More Than a Logo
NOVEMBER/DECEMBER . 2017
Tetric Evo Line ®
One composite system for all indications
“
Tetric EvoFlow Bulk Fill is my go-to material for everyday posterior restorations..
”
– Dr. Ronaldo Hirata Assistant Professor of Biomaterials New York University
The Tetric® Evo Line of composites offers an esthetic and predictable restoration in all cavity classes.
• Indicated for anterior and posterior restorations • Exceptional handling and esthetics • Clinically proven performance
Visit TetricEvoLine.us to see this case and much more.
BEFORE
< – 4 mm
© 2017 Ivoclar Vivadent, Inc. Ivoclar Vivadent, Tetric EvoFlow and Tetric EvoCeram are trademarks of Ivoclar Vivadent, Inc.
+
< – 5 mm
BEFORE
< – 4 mm AFTER
Dr. Hirata chose Tetric EvoCeram Bulk Fill flowable combined with Tetric EvoCeram to replace this original restoration. Its adaptable, flowable properties lowers the instances of voids leading to better long-term clinical results.
November/December . 2017
From The Publisher
Helping DSOs Flourish............................................. 4
ADSO Partnering for Growth 2017 conference..................... 6 How to Leverage Emotions at Work....................................... 8 Lasers in Hygiene
Have you considered?..............................................12
Solutions that Work
Training across a large DSO calls for sensitivity on the part of the manufacturer.........16
Tools for Success
Excellent training and thorough education lay the groundwork for optimal patient outcomes.................................18
Raising the Bar
As dental practices – both large and small – face greater demands, service technician Greg Rehms works harder than ever to exceed expectations..............20
More Than a Logo
Branding and the DSO...........................................24
The Ideal Cure
As curing technology has become increasingly sophisticated, curing lights have become more and more diverse, leading dentists to question which light solution and bulk fill composite best meets the needs of their practice..................32
Instructions for Use
What they are and why they are important to the dental practice............................36
OSAP: Hit the Ground Running
The OSAP Dental Infection Control Bootcamp™ 2018 experience offers attendees an opportunity to enhance their infection control knowledge.........................40
Industry News...........................................48 Efficiency In Group Practice is published six times a year by Share Moving Media • 1735 N. Brown Rd. Ste. 140 Lawrenceville, GA 30043-8153 Phone: 770-263-5257 • Fax: 770-236-8023 www.dentalgrouppractice.com
EDITORIAL BOARD
Jack Allen, national purchasing director, Great Expressions Dental Centers. DeAnn McClain, vice president of operations, Heartland Dental. Lorie Streeter, FAADOM, CTC, chief operating officer, American Association of Dental Office Managers.
EDITOR Laura Thill • lthill@sharemovingmedia.com MANAGING EDITOR Graham Garrison • ggarrison@sharemovingmedia.com ASSOCIATE EDITOR Alan Cherry • acherry@sharemovingmedia.com CIRCULATION Laura Gantert • lgantert@sharemovingmedia.com ART DIRECTOR Brent Cashman • bcashman@sharemovingmedia.com
PUBLISHER Bill Neumann wneumann@sharemovingmedia.com
ADVERTISING SALES Diana Craig dcraig@sharemovingmedia.com
ADVERTISING SALES Jamie Falasz jfalasz@sharemovingmedia.com
Efficiency In Group Practice is published six times a year by Share Moving Media, 1735 N. Brown Rd. Ste. 140, Lawrenceville, GA 30043-8153. Copyright 2017 by Share Moving Media All rights reserved. If you would like to subscribe or notify us of address changes, please contact us at the above numbers or address. POSTMASTER: Send address changes to Share Moving Media, 1735 N. Brown Rd. Ste. 140, Lawrenceville, GA 30043-8153. Please note: The acceptance of advertising or products mentioned by contributing authors does not constitute endorsement by the publishers. Publishers cannot accept responsibility for the correctness of an opinion expressed by contributing authors.
ISSUE 6 • 2017 : DentalGroupPractice.com
3
From the Publisher
Helping DSOs Flourish This is the last issue of Efficiency in Group Practice for 2017. As we head into the holiday season, I’d like to thank all our 2017 advertisers for making our fifth year publishing this DSO-centric magazine our most successful. We continue to grow our readership with relevant and timely dental support organization related content. As the DSO industry continues to grow and evolve, Efficiency in Group Practice will remain at the forefront of providing news and exclusive content for emerging dental groups and dental support organizations. Recently returned from the ADSO’s Partnering for Growth Conference in Washington, DC, I am struck by the increasing number of organizations and events that are catering to the needs of emerging dental groups. The number of training, consulting and educational resources is at an all time high. These events and organizations ensure that a new wave of dental groups and DSOs will have the ability to flourish and scale much more effectively than in the past. The Dentist Entrepreneur Organization, Dental Group Evolution, Scaling Up Dental, and Partnering for Growth are all built to guide entrepreneurial dental groups to successful outcomes. Efficiency in Group Practice will continue to cover these meetings and organizations in 2018 and beyond, as they continue to impact the growth of the industry. Our goal at Efficiency in Group Practice is to provide quality content to assist you, whether you are an emerging dental group or an established DSO looking for the latest education and information specifically suited to multi-location dental groups. In this issue we review hot topics, such as training, marketing and branding. When it comes to branding your group of dental practices, we go to the experts to get their tips on marketing and branding. Ryan Torresan of Great Expressions Dental Centers has capitalized on lifestyle, passion, health, empowerment and aspirations of their patients to convey the GEDC brand. Aldo Benedetto of Benevis shares his brand building techniques for Kool Smiles with a goal of creating a high-quality patient care brand in a fun and compassionate environment. Aside from branding and marketing from a patient perspective, Kasey Pickett of Aspen Dental shares her team’s community based strategy to make sure that dentists that partner with ADMI feel supported, mentored and connected. If training and education is important to your DSO, make sure you take a peek at our article on DSO training. We get perspective not only from dental service organizations, but from their industry partners as well. We look forward to serving the DSO industry in 2018 and beyond,
Bill Neumann 4
Efficiency In Group Practice : ISSUE 6 • 2017
Custom-fitted Dental Cabinets Dental Units and Lights Dental Chairs and Stools
ADSO Partnering for Growth 2017 conference
The Association of Dental Support Organizations (ADSO) hosted its first ever Partnering for Growth 2017 conference, September 21-22, at the Gaylord National Resort & Convention Center near Washington, D.C. The conference provided educational content geared specifically to connect with small & emerging groups. Event summary In September, the Association of Dental Support Organizations (ADSO) hosted the first annual Partnering for Growth Conference at the Gaylord National Resort & Convention Center in National Harbor, Maryland. With a focus on smaller to mid-size DSOs, the conference provided attendees the benefit of learning from some of the most knowledgeable executives with larger DSOs that have been in the industry for many years, as well as industry partners and other experts.
6
Efficiency In Group Practice : ISSUE 6 â&#x20AC;˘ 2017
Sponsored by many of the ADSOâ&#x20AC;&#x2122;s Industry Partners including co-title sponsors Houlihan Lokey and Henry Schein, the day and a half event provided educational content and informational sessions on leadership, finance, compliance and marketing hosted by members of the ADSO including CEOs from some of the top DSOs in the country, finance experts, and compliance experts. The conference also featured Talk Table opportunities, where attendees could meet with industry leaders, providers, and other stakeholders.
Finally, there’s an intraoral camera that is easy to use, captures crystal clear images and integrates with your imaging software. For less than $300. Seriously.
Our Intraoral Cameras and ExamTab tablets offer the same high quality features found in systems that cost thousands more, plus everything is backed by our no-risk satisfaction guarantee, a one year warranty and lifetime tech support. It’s time for one in every operatory. Integrates with Dexis, Eaglesoft, Schick, XDR, Ascend, MacPractice, TigerView, VixWin, Apteryx, Curve Hero, MiPACS, Romexis, Sidexis, Carestream, Kodak, Twain and more - guaranteed.
registered
mouthwatch.com | 877.544.4342
Michael Bileca, ADSO president and executive of Dental Care Alliance, reflects on the conference ADSO: What makes the Partnering for Growth conference valuable to emerging and smaller DSOs? Bileca: The Partnering for Growth conference is mutually beneficial for larger and smaller DSOs because we all get to figure out where any gaps are, and what we can do to keep the thriving industry’s momentum rolling. Partnering for Growth allowed us to provide resources and engagement opportunities to not only our own members but others within the community. Having the opportunity for industry veterans and those just starting out to meet in a collaborative, interactive environment is invaluable. ADSO: What is your advice to emerging DSOs looking to expand within the DSO industry? Bileca: My advice to smaller or emerging DSOs would be to look to the ADSO as a resource. The ADSO brings together DSOs, providers and industry partners from every corner of the DSO space. The ADSO facilitates dialogue
and facetime throughout the year; events like the Partnering for Growth conference are an excellent way to learn more about different strategies that can help your company grow. I encourage anyone who is interested in developing relationships and learning to a more in-depth degree about the DSO community to also attend the 2018 ADSO Summit in Austin, Texas. ADSO: What are the top takeaways from the first annual Partnering for Growth conference? Bileca: I would hope that everyone came away with something from this conference. It was particularly apparent, through Talk Table opportunities in between sessions, the networking reception, and in the programs that we all have something to learn from one another. It’s important to remember that opening the line of communication throughout the industry only makes the industry itself stronger. The whole industry benefits when everyone is doing well. ISSUE 6 • 2017 : DentalGroupPractice.com
7
Leadership
How to Leverage Emotions at Work By Lisa Earle McLeod
When was the last time you felt inspired? What made you feel that way?
If you’re like most humans, inspiration requires an intense level of emotion. Research tells us if we want people to act, we have to appeal to their emotions. Neuroscientist Paul Zak researched the physiological impact of emotional stories. He measured the blood of participants before and after he told them an emotional story vs. a flat narrative. Both stories were aimed to get the participants to donate money. The “flat” narrative did not increase oxytocin or cortisol, and participants did not report empathy for the story’s characters. Those who were subject to the emotive story were willing to give 56 percent more money to the cause, which the researchers later revealed as made up. Dr. Zak concluded emotionally engaging narratives inspire post-narrative action.
8
Efficiency In Group Practice : ISSUE 6 • 2017
Dental Care Alliance Congratulates Our Partner Doctor Stephen Price, DDS Dental Associates of Northern Virginia Certified Invisalign Instructor & Elite Provider ®
Winner of the 2017 Invisalign GP Summit Shootout Sponsored by Align Technology ®
This is the highest industry recognition from Align Technology. In addition to treating this complex case involving severe crowding, deep bite, anterior and posterior crossbite, diastema, and asymmetrical arches, Dr. Price personally taught this teenager with cerebral palsy the fine motor skills he needed to manage his Invisalign therapy and achieve amazing results. Dental Care Alliance has built a winning strategy of growing through mergers and affiliations, equity partnerships, growth strategies, and retirement solutions. We’re proud of the high-quality patient care our team provides every day to people in communities across the country. Changing Smiles. Changing Lives.
855.979.3524 Affiliate@DentalCareAlliance.com DentalCareAlliance.com
BEFORE
AF TER
Leadership
do. Include names, details, how the other people feel, and the lasting impact you had on them. Telling one emotional story about a specific customer, how they looked and how they felt, is more powerful than saying we helped 10,000 customers this week. An emotional story will sustain people on their worst days because it allows them to connect the dots from what they are doing to who it is impacting. Let’s say you work in distribution for a plumbing company. Which sounds more appealing to you, “Our customers are depending on us to get these orders out on time.” Or “I remember hearing about the Jones family, in Washington. They had six-week-old twins when their basement flooded. The wife, Karen, was really nervous about mold and moisture in their house. They were living in her mom’s basement waiting for their house to be repaired. With both babies and all their stuff in cramped quarters, it put a lot of stress on their family. Because we got the parts there on time, they were back in their home in two weeks, and were confident the home was safe for their children. There are thousands of families like the Joneses who are depending on us to get these materials out on time.” Which cause are you more interested in, getting parts out on time, or getting the Jones family back into their home? As a leader, you don’t need to lie, or over exaggerate. You simply need to authentically bring emotion to the front and center of your organization. We’ve been told not to get emotional at work. Neuroscience has now proven, that’s the worst advice ever. Emotions drive inspiration. When you help others feel inspired, it has a ripple effect right back to you.
As a leader, formal or informal, you want people to be inspired. You want to ignite positive emotions, you want people to buy into your ideas and work hard for the organization or cause.
So what can we learn from Dr. Zak’s experiments? If you want people to act, you can’t just make them think, you have to make them feel. Fear-based leaders know this, that’s why they create cultures of fear. Fear is a feeling that will prompt action. But only short-term action, and only enough action to remove the fear. It’s not sustainable. As a leader, formal or informal, you want people to be inspired. You want to ignite positive emotions, you want people to buy into your ideas and work hard for the organization or cause. The more you can help people see an emotional picture in their mind, the more emotionally engaged they will be. Paint mental pictures of customers you help, the impact of projects you’ve done, or in some cases, the consequences of not doing whatever you need to
Lisa Earle McLeod is a leading authority on sales leadership and the author of four provocative books including the bestseller, Selling with Noble Purpose. Companies like Apple, Kimberly-Clark and Pfizer hire her to help them create passionate, purpose-driven sales organization. Her NSP is to help leaders drive revenue and do work that makes them proud. 10
Efficiency In Group Practice : ISSUE 6 • 2017
THE NEW LOOK OF NITROUS OXIDE/OXYGEN S E D AT I O N Low-profile design Fits snugly around nose without tape Translucent Not made with natural rubber latex
New
AXESS® CAPNOGRAPHY ADAPTER
Attaches between the Mask and the Scavenging Circuit.
TO LEARN MORE ABOUT AXESS OR TO REQUEST COMPLIMENTARY MASK SAMPLES accutron-inc.com/Axess or Call 800.531.2221
Nitrous Oxide/Oxygen Sedation
Axess® is a registered trademark of Crosstex International, Inc. Accutron™ is a trademarks of Accutron, Inc., a subsidiary of Crosstex International, Inc.
Hygiene
Lasers in Hygiene Have you considered?
Lasers have been utilized in the medical and dental environment for years. There are many benefits to utilizing lasers in dentistry compared to traditional treatment methods, or to enhance current treatment modalities. Technological advances have and will always evolve, and as clinicians seek to offer their patients the most up to date, technologically advanced treatment options, they should consider the use of a diode laser in the practice. By Heidi Arndt Heidi Arndt, RDH, BSDH has worked in the dental field for 18+ years. Her experience ranges from working as a treatment coordinator, dental assistant, and practice manager before graduating from the University of Minnesota with a bachelorâ&#x20AC;&#x2122;s degree in Dental Hygiene. In 2011, Heidi founded Enhanced Hygiene. She is dedicated to helping dental practices realize their total hygiene profit potential through the development of their hygiene team, quality patient care, patient-centric service and by empowering the entire team.
12
For treatment of periodontal disease, a diode laser is used as an adjunct to non-surgical periodontal therapy. This is performed as the dental laser tip is methodically maneuvered within the sulcus, in short overlapping strokes to aid in the destruction of the bacteria by creating an environment that the bacteria will not thrive.
Incorporating laser treatment There are many ways to incorporate laser treatment into a dental practice. For use in the dental hygiene operatory the laser is used for bacterial reduction. With the growing knowledge of the etiology of periodontal disease, we want to focus on incorporating additional resources to our non-surgical periodontal therapy to ensure that we are reducing the bacterial load which will contribute to reducing the inflammatory response associated with periodontal disease. In addition to bacterial reduction, lasers can also be utilized in guided-tissue regeneration, laser-assisted periodontal therapy and bio-stimulation. When introducing a new technology to patients, it is always recommended to inform the patients of clinical and radiographic findings, as well as incorporating a comprehensive medical history to assist in obtaining all necessary information to assess the patientâ&#x20AC;&#x2122;s risk for periodontal disease. With this information, you can begin to educate the patient on the newest ways to prevent, treat or maintain the current state of their oral cavity.
Efficiency In Group Practice : ISSUE 6 â&#x20AC;˘ 2017
Hygiene
It is important to know that currently there is no long-term systematic research to support the use of lasers as an adjunct to non-surgical periodontal therapy, but we do know that there are clinicians utilizing diode lasers in accordance with their state dental hygiene practice acts with successful outcomes, such as increased wound healing and positive tissue outcomes. We truly believe future research will show the positive benefits of incorporating the diode laser as an adjunct to scaling/root planing, periodontal therapy and gingivitis therapy.
Explaining the service
In addition to bacterial reduction, lasers can also be utilized in guided-tissue regeneration, laser-assisted periodontal therapy and biostimulation. When introducing a new technology to patients, it is always recommended to inform the patients of clinical and radiographic findings, as well as incorporating a comprehensive medical history to assist in obtaining all necessary information to assess the patient’s risk for periodontal disease .
Currently, there are no CDT codes specific to laser use, but it is possible to still provide the service by explaining to the patient that insurance does not currently recognize the procedure, which is often the case with newer technology. With our commitment to using the most up-to-date technology, we are providing narratives to the respective insurance providers so they may understand the ever-evolving landscape of oral healthcare. Without a specific CDT code available, many dental groups are using the D4999 (Un-specified Periodontal Procedure Code) to bill the procedure to the patient. As mentioned before, dental insurance is not recognizing a benefit for bacterial reduction at this point, which requires the dental group to pass the cost onto the patient.
Lasers and ROI You may wonder if there is a true Return of Investment (ROI) to incorporating the diode laser into the
dental hygiene operatory, and it is important to note a few things before considering your ROI. No. 1: Do you have a strong and current periodontal therapy protocol in place for your practice? Is your team committed to recognizing periodontal disease and gingivitis at the earliest point? With more than 50 percent of the U.S. population suffering from periodontal disease, you should see multiple periodontal patients/day in your practice for scaling/root planing and/or periodontal maintenance. Then also consider how many gingivitis patients would also benefit from laser use.
No. 2: Is your team comfortable and committed to discussing out-of-pocket expenses with your patients? As mentioned before, insurance does not offer a benefit for bacterial reduction using a diode laser. You will need to pass the fee onto your patient for this procedure. No. 3: Commit to getting your entire team laser certified and educated on how to use the laser, and how to communicate the benefits of laser use to your patients. A strong training program and a supported implementation process will ensure your team is comfortable and confident with bring a laser into their standard of care. Lasers are here to stay. We encourage all dental hygiene teams to look at the benefits of lasers and how they can integrate into their current practice. If you have questions of how to integrate lasers into your dental group, please contact us today: www.enhancedhygiene.com or hello@enhancedhygiene.com.
Annaji, S. (2016). Efficacy of Photodynamic Therapy and Lasers as an Adjunct to Scaling and Root Planing in the Treatment of Aggressive Periodontitis – A Clinical and Microbiologic Short Term Study. Journal of Clinical and Diagnostic Research. doi:10.7860/jcdr/2016/13844.7165 Blayden, J., & Mott, A. (2013). Soft-tissue lasers in dental hygiene. Ames, IA: Wiley-Blackwell. Convissar, R. A. (2015). Principles and Practice of Laser Dentistry. St. Louis, MI: Elsevier Mosby. Fontana, C. R., Kurachi, C., Mendonça, C. R., & Bagnato, V. S. (2004). Microbial reduction in periodontal pockets under exposition of a medium power diode laser: An experimental study in rats. Lasers in Surgery and Medicine, 35(4), 263-268. doi:10.1002/lsm.20039 Harris, D. M. (2004). Laser antisepsis of Phorphyromonas gingivalis in vitro with dental lasers. Lasers in Dentistry X. doi:10.1117/12.549028
14
Efficiency In Group Practice : ISSUE 6 • 2017
GROUP PRACTICES REQUIRE: MAXIMUM EFFICIENCY COMPLETE ORGANIZATION ENSURED SAFETY AND INFINITE CONFIDENCE.
INSTRUMENT MANAGEMENT
INFINITY SERIES™ CASSETTES The most sophisticated solution for instrument management As dentistry’s innovator of the cassette-based instrument management system, Hu-Friedy believes that every practice deserves the peace of mind and confidence of knowing they are employing the most contemporary method of processing instruments. Our Infinity Series Cassettes offer: • An open hole pattern that promotes water flow throughout the cassette • Color-coded silicone rail system that significantly reduces instrument contact and allows for more water flow while protecting the instruments during reprocessing • Easy-to-use, ergonomic latch that allows for one-handed opening Performing at your best means having confidence in what you do. Hu-Friedy’s IMS solution advances Group Practices to the next level in efficiency, safety and patient care.
To learn more about how IMS can enhance your Group Practice visit Hu-Friedy.com/Infinity-Series ©2017 Hu-Friedy Mfg. Co., LLC. All rights reserved.
Training
Solutions that Work
Training across a large DSO calls for sensitivity on the part of the manufacturer.
The merits of a sound training program cannot be discounted. Still, it’s important for manufacturers to respect their DSO customers’ organizational structure and tight schedules – something Hu-Friedy pays close attention to when educating clinicians on solutions critical to achieving the best possible patient outcomes. Indeed, creating the ideal education and training programs for a busy DSO involves a thorough understanding of the customer’s needs, according to the Hu-Friedy Strategic Markets Team. DSOs often have their own product formularies, their own learning and development programs, and a unique structure, making it difficult for clinicians to adjust to interruptions in their busy schedules. Without consistent training throughout its organization, however, the DSO may fail to use products correctly or to their potential. Additional risks include: • Inconsistent or failed product performance. • Decreased return on investment. • I ncreased costs due to outsourcing basic equipment maintenance, which could be performed by a well-trained team. When implementing training programs, the Hu-Friedy Strategic Markets team has found that empowering the DSO to be engaged and educated on a company initiative dramatically improves acceptance and compliance. By scheduling regional meetings with the DSO, the company has been able to reach more clinicians and provide hands-on training and presentations by clinical experts. Webinars, too, have proved to be an effective tool for product-specific training, as they can be offered to multiple sites with minimal interruption, and on-demand training modules can be easily incorporated into the organization’s internal learning and development programs. Lunch-andlearns, too, continue to be well received, although it can be difficult to reach an entire DSO, particularly one with as many as 900 locations. 16
Efficiency In Group Practice : ISSUE 6 • 2017
Consistency counts Hu-Friedy offers training across several product areas, including: • Instrument management systems (IMS). The Strategic Markets Team works with clinicians to virtually eliminate the risk of instrument sharps injuries. Hu-Friedy’s IMS cassette system helps DSOs maintain standardized instrument reprocessing protocols by supporting systems-based (versus people-based) operations, virtually eliminating sharps injuries and saving between 8-10 minutes per patient. • The goal is to create an equipment-run system, not a people-run system, according to the Strategic Markets Team. In addition, the Air-flow technology. Currently considered the most efficient protocol for biofilm removal, air-flow technology creates a safe and effective protocol for the maintenance of implants, ortho brackets, aesthetic dental crowns and veneers, and periodontal maintenance. • Sterilization observation. This includes an in-depth assessment of a dental practice’s instrument reprocessing and infection prevention protocols with regard to the 2003 CDC Guidelines for Infection Control in Dental Healthcare Settings. A summary report is provided, outlining the assessment results and steps to achieve best practices/standard of care. DSOs, in turn, can use this as a calibration tool to integrate within their current compliance program. Consistent training and standardization throughout a large DSO helps ensure that all clinicians have access to quality products and can use them correctly and efficiently. Clinicians should have the autonomy to make choices over the products they use. For the best return on investment, it’s important that essential products are available on formulary and that non-essential product purchases account for the best possible value. And, always, the goal should be to ensure a safe working environment for staff and patients.
COMPLETE QUALITY.
COMPLETE PACKAGE.
Halogen Light offers true, reduced shadow, white light that helps to properly identify shades, see details and diagnose tissue.
The Assistantâ&#x20AC;&#x2122;s Delivery Unit option puts instruments within easy reach and includes vacuum solids collector and water quick connect.
The Asepsis 21ÂŽ Delivery System offers superior reliability and peace of mind knowing that its removable surfaces are easy to clean, promoting improved asepsis at the point of care.
The Left/Right configuration maximizes flexibility and is designed to allow instruments to be positioned virtually anywhere around the chair.
The Midmark Dentist (shown) and Assistant stools deliver premium styling and exceptional comfort. They are ergonomically refined to address musculoskeletal pain common in dentistry.
Ask your Midmark representative about dental practice solutions for your Operatory, Imaging, Instrument Processing, Air & Vac and Cabinetry needs, and about our full-line of medical solutions.
midmark.com/operatory | 1-800-MIDMARK *Image shows optional upgrades Midmark Corporation, Dayton, OH
Training
Tools for Success
Excellent training and thorough education lay the groundwork for optimal patient outcomes.
In a busy group dental practice, where clinicians are continually evaluated on their performance and efficiency, office time is often limited. As a result, training and education – the foundation for providing successful clinical outcomes – don’t always take precedence. “Education provides the platform for cutting-edge information on techniques, technology and clinical products within the market,” says Scott Welch, Director of Ivoclar Vivadent provides industryNational Accounts, leading educational Ivoclar Vivadent, Inc. speakers, webinars “Ivoclar Vivadent and online training, believes that education all of which are is the key component effective means to to success in helping meet the variety of dentists address the educational needs of daily challenges they DSO practitioners. Scott Welch face within their practice.” Ultimately, this leads to optimal clinical outcomes, satisfied patients and overall self-esteem, he adds. By providing innovation matched with educational support to as many dental clinicians as possible, Ivoclar Vivadent strives to “increase knowledge 18
Efficiency In Group Practice : ISSUE 6 • 2017
and awareness of the various challenges that dentists face in their practice,” Welch continues. Ivoclar Vivadent provides a variety of solutions to successfully meet these challenges, he says. “Based on the type of structure of the DSO, the training will vary. Ivoclar Vivadent provides industry-leading educational speakers, webinars and online training, all of which are effective means to meet the variety of educational needs of DSO practitioners.” In addition, the company hosts Open House programs for dentists and their key staff at its North American headquarters in Amherst, New York. These are distraction-free formats where attendees can become thoroughly acquainted with the benefits associated with the Ivoclar Vivadent product line.
Consistency across the practice Ideally, all locations within a large dental practice or DSO rely on the same products and solutions, notes Welch. “Doing so helps offices better understand the chemistry of how products work together,” he says. “It is critical that the clinicians and staff have a solid understanding of the material science and limitations of the various products. For example, they need to understand the unique differences between ceramics, zirconia and resins. As clinicians have seen, resin cements, lithium disilicate (IPS e.max), lithium silicate (not IPS
e.max ) and zirconium oxide are not all the same, even when they are sometimes generally categorized together.” When dental offices utilize Ivoclar Vivadent’s entire product portfolio, the company’s customer service department can provide immediate solutions to issues that may arise in a dentist’s office, Welch points out. Combining adhesives, cements, and composites from different manufacturers can increase the potential for clinical failure based on the mixed chemistries. It is essential that dentists have the ability to independently make a clinical decision based on the needs of a particular patient. Innovative systems from Ivoclar Vivadent provide the maximum longterm clinical success.
A league of its own Ivoclar Vivadent’s dental customers tend to agree: platform. She then follows up in person with each The company provides a service that is unmatched. office to answer questions and help reiterate our “Ivoclar Vivadent is a well respected company in the reasons for utilizing certain products. This has helped field of dental materials with great us get buy-in from all of our doctors research, impeccable support and and team members and has helped reliable quality,” says Dr. Joseph Rubis, eliminate the need for multiple DDS, owner of Advanced Family versions of similar materials. Angela Dental. “The company has provided also provided us with an excelin-office support and training unlike lent speaker for one of our doctor other companies. Their representaprograms, which in turn helped us tives offer unmatched knowledge produce more consistent treatment and constantly prove their dedication outcomes by properly using some of to training people in the field. It is the best products in the industry.” Dr. Joseph Rubis, DDS extremely important to have compaMario Mariscal, RDA-EF, manager, nies and representatives who focus field development, Pacific Dental on quality and have the ability to Services, agrees. “Ivoclar has a great follow up when trying to streamline group of people working for them,” efficiencies across an entire platform. he says. “They are always willing “Our Ivoclar Vivadent representato help our regional back office tive, Angela, has been an outstanding trainers and supported practices by resource for our organization,” Rubis providing proper knowledge and continues. “She has joined me on direction, enabling us to consistently webinars about product implemenuse their products and materials tation and usage, which have helped correctly and provide optimal results Mario Mariscal me create more consistency across a in the process.”
ISSUE 6 • 2017 : DentalGroupPractice.com 19
Service Tech Profile
Raising the Bar
As dental practices – both large and small – face greater demands, service technician Greg Rehms works harder than ever to exceed expectations. By Laura Thill
A lot has changed in the 28 years since Greg Rehms joined Burkhart Dental as a field service technician. But the importance of the tech-customer relationship has remained the same – and likely always will, he notes. “Just about anyone can fix equipment, but it takes a certain personality type to know how to foster relationships,” he says. “Service techs must be able to do both, and do them well. “My customers have always relied on my knowledge and my ability to ensure their equipment functions efficiently,” Rehms explains, making it as important as ever for techs to build strong, trusting relationships with their customers. “At Burkhart, we are very relationship-oriented. Over the years,
20
Efficiency In Group Practice : ISSUE 6 • 2017
BIG SUCTION
SMALL MACHINE Quiet, Compact & Energy-Efficient Mojave dry vacuum systems are designed to provide the highest operational performance with low operating costs and virtually no maintenance, all in a compact footprint. • Sound-reducing impeller design • Completely waterless with no tank • 3-phase motor generates higher torque and less heat • Energy efficient system that reduces your utility bills TAKE ADVANTAGE OF THE INCREASED DEDUCTION LIMIT FOR SECTION 179 You may deduct the full cost of dental equipment from your 2017 taxes up to $500,000. Please consult with your tax advisor for further information. For more information, to schedule a demo, or to place an order, contact your local dealer representative. To learn more, visit www.airtechniques.com
Service Tech Profile
I’ve built greater customer trust with each service call and equipment installation, and I’ve grown closer than ever to the dentists and their staff.”
The evolving practice Today, dental practices are under greater pressure to ensure their practice is profitable, Rehms notes. They must work more closely with insurance companies and adapt to constantly changing technology, including digital radiography, intra-oral scanners and milling machines, as well as learn to log and track
As the demands on dentists have changed, so too has the relationship between service techs and their field sales rep counterparts, notes Rehms. “Today, the service tech-sales rep relationship requires joint strategic planning around our customers’ needs,” he says. “Our account managers work long hours, and I must be respectful of their time. This calls for optimal time management skills on my part.” Communication between service techs and sales reps – and lots of it – is key to meeting their customers’ needs, he adds. “It’s important that we are always on the same page, especially with regard to recommending new equipment. We want to ensure our customers get the best solution possible and don’t want to confuse them by offering more than one opinion.”
“ Just about anyone can fix equipment, but it takes a certain personality type to know how to foster relationships. Service techs must be able to do both, and do them well.”
DSOs – a growing trend
In the face of these challenges, Rehms has seen many dentists – particularly newer ones who carry debt from dental school – join dental service organizations (DSOs). Regardless of the size of the dental practice, he makes it – Greg Rehms, Burkhart Dental, field service technician. a point to never lose sight of his customers’ needs and expectations, equipment problems in their computer system. and then exceed their expectations. “In order to give “Overall, dental practices have adapted to new techmy dentists the very best service they deserve, I need to nology very well,” he says. “But, the ones who fare take time to communicate with them,” he explains. That best are those devoted to training their staff. And, it’s said, working with a multi-site dental practice comes important that they devote sufficient time to training. with a unique set of challenges. “One of my newer It’s not just a matter of exposing the dental staff to customers is a DSO with eight locations,” he says. “The new equipment, but ensuring they are truly comfortchallenge for me has been to get to know all of the able with the new technology. The difference can dentists and staff across all of the offices, and build mean a much happier practice! that trust.” Indeed, he looks forward to the relationship “As dentists get increasingly busier, it’s becomgrowing based on honesty and clear communication. ing harder to schedule face time with my custom“I helped facilitate a meeting between the two owners,” Rehms continues. “As a result, it has become ers of this DSO and Burkhart’s president, Lori Burincreasingly important for me to stay on top of serkhart,” Rehms says, noting that the emergence of DSOs vices calls, parts ordering and van inventory, office continues to be an important industry trend. “I’m very checks for new equipment, technology and training. excited about this. It’s critical for Burkhart to be in close Service techs who aren’t organized and detail-oritouch with our customers and make them feel that much ented will struggle, and it’s bound to have an impact more appreciated. The bottom line is, no matter who our on their customers.” customer is, we’re all in this together.” 22
Efficiency In Group Practice : ISSUE 6 • 2017
AIR-FLOW THERAPY:
MORE COMFORTABLE
CLEANER, MORE EFFICIENT COMPLETELY COMPREHENSIVE
BIOFILM REMOVAL. THERE’S A BETTER WAY.
AIR-FLOW® Therapy is not simply an air polisher — it is an advanced biofilm management system that is uniquely equipped to reach and remove biofilm on even the most difficult and delicate surfaces, where other technologies have limited access or would take too long.
TO SEE THE BETTER WAY FOR YOURSELF, REQUEST A DEMO AT HU-FRIEDY.COM/POWERREQUEST ©2017 Hu-Friedy Mfg. Co., LLC. All rights reserved. [827] HFL-002/0817
More Than a Logo By Laura Thill
A catchy slogan? A flashy website? A cool logo? They can’t hurt. For DSOs, however, branding their organization has become a way to connect with patients on a much more intuitive level. Brands today are about feeling, experience and emotion – an identity that patients can – and want to – relate to. “Branding is about so much more than signage,” says Kasey Pickett, senior director of communications, Aspen Dental Management, Inc. (ADMI). ADMI dental practices operate under the brand name, Aspen Dental, but are independently owned, she notes. “The Aspen Dental brand isn’t defined by the logo, colors or the design of the office, but by a community of nearly 1,000 dentists and their teams, and their shared commitment to breaking down the barriers to better care, better smiles and better lives. The Aspen Dental brand promise is about making dentistry easier. “American Dental Association research shows that more than 150 million Americans did not visit a dentist last year,” Pickett continues. (Dental care utilization among working age adults was just 35.5 percent in 2014.) “Our own research shows that as many as 25 percent of Aspen Dental patients have not seen a dentist in over five years, and one in 10 patients has not seen a dentist in a decade or more. The reason they aren’t visiting the dentist regularly is because there are so many barriers – whether emotional barriers like fear and shame, or practical barriers like cost and access. That’s why our marketing efforts are 24
Efficiency In Group Practice : ISSUE 6 • 2017
really focused on communicating one message: Making dentistry easier. We want patients to understand that no matter what their barriers might be, the doctors and teams at Aspen Dental will work hard to make it easier for them to get the care they need.” “As one of the few DSOs that is 100 percent branded, at Great Expressions Dental Centers (GEDC), branding is very important and encompasses much more than signage,” says Ryan Torresan, vice president of marketing and public relations, Great Expressions Dental Centers. In his 6+ years with the organization, branding at GEDC has largely focused on emotions. “GEDC marketing capitalizes on the lifestyle, passion, health, empowerment and aspirations of GEDC patients,” he says. “By engaging in emotion, we can create a memorable identity every time someone sees
INCREASE YOUR
PRODUCTIVITY
Time is one of your most valuable resources.... What would you do if you had more time in your day? Generate more productivity per chair by reducing procedure times or allowing for more procedures in one visit
Surpass your production goals with increased flexibility in patient scheduling
Help your office manage challenging or difficult patients with reliable clinical results
Increase patient retention through greater patient comfort and satisfaction
Free up your assistants to focus on more productive activities
Optimize hygiene appointments to allow the team to stay ahead of schedule
Using an Isolite System will help stream line your dental isolation and control the oral health environment to enhance your clinical care, maximize your scheduling and productivity, and help improve the patient experience. Contact us to learn more about our exclusive DSO packages and pricing. facebook.com/ISOLITESYSTEMS
youtube.com/ISOLITESYSTEMS
800-560-6066 isolitesystems.com/DSO linkedin.com/COMPANY/ISOLITE-SYSTEMS
Cover Story
our smiley logo – whether online, in television ads, at our SmileCenter, on outdoor signs or in the dental office. And, patients are more likely to remember and purchase services that make them feel good.” “Branding is more than the standardization of logos and fonts or something achieved by spending money on creative and advertising,” says Aldo Benedetto, vice president of marketing at Benevis. “To develop a meaningful and valuable brand, it is essential to define the desired brand image and treat every patient interaction as an opportunity to build the brand. Most of the offices that Benevis provides non-clinical support to are Kool Smiles offices. The Kool Smiles brand represents high quality patient care in a fun and compassionate environment.” In addition to a focus on making dentistry accessible to children, Kool Smiles maintains a commitment to serving the underserved, he notes. “Building trust, educating and ultimately providing a dental home for patients are the main branding objectives for Kool Smiles. “We believe that people generally choose doctors based on recommendations from someone they trust – usually Aldo Benedetto friends and family,” Benedetto continues. “Our goal is for our patients’ experiences to be positive and memorable so they are confident in recommending us. As you might expect, a focus on patient experience plays a significant role in patient retention, which is a key area of focus for our organization. “Professional, eye-catching signage, appealing creative, and an intuitive, well functioning website are requirements in the industry these days, as patients expect nothing less from providers,” Benedetto says. “However, in order to stand out in the marketplace, it is important that every aspect of the patient experience is considered. It is challenging to manage the many interactions that occur between exposure to an ad, the first call to schedule an appointment, appointment reminders, rescheduling, in-office experience and follow ups, but because of the difficulty, few do it very well, creating an opportunity for those committed to patient experience.” 26
Efficiency In Group Practice : ISSUE 6 • 2017
Indeed, branding is largely about the patient experience, notes Torresan. Rather than telling patients what to think and how to feel, GEDC connects with them. “Branding builds trust, and one way we do that is by incorporating the patient experience. We put the patient at the heart of the services we promote. For example, take the original photography we use in our print and digital advertising; not only does it showcase how a variety of dental services, like whitening or orthodontics, fits patients’ lives, but it features patients in their everyday natural settings, engaged in healthy activities. The goal is to show the healthy lifestyle they want to live.
“ Branding is more than the standardization of logos and fonts or something achieved by spending money on creative and advertising. To develop a meaningful and valuable brand, it is essential to define the desired brand image and treat every patient interaction as an opportunity to build the brand.” – Aldo Benedetto, vice president of marketing at Benevis
“Showing how GEDC products and services fit people’s lives reinforces the brand pillars of GEDC and further solidifies an emotional connection with our audience,” Torresan says. It is an approach that reinforces in-office patient education on the benefits of the service. “It is one reason why the office design and segmented digital communications is built around our patients’ flow and brand. From the consistency in the office colors, phrases and placement of messages, and timing of when the digital message is received, to the passion behind what the messages stand for, GEDC is able to reinforce our brand to our patients, which helps with retention and loyalty.”
Branding across the organization It’s one thing to achieve a sense of community within a dental office. It’s quite another to create that same
IT’S SO SIMPLE TO ACHIEVE CONSISTENT CLINICAL IMAGES 8 Dental shooting modes – Easier, faster and more reproducible images Auto-cropping, smart focus and zoom Auto flash adjustment for true color 3.5 inch LED/LCD touchscreen – Works with exam gloves Water/chemical resistant – Essential for infection control in the office Ultra-lightweight body: approximately 1lb
EyeSpecial C-III
SNESCIII-0917
THE DENTAL CAMERA THAT MAKES IT EASY
Scan Here for Instructional Video Shofu Dental Corporation | San Marcos, CA
www.shofu.com | 800.827.4638 Photo courtesy of Luciana Arcaro, CDA, CDT, MBA.
Cover Story
sense of belonging for hundreds of clinicians at multiple locations. “For dentists who own and operate Aspen Dental branded practices, the benefit of being a part of the Aspen Dental network is the culture of community, collaboration and camaraderie,” says Pickett. “Our dentists get the best of all worlds – the freedom to own and operate their own private practice under the Aspen Dental brand; the mentorship and support that comes from having access to a network of 1,000+ like-minded dentists; and the business and marketing expertise of our team of experts at ADMI.” A centralized approach to branding is key to conveying a consistent message across a large DSO, according to Benedetto. It’s equally important to ensure the staff at each location is engaged and on board with the corporate message, he notes. “Centralization of our branding and marketing has allowed us to develop deep expertise in the technical customer experience delivery, and has also allowed for control of the brand and consistent messaging,” he explains. “We have also developed guidelines for local marketing, which has improved consistency of execution. However, hiring the right people and making sure those people are engaged and focused on memorable experiences is the key area of focus. Our leaders are great ambassadors of our brand and our culture, and have really done a great job of managing this at the local level.”
When team members understand the brand and respect its value, they tend to stay the course, rather than go rogue, notes Torresan. With the right tools in place, DSOs can encourage all of its dental practices to follow the branding and convey that message to patients, he points out. For instance, GEDC offers its dental practices: • A brand plan that provides guidelines, pre-defined standards and offers for operations leaders. • A local marketing budget for each vice president of operations that allows him/her to choose his/ her own marketing or community involvement sponsorship for his/her offices, while having the centralized marketing department create the ads and marketing materials within the brand standard. Ultimately, the marketing department holds the trump card in case requested marketing is something already offered or a conflict for the brand. • Pre-branded items, which each dental office (with its own unique user ID and password) can order through a centralized online store 24-7. • A marketing calendar published in advance of actual promotions, educating team members to communicate with their patients/customers.
Ryan Torresan, Vice President of marketing and public relations for GEDC (center), says branding builds trust, and one way to do that is by incorporating the patient experience.
28
Efficiency In Group Practice : ISSUE 6 • 2017
• An email channel for input that is routed to the entire marketing team, which can be weighed for future marketing decisions, etc. “Alignment with operations is also key, as service inside each location is a reflection of the brand,” says Torresan. “You want to have operations onboard with the marketing plan and brand, create an understanding of the brand, and provide information that supports the brand/company to ensure the brand is consistently represented. This will help with the execution of promotions and the removal of items that violate the branding.” A strong brand depends on a strong, centralized marketing department, with buy-in from operations and team members, he adds.
Taking a global perspective DSOs work hard to provide easier access to dental care and “make the patient experience easier for all,” says Torresan. As the patient demographics change from region to region, or from one dental office to the next, however, marketing tactics must be flexible. “A successful
dental practice is part of the community within a few mile radius of the office, so people around that office want to see marketing that resonates with them,” he points out. Rather than base the process on team member opinion, the DSO should start with market research that focuses on demographics, lifestyle purchase/activity data and consumer-need research, notes Torresan. “Once you build a model and analyze the data, sense-check it by talking to the team members in the location to see if their insights generally match back to the data,” he says. “If it does, you know you have strengthened your marketing efforts and will help meet the needs of the office. Those team members can also become a trusted source at that location, who can help you customize it to the local community. Market segmentation and automation based on that segmentation is important to customizing marketing for hundreds of locations. It will ensure that marketing better matches customer needs; is a stronger market strategy leading to expansion; and is a lifecycle market, which will help with retention.” “After we commissioned a few research studies and did consumer focus groups with both our patients and people who are not our patients (or who did not go to ISSUE 6 • 2017 : DentalGroupPractice.com 29
Cover Story
the dentist in the last 12 months), we learned what they wanted inside a dental location – in terms of the communication inside the office, as well as what transpires before and after they leave the office,” says Torresan. “This led to a campaign to hang artwork that reflected giving back to the local community in the hallway between the lobby and operatory. It also gave us direction to segment email marketing based on the treatment they recently received and GEDC activities in their zip codes.” As a result, GEDC ensures its marketing campaigns resonate more closely with patients – taking into account their background and their interests.
Dental, our brand is all about making it easier for patients to access the care they need, on their own terms.” Indeed, as the dental industry becomes increasingly competitive, and patients have more choice in managing their healthcare, “poor experiences are an easy way to lose patients,” says Benedetto. “There are many ways to impress patients, but our approach has been to focus on the experience,” he says. “Our teams go above and beyond every day, and we are proud of what they do.” Particularly as consumers depend increasingly on technology – smart phones, the Internet, Facebook and other social media sources – to connect with brands, DSOs will have to expand their marketing campaigns, Torresan points out. “Marketing is about values, and in the dental industry, patients value a healthy family,” he says. Moving forward, dentists and DSOs will need to be clear about the message they want to convey to patients, he adds. In addition, healthcare – including dental healthcare – has come to be regarded by some as a discretionary expense, Torresan continues. Patients now demand greater transparency when they interact with providers and GEDC, in turn, has expanded its brand to – Kasey Pickett, senior director of communications, ensure it meets all patients’ needs. Aspen Dental Management, Inc. “Our approach today is to make it as easy as possible for people “Any company that is doing search engine optito get dental care,” he says. As a result, the organimization or search engine marketing should be doing zation has adopted an emotional-based approach to demographic and lifestyle analytics at a very localized advertising. By communicating with patients in a way level, as well as be building tagging framework,” says they appreciate; by emphasizing affordable dental care Torresan. “Success in online marketing is dependent on with programs to support it; and by educating patients targeting demographics and lifestyle, and tracking the about the value of dental services and showing them results to optimize.” how it can fit their lifestyle, GEDC intends to make the patient experience more positive than ever. “The An industry in transition bottom line is that consumers have choices, and if The traditional healthcare delivery model is changing, we are lucky, we have a few seconds to get them to notes Pickett – a change that is patient-driven. “Patients understand the services we offer and how we can help are demanding affordability, personalized services, transthem,” he says. “Our goal is to make an emotional parency, access and convenience,” she says. “At Aspen connection with our patients.”
“ The reason they aren’t visiting the dentist regularly is because there are so many barriers – whether emotional barriers like fear and shame, or practical barriers like cost and access. That’s why our marketing efforts are really focused on communicating one message: Making dentistry easier. We want patients to understand that no matter what their barriers might be, the doctors and teams at Aspen Dental will work hard to make it easier for them to get the care they need.”
30
Efficiency In Group Practice : ISSUE 6 • 2017
™
TheraCem Self-Adhesive Resin Cement
THE FUTURE IS HERE with the “NEXT GENERATION CEMENT” Calcium & Fluoride Release Easy Clean-Up Strong Bond to Zirconia Alkaline pH in Minutes
TheraCem is a dual-cured, calcium and fluoride-releasing, self-adhesive resin cement indicated for luting crowns, bridges, inlays, onlays and posts (prefabricated metal/ non-metal/fiber posts).
Contact us Today:
1-800-247-3368 MC-10145BD
U.S. Customers Only. Rx Only.
www.bisco.com
Curing Light
The Ideal Cure
As curing technology has become increasingly sophisticated, curing lights have become more and more diverse, leading dentists to question which light solution and bulk fill composite By Laura Thill best meets the needs of their practice.
Curing lights today are an integral part of modern dentistry, notes Shashikant Singhal, BDS, MS, director of professional services, Ivoclar Vivadent, Inc. “Nowadays, curing lights are used not only to polymerize dental composites, but also to cure dental adhesives; resin cements in various clinical situations, like curing through ceramic restorations; post and cores; and deep restorative cavities,” he says. “Therefore, to provide an ideal restoration with long-term clinical success, it is critical for a clinician to select a curing light that meets all the requirements.” Curing light technology features quartz-tungsten halogen, plasma arc, argon laser and most contemporary LED curing lights, he adds. But, that begs the question: How can dental providers determine the ideal curing light solution for the needs of their practice? 32
Efficiency In Group Practice : ISSUE 6 • 2017
The science behind the cure The rapid changes in light curing technology in recent years – and the impact this has had on the chemistry of light-cured resin-based materials – makes it more important than ever for dentists to fully understand the curing process, as well as challenges. “Clinicians must understand the chemistry of the composite, their curing lights and the polymerization technique, as inadequate polymerized composite restorations tend to show high wear, chipping, catastrophic fracture and compromised esthetic by staining,” says Singhal. For starters, light cured resin-based materials consist of a number of
ingredients, including resin matrix; filler particles coulight probe to ensure the composite material is uniformly pled with matrix, using coupling agents; and photo-iniand adequately polymerized, he says. “A non-uniform distiators, according to Singhal. “The photo-initiators tribution of light energy results in localized hot spots of absorb light energy of specific wavelengths from curing adequate energy, resulting in inadequate polymerization light units,” he explains. “The energy absorbed excites of the remaining exposed composite surface. These lights the molecules and enables the formation of free raditend to be more economical, but they have limitations, cals; this, in turn, initiates polymerization.” For years, such as a non-homogenous beam profile or a narrow specclinicans relied on the photo-initiator, Camphorquinone, trum, which can compromise the clinical outcome.” he points out. However, Camphorquinone has a yellowIvoclar’s Bluephase® Style curing light from Ivoclar Vivadent meets Sighal’s standards for wavelength specish color, prompting the use of lighter colored initiators, trum, power intensity and a homogenous beam profile. such as Lucirin TPO and phenyl-propanedione (PPD). Recently, Ivoclar Vivadent patented a new photo-initiator, Ivocerin, designed for use in bulk fill technology and color stable resin cements. When purchasing a new curing light, Singhal looks for light units that offer a broad wavelength spectrum, high power intensity and a homogenous beam profile – attributes that ensure the curing light unit will ade– Shashikant Singhal, BDS, MS, director of professional services, Ivoclar Vivadent, Inc. quately polymerize all resin-based material, he notes. “Photo-initiators “Bluephase Style curing lights absorb light energy of a specific wavelength spectrum to are equipped with advance facilitate the polymerization,” he says. “Most – but not all polywave light emitting – contemporary LED curing lights have a narrow wavediode technology, enabling length spectrum of 430 – 480 nm. The absorption specthem to achieve an optimal trum of Camphorquinone (CQ) is between 390 – 510 nm, broad spectrum wavelength and Ivocerin is between 370 – 460 nm.” By comparison, range from 385 - 515 nm, Lucirin TPO and PPD absorb light in the range of less with high power intensity of than 430 nm, and the materials may not be cured properly 1,200 mW/cm2,” he says. using a narrow spectrum LED curing light, he adds. “Polywave technology serves It’s also important to consider the amount of energy Shashikant Singhal as a benchmark for many required to adequately polymerize the material, says Sinclinicians, as it enables them to cure all dental restorative ghal. “This is calculated by the power intensity of a curing materials with different photo-initiators systems (e.g. light exposed over a period,” he explains. To ensure adeCamphorquinone, Lucirin TPO, phenylpropanedione quate polymerization, most manufacturers recommend (PPD), Ivocerin etc.). Additionally, Bluephase Style curbetween 10 and 20 seconds of light polymerization for ing lights are equipped with a parallel light guide, which a resin composite, with a curing light power intensity of helps reduce light-intensity loss when the light guide 1000 mW/cm2. “The light units with lower power intenneeds to be held at distances from the material to be sity can result in compromised polymerization of a resin polymerized.” The Bluephase Style’s light guide, in comcomposite,” he points out. bination with the unit’s ergonomic pen design, ensures Finally, it is also critical to have uniform distribution easy access to the entire mouth, he adds. of light – or beam homogeneity – at the end of the curing
“ Curing lights are used not only to polymerize dental composites, but also to cure dental adhesives; resin cements in various clinical situations, like curing through ceramic restorations; post and cores; and deep restorative cavities.”
ISSUE 6 • 2017 : DentalGroupPractice.com 33
Curing Light
Myths and challenges Few non-surgical restorative procedures today do not require the light polymerization of dental materials. “While there has been much attention to the details of diagnosis, clinical procedures and the development of improved adhesives and resins, light polymerization is often taken for granted,” says Singhal. Some clinicians may not fully understand the curing process, he notes. “Not all curing lights are the same, and not all hard materials are completely polymerized, and it’s important that dentists be aware of this,” he says. Indeed, there is much variance from one curing light to another, Singhal points out. Higher end curing light units, designed with a higher quality LED curing light, tend to
provide consistent power output over longer periods of time, he notes. It’s equally important for dental offices to measure power output of their curing lights regularly. “Dental manufacturers invest in high-quality radiometer devices like an integrating sphere, which can measure power output of a curing light with accuracy of ± 5 percent, however these devices are expensive,” he adds. “Other less expensive chairside radiometers are also available.” Again, dentists get what they pay for, and the less expensive, conventional hand held radiometers fail to provide accurate light intensity measurements, in his opinion. “Most handheld radiometers are only capable of measuring power output over a small area of the probe, 34
Efficiency In Group Practice : ISSUE 6 • 2017
resulting in an inaccurate or false reading,” he says. “In contrast, Ivoclar Vivadent’s Bluephase® Meter II features a surface sensor, permitting the meter to measure power output over the radiating surface of the curing light probe with an accuracy of ± 10 percent.” Investing in higher end equipment and materials not only helps ensure optimal results, it often saves dentists – and patients – time, Singhal notes. For instance, using traditional resin-based filling material requires a longer time to polymerize increments of composites, while restoring deep cavities, he says. “Factors such as air bubbles, compromised adaptation of layers, contamination and heat generation from multiple polymerization cycles during the restorative procedure can further compromise the clinical outcome,” he explains. “Other factors, like composite shades and translucencies, can also affect the light polymerization reaction. Lab studies have shown that darker, opaque dentin shades require higher light energy for polymerization compared to lighter, more translucent – Shashikant Singhal enamel shades. Conventional initiator systems alone are unable to cure increments exceeding 1.5 - 2 mm. So, it’s critical that clinicians consider all variables during polymerization of these materials.”
“While there has been much attention to the details of diagnosis, clinical procedures and the development of improved adhesives and resins, light polymerization is often taken for granted.”
Bulk fill composites Dentistry is quickly changing, notes Singhal, and with that comes the availability of increasingly efficient products – including bulk fill composites. “These materials have higher depth of cure compared to conventional composites and allow clinicians to restore cavities in thick
increments of 4-5 mm, decreasing chairside time without compromising clinical outcome.” Dental manufacturers can achieve an increased depth of cure by increasing either the concentration of photo-initiators, curing time or translucency of the material, he says. “Increasing the concentration of photo-initiators and polymerization time will enhance reactivity of the material to light energy, whereas increased translucency allows deeper light penetration to achieve a higher depth of cure,” he explains. That said, increasing photo-initiator concentrations can decrease working time, while an increased polymerization time means greater heat generation from the curing light unit and a longer chairside time, and increased translucency can compromise the esthetics of the restoration. Unlike conventional approaches, which employ a composite layering technique, Ivoclar Vivadent’s Tetric® EvoCeram Bulk Fill composite – a light cured composite indicated for direct restorations in posterior teeth and for class V restorations – has a sculptable viscosity and is formulated to be light polymerized in bulk increments of up to 4 mm, notes Singhal. “The time required to adequately polymerize this material from a light curing unit with an intensity greater than 1000 mW/cm2 is only 10 seconds,” he says. “Tetric EvoCeram Bulk Fill includes a patented light initiator/polymerization booster, Ivocerin, for a high depth of cure. It combines advanced composite-filler technology to achieve the desired mechanical properties and high surface finish; a pre-polymer shrinkage stress reliever to minimize polymerization shrinkage stress; and a light sensitivity filter for adequate working time. “Ivocerin is truly an innovation in photo-polymerization technology,” he continues. “Traditional photo-initiator systems, such as Camphorquinone, have limitations, such as low quantum efficiency (low sensitivity to light). In addition, the use of amine-based co-initiators with Camphorquinone may cause discoloration of composite material due to the oxidation of the remaining amine component. To overcome these challenges, and to innovate an ideal photo-initiator technology for con-
temporary bulk fill materials, Ivoclar Vivadent collaborated with Professor R. Liska of the Vienna University of Technology to develop and patent the germanium-based photo-initiator, Ivocerin. Unlike conventional photo-initiators, Ivocerin is approximately ten times more reactive to the curing light, thereby requiring less light energy. The absorption spectrum of Ivocerin ranges from 370 – 460 nm, so light can be activated using commercially available curing light units. And, Ivocerin’s amine free chemistry ensures that composite materials are highly color stable.” For Ivoclar Vivadent Inc., innovation comes down to the ability to perfect strategies, products and services, Singhal points out. “We strive to anticipate our customers’ needs, and we continually challenge our research and
“ Clinicians must understand the chemistry of the composite, their curing lights and the polymerization technique, as inadequate polymerized composite restorations tend to show high wear, chipping, catastrophic fracture and compromised esthetic by staining.” – Shashikant Singhal
development team to find better, more effective and efficient solutions to meet clinicians’ requirements. “Ivoclar’s research and development team includes chemists, researchers and well-trained dental professionals, who understand what dentists truly need to run a successful practice,” Singhal says. “Once a product is developed, our team creates educational content, such as scientific literature and animated and clinical tip videos, which are available on the Ivoclar Vivadent North American website.” These resources – as well as online training sessions – are available to dentists, as well as their staff and their distributor sales reps, he adds. “Our longtime customer service support, which includes experienced clinicians, registered dental hygienists/ assistants and trained customer service representatives, is always available. We mean it when we say, ‘Customer satisfaction is guaranteed!’” ISSUE 6 • 2017 : DentalGroupPractice.com 35
Infection Control
Instructions for Use What they are and why they are important to the dental practice When you purchase a new car, you find the time to read and review every page of the ½-inch-thick owner’s manual to ensure the new vehicle runs at peak performance. When you purchase a new television for the dental reception area, you unfold the thin accordioned sheets of diagrams to review the set-up and ensure that each connection jack has the correct cords plugged in, prior to turning it on for viewing. So why do dental healthcare personnel discount – or even ignore – instructions for use (IFU) that accompany medical/dental devices or products used in the dental practice? In fact, does everyone in the practice even know what IFU stands for and why it’s important? IFUs are provided for medical devices and products in accordance with federal Food and Katherine Schrubbe, RDH, Drug Administration BS, M.Ed, PhD, is director (FDA) standards. In of quality assurance at October 1982, the FDA Milwaukee, Wisc.-based merged the Bureau of Dental Associates. Medical Devices and the Bureau of Radiological Health to establish the Center for Devices and Radiological Health (CDRH). The Center develops and implements national programs to protect the public’s health in the fields of medical devices and radiological health. These programs are intended to assure the safety, effectiveness and proper labeling of medical devices; control unnecessary human exposure to potentially hazardous ionizing and nonionizing radiation; and ensure the safe, efficacious use of such radiation.1 In an ever-increasing society of litigation, dental healthcare personnel must be aware of, educated and accountable for the proper use and maintenance of medical/dental devices utilized in the dental practice. In large group practices and DSOs, where there are greater numbers of staff, calibration and team members to be trained, it is vital that the IFU are a key component of patient care and staff safety. By Katherine Schrubbe, RDH, BS, M.Ed, PhD
36
Efficiency In Group Practice : ISSUE 6 • 2017
Everything from sterilizers to hand-held x-ray equipment, chemical indicators and more contain IFU, which must be explicitly followed for peak performance of the device. Part of the FDA’s mission is to protect the public’s health by assuring the safety, efficacy and security of human and veterinary drugs, biological products, medical devices, our nation’s food supply, cosmetics and products that emit radiation.2 In the daily routine of dental practice, most dental team members are primarily focused on CDC and OSHA compliance and may not realize how great an impact the FDA makes. On March 17, 2015, the FDA released “Reprocessing Medical Devices in Health Care Settings: Validation Methods and Labeling Guidance for Industry and Food and Drug Administration Staff.” The document not only superseded the April 1996 guidance titled, “Labeling Reusable Medical Devices for Reprocessing in Health Care Facilities: FDA Reviewer Guidance”, but included an appendix (E) that was updated June 9, 2017.3 Let’s take a brief review of the highpoints of this document as it relates to reprocessing reusable devices in the dental practice. For starters, the 2015 FDA guidance focuses on the importance of stated methods for reprocessing reusable/reprocessable devices, sterilization parameters and labeling requirements for manufacturers submitting devices for
510(k) clearance. A 510(k) requires demonstration of substantial equivalence to another legally U.S. marketed device; substantial equivalence means that the new device is at least as safe and effective as the predicate. The guidance document applies not only to new devices, and exemption from 510(k) does not mean a device is exempt from compliance with labeling or quality system requirements.4 The updated 2015 guidance states that for reusable medical devices, validated reprocessing instructions are expected from the manufacturer.3 Section 6 of the 2015 guidance document lists six criteria manufacturers should include in their IFU to ensure users – in this case, dental team members or dental healthcare personnel – understand, implement and facilitate the IFU correctly: • Criterion 1: Labeling should reflect the intended use of the device. This includes how and where the device is used. For instance, is it only used on skin? Mucosal surfaces? Sterile tissues of the oral cavity? The label should state the reprocessing method that reflects the physical design of the device, its intended use and the soiling and contamination to which the device will be subject during clinical use.3 This provides the DHCP with the information needed to use the device as intended; it is not acceptable to make a subjective decision on device usage once the manufacturer and FDA have made this determination. • Criterion 2: Reprocessing instructions for reusable devices should advise users to thoroughly clean the device. Cleaning is the most important step in the instrument processing cycle.5 The criterion here states that instructions to the user should clearly communicate how to achieve thorough cleaning and that details of the cleaning procedure will vary depending on the complexity of the device.3 From the user perspective, the CDC recommends that dental team members assigned to sterile processing areas be trained and understand the importance of cleaning instruments prior to disinfection or sterilization.6 CDC Key recommendations for sterilization and disinfection of patient-centered devices for dental setting.6 • Criterion 3: Reprocessing instructions should indicate the appropriate microbicidal process for the device. In this section, the guidance states that the method for reprocessing should be consistent with
current infection control protocols and that whichever reprocessing method(s) is recommended, the compatibility of the device with the method(s) and the ability of the method(s) to successfully reprocess the device features should be validated and then stated in the instructions for use.3 Dental team members must read and understand the IFU for sterilizer cycle times and temperatures. • Criterion 4: Reprocessing instructions should be technically feasible and include only devices and accessories that are legally marketed. This criterion, which was intended as a recommendation for manufacturers to provide the dental team with streamlined, understandable IFU, can actually be quite confusing. It’s intended to ensure that the method for reprocessing the device includes the equipment and accessories needed to implement the instructions, which should be clearly defined. In short, manufacturers should not come up with unreasonable methods or obscure devices needed for the reprocessing of their device. “The FDA recommends that the instructions specify sterilization methods and parameters that are technically feasible for the user. That is, sterilization cycle parameters specified in the labeling for reprocessing a device should be consistent with validated sterilization cycle parameters for commonly available, legally marketed sterilizers.”3 This is demonstrated in the sterilizer manufacturer market, where manufacturers are required to meet AAMI standard cycles to ensure IFU for sterile packaging systems don’t conflict with IFU for sterilization indicators used to monitor their cycles.7 • Criterion 5: Reprocessing instructions should be comprehensive. This lengthy criterion outlines each segment of the reprocessing steps in detail. ISSUE 6 • 2017 : DentalGroupPractice.com 37
Infection Control
It states that the instructions should describe any accessories that are needed for safe reprocessing, and notes whether personnel need any special protection for personnel during reprocessing.3 When the dental practice obtains new equipment or devices, it is critically important to review the IFU and follow the detailed steps for reprocessing without shortcuts. Since the IFU have been validated, compliance will provide the intended and expected results. •C riterion 6: Reprocessing instructions should be understandable. Simply stated, the IFU should “be clear, legible (i.e., reasonable font size) and provided in sequential order from the initial processing step through the terminal processing step.”3 The criterion also states that IFU should be written in “simple” language and that charts, diagrams and pictures can be helpful to end users working to comply with them. If the practice obtains new a sterilizer with an accompanying cycle chart, it is a great idea to post this information in the sterilization area for dental healthcare personnel to refer to. This way, all team members have access and there is no question or confusion about how to use the sterilizer. Older, legally-marketed reusable devices with IFU prior to the 2015 guidance may not be consistent with state-of-the-art
science, according to sources such as the FDA and Andrew Steen, CDRC Senior Lead Reviewer, Dental Devices Branch. Labeling alone is not sufficient to ensure these devices are clean, disinfected or sterile, and the purity or quality of the device may fall below that which it purports or is represented to possess.8 In addition, the device may be misbranded such that labeling does not bear adequate IFU and the device is dangerous to health.8 The CDC and FDA agree that devices absent of IFU should be considered single-use – used on a single patient and then disposed of appropriately. This includes dental burs and endodontic files.6,8 For current practice, these devices should be considered single-use, notes Steen. In the future, if the manufacturer has IFU that meet the 2015 guidance, it should be followed. If there are no IFU, or if they are incomplete, clinicians should continue to consider them single-use.8 Given the constant stream of new and emerging technology today, and the numerous medical/dental devices currently used in dental practices, IFU should continue to play an important role. The FDA 2015 guidance has set strong recommendations, including clear expectations, for manufacturers. Dental healthcare professionals must be aware of the devices in their practice, and understand and carry out the appropriate IFU. All dental team members – especially those assigned to instrument reprocessing – must take their role in this process very seriously.
Editor’s Note: Katherine Schrubbe, RDH, BS, M.Ed, PhD, is an independent consultant and invited speaker for continuing education and training programs on OSHA and dental infection control for local and national dental organizations, schools of dentistry and private dental groups. She has held positions in corporate as well as academic dentistry and continues to contribute to the scientific literature. References: 1. U S Department of Health and Human Services. Public Health Service Food and Drug Administration. Labeling – regulatory requirements for medical devices. HHS Publication FDA 89-4203. https://www.fda.gov/downloads/medicaldevices/deviceregulationandguidance/guidancedocuments/ucm095308.pdf. Accessed September 27, 2017. 2. U S Department of Health and Human Services. Public Health Service Food and Drug Administration. FDA Mission Statement. https://www.fda.gov/downloads/aboutfda/reportsmanualsforms/reports/budgetreports/ucm298331.pdf. Accessed September 27, 2017. 3. U S Department of Health and Human Services. Public Health Service Food and Drug Administration. Reprocessing Medical Devices in Health Care Settings: Validation Methods and Labeling Guidance for Industry and Food and Drug Administration Staff. March 17, 2015. https://www.fda.gov/downloads/medicaldevices/deviceregulationandguidance/guidancedocuments/ucm253010.pdf. Accessed September 27, 2017. 4. U S Department of Health and Human Services. Public Health Service Food and Drug Administration. https://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/HowtoMarketYourDevice/PremarketSubmissions/PremarketNotification510k/default.htm#when. Accessed September 27, 2017. 5. M olinari JA, Harte JA. Cottone’s Practical Infection Control in Dentistry. 3rd ed. Philadelphia: Lippincott Williams and Wilkins; 2010; 223. 6. C enters for Disease Control and Prevention. Summary of Infection Prevention Practices in Dental Settings: Basic Expectations for Safe Care. Atlanta, GA: US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Oral Health, March 2016. 7. H ughes C. Manufacturer’s IFU. What are they and why they are so important? OSAP Annual Symposium; Baltimore, 2015. 8. S teen AI. FDA Regulations and infection control in the dental setting. OSAP Annual Conference; Atlanta, 2017.
38
Efficiency In Group Practice : ISSUE 6 • 2017
www.TheDentalFacts.com
Brought to you by Share Moving Media DentalFacts was founded in 1994 to provide timely and accurate business and technical information to the worldwide dental industry. Today, Share Moving Media, your trusted providers of the Weekly Drill, First Impressions, and Efficiency in Group Practice magazines is carrying out this legacy and continuing to deliver the most up-to-date industry news!
Subscribe today to keep up with the last technical information in the dental industry. Contact us today for more information...
Safest Dental Visit
TM
Hit the Ground Running The OSAP Dental Infection Control Bootcamp™ 2018 experience offers attendees an opportunity to enhance their infection control knowledge.
40
Efficiency In Group Practice : ISSUE 6 • 2017
From the infection control coordinator to the industry sales representative, it’s critical for individuals in the profession to stay on top of the latest guidelines, regulations and strategies for infection prevention and safety in dental settings. The Organization for Safety, Asepsis and Prevention (OSAP) Dental Infection Control Boot Camp™, January 8 – 11, 2018, in Baltimore, Md., is an educational course covering a comprehensive curriculum in infection prevention and safety to support the Safest Dental Visit™. Serving as a crucial building block for every dental professional with infection control responsibilities, this training course takes the OSAP Boot Camp™ attendee through several engaging days of infection control education sessions, workshops and hands-on learning, provides interactive Q & A time with instructors and offers up to 24 hours of continuing dental education credit (CDE).
The attendee The OSAP Dental Infection Control Boot Camp™ participant is a dental professional with infection control responsibilities, who is looking for a comprehensive curriculum in infection control and safety in dentistry. This program is perfect for infection control coordinators, infection prevention and safety educators, compliance officers in group practices and on dental boards, federal service employees responsible for infection control in their duty stations, Federally Qualified Health Center (FQHC) personnel, consultants and sales representatives.
Day one: Strategy, principles and theory Attendees receive rich OSAP Dental Infection Control Boot Camp™ resources as they are prepared for three days of fast-paced learning and interactive education. Day one provides attendees with the principles and theory behind patient safety and introduces the role and responsibilities of the infection control coordinator. Important topics covered include infection control regulations, guidelines and standards, microbiology, antibiotic resistance and stewardship, OSHA bloodborne pathogens and hazard communications. Attendees are also exposed to their first Boots on the Ground session to put learning into action during exciting hands-on exercises.
program development, responses to infection control breaches and crucial document requirements offer tools and information that attendees can refer to when they get back to their dental settings. Attendees also benefit from the latest innovations and dental infection control solutions during the vendor product fair, and facilitators will be available to help them apply what they’ve learned in interactive workshops.
Bonus day four: Federal Service focus Federal Services attendees will have additional training sessions on Thursday morning, January 11, covering topics specific to their guidelines, environments and opportunities. This may include the Air Force, Army, Navy, Coast Guard, Public Health Service and Veterans
This program is perfect for infection control coordinators, infection prevention and safety educators, compliance officers in group practices and on dental boards, federal service employees responsible for infection control in their duty stations, Federally Qualified Health Center (FQHC) personnel, consultants and sales representatives. Administration attendees. Federal Service personnel may qualify for an additional 4 hours of CDE credit.
Day two: Operations and management
Experience the journey
During day two, attendees are guided through education designed to help translate theory into the everyday realities of dental settings. Experts in infection control lead attendees through topics that include personal protective equipment (PPE), proper hand hygiene, biofilms and waterlines, instrument processing and operatory preparation. There will also be another round of fast-paced Boots on the Ground sessions.
Each OSAP Dental Infection Control Boot Camp™ is unique because of the diversity, engagement and camaraderie of the participants. Attendees will experience their own journey by registering for the 2018 OSAP Dental Infection Control Boot Camp™ today. Deadlines and discounts for registration, hotel information and updates on the topics for the 2018 OSAP Dental Infection Control Boot Camp™ are available on OSAP.org. OSAP encourages everyone to register early for the greatest registration discounts. Registration closes on December 15, 2017. To learn more about OSAP, its mission or becoming a member, visit OSAP.org today. While membership is encouraged, the Boot Camp event is open to non-members as well.
Day three: Application and innovation As the program nears completion, Boot Camp attendees dive deeper and learn about important strategies and applications to take home. On day three, courses on exposure incident management, writing SOP’s, policy and
ISSUE 6 • 2017 : DentalGroupPractice.com 41
Sponsored: KaVo Kerr
KaVo ELECTROmatic System TM
• Primary function: •A ir-to-electric electric upgrade system with dual motor and endo options. • Life of equipment: •K aVo’s trusted quality – together with a 3-year warranty and modular system for easy replacement of water filters and tubing – ensure the ELECTROmatic delivers versatility, excellence and comfort. • KaVo’s MASTERmatic and EXPERTmatic electric handpieces come with a two-year warranty, which can be extended to 2.5 years when maintained with a QUATTROcare plus maintenance system. • Repair or replace? • The ELECTROmatic system’s modular design allows for easy technician-free part replacement for water filters, LED bulbs and tubing. • How it works: • By combining the new KaVo ELECTROmatic with KaVo’s industry-leading electric handpieces and a short, powerful, lightweight motor, KaVo provides an ideal solution for synchronized efficiency. • What you need to know: The KaVo ELECTROmatic is available in three models, which means there is an electric solution for every dental office. The ELECTROmatic is the first dual-motor electric retrofit system in North America. •W ith 20 pre-programmed endodontic file systems and reciprocal movement, the ELECTROmatic Premium offers a true all-in-one electric platform. • Improvements to the technology: • ELECTROmatic control box: • Dual motor option. • Dentists can choose remote mount display for the best ergonomic viewing position. • Over 20 preprogramed endo file systems. • SMARTdrive sensorless control allows a high torque at low-speed ranges. 42
Efficiency In Group Practice : ISSUE 6 • 2017
TM
• MASTERmatic handpiece: • KaVo has paired the ELECTROmatic with the MASTERmatic LUX M25 L and the MASTERmatic LUX M05 L Mini High-speeds, which combine small head size with powerful and quite performance. The MASTERmatic high-speed attachments feature a triple-gear system for smooth, reliable operation and patented angles for superior access. • COMFORTdrive handpiece: • KaVo’s most innovative handpiece – the COMFORTdrive 200XDR – offers a blend of optimal performance and superior ergonomics, with nearly silent operation. Thanks to integrated micromotor technology, COMFORTdrive delivers the precise cutting performance of an electric handpiece, with a light-weight, ergonomic design similar to that of an air-driven handpiece. • KL703 LED short motor • The KL703 LED brushless electric motor is 30 percent lighter and 25 percent shorter than other market leading electrics. Paired with KaVo’s ELECTROmatic systems, it connects with any attachment with ISO 3694 (E-style) connection. • Price range: • $1,899-$4,199 MSRP. KaVo ELECTROmatic Highlights • KaVo’s ELECTROmatic provides the most recent improvements in electric handpieces. • With three models from which to choose, the KaVo ELECTROmatic offers an electric solution for every office. • KaVo’s ELECTROmatic SAFEdrive feature, MASTERmatic handpiece quality and the QUATROcare maintenance system have addressed any overheating concerns. • The KaVo KL703 short motor and COMFORTdrive, together with the MASTERmatic M25L and M05L, address any heavy or bulky handpiece concerns. • KaVo quality handpieces provide the dental practice with versatility, excellence and comfort. • With three models from which to choose, the KaVo ELECTROmatic offers an electric solution for every office, no matter what its needs and budget is.
WHILE WE KNOW
endodontics
ISN'T A BREEZE, WE CAN HELP MAKE IT MORE CLEAR
Kerr is providing the instrumentation to support your best outcomes. Learn more at KerrEndodontics.com
Together, we’re more.
™
Sponsored: KaVo Kerr
The Ethical Choice
A great handpiece design makes it easy for dentists to follow sterilization protocols. Sterilization best practices have long been considered key to providing safe, ethical patient care. In the past 10 years, infection control experts have added dental handpieces to the list of instruments that present a risk of cross-contamination. “For many years, we have been aware that reusing a dental handpiece without autoclaving it can place patients at risk,” says Noel Brandon Kelsch, M.S., current president of the governing board for hygienists in the state of California; representative for the DHCC on the infection control review committee for the state of California. “Related studies have repeatedly shown that both high- and low-speed handpieces that are not autoclaved can be a source of cross-contamination.” (Chin JR, Miller CH, Palenik, CJ, Internal contamination of air-driven low-speed handpieces and attached prophy angles. J Am Dent Assoc. 2006 Sep; 137(9): 1275-80.) In fact, such studies have demonstrated that, even with the use of a simple prophy angle the internal unit of the handpiece can become contaminated, increasing the risk of cross-contamination, she adds.
Infection prevention guidelines in dental practices In its 2008 Summary of Infection Prevention Practices in Dental Settings: Basic Expectations for Safe Care, the Centers for Disease Control and Prevention (CDC) points out that handpieces can be contaminated internally with patient material and therefore should be heat sterilized between patient use. "Dental handpieces and associated attachments, including low-speed motors and reusable prophylaxis angles, should always be heat sterilized between patients and not high-level or surface disinfected,” states the CDC. “Although these devices are considered semicritical, studies have shown that their internal surfaces can become contaminated with patient materials during use. If these devices are not properly cleaned and heat sterilized, the next patient may be exposed to potentially infectious materials." 44
Efficiency In Group Practice : ISSUE 6 • 2017
SMARTmatic Series KaVo Kerr’s SMARTmatic Series handpieces are designed for comfort, easy use and efficient sterilization, enabling clinicians to follow CDC sterilization guidelines and ensure their patients’ safety and comfort. Features include: • Stainless steel, rustproof construction, enhancing the life of the handpiece. • One-piece handpiece sleeve with no gaps or edges, eliminating the need to disassemble before sterilization and making cleaning easier. • Smaller head size for improved sight lines.
“Debris, bacteria and viruses are harbored internally in the handpiece,” adds Kelsch. “Available studies demonstrate that clinicians put their patients at risk when they fail to sterilize the handpiece between uses.”
Addressing the challenges When efficient sterilization processes are in place, the dental practice saves time and money. With the right design, dental handpieces can be sterilized quickly and effectively. Clinicians should look for a handpiece with the following features, according to Kelsch: • Sleek design, making it easy for clinicians to grip. • Smooth, gapless surfaces, preventing debris and bacteria from collecting. • Resilient finish, such as titanium, which withstands chemicals and the sterilization process better than chrome plate. • Easily taken apart for simple reprocessing. • Easy-to-follow instructions for use. A good handpiece is well worth the investment, notes Kelsch, especially considering that a single handpiece may last up to 1,000 patient visits. A higher-end, well-designed handpiece that is easier to use and facilitates faster sterilization can lead to reduced time in the chair for patients, she points out, resulting in greater patient – and staff – satisfaction throughout the practice.
Rotary when you want it. Reciprocation when you need it. Peace of mind throughout.
TF™ Adaptive
CONTROL. SIMPLICITY. PEACE OF MIND. TF Adaptive uses a patented feedback algorithm to change the motion of the file based on the applied load. As the stress increases or decreases, the motor responds accordingly, giving you the benefits of both rotary and reciprocation at exactly the right moment. TF Adaptive files offer improved file durability, flexibility and better debris removal. The intuitive colorcoded system is designed for efficiency and ease of use. Learn more at: TFAdaptive.com
MKT-17-0273 ©2017 Kerr Corporation
Together, we’re more.
™
Sponsored: Kerr Endodontics
Taking control TF™ Adaptive by Kerr Endodontics removes the uncertainty from root canal treatment, allowing dentists to focus on an ideal patient experience and exceptional results.
At Chicagoland Smile Group – a growing network of 12 multi-specialty dental practices and 45 dentists and dental specialists – delivering quality clinical patient care and a positive patient experience is a daily priority. To ensure his dental teams meet their high standards of care, founder and president Dr. Roshan Parikh encourages them to use high-quality, reliable
Chicagoland Smile Group Dentist and entrepreneur Dr. Roshan Parikh is the founder and president of Chicagoland Smile Group. His vision is to build a bestin-class dental support organization in the Chicago area, offering dentists and dental specialists the opportunity to focus on the clinical aspects of dentistry, providing exceptional care for every patient. Since 2008, the group practice has grown to include a network of 12 multi-specialty dental practices with 45 dentists and dental specialists, all dedicated to advancing dental healthcare in the greater Chicago area.
46
Efficiency In Group Practice : ISSUE 6 • 2017
tools, such as Kerr Endodontics’ TF Adaptive system, designed to give clinicians greater predictability, control and efficiency when performing root canal treatment. “Patient care can be challenging, so we don’t want lesser-quality materials and instrumentation to prevent us from providing our patients with an optimal experience and results,” he says. “For that reason, we rely strictly on materials and instrumentation that are predictable, time and time again.”
Gaining experience, building confidence “We offer endodontic therapy at all of our locations,” says Dr. Parikh, adding that both his endodontists
and general practitioners perform root canal treatment. Indeed, not all clinicians leave dental school with the confidence to do so, he admits. “In dental school, students typically are considered competent after completing as few as five root canals,” he says. In fact, some programs – even those that include postgraduate endodontics – teach students to refer root canal treatment to an endodontist, particularly if it’s not a straightforward procedure, he adds. “And lack of experience results in a lack of confidence.” The easy-to-use TF Adaptive system puts clinicians in control, enabling them to focus on a better patient experience and superior results, notes Dr. Parikh.
“A patient’s tooth anatomy may not be predictable, but Kerr Endodontics’ TF Adaptive system is.” – Dr. Roshan Parikh, D.D.S., M.B.A., founder and president, Chicagoland Smile Group.
A patient’s tooth anatomy may not be predictable, but the TF Adaptive system is, he points out. “The TF Adaptive’s reciprocating files can cut through – and reach – the apex with an efficiency that translates into decreased chair time for the patient and increased production time for the dentist or dental specialist,” he says. “In an endodontic world of complicated file systems, practitioners must often use 6-10 files to get down to the apex and enlarge canals appropriately. We have heard only positive feedback from our Chicagoland Smile Group dental team about the TF Adaptive system’s ease of use and zero-file separation, and the resultant decreased patient chair time during endodontic therapy.”
TF Adaptive system With TF Adaptive by Kerr Endodontics, dentists and dental specialists can count on predictability, durability and flexibility. The intuitive color-coded system ensures peace-of-mind for new and experienced clinicians alike, enabling them to focus on providing an efficient, successful root canal treatment and an optimal patient experience. Key features include: • Adaptive motion technology. Adaptive Motion incorporates a patented feedback algorithm, designed to change the motion of the file based on the applied load, or stress. When there is minimal stress on the file, the system provides a rotary (clockwise) motion. As the file cuts more dentin, the motion automatically transitions to reciprocation (counterclockwise), preventing the file from grabbing too much of the canal wall. As the stress increases or decreases, the motor responds accordingly, ensuring precision and success. • Flexibility. Designed with R-Phase technology, TF Adaptive files are up to 70 percent more flexible than other file brands, enabling clinicians to comfortably navigate curved canals and decreasing the risk of canal transportation. • Durability. TF Adaptive files are twisted – not ground – into shape, reducing the risk of microfractures and file separation. The unique design ensures files are up to 58 percent more resistant to fracturing than other leading brands. Removing the uncertainty from root canal treatment permits dentists to work more efficiently and focus on an ideal patient experience and exceptional results, leading to a stronger relationship with the communities they serve.
Editor’s note: Sponsored by Kerr Endodontics. ISSUE 6 • 2017 : DentalGroupPractice.com 47
INDUSTRY NEWS Western Dental acquires Kids Dental Kare
Henry Schein hosts disaster-relief symposium
Western Dental (Orange, CA) acquired Kids Dental Kare (Los Angeles, CA), a provider of pediatric dental services in 14 California cities. With the new affiliation, Western Dental and its affiliated clinics operate more than 245 oral health clinics in California, Arizona, Nevada, and Texas.
Henry Schein Inc (Melville, NY) joined the Texas Dental Association, the Texas Veterinary Medical Association, the Texas Veterinary Medical Foundation, and The University of Texas Health Science Center at Houston (UTHealth) School of Dentistry to host an expert-led symposium to help healthcare professionals restore and reopen their practices post-natural disaster. The event was free for all healthcare professionals.
Mid-Atlantic Dental Partners names new COO Mid-Atlantic Dental Service Holdings LLC (Plymouth Meeting, PA), operating as Mid-Atlantic Dental Partners, named Leigh Feenburg as the company’s COO. As COO, Feenburg will be responsible for all dental operations and achievement of the company’s operational and financial goals. Feenburg previously was a VP of operations in Florida and Texas for Great Expressions Dental Centers. Additionally, Mid-Atlantic Dental Partners announced that Dr. Rob Samit will join the company’s board of directors. Dr. Samit is the founder of MyEyeDr.com.
Heartland Dental announces hurricane relief efforts Heartland Dental (Effingham, IL) spearheaded a relief effort to help the company’s supported dentists and team members affected by Hurricanes Harvey and Irma. Heartland Dental has raised over $40,000 for its disaster relief fund to assist supported dentists and team members affected by natural disasters. Heartland Dental has also pledged to match up to $50,000 and has already donated 6,000 tubes of toothpaste and 7,500 toothbrushes to Harvey victims. Donations for Heartland Dental supported dentists and team members who have been affected are still being accepted. 48
Efficiency In Group Practice : ISSUE 6 • 2017
American Academy of Periodontology names new officers for 2017-2018 year American Academy of Periodontology (AAP) (Chicago, IL) named Steven Daniel as president for the 20172018 year. Other newly installed officers include President-elect Richard Kao, VP Bryan Frantz, and Secretary/ Treasurer James Wilson. AAP also announced it awarded members for their contributions and accomplishments both within the AAP and the specialty of periodontics. The awardees were honored at a ceremony during the AAP’s 103nd Annual Meeting, held September 9-12 in Boston, Massachusetts
Georgia Dental Association names new president The Georgia Dental Association (Atlanta, GA) named Dr. Robin Reich as its 2017-2018 president. The GDA is a constituent of the American Dental Association. Reich has been member of the Georgia Dental Association since 1985 and held multiple officer positions at the district, state, and national levels.
Quality. Efficiency. Value. (We have a lot in common.)
5 YEAR WARRANTY
Get A-dec quality at an affordable price. Now you don’t have to sacrifice performance for price. A-dec offers equipment designed specifically for Dental Support Organizations, with rich feature sets that support productivity, along with legendary quality and reliability. That’s the true definition of value.
DSO Performer Chair Package includes: Chair with One Piece Floorbox Performer Delivery Unit with Standard Touchpad Assistant’s 3-Position Touchpad with Syringe 300 LED Light
To learn more about our exclusive DSO packages and pricing, contact your A-dec representative or visit a-dec.com/DSO.
Special DSO Member retail pricing is only available to qualified Dental Support Organizations. © 2017 A-dec Inc. All rights reserved.
Performer Monitor Mount
INDUSTRY NEWS Industry leaders launch Ventyv, new infection prevention company Ventyv (Tampa, FL) is a recently established provider of infection prevention products. The company’s initial product launch is in the hand-protection category. Ventyv’s mission is to deliver superior infection prevention products that are consistently available to meet the demands of workers in the industries Ventyv serves. Ventyv will continue to supply Polymed latex exam gloves. Ventyv is a member of the Sri Trang Group. Its subsidiary, Sri Trang Gloves Thailand (STGT) is the manufacturer of Ventyv products. Billy Harris, CEO of Ventyv, is currently a board member of STGT and previously served as CEO for a Sri Trang joint venture in the hand protection category. Learn more at www.Ventyv.com
The American Dental Association (ADA) (Chicago, IL) and the Council for Affordable Quality Healthcare (CAQH) (Washington, DC) launched a new credentialing service for all U.S. dentists. The service can let users know if licenses or documentation are set to expire. The ADA credentialing service, powered by CAQH ProView, enables dentists to enter professional and practice information in a secure digital platform, which lets them allow participating dental plans access to their information. The information can be used for credentialing as well as for provider directories, network adequacy, and other business needs. Automatic reminders to review profile information are sent every 120 days.
GEDC partners with Purpose Prep
Delta Dental of Kentucky names new CEO
Great Expressions Dental Centers (GEDC) (Southfield, MI) teamed up with Purpose Prep, an online education resource for American schools. GEDC will sponsor students in Detroit, Michigan as they undergo two of Purpose Prep’s hybrid e-learning courses. The program, which features classes taught once a week during regular school hours, will take place September 2017 through May 2018. GEDC also has provided 100 students with a backpack full of school supplies and dental products.
Delta Dental of Kentucky (Louisville, KY) named J. Jude Thompson as CEO. Thompson has served on the Delta Dental’s board since 2009 and has been its interim CEO since March 2017, when its previous CEO, Clifford Maesaka Jr., resigned.
Light Wave Dental Management affiliates with Herbert Dental Group Light Wave Dental Management (Woodbridge, VA), a portfolio company of affiliated funds managed by Alpine Investor (San Francisco, CA), recently affiliated with the Herbert Dental Group, which has offices in Leesburg and Purcellville, Virginia.
NIDCR names new deputy director The National Institute of Dental and Craniofacial Research (NIDCR) (Bethesda, MD) named Douglas Sheeley, ScD, as new deputy director, effective October 16. Sheeley previously was senior scientific officer and acting chief of the Biomedical Technology Branch at the National Institute of General Medical Sciences. 50
ADA launches new credentialing service
Efficiency In Group Practice : ISSUE 6 • 2017
Aspen Dental to open 3 new affiliated offices in Minneapolis, MN Aspen Dental Management Inc (Syracuse, NY) announced it will open three new Aspen Dental-branded practices in Minnesota in October and November. Offices will open October 19 in Baxter, November 2 in Oak Park Heights, and November 9 in Willmar.
Dental Select names VP of sales and chief growth officer Dental Select (Salt Lake City, UT) promoted Jeff Van Leeuwen to VP of sales and Suzette Musgrove to chief growth officer. In his new role, Van Leeuwen will work closely with and be responsible for all sales employees, building and identifying strategic business opportunities, and furthering the advancement of nationwide development. As chief growth officer, Musgrove will oversee all business development activities, including key General Agent partnership opportunities and distribution strategies.
The New RMGI Restorative The New RMGI Restorative BEFORE AND AFTER PACKING … BEFORE AND AFTER PACKING …
other brands
Ionolux Ionolux Plus
other brands
Ionolux Ionolux Plus
LIGHT-CURED RESIN MODIFIED LIGHT-CURED RESIN MODIFIED GLASS IONOMER RESTORATIVE GLASS IONOMER RESTORATIVE • Composite-like esthetics and handling • • Composite-like Light-curing foresthetics fast finishand andhandling flexible working time • Light-curing for fast finish and flexible working time • Immediately packable after application • • • •
Immediately after application Does not stickpackable to the instrument, easy to shape Does not stick to the instrument, easy to shape Excellent translucency for better esthetic results
• • • •
Excellent translucency for bettersecondary esthetic results High fluoride release minimizes caries High fluoride release minimizes secondary caries Highly radiopaque
• • • •
Highly radiopaque Fits virtually all GIC applicators Fits virtually all GIC applicators No dentin conditioner or adhesive required • No dentin conditioner or adhesive required
Call 1-888-658-2584 Call 1-888-658-2584
VOCO · 1245 Rosemont Drive · Suite 140 · Indian Land, SC 29707 · www.vocoamerica.com · infousa@voco.com VOCO · 1245 Rosemont Drive · Suite 140 · Indian Land, SC 29707 · www.vocoamerica.com · infousa@voco.com
New Stienlfg Activa lfSele apsu NeCw ting
® Ionolux Ionolux®
Activa Capsule
BEFORE
AFTER
BEFORE
AFTER