By John C. Cranham DDS, Clinical Director The Dawson Academy
I was recently interviewed by a local newspaper, upon the opening of my new Dental Practice. The person that was interviewing me asked me how many things that I was taught in Dental School was I still doing the same way. Having graduated from The Medical College of Virginia in 1988, I had to think about that for a minute. I was struck by the conclusion that I do nothing the way I did it in Dental School!
While dentistry has certainly changed dramatically in the last 20 years, the technological advances that are occurring today, is moving our profession at warp speed. While this is exciting, there are numerous challenges to correctly implementing these high tech tools, in a way that they will be optimally utilized, while not create a financial burden to the practice.
The mistake that is often made is to think the technology will be a magic bullet for the practice. A dental office that is in a financially unhealthy place will generally not benefit from an expensive technology, which may even put more economic stress on it. It is important to remember that these devices are simply tools that will allow us to do our dentistry better, more efficiently and provide our patients with a better experience. If we start with a well-run practice, with a clear vision for who we are and the services we provide, it will become obvious which technology we should implement first, and a logical timetable for which the other technologies can be brought into the practice environment.
Start with a Philosophy of Practice
Getting Clear on the specific mission of your practice is probably the most important thing any Dentist can do. In Dental school most of just hopes for a full schedule, but as that begins to happen, most mature practices begin to focus on some aspect of Dentistry. At The Dawson Academy, we attract Dentists who want to learn to solve complex esthetic & functional problems. We place a high emphasis on diagnosis, treatment planning and sequencing dentistry in a way that the vast majority of our patients can afford optimum care. The curriculum is structured to train Doctors to visual optimally, to procedurally do the work clinically, and lastly to organize the team around them to optimize efficiency as well as profitability. While this is not the only philosophy out there, it has certainly worked will thousands of Doctors who have chosen this path. The important philosophy, a practice vision, and stick to it.
Don’t let the Technology Define the Practice
All to often if the vision for the practice is lacking, when technology is purchased it can become the center of the practice. A perfect example of this is Chairside CADCAM technology. I have been involved with Chairside CADCAM, currently using the D4D, for 5 years. It is an incredible tool for providing beautiful all-ceramic restorations for your patients. It is not, however, a machine that will allow you to do 100% of fixed prosthetics. Having a solid foundation for treatment planning, restoration selection and adhesion is vital to the integration of this tool into your practice. If this background is lacking, then it is easy for the technology to drive the practice. This can lead to using the wrong materials in the wrong places, and ultimately an increased failure rate.
Whatever technology you choose, remember that it is a tool designed for specific situations. While the training you will receive will emphasis the proper use of the instrumentation, pay special attention to its limitations. As you integrate it into your own practice of excellence, find the “sweet spot” in the practice for when it works best. This will increase the predictability, efficiency and profitability of your purchase.
Align the Technology with the Practice Focus
Once a philosophy of practice is established, the technology that would be of most value, is often very obvious. If the Doctor does a lot of surgery, perhaps placing implants & doing complex extractions, cone beam technology will be a huge benefit. On the other hand if the dental team does a lot of operative dentistry, crown & bridge, and soft tissue surgical procedures; the Waterlase MD will increase the number of procedures you provide your patients, while also increasing efficiency.
Over the years we have gradually implemented various technologies into our restorative practice. These five are at the heart of our new practice:
Digital Radiography (Dexis)
Digital radiography in conjunction with digital photography are often the first technologies introduced into a dental practice. Since we all take x-rays, digitizing the process increases efficiency and diagnostic capabilities of the team. I choose Dexis because of the quality and versatility of the sensor, the software platform, as well as the integration into Dentrix (my management software). Having the patients chart, progress notes, photographs and xrays on one screen make treatment planning extremely efficient.
Chairside CADCAM (D4D)
Being able to do a percentage of your crowns, inlays and onlays in one appointment, with one injection, without the need of a temporary restoration, is a tremendous service to the patient. Today with the addition of EMAX CAD, a lithium disilicate material, which is an extremely strong ceramic, only expands our opportunity to utilize this technology with total confidence. Dental teams that focus a percentage of there practice to lab fabricated, indirect restorations, will find a good fit with this technology. I chose D4D because of the ability to scan without powder (I do paint a liquid on the teeth prior to scanning), taking images from multiple angles to increase the accuracy of the model, the ease of use of the software, and the quality of the people running the company.
Laser Dentistry (Waterlase MD)
The Waterlase is the latest technology integrated into our practice. While I have had several years of experience with a couple of different diode lasers, the Waterlase MD is at a different level. It gives the dental team the ability to perform procedures on both soft tissue, and hard tissues. We utilize it during crown and bridge procedures to create micro-troughs around our crown preps prior to impressioning, for closed flap crown lengthening procedures (when indicated), gingivectomies, and the preparation of teeth during operative procedures. It has decreased the amount of anesthetic that is required during operative dentistry (allowing us to work in multiple quadrants in one appointment), as well as attract dental phobic patients who hate the sound of the drill.
Cone Beam Computerized Tomography (Sirona Galileos)
Cone Beam Computerized Tomography (CBCT), is providing the 3rd dimension in virtual diagnosis and treatment plan. While I was initially interested in the ability to image patients with TM Joint problems, I soon found it invaluable when treatment planning implant cases. Having the ability to virtually place implants, having the ability to precisely communicate to the surgeon where the implants need to go, is a game changer. There is no longer the patient who gets opened up and we find that there is not enough bone. We can plan for bone grafts, so that the implants are placed in the ideal position for the prosthetic solution. This technology has expanded my diagnostic capabilities helping TMJ patients, as well as increased my confidence enough to begin placing the easier implants in my practice.
Dental Microscopy (Global G6)
Any time we an see better, we have the ability to improve our clinical skills. Caries detection, margination, trying in restorations, tooth preparation and endodontic procedures will all be better under a microscope. While dental microscopy has primarily been utilized by dental specialists, it is making its way into restorative practices throughout the world. We have found it not only dramatically improved our ability to see, but it forces us to keep our back straight, into an ideal posture to provide dental services.
Get help in developing your business plan of implementation
Whatever technology you may be thinking about, get some help with the implementation process. The better your local Schein Technology specialist knows you and your practice, the better recommendations they can make about which technologies should be considered first, and how to integrate into your practice.
Beyond the obvious financial implications to be considered, also do not forget to discuss the training requirements with your team. Remember that everyone is not crazy about change, and some teams have a harder time with it than others. The earlier they get involved with the process, the greater the excitement will be and the smoother the transition. Having the right team attitude about something new in the office can make or break the implementation process.
Utilizing the latest technologies to do routine and complex dental procedures has allowed us to do procedures with better quality, increased efficiency, as well as increased profitability. Beyond that it is just plain fun! Dentistry is now moving at ever evolving, rapid pace. As you consider technology integration, first get clear on the specific vision of your practice. Then and only then can we choose the right tools for the time. Following this path will make the integration of the latest technology a smooth, fun & rewarding experience.
