margins and interproximal areas. If dentists can find caries earlier, they can focus on remineralization rather than giving the patient a filling. “You can place a filling, but are you treating the disease? You’re not. You’re treating the after effects of the disease. We need to manage the disease process. It’s not just fillings, it’s how can we prevent caries or re-harden early,” Dr. Abrams said. “We’re using our eyes to look at the surface of the tooth when the break down is beneath the surface.”
IMPROVED PATIENT EDUCATION Many patients think if their tooth doesn’t hurt there isn’t really a problem, Dr. Maragliano-Muniz said. With the Canary System, she can show them images of their tooth and the decay, while explaining what the number readings they heard during the scan say about a tooth’s health. CONTINUED ON PAGE 16 >>
The images from the device also provide documentation, making it easy for Dr. MaraglianoMuniz to compare how the tooth looks today to how it looked during the last visit. Monitoring lesions helps determine if treatment is working and, if not, what should happen next. “Patients are more likely to accept treatment and they also feel more engaged,” she said. “We show them their score and their tooth and explain how we want to fix the problem. Most of them look forward to getting the Canary done at their next visit so they can see how they progressed.” Dr. Peter Boulden uses the DIAGNOdent from KaVo and said it’s an important part of every exam. When using it on patients for the first time, he explains how it gives him a better look at their teeth so he can find caries earlier. He lets them hold the device and educates them about what the different number readings mean. This gets patients involved in the process, which makes them more likely to accept treatment. “It takes 30 seconds to a minute tops but it’s an added value to the comprehensive exam that you’re not charging for,” Dr. Boulden said. “I didn’t just take a quick look. I used laser cavity detection.” Caries detection devices help improve communication and make patients more likely to trust your recommendation, said Lindsay Viola, product manager for the CamX Spectra caries detection device from Air Techniques. Patients can actually see how severe the cavity is, giving them the ability to make an informed decision about treatment.
WHAT TO LOOK FOR If you’re considering investing in a caries detection device, it’s important to find something that’s easy for you and
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your team members to use, Viola said, and that integrates seamlessly with your practice management system. “It should produce repeatable results across all of your staff,” Viola said. “It will only increase production if you’re using it, and you’ll only use it if it’s easy to use. It also should be easy to implement into your workflow.” Patients must be able to understand the image and what it’s telling them about the tooth, Viola said. The CamX Spectra provides a color scale, with red meaning bacteria was detected and green meaning it wasn’t. Other devices use numbers to alert doctors and patients to areas of concern. Before purchasing a device, Dr. Abrams recommends asking the manufacturer what it does, what it measures and how it measures it. It’s also important to ask to see studies about the effectiveness of the device and to purchase from a company with a reputation for good customer service.
GROW YOUR PRACTICE There are a variety of benefits that come with using a caries detection device, from providing more conservative dentistry to delivering better care to increasing practice revenues, Dr. Boulden said. Patients will view your practice as high-tech, and you’ll increase production because not only will you find and treat more problems earlier, patients will put more trust in your recommendations and be more likely to stay loyal to your practice. “You’re investing in the practice and empowering yourself to be a better dentist,” Dr. Boulden said. “You look cool. It’s marketable. You can put it on the website and show videos of you using it. It’s a tremendous value for just a few thousand dollars.” When you invest in a caries detection device, it shows patients you’re committed to managing disease, Dr. Abrams said, and to treating problems early so a small lesion doesn’t eventually lead to a root canal. These devices help you accurately diagnose the problem so you can provide the best, most conservative treatment. “Caries is one of the biggest drivers in our clinical practice. Patients are looking for solutions; they’re not looking for fillings,” Dr. Abrams said. “Patients are expecting us to diagnose and manage caries in a 21st century way, not just use our eyes or take x-rays that don’t tell us anything. Finding and restoring problems early differentiates your practice, generates revenue and provides patients with appropriate care. You can grow your practice while providing the best care possible.”
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Use CLINICAL PHOTOGRAPHY
By Renee Knight, Editor
to grow your practice
Taking high-quality photos improves communication with both your lab and your patients, as well as increases case acceptance.
the area. Patients are involved in the process, making co-diagnosis possible. “The best patients are the most informed patients. Photos let them visualize what’s going on, so it’s not about sales anymore,” Dr. Shaw said. “It’s definitely an essential part of my practice. GPs are going to take different styles of photos, but any time patients can see what’s going on, they’re going to be more trusting and more understanding of their needs and more accepting of proper treatment.” Incorporating clinical photography into your appointments offers a variety of benefits that can help your young practice grow. Here’s a look at those benefits, what to consider when investing in a camera and how to make clinical photography part of your practice.
PHOTOS COURTESY OF DR. IAN BRAWNER
r. Doug Shaw has built his practice around clinical photography. He takes a full set of intraoral and extraoral images every time a new patient comes into his orthodontics practice, and uses those images to help his patients understand their needs and why he’s recommending treatment—which in turn makes them more likely to say yes to that treatment. There’s no doubt clinical photography has helped Dr. Shaw grow his practice, which he opened in 2014. Showing patients high-quality clinical images that illustrate their condition rather than just trying to explain it to them chairside creates a better overall experience, and that sets him apart from other orthodontists in
Images Dr. Ian Brawner took using the EyeSpecial C-II from Shofu Dental.
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to your practice through advertising and marketing. “If you can take decent photos and relay what you’re seeing to the patient, that’s going to be your No. 1 money maker. Co-diagnosing is very big,” Chappell said. “It helps with case acceptance and treatment planning. Doctors can look at photos at a later date, treatment plan and present the case to the patient. Photos are just as important as bite records and models.”
PHOTO COURTESY OF SHOFU DENTAL
FINDING THE BEST CAMERA FOR YOUR PRACTICE For Dr. Brawner, finding an easy-to-use camera was important to him, which is why he went with the EyeSpecial C-II from Shofu. The digital camera is designed specifically for dentistry and comes with THE BENEFITS eight pre-set dental shooting modes. It’s very user-friendly, Not only does clinical photography improve communication making both him and his team members comfortable with your patients and increase case acceptance, it also taking photos. improves communication with your Dr. Shaw suggests looking lab, said Dr. Ian Brawner, who uses for a camera that features a the EyeSpecial C-II from Shofu macro lens for close shots and a Dental. Photos give lab technicians ring flash so you can adjust your a much better idea of shade and depth of field. The ability to other tooth characteristics, reducing adjust flash is key to achieving the number of questions they the proper lighting and have—leading to a better, more capturing high-quality images. esthetic final result. These are the types of “It gives the lab the closest features you would typically find thing to actually being with the The EyeSpecial C-II from Shofu Dental in an SLR camera, which is what patient,” said Dr. Brawner, who Dr. Krieger prefers. SLR cameras tend to have more capabilities typically sends between 20 and 40 photos to his lab with than a basic point and shoot, such as the ability to control the each case. “Good photography allows them to get as much flash and the lighting as well as to get clean close-up images. information as possible.” Do your research to make sure the camera you choose Clinical photos enable you to better document cases as works best for your practice. Invest well as to learn from those cases, said Dr. Glenn Krieger, an in something you know you and orthodontist and Director of The Krieger Continuum. Through FROM THE ADVISORY BOARD your team members will use and high-quality images you can critically evaluate crown preps and orthodontic outcomes, for example, and that will help you hone that will give you the high-quality images you need. your skills and become even better at your craft. You can also use clinical photos to collaborate with other GET THE MOST OUT clinicians, Dr. Shaw said. This improves communication and OF YOUR CAMERA helps you build better relationships with colleagues, who Dr. Julie Boerger Training is key to taking appreciate the fact you took the time to properly document uses an intraoral camera quality photos, and Dr. Krieger your cases and share your findings. They’ll want to continue to and an extraoral camera recommends investing in hands-on work with you and may even refer patients to your practice. in her practice to help continuing education from a And that’s not the only benefit of properly documenting with diagnostics, clinical photography expert. cases. Insurance companies are much more likely to approve insurance claims and This can be difficult to find, but claims if you include images that clearly show the need for to explain to patients why is something he offers through treatment, PhotoMed General Office Manager Sean Chappell treatment is required. Krieger Continuum courses. said. These images also can be used to attract new patients WINTER 2016
FROM THE ADVISORY BOARD
Other resources are available on his blog, DEVELOP A PROTOCOL dentalphotography.blogspot.com. Once you invest in a camera that works Dr. Krieger has taught clinical for your practice and complete the photography for about 15 years and proper training, you should develop a cautions dentists to be leery of investing protocol to make sure you actually use Dr. Larry Dougherty in expensive courses or equipment they the camera, Dr. Krieger said. Determine uses a DSLR camera for don’t really need. Make sure the person who’s going to take the pictures, who’s whitening and cosmetic teaching the course is actually an expert going to upload them to the computer, cases as well as lab whose advice you can trust. Ask to see how often they should be uploaded, communication. examples of their clinical images and how they’re going to be stored and how look for a course that focuses on proper they’re going to be backed up. techniques. There are about 11 basic images dentists should take, YOU’LL GROW YOUR PRACTICE Dr. Krieger said, and proper training will help you avoid Clinical photography is a huge practice builder, common mistakes. Typically mistakes happen if you don’t Dr. Krieger said, and is a great investment for young use mirrors or retractors properly, if you’re not close enough dentists just starting out. Patients will appreciate you to the subject or if you’re using the wrong equipment. taking the extra effort to educate them on their condition “Training is more important than camera selection,” Dr. through what Dr. Krieger calls co-digital diagnosis, Shaw said. “If you have a great camera and don’t know how making them more likely to accept treatment and to to get the right angles and how to control the lighting, you’re stay loyal to your practice. not going to have good images. But you can have a less than “You don’t have to be a salesman when using clinical ideal camera and get a decent image by patient positioning photography in your practice. You just have to use the and using proper mirror and retraction techniques.” photos to guide patients to understanding their needs,” Many of the manufacturers who offer dental specific Dr. Shaw said. “When you do that, case acceptance will cameras also provide in-house training, Chappell said. sky rocket.”
WANTED Advisory Board Members The New Dentist™ Magazine Sally McKenzie, publisher of The New Dentist™, announced that the magazine is currently seeking applicants to join the publication’s advisory board. Dentists who have graduated dental school between 2009-2016 are invited to apply. Board members serve for a two-year term in a volunteer advisory capacity helping to identify pertinent topics for today’s new dentists. “It’s an honor to work with these new dentists who have great insights into the successes and challenges they face daily in the profession. They are in the trenches and know what’s important to their fellow new dentists and are willing to share their experience with their colleagues,” said Ms. McKenzie.
This open enrollment will continue until December 15, 2016. Interested new dentists can apply by going to The New Dentist™ website,
20 THENEWDENTIST.NET W I N T E R 2 0 1 6
Built in dental cropping grid lines to get a clear and concise image, the first time.
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3.5 inch LED/LCD touchscreen – Works with exam gloves Water/chemical resistant – Essential for infection control in the office *HIPAA compliant: Brinker, S. (2015, January). HIPAA compliance and digital photography with personal mobile devices. Dental Products Report, 76-80.
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Visit www.shofu.com or call 800.827.4638
By Marya (Vaysburg) Polan, DDS
Transitioning to CAD/CAM: 5 Tips for Mastering the Digital Impression Entering high school, I was six feet and three inches tall. I was asked to play on every sports team solely because of my size. Even though I had never touched a volleyball, the coach was thrilled when I showed up to the first practice. That day, I learned volleyball required great acuity and awareness, and the only thing being tall helped with was intimidating opposing playMarya (Vaysburg) Polan, DDS ers. Learning to spike the ball seemed like an impossible goal. Eight years later, I competed in my last NCAA Division I volleyball game. I felt like a master in my position, with high school students admiring my skill from the stands. Transitioning from a newly graduated dentist to a successful practice owner was a similar challenge to learning volleyball. As a new dentist in a fully digitized practice, I prepped my first crown in about one hour. When the CEREC® CAD/CAM scanning unit was rolled in, reality hit me: I was already an hour into the appointment and still needed to scan, design, mill, glaze, and deliver this crown! That day, it took me just shy of four hours to complete the crown. Three years later, I’m completing CAD/CAM restorations in less than 90 minutes. Learning digital dentistry takes patience and practice. Mastering the digital impression is a great way for dentists to start incorporating CAD/CAM into their practice. Scanning our own preparations makes us stronger clinicians and better leaders. Assessing the preparation, occlusion, and anatomy of surrounding teeth is necessary for designing a beautiful restoration. Scanning is a simple skill to learn and patients love that they don’t need a gooey impression. Just like learning a sport, learning new skills with CAD/CAM requires breaking things down into fundamental steps. Here are five tips every dentist can use to master the digital impression: 1. Stay calm. Keep in mind no harm can be done to patients by scanning their teeth. If we get a bad image, we can just erase it and take it again. The more times we do it, the easier it becomes. 2. Only scan what you need. Know the 3-2-1 rule for scanning. Scan three surfaces on the prepped arch (buccal, occlusal, lingual), two on the opposing arch (buccal and occlusal), and scan one surface for the bite (buccal). Once the camera is passed over these areas, stop and assess the images. If more information is needed, take additional pictures of that specific area.
22 THENEWDENTIST.NET W I N T E R 2 0 1 6
The critical areas for the prepped arch are the margins and contacts of adjacent teeth. For the opposing arch, the critical areas are the occlusal surfaces that will be in contact with the restoration and the buccal gingival tissue the software will use to stitch the bite together. For the bite scan, the gingival margins need to be seen clearly in the area the bite is being put together. 3. Stitch the bite in the premolar area. The software works best when the bite is stitched in the premolar area. If the bite is always done in the same place, it’s easier to check for accuracy. For buccal surfaces being scanned, only this one area is needed in detail. 4. Warm up the camera. Every system is different, but the Omnicam requires heating for optimal use. It can take between 10 to 20 minutes to heat up. Turn the computer on before the prep so it’s ready to go when it’s time to take the images. If the camera is not warmed up, it can fog and generate distorted images. 5. Use the foot pedal. The camera has three settings that can be referred to as “ON,” “OFF” and “PAUSE.” Using the foot pedal, we can transition between these settings while holding the camera. Click the foot pedal once to turn the camera “ON” and actively take images. By pushing the foot pedal up and holding it, the camera goes into the “PAUSE” mode. This is the most important mode for dentists new to scanning, as the camera is opened without taking images. This presents an opportunity to get positioned and practice the scan, or to check the isolation and light. When ready, the pedal can be released to turn the camera back to the “ON” mode. For new users, using the foot pedal can help produce higher quality scans. Mastering the digital impression is one simple step that can take practices to the next level. From there, we can complete same-day restorations or seamlessly send the scans to the lab. In dentistry, we all have moments when we feel like that awkward teenager trying to learn a new sport. By committing to learning CAD/CAM technology, we can gain more confidence and a better grasp of dentistry than ever before. For dentists looking to start the transition to digital dentistry, the digital impression is a great place to begin that journey. Marya (Vaysburg) Polan, DDS, is a 2013 graduate of University of the Pacific Arthur A. Dugoni School of Dentistry. Dr. Polan is an owner dentist supported by Pacific Dental Services® in Alameda, Calif.
Numbers to Watch
continued from page 11 •
Don’t make your patients wait weeks to see the hygienist.
6. Overhead. Practice overhead ideally should be between 55 to 65% of collections, with 65-70% being more realistic for a new dentist. Here’s the ideal break down: Dental Supplies: 5% Rent: 5% Lab fees: 10% Office supplies: 2% Payroll: 20% Payroll taxes and benefits: 3% Miscellaneous: 10% If any of these are higher, it’s time to figure out why and to determine how to fix it. If you spend too much on supplies, set a budget. Spending more than 5% on rent? Start producing and collecting more. Lab fees past the 10% benchmark? Look at the charge of the lab per unit
continued from page 13 versus what you charge. You should charge 7 to 8 times the lab fee. If that makes the fee unrealistic, look for a more affordable lab. And if payroll costs are beyond the 20-22% benchmark, it might be because there are too many employees, hygienists earn a guaranteed salary no matter what they produce and team members receive raises every year whether they’ve earned them or not. Provide team members with detailed job descriptions and clear performance measurements, and only give raises when they’re earned. This will help keep payroll costs under control and overhead down. Your young practice has so much potential. Monitor these numbers and make corrections when necessary. This will help ensure you have a healthy practice and a robust bottom line.
“They got 40 something Google reviews overnight. It was a game changer,” Tucker said. “This separated their practice from the competition. We can turn eyeballs and traffic on websites and on Google into revenue.”
BENEFITS FOR A NEW DENTIST Dentistry needs to be convenient for your patients. They’ve come to expect communication options that work best for their busy lives, and if your practice doesn’t offer them, they’ll likely move on to one that does. Investing in a patient communication system will help you attract more patients, confirm more appointments and get more recall patients in the chair, not to mention reduce broken appointments and improve practice efficiencies—all of which are great ways to grow your practice and your bottom line.
Business Management Training for Dentists. This two-day, one-on-one customized training program walks the dentist owner step-by-step through the business operational systems of dentistry. The Business of Dentistry
• Overhead • Production Objectives Staff Management Recruitment, Hiring, Dismissal Performance and Salary Review Systems Management Watching The Numbers Patient Retention Cash Flow Management w w w. m c k e n z i e m g m t . c o m
To take your career to the NEXT LEVEL, e-mail firstname.lastname@example.org or call 877-777-6151. WINTER 2016
IMPLANTS to your practice
By Danny Domingue, DDS, FAAID, DABOI/ID
Editorâ€™s Note: This is the first article of a three-part series about how to add implants to your practice.
Dental implants are now, more than ever, becoming the standard of care for replacing missing teeth. Patients are certainly more aware of dental implants than in years past. While perhaps not yet as ubiquitous as Starbucks, it is rare to encounter a dental practice that doesnâ€™t offer dental implants. Personally, I am glad to have been placing and restoring dental implants for all of my nine years in practice.
24 THENEWDENTIST.NET W I N T E R 2 0 1 6
General dentists who place and restore implants cite a substantial personal reward. A colleague I met through the American Academy of Implant Dentistry (AAID), Dr. Jeffrey Meister, a general dentist from Munster, Indiana, added implant dentistry to his practice in 1996, almost a decade after completing dental school. He is pretty outspoken about how implant dentistry re-invigorated his practice and feels as if it keeps him on the leading edge of care for his patients. Another AAID friend, Dr. Bernee Dunson, a general dentist from Atlanta, Georgia, maintains that a dentist can’t practice contemporary dentistry without practicing implant dentistry. Nearly three-quarters of implant dentists provide both implant surgery and restoration, according to the AAID’s 2015 Implant Dentistry Benchmarking Study. I provide both phases in my practice and have grown my skills to include more advanced techniques such as guided surgery and soft tissue augmentation around implants. However, you don’t need to offer that level of treatment right away. You can add dental implants to your practice one step at a time.
You aren’t selling implants. You’re improving a patient’s quality of life. Don’t be overwhelmed by the idea of offering implants in your practice. You don’t have to accept complicated cases right away. It all starts by having conversations with your patients about improving their lives. I began offering implants as an associate in my first private practice. The dentist I was working for had 30 years of experience and didn’t offer implants, but I was really interested in them. In the beginning, when I identified a case I thought I could handle, I started by talking with the patient about it. I found it important to always think about the patient’s perspective. If I discuss the scientific reasons for the procedure, I might think my patients will be impressed, but in reality I could be scaring them away. Instead, I discuss implant treatment as having the greatest benefit for them. This is the foundation of my implant practice today. Another way to think about the conversation is to discuss the benefits of treatment rather than the features. For example, CONTINUED ON PAGE 26 >>
IMAGE COURTESY OF THE AMERICAN ACADEMY OF IMPLANT DENTISTRY
Even with the rise of implant dentistry, the number of patients certainly isn’t in dwindling supply. The prevalence of periodontal disease is still the leading cause of natural tooth loss. Every year new surgical and prosthetic techniques enable more patients to become candidates for implants. General dentists and specialists alike are more capable than ever of tapping into the abundant available resources to help treat any type of case. With more and more courses being offered in every locale as well as online, there is no excuse not to obtain dental implant training.
Dr. Daniel Domingue was born and raised in Lafayette, LA. He received his DDS from the LSU School of Dentistry in New Orleans in 2007. Further training included one year General Practice Residency and a two year Implantology Fellowship. Dr. Domingue is a Fellow of the American Academy of Implant Dentistry and a Diplomate of the American Board of Oral Implantology, the highest recognition possible for a general dentist practicing implantology. He was recognized as the youngest recipient of this certification in the world. He is the Founder and President of Acadian Southern Society, serves as Chair of AAID’s Membership Committee and is co-host of AAID’s Podcast.
“General dentists who place and restore implants cite a substantial personal reward.” I talk about how they will be able to chew comfortably again instead of selling them on the scientific processes involved. If you focus on the features, you’ll sound like you’re giving a sales pitch. Focusing on the benefits implants offer will help your patients understand how their lives will improve.
What if insurance doesn’t cover it and my patients can’t afford it? Cost is a big concern for patients. It is by far the No. 1 question the AAID receives from consumers. You should approach this discussion by explaining the value of dental implants. Value in terms of improving their quality of life as well as the life expectancy of dental implants. Typically, dental implants are permanent replacement options. So while an alternative treatment plan might cost less, if it has to be replaced every two to three years, is it really a “better deal?” In my practice, dental implants are the best treatment option for replacing missing teeth; however, insurance
coverage for implants is not widely accepted. I checked with the AAID, and in the January 2016 issue of AAID News, they explored this topic. In that article, Dr. James Bramson, chief dental officer at United Concordia, said “More and more employers want plans that cover dental implants, recognizing that implants are a very good option for their employees.” This is certainly a step in the right direction for those lucky enough to have such coverage. Evelyn Ireland of the National Association of Dental Plans added, “Implant coverage is more common now and most commonly assigned to major coverage, which is paid at 50% of the discounted fee when dentists are in network and 50% of usual fees when not.” However, coverage of implants is often limited by both a “dentally necessary standard” as well as frequency limitations per tooth. Don’t leave your patients in the dark about payment options. Find out in advance if implants are covered by their insurance, and advise them accordingly.
I’m convinced. What are my next steps? First, make sure you have the skills to confidently place and restore implants. You need to be comfortable with the surgical aspects. Most importantly, you must know what you don’t know so you can avoid complications that could lead to patient discomfort, complaints, litigation, or worse. Second, you need to know what changes and additions need to be made to your practice operations. Do you need additional or different staff members? What training will they need? What will happen to your overhead? Finally, once you are ready to go, how will you find patients to support your new skills? We will cover these items and more in parts 2 and 3 of this series. 26 THENEWDENTIST.NET W I N T E R 2 0 1 6
BEEN THERE, Done That
Key Opinion Leader
loans or buying a practice, but don’t take on debt for cars and vacations. Cars depreciate but educate appreciates.” Taking on debt to purchase equipment that will lead to practice growth is also a good investment—but only if the equipment allows you to add services your patients want and if you’re actually going to use it, Dr. Miyasaki said. Lack of Dr. Michael Miyasaki follow through can be costly, but if you properly implement technologies like laser dentistry or cone beam into your on growth practice, not only will you be able to offer patients better care, you’ll also see a return on that investment. r. Michael Miyasaki has “You have to commit to getting over the learning come full circle. When curve,” Dr. Miyasaki said. “We have CEREC CAD/CAM he graduated from dental and we use it every day to create crowns versus sending school about 30 years ago, he joined his father’s practice in them out to the lab and patients coming back for a second Sacramento before branching out on his own. Over the years appointment. It pays for itself plus thousands more on he’s practiced and taught in LA and Las Vegas, but decided to top of that. We’re saving time and it’s making us more come back home about five years ago to work alongside his productive. As long as you commit to using technology father again, a man who recently retired after practicing for you will see the return. When dentists buy more than 50 years. equipment and don’t use it, that’s where it Dentistry is an important part of Dr. Products Dr. Miyasaki becomes a financial burden.” Miyasaki’s family with many of his cousins recommends: Dr. Miyasaki also suggests focusing on and uncles taking the same path. His n Loupes from Orascoptic providing more comprehensive care to fewer daughter started dental school just a few patients rather than trying to get 100 new patients months ago, and Dr. Miyasaki has enjoyed n The Solea hard tissue in the chair every month. That approach is better sharing his advice and experiences with her laser from Convergent Dental for both you and your patients, he said, and will as she begins her journey. help keep you from feeling overwhelmed. Young One of his first pieces of advice is n Gemini dual wavelength soft tissue laser from dentists also tend to work too much. When Dr. to develop a plan. Determine your goals, Ultradent Products Miyasaki first started, he worked 40% more hours but don’t be afraid to change your plan n Myotronics Model K7 than he does today—but was less productive. It’s as new opportunities arise. Education is Evaluation System for three important to find ways to be more efficient so you also important to growth, he said, and dimensional jaw tracking, can get more done in less time. remember most of what you learn comes surface electromyography Treating your team and patients with respect after you graduate. and temporomandibular is also important for growth, Dr. Miyasaki said. “Many new graduates come out joint sound study Remember you can’t do this on your own; you of dental school frustrated because n Air abrasion for minimally need a loyal patient base and a strong team to they realize they don’t know it all,” Dr. invasive dentistry achieve success. Miyasaki said. “Find mentors you can n CEREC CAD/CAM from “A lot of new graduates are overwhelmed trust and who will help you grow. Invest Sirona Dental and don’t stop to think that it’s our teams that in yourself. My dad told me to take a lot n GALILEOS 3D imaging make us successful,” he said. “They also need of CE. I believe in that.” unit from Sirona Dental to watch the business and grow it intelligently. In August, Dr. Miyasaki and his Watch the numbers. If you have a dollar left daughter took more than 50 hours of CE— at the end of the month it doesn’t mean it was a successful the amount California requires over a two year period. Why so month. You have to plan for greater growth ahead.” much? Investing in education helps dentists reach their goals and improve their skills. Growing as a dentist and as a team are vital to success, and education is a huge part of that. Dr. Michael A. Miyasaki practices general dentistry in Sacramento, “I told my team at the beginning of the year if we want CA, and has been involved in dental education for nearly 30 years. He is the Director of Education for the Pacific Aesthetic Continuum, which to do better than we did in 2015, we can’t be the same people conducts live-patient treatment programs across the United States with the same skills,” Dr. Miyasaki said. “We have to grow and with an emphasis on comprehensive restorative dentistry done esthetenhance our skills. I’ve told our young associate to do his best ically. His goal is to make it easier for his colleagues to provide quality to stay debt free. Take on debt to make money, like student dental care and to be successful in practice with happy patients.
on the Street
The latest news on products and services for new dentists and their practices The Canary System
OralID™ With oral cancer on the rise, Forward Science was founded to create a simple and efficient oral cancer-screening device. OralID™ was designed to innovate the current fluorescence oral screening devices on the market. Winning countless awards, OralID™ has become a “must-have” product for early oral cancer discovery. Designed to screen every patient, OralID™ is the only product that truly has no per patient costs. Forward Science includes a proprietary SmartFilterID™ to easily photo document lesions through any smart device. Given its simple design, OralID™ may be implemented into every exam, giving clinicians the ability to Shine Light. Save Lives™. For more information call 855-696-7254 or visit forwardscience.com. PHOTO COURTESY OF FORWARD SCIENCE
The Canary System, with its unique crystal structure diagnostics, can quantify, monitor and record changes in the structure of enamel, dentin and cementum. Clinical trials have shown it is more accurate than bitewing X-rays for detecting proximal caries. The Canary System is a laser-based device that detects cracks and caries not seen with other devices but that do require treatment. It can detect caries beneath opaque sealants, around the margins of restorations, on interproximal, occlusal and smooth surfaces. The Canary Cloud enables dentists to view and manage this data and track Canary usage in the office. For more information visit thecanarysystem.com. PHOTO COURTESY OF QUANTUM DENTAL TECHNOLOGIES
FitStrip™ Interproximal Finishing and Contouring System This comprehensive kit includes eight varieties of diamond coated abrasive strips, two interproximal saws and two interchangeable handles. FitStrip™ is indicated for use in IPR, contact reduction, interproximal finishing and contouring, crown and bridge cement removal/clean up as well as separating inadvertently bonded teeth. Both single sided and double sided strips are included. All the strips feature the unique ability to be adjusted from straight (for contact reduction) to curved (for interproximal contouring) with a twist of the color coded barrel, eliminating clinician hand fatigue. The interchangeable handle easily attaches to any of the FitStrip™ components, significantly improving ease of use and patient comfort. The clinician’s hand stays outside the mouth, providing a clear field of view and easier operation. For more information call 1-888-437-0032 or visit garrisondental.com. PHOTO COURTESY OF GARRISON DENTAL
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