FI Aug 19 by BOC design Inc

For Dental Sales Professionals

Manufacturer Reps to Watch Manufacturer reps value their relationship with their distributor rep partners. ALSO INSIDE:

All the Right Moves For Eric Shirley, president of Patterson Dental, the best solutions lie beyond the obvious answers.

August 2019

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AUGUST 2019

FOR DENTAL SALES PROFESSIONALS

MANUFACTURER REPS TO WATCH

34 4 10

Publisher’s Note Selling Season

All the Right Moves

Safe water, safe patients

Growing attention to the hazards of contaminated dental unit water has led more dental clinicians to take the necessary steps to protect their patients.

14 20 28

Instructions for use: They’re meant to be read!

30 32 44 48

Kid-friendly dentistry

For Eric Shirley, the best solutions lie beyond the obvious answers.

Assumption of knowledge is a dangerous thing.

Engineering and Work Practice Controls

A Dash to the 2019 Finish Line

Four steps to implementable success

Don’t let your dental customers overlook key elements of the Bloodborne Pathogens Standard.

Pedodontists

Advanced technology, together with experience and a measure of sensitivity, enable pedodontists to provide the best possible care for their young patients.

Treating young children requires a unique skill set.

Quickbytes

Handpieces

Technology News

Dental professionals today have more – and better – handpiece options.

News

Editor’s Note

The Greatest Blessing

August 2019

First Impressions

www.firstimpressionsmag.com

Yesterday’s dental water standards won’t meet today’s regulations.

Outdated thinking and habits have left many clinics with a mess in their dental unit waterlines. A 2018 study showed that 1/3 of waterlines tested failed to meet the <500CFU/ml drinking water standard.* Regulations around the country are changing. Don’t let your customers fall behind in dental water compliance. Sterisil® Straws are an easy and efficient solution with clinically proven effectiveness.

Visit us online at Sterisil.com

*Dewhirst, Nancy, and John Molanari. Treating and Monitoring Dental Water. Compendium, 2018.

1/3 OF SAMPLES TESTED FAILED TO MEET THE DRINKING WATER STANDARD

PUBLISHER’S NOTE

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

Selling Season

Managing Editor Graham Garrison ggarrison@ sharemovingmedia.com Publisher Scott Adams sadams@ sharemovingmedia.com Founder Brian Taylor btaylor@ sharemovingmedia.com

Over the course of my 25-year career in this industry, I’ve always looked forward to the fall. The days start getting shorter, the air is cooler, college football is cranking up and selling season is in full swing. As the kids prepare to go back to school, all the doctor visits and dental visits pick-up – meaning more sales through distribution, especially on sundries. Between now and the next issue of First Impressions, your selling season will be in full swing. As a rep, for me this was always the time to close my year strong and ensure my budget was made. I spent several years in the distribution space, but my first 12 years in the industry were spent selling consumables – first for a disinfectant and soap company, then for a glove manufacturer. From a distribution standpoint, these products can be boring and oftentimes the source of aggravation for you and you customers. For this reason, I always liked to pick 1-2 months out of the year to focus on the sundries category to ensure I was getting all the business, as well as hitting this category with a focused effort. If you stop and think about it, sundries make up a huge part of your sales and typically come in with a healthy margin. There’s no better time of the year than now to focus on your core products. Your accounts know visits are picking up, and they need to be prepared with their supplies, typically making them open to the conversation. My challenge to you over these next few months is to ask for their business and be sure you’re getting your share in each account. If nothing else, it displaces a competitor that may be in there while it increases your reoccurring monthly sales numbers. Good Selling, R. Scott Adams

August 2019

First Impressions

Senior Director of Business Development Diana Partin dpartin@ sharemovingmedia.com

Director of Business Development Jamie Falasz, RDH jfalasz@ sharemovingmedia.com Art Director Brent Cashman bcashman@ sharemovingmedia.com Circulation Wai Bun Cheung wcheung@ sharemovingmedia.com The Dental Facts Editor Alan Cherry acherry@ sharemovingmedia.com

First Impressions is published bi-monthly by Share Moving Media 1735 N. Brown Rd. Ste. 140 • Lawrenceville, GA 30043-8153 Phone: 770/263-5257 • Fax: 770/236-8023 www.firstimpressionsmag.com First Impressions (ISSN 1548-4165) is published bi-monthly by Share Moving Media., 1735 N. Brown Rd. Ste. 140, Lawrenceville, GA 30043-8153. Copyright 2019 by Share Moving Media. All rights reserved. Subscriptions: $48 per year. If you would like to subscribe or notify us of address changes, please contact us at the above numbers or address. POSTMASTER: Send address changes to Share Moving Media., 1735 N. Brown Rd. Ste. 140, Lawrenceville, GA 30043-8153. Please note: The acceptance of advertising or products mentioned by contributing authors does not constitute endorsement by the publisher. Publisher cannot accept responsibility for the correctness of an opinion expressed by contributing authors.

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

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

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DISTRIBUTION

BY LAURA THILL

Eric Shirley

August 2019

First Impressions

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All the Right Moves For Eric Shirley, the best solutions lie beyond the obvious answers.

When Eric Shirley joined Patterson Dental as president of the dental business unit earlier this year, he brought with him years of industry experience and perspective, as well as a fresh vision for the company and its business partners. “Patterson has two critical and unique assets: our customers and our teammates,” says Shirley. “With that wonderful foundation, I am not here to solve huge problems. My role is to ask the right questions and challenge ourselves to think in ways that enable our teams to make our customers more successful.” Both distributors and manufacturers are tasked with increasing the value of oral healthcare, he points out. “It’s about empowering the clinical team to provide better and more efficient care, enabling the practice to adopt new technologies and products, and designing oral healthcare environments that do all of this more effectively and comfortably.” “Distributors and manufacturers both have a role to play in that. If we each do our jobs really well, we’re going to increase the value of oral healthcare and help patients receive better care. Ultimately, we’re going to help the practices become more successful.”

From manufacturing to distribution Shirley’s career took root in dental manufacturing when he joined Kavo Kerr (currently part of Danaher) in 1991 as the Southern California territory manager, as well as a product and marketing manager. He remained with the company for seven years, after which he joined Dentsply as the director of marketing for preventive care. For the next six years,

he assumed various sales and marketing roles at Dentsply. In 2004, he joined Midmark Corp. as vice president of sales and marketing for the company’s dental business, later transitioning to general manager of both the dental and animal health divisions. Afterward, he was appointed Midmark’s chief commercial officer and directed the customer-facing efforts for all three of the company’s businesses: Medical, Dental and Animal Health.

couldn’t necessarily articulate. The discovery of unmet needs is critical on the manufacturing side, as is the ability to utilize real, established processes within those business units to achieve goals.” It’s precisely this experience, he adds, that he hopes to offer Patterson.

Meeting the need For Shirley, the reasons for joining Patterson were clear. “Patterson has always impressed me as an organization that truly understands the dynamics of the dental practice, including how to bring real value-added expertise to help the practice team achieve its goals,” he

“ Our customers’ needs are not the same as they were 10 or 15 years ago, and they will continue to change over the next 10 or 15 years. Our goal at Patterson is to understand our customers’ needs and position ourselves as the one company that can address those needs.” “Midmark utilized the Toyota Production System in all of its manufacturing facilities and office environments – an experience that was very educational and eye-opening,” says Shirley. “Working on the manufacturing side taught me a great deal about process, operations and product development. I learned to look beyond answers to the questions and to really search for new ways to solve problems that the customer or clinical team

explains. “I worked with Patterson as a supplier partner for many years and have gotten to know the organization’s values very well. I’ve long been fascinated with how deeply Patterson knows the practice mechanics of its customers.” As newly appointed president of Patterson Dental, Shirley embraces the opportunity to bring new insight to dental practices, including practice owners and the clinical team, ultimately improving the care

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First Impressions

August 2019

DISTRIBUTION

A history of philanthropy Eric Shirley, newly appointed president of Patterson’s dental business unit, has long been involved in a number of philanthropic efforts, including TeamSmile and the Dental Lifeline Network. So, it’s no surprise he feels at home at Patterson Dental. “Since 2004, the Patterson Foundation has given $3.2 million in scholarships to 415 students from Patterson families and $7.6 million in grants to 140 nonprofit organizations,” he points out. “So, I know how strongly the Patterson team feels about the mission and the work of the Foundation, and they’ve already encouraged me to continue the philanthropic work that I do.

patients receive. It’s becoming increasingly important to provide dental practices with the data and insights necessary to achieve their goals, he points out. “Whether we offer new services, integrate technology, design dental practices, facilitate transitions, or use our data to find new sources of revenue for the practice, I think it’s critical for us to understand how we can evolve and change as a partner to help our customers achieve these goals,” he says. “It’s important to understand what our dental customers need from a distribution partner, and to realize that these needs are changing – needs that are unique to each customer,” he continues.

“The TeamSmile work is what I’m most proud of because I’ve seen how the organization has grown in the years I’ve been a part of the Board of Directors,” Shirley continues. “The passion of Dr. Bill Busch and the many people who work with TeamSmile to provide free dental care to children all over the country – including partnering with professional sports teams – has been so inspiring. I’m really proud of what they do. We began 13 years ago with a single event with the Kansas City Chiefs; today, the program has mushroomed into 40 annual events with 40 professional sports teams!”

“Our customers’ needs are not the same as they were 10 or 15 years ago, and they will continue to change over the next 10 or 15 years. Our goal at Patterson is to understand our customers’ needs and position ourselves as the one company that can address those needs.” Shirley couldn’t have joined Patterson at a more opportune time. Today more than ever, the company works to understand its dental customers’ needs and address the unique goals and objectives of each practice. “We are focusing on what makes the Patterson difference impactful to a dental practice,” he says. “It’s about the data and insights we

“ Working on the manufacturing side taught me a great deal about process, operations and product development. I learned to look beyond answers to the questions and to really search for new ways to solve problems that the customer or clinical team couldn’t necessarily articulate.” 8

August 2019

First Impressions

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bring to this conversation and getting to know what each practice really wants to accomplish.” This can vary widely from practice to practice, depending on whether it’s a large dental service organization, a regional group practice or a smaller solo practice, he adds. Sometimes dental practices are looking to design better operatories or acquire other practices, Shirley continues. In some cases, their goal may be to add new services, procedures and technologies. What sets Patterson apart is “its ability to have those kinds of deep, one-on-one conversations with practices,” he points out. “We are becoming a stronger partner to dental practices, bringing business and clinical solutions to help each practice accomplish their individual goals.” In turn, Patterson’s dental customers are placing greater trust in the distributor by installing its software, equipment and technology offerings, helping to fuel its leadership position in the dental industry.

A look to the future In Shirley’s experience, not only will the needs of dental professionals continue to

change in years to come, so, too, will the industry landscape. In fact, he expects the industry to expand, making room for both large and small players. “We will continue to see the role of Dental Service Organizations (DSOs) grow and new models emerge,” he says, adding that these organizations will look very different in three or five years. “We’ll see new models emerge in size and scope,” he says. “We’ll also see new and changing ownership models. For instance, we may see more medium-sized regional service organizations that are made up of practices with the same consistent values and core concepts.” At the same time, Shirley anticipates the re-emergence of the small practice environment. “I’m really encouraged by what I see with the solo practice model,”

he says. “Solo practices want to be more relevant and provide better care and a different patient experience. They are clearly asking themselves some tough questions about how they can compete in the new world; I’m encouraged by what I see in all areas.” In addition, he has great confidence in today’s millennial dental graduates, who as a group appear eager to begin their careers and give back to their community. “I have the pleasure of working with a lot of dental school graduates, [many] who are eager to own several practices,” he points out. “I also see dental school graduates who are interested in public dentistry and giving back to the community, and I think that’s great too. I’m encouraged by what I see in the graduating classes

of dental schools; I think it’s going to be exciting for the future. “I’ve fallen into an industry that is really [fantastic] to be a part of,” says Shirley. “Everybody wants to do the right thing and improve the oral healthcare of the patients that we all serve.” That said, he credits the people in his life – family, friends and colleagues – who have inspired him to try to make the world a better place. “I’m lucky to have a very supportive family and so many wonderful friends and colleagues in this industry who have helped me so much,” he says. “My parents and grandparents have been an inspiration to me, and I feel like I’m trying to bring their legacy forward. They have worked so hard over the years, and I am grateful for their example of work ethic and love.”

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SALES FOCUS

Safe water, safe patients Growing attention to the hazards of contaminated dental unit water has led more dental clinicians to take the necessary steps to protect their patients.

August 2019

First Impressions

There are no shortcuts to obtaining compliant dental water. Without the right products and protocols, however, dental practices will not be able to meet the acceptable standard for water delivered to patients during non-surgical procedures. Whatâ&#x20AC;&#x2122;s more, even though compliance with water safety standards in the United States has not been required by law, that is changing.

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â&#x20AC;&#x153;A dental practice simply will not achieve compliance without effective, EPA-validated products used in accordance with the correct protocols,â&#x20AC;? says

Jerod Mendolia, marketing assistant, Sterisil, Inc. “At Sterisil, our philosophy is embodied in the acronym, PPC: Products + protocols = compliance. We have applied this methodology with great success in various settings, from mid-sized five-chair clinics to Ivy League dental schools.” New technology is important, he adds. But unless clinicians are educated on the appropriate protocols and develop a conscientious attitude, “we are setting them up for failure.”

A serious business Because dental water is used as an irrigant solution in conjunction with highspeed rotary handpieces, potentially contaminated aerosols and spatter can carry waterborne pathogens through the air, increasing the potential for infections. Unwanted health implications associated with contaminated dental unit coolants range from the exacerbation of existing asthma symptoms due to endotoxin exposure to complex bacterial infections, such as Legionnaires’ disease, according to the Organization for Safety and Asepsis Prevention (OSAP). In recent years, two high-profile cases have linked dental unit water to serious infections, notes Mendolia. The first incident occurred at Dentistry for Children in Jonesboro, GA. A second incident occurred at Children’s Dental Group in Anaheim, CA. In both cases, Mycobacterium were isolated as the cause of infections in pediatric patients who received a pulpotomy procedure with contaminated dental unit water, he points out. Although the Centers for Disease Control and Prevention (CDC) has recommended that water delivered to patients during non-surgical dental procedures meet Environmental Protection Agency (EPA) standards for drinking water (<500CFU), some question whether this is sufficient in a clinical environment. “In 1995, the American Dental Association

challenged dental unit manufacturers to develop the equipment necessary to deliver effluent handpiece water with <200CFU,” says Mendolia. That standard has since been raised to the <500CFU/ ml drinking water standard. “Currently, there are many products on the market validated to deliver levels of disinfection well below 200CFU. I don’t think it is unreasonable to expect dental professionals to meet this higher standard considering the number of products and protocols available with advertised effectiveness claims at 10CFU.”

from the filter, according to Mendolia. For best results, filtration should be paired with an ion exchange-based product for shock and residual disinfection. “Clinicians should steer clear of filtration methods that require water storage in a tank,” he says. “Unless the practice has something like a UV light after the tank, water storage can lead to incubation of existing bacteria in the tank to >500CFU. Most waterline treatment products will have some sort of disclaimer stating for use with potable water. So, contaminated storage tank

Unwanted health implications associated with contaminated dental unit coolants range from the exacerbation of existing asthma symptoms due to endotoxin exposure to complex bacterial infections, such as Legionnaires' disease, according to the Organization for Safety and Asepsis Prevention (OSAP). The right solution For many dental professionals, the importance of delivering safe water during patient treatment is clear. Navigating their options, however, can sometimes be tricky. There are several methods available for treating water, notes Mendolia, and clinicians must stay informed in order to best serve their patients. There are advantages and disadvantages to each. There are many filter options capable of removing some level of microbial contaminants, but without the presence of a residual disinfectant, filtration alone is insufficient to consistently maintain and prevent microbial growth downstream

water would be unsuitable for use with many chemical treatments based on this alone. “Since the introduction of the independent bottle reservoir, chemical treatments have become a viable and convenient method for reducing effluent dental water microbes,” he continues. “When dental clinicians follow the instructions for use (IFUs), they can expect good results. However, when using municipal tap water, they must do so with caution. Municipal contaminants like chlorine and copper can interfere with the efficacy of some chemical treatments. The best regimens will always feature both shock and maintenance treatments that are

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First Impressions

August 2019

SALES FOCUS

compatible with one another. Whenever possible, clinicians should use distilled water in their bottle reservoirs for the best results.” In theory, in-office distillers are a viable solution, notes Mendolia. However, they are often associated with water test failures. “The machinery of distilling demands regular cleaning and disinfection to ensure the water purity and microbial viability,” he explains. “Once water has

is not the most effective method. Deionized water is essentially the same thing, and the process by which it is created does not increase the bacterial content. It is for this reason, all Sterisil systems employ this technology as the final purification step. Now you have a very pure base water to which a residual disinfectant can be introduced, with minimal interference from microbes or chemical contaminates.”

“ Dental practices should always consult with their dental unit manufacturers and their waterline treatment providers about water testing. Minimum standards for water testing should be followed whenever possible, even though they are recommendations rather than requirements. If the dental practice’s protocols are in line with these standards, it is off to great start.” — Jerod Mendolia, marketing assistant, Sterisil

been heated into a gas and condensed back into liquid, it no doubt will be above room temperature. This increases the likelihood you are incubating bacteria as it’s stored. Without a residual disinfectant or some sort of shock treatment prior to introduction to the chair, it’s unlikely the 500CFU drinking water standard will be met, and the practice risks violating the manufacturer’s labeling. “Don’t get me wrong,” he says. “Distilled water is much better than municipal tap water in just about every way. But physically distilling water

August 2019

First Impressions

Pre-sterilized water is clean enough for any dental procedure, says Mendolia. “However, once it is introduced into a dental chair, it is unlikely to meet the <500CFU standard,” he points out. “Unless the dentist intends to irrigate with single-use pipettes or purchase a very expensive sterile water generator, this will not be a viable option.” And, the cost of purchasing sterile water makes this an unaffordable option for many dental practices, he adds. Mendolia recommends that dental practices use their bottle reservoirs for

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their intended purpose. “The independent bottle reservoir was designed to isolate the dental unit from municipal tap water and provide a conduit through which antimicrobial treatments could be introduced,” he says. “Tap water is not suitable for the dental setting for many reasons, but particularly due to the infinite variability in water chemistry. If clinicians are using residual disinfectants to control microbes in a dental chair, these details matter. Distilled water will always save the dental practice a lot of headaches in the end, trust me. “Dental practices should always consult with their dental unit manufacturers and their waterline treatment providers about water testing,” Mendolia continues. “Minimum standards for water testing should be followed whenever possible, even though they are recommendations rather than requirements. If the dental practice’s protocols are in line with these standards, it is off to great start.” A passing water test verifies the absence of bacteria and validates the dental practice’s disinfection efforts, he points out. “According to OSAP, dental practices should be testing within 30 days of introducing a new product or new protocols, and then every 30 days thereafter,” he says. “The initial test validates the product and protocol’s efficacy, and subsequent tests validate the protocol execution throughout the product’s lifespan (assuming the product did not expire prematurely). If both tests pass, the practice can begin testing every six months. If there is a test failure, the clinician should shock immediately and retest per the waterline treatment manufacturer’s IFU. I personally recommend testing through a thirdparty lab that specializes in dental water microbes, like Agenics They offer HPC counts and many other water chemistry

metrics that help diagnose problems should they arise.”

Legal precedent Compliance with water safety standards in the United States has not been required by law. But, that’s quickly changing. “Water compliance may not have been the law in 2016, when 73 pediatric patients contracted Mycobacterium infections from contaminated dental water at Children’s Dental Group in Orange County, CA,” says Mendolia. However, in 2019, it became a law in California, he points out, noting that eventually much of the country will likely follow suit. “What I try to impress on people is that this issue isn’t going away,” he

says. “Now that there are legal precedents associated with patient vs. clinicians, and manufacturers vs. clinicians, with regard to this topic, it will be difficult for dental clinicians to prove in court that they are not responsible for any infections related to dental water in their practice, even if they weren’t legally required to take action.” That said, for some dental professionals, cost will always be an obstacle. “We must focus on the relative cost per liter differences among the various products, relative to their overall need for water,” says Mendolia. “If a large practice intends to confront this problem head on, it would serve them well to go with the option that has the lowest cost per liter. That’s not always the low-

est initial cost, but the purchase will pay for itself with time. Sometimes dental practices just want to get their toes wet, so to speak. “Low cost options like Citrisil tablets are a good place to start, with the same great treatment you get from the higher end products,” he says. But, they’re not as convenient as a long-term solution. “The low-cost options in this category always leave something to be desired when it comes to efficiency and cost per liter.” As more practitioners are on board with the need for waterline treatment, they are looking for solutions that provide enhanced efficiency and require less staff involvement, notes Mendolia. “We are here to help,” he adds.

SALES FOCUS

Instructions for use: They’re meant to be read! Assumption of knowledge is a dangerous thing.

If you don’t read the instructions that accompany your new iPhone, chances

are you – or your teenage son or daughter – will figure it out. When it comes to dental equipment, however, dental professionals should never assume they know how to use a new product. It can lead to detrimental – even life threatening – consequences for their staff, their patients and their practice.

Particularly in the case of waterline treatment, noncompliance can lead to serious infection outbreaks, according to Leann Keefer, RDH, MSM, director, clinical services and education, Crosstex, a Cantel Medical Company. Nevertheless, dental professionals commonly refer to manufacturer instructions for use (IFUs) only on a need-to-know basis, they point out. “In order to get the most effective and efficient use of any product, compliance with IFUs is critical,” says Keefer. “With regard to documentation and training, everyone in the office needs to be on the same page with the technology,

August 2019

First Impressions

not just the person who does the ordering. Procedures and policies of water management are an integral part of the office’s infection control manual, and the IFUs are critical to use in protocol development.” Unfortunately, many dental offices set aside the IFUs, referring to them when they have a specific question. In fact, after adopting new technology, some dental teams assume they can transfer knowledge from previous clinical experiences, she adds. But, they do so “without necessarily being aware of the differences and nuances in science, procedure or technique. Assumption of knowledge is a dangerous thing.”

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Vigilance and caution When adopting new waterline treatment technology, dental professionals are tasked with being extra cautious. For instance, it’s not unheard of for a manufacturer of a validated water treatment system to omit providing a monitoring protocol in their IFU, notes Keefer. In this case, the dental practice should reach out to the manufacturer for a best-practice recommendation, she points out. In addition, the dental team must be aware of discrepancies in directions for use from one manufacturer to the next. “Dental offices need to be aware of the differences in instructions for use from both dental chair manufacturers and waterline treatment manufacturers and reach out to these manufacturers when IFUs provide conflicting information,” she says. “For example, a dental chair manufacturer may recommend the use of a hypochlorite solution as an intermediate shock for bacterial reduction in the dental waterlines.

However, use of this chlorine-based product may conflict with best practices for other automated dental waterline products that may be in use. “OSAP issued a white paper in September 2018 specific to waterlines that speaks to the importance of contacting dental chair manufacturers and waterline treatment manufacturers for specific guidance and instructions on methods to improve and maintain the quality of dental procedure water,” says Keefer. “Per FDA [guidelines], dental practitioners should consult with the dental unit manufacturer’s instructions for the recommended maintenance schedule of the dental unit waterlines,” she continues. “Dental practitioners should adopt appropriate infection control procedures for dental unit water lines (DUWLs) based on the manufacturer’s instruction for use. This should include infection control measures such as (but not limited to) monitoring water quality. The water management plan should include specific testing locations and frequencies, and actions to take (e.g., remediation, retesting at shorter intervals) based on test results. [Practitioners] should follow the manufacturer’s instructions for cleaning and disinfecting the dental unit at recommended intervals. They should contact the manufacturer of the dental unit to obtain the most up-todate instructions or direction for reprocessing of the dental unit.”

Risks and realities It can’t be said enough: When dental practitioners ignore DUWL treatment protocols, it places the staff, patients and, ultimately, the practice at risk. “Whether using a DUWL treatment like Crosstex DentaPure™ Cartridges or Liquid Ultra™ Solution, or a different DUWL treatment method, it is imperative that dental offices follow the instructions for use to ensure the chosen waterline treatment meets the product-

approved claims for CFU/mL reduction to meet EPA standards of <500 CFU/mL,” says Keefer. “We frequently overlook the risk of the staff’s constant exposure to contaminated bioaerosol. Clinicians work between 14-16 inches from a patient’s mouth, and aerosol can carry over three feet. Studies have shown that occupational asthma is triggered due to endotoxins contained in aerosols.” (https://cdn.ymaws.com/ www.osap.org/resource/resmgr/Docs/2_ SADJFebruary_2009_REVIEWOc.pdf.)

hospitalized. Despite treatment and antibiotics administered at the hospital, she developed rapid and irreversible septic shock and died two days after being admitted. (https://www.eurekalert.org/pub_ releases/2012-02/l-dow021412.php) “At Crosstex, we provide a selection of literature that includes procedural guidance for following our DWUL IFUs after purchase, while addressing the evidence-based science behind why treatment is so important,” says Ilene Russo,

“ In order to get the most effective and efficient use of any product, compliance with IFUs is critical. With regard to documentation and training, everyone in the office needs to be on the same page with the technology, not just the person who does the ordering.” — Leann Keefer, RDH, MSM, director, clinical services and education, Crosstex, a Cantel Medical Company

In a few widely publicized cases, it was the patients who suffered the most. In 2015, contaminated dental treatment water at a Georgia Pediatric dental clinic led to at least 23 children becoming infected after pulpotomies. Their ages ranged from 3 to 11, according to the Centers for Disease Control and Prevention. They had all been infected with Mycobacterium abscessus, a rapidlygrowing bacterium known to contaminate waterlines in dental offices. (https://www. ajc.com/news/local/georgia-didn-sanction-dental-chain-accused-infectingchildren/5501Ebv2D27LyuerW1ywdI/.) In 2016, an Anaheim, California, pediatric dental clinic’s water system became infected with Mycobacterium, causing over 70 children to be hospitalized following pulpotomies. In early 2011, an 82-year-old woman in Italy contracted Legionnaires’ disease, which was traced to equipment in a dental surgery she attended shortly before being

Crosstex waterline product manager. “We also provide live CE programs, as well as on-demand webinars covering the science, treatment choices and implementation (www.crosstexlearning.com).” In addition, Crosstex sales representatives refer dental offices to the CDC Summary of Infection Prevention Practices in Dental Settings: Basic expectations for selfcare (https://www.cdc.gov/oralhealth/ infectioncontrol/pdf/safe-care2.pdf). “Following IFUs is not a standalone issue for waterlines,” says Keefer. “It’s a standalone mindset for how we approach overall infection prevention and control in the dental setting. This becomes both an ethical and a clinical choice when patient safety is in question. It should not take tragic headlines to ensure compliance. However, if reminding clinicians of the risks and realities associated with noncompliance shifts the paradigm, Crosstex will continue to keep these preventable incidents top-of-mind.”

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First Impressions

August 2019

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A new era for bonding A true universal, Tokuyama Universal Bond saves the dental team time and guesswork.

For Sia Abai, DDS, MMedSc, a Tustin, CA-based prosthodontist and owner

of Abai Center for Advanced Dentistry, preparing patients’ teeth for ceramic bonded restorations used to be a time-consuming process, often involving multiple steps and potential inaccuracies. Today, that’s no longer the case. “Once I began using Tokuyama Universal Bond, our workflow immediately improved,” says Dr. Abai. A solo practitioner who relies on one assistant, one hygienist and an office manager to help him run his practice, he knows very well the value of efficiency. “One of the greatest clinical challenges of bonding and cementation procedures is the multiple steps required to prepare the tooth structure for direct restorations, as well as both the tooth structure and restoration for indirect restorations,” he points out. “The multiple-bottle techniques of the past can potentially lead to inaccuracies in treatment workflows, and they often require additional staff training in various and separate silanating agents and bonding products. Tokuyama Universal Bond has reduced the guesswork for my team when it comes to applying the right product to the proper material.”

One step, many applications “Tokuyama Universal Bond is unique in that it is truly a one-step bonding agent compatible with many clinical situations,” says Dr. Abai. “Whether I am doing immediate dentin sealing, a direct restoration or an indirect restoration, I can depend on this bonding agent to provide a strong bond, without requiring multiple time-consuming

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First Impressions

steps.” And, because it is so versatile, he can use it on any substrate, including metals and ceramics, such as zirconia, optimizing his bonding technique without the need for primers or activators, he adds. “Tokuyama Universal Bond has definitely facilitated greater efficiency at my practice,” Dr. Abai continues. “For one, the product allows for selfetching and requires a short application time, with no light curing. The application is as simple as mixing a two-bottle system and applying the mixture to the surface, followed by gentle air application. The entire process takes me 20 seconds – a timesavings that is invaluable to both my staff and patients.”

Tokuyama Universal Bond: At a glance Tokuyama Universal Bond offers much more than your typical bonding agent. • Quick & Easy. Application takes 25 seconds and requires no light cure, agitation or wait. • Reliable. Provides high bond strength for both direct and indirect restorations. • True Universal. Works on all restorative substrates. No additional activators or primers are required. • Active Chemistry. The self-curing bond offers worry-free polymerization where curing lights cannot reach. In addition, Tokuyama Universal Bond is compatible with different etching techniques, including total-, self- and selective-etch mode. It works with all dual and self-cured materials, without the use of a separate activator. And, it can be used as a primer for silica-based and metallic restorations.

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PRACTICE POINTS

BY KRISTINE BERRY, RDH, MSEC

A Dash to the 2019 Finish Line Four steps to implementable success Editorâ&#x20AC;&#x2122;s note: Are your dental customers close to reaching their year-end goals? The following article by executive business coach Kristine Berry, RDH, MSEC, points dental owners in the right direction.

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Where are you regarding reaching your year-end goals? I invite you to pause and take stock of your successes from the last two quarters. This article focuses on the support you need in planning for the months ahead.

Some people do not even know what’s possible for their businesses; you may need someone to help you get a clear vision of how you want your office to be. At Next Level Practice, a dental practice management firm, goals are achieved through the following divisions: leadership, management, administration, marketing, case acceptance, finance and quality assurance. With these divisions in mind, you can begin to create specific destinations for your business. For example, one of my clients took the quality assurance division and set monthly calibrations with the clinical teams to ensure everyone was working to their

Looking backwards to the first two quarters of the year: • What successes did your team have? • What major accomplishments did your team have? • What were the key lessons learned? • What habits or practices helped you? • What role did you play in planning? • What systems and practices supported your focus and planning? • What got in the way? • What do you NOT want to carry forward into the coming seasons?

enough. This article offers tools and a roadmap to make your dash to the 2019 finish line more focused, effective and without carnage.

What’s this you say? You have not yet laid out your goals for this year? If a poll was taken of most people, it would reveal that the life they lead is a result of happenstance and not planning. The same goes for business. It’s my belief – and the belief of many business and professional coaches – that the business solvency of the companies we lead is more often a result of lack of planning, rather than over-planning or having the wrong plan. Perhaps you dread tracking key metrics, you never planned what your income will be, or you never decided how many patients you want to have. Perhaps you are at a point where you wish your team would listen to you so that you only have to say something once for it to get done! Perhaps you are feeling like you’ve been on a treadmill for the first half of 2019 and are wishing to finally see growth. Lastly, perhaps you feel the people around you just don’t care- or maybe that you don’t care anymore. Effectiveness in business requires a focus on both results and relationships. One without the other is not

In order to achieve the goals you set and gain the freedom you deserve, you may need to disrupt your current modus operandi. You can do so by becoming aware of the way you see yourself and the manner you customarily use to relate to everyone around you.

In order to establish and achieve your goals, you must follow these 4 steps: 1. Discover your direction. 2. Identify your gaps. 3. Pack your practice with meaningful purpose. 4. Create sustainable results.

Discover your direction This is where the rubber meets the road. “Where is the road?” you ask. My answer: “Where do you want it to be?” Whether or not you set goals for your practice in January, yesterday or you commit to doing it after reading this article, Step 1 is to create space. You must clarify and specify the future you want for your business, where you want to go or what you want to have.

highest standard of care. In the leadership department, a doctor who owned multiple locations shared that she kept encountering the same obstacle: Her team did not want to implement anything 100 percent. During one of our coaching sessions, she was willing to explore why this kept happening. She discovered that her team did not trust her to keep and honor her word about the changes, or to hold anyone accountable; she was

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First Impressions

August 2019

PRACTICE POINTS known for not following through. Her team was playing the waiting game – always waiting for her to go on to the next idea. So, the doctor’s end game was to implement a system to interrupt that pattern. She realized it started with her leadership and that she needed to develop this first.

Identify your gaps Once you have identified where you want to go, the next step is to identify the gaps between what you want for your business and where you are now. For example, if you want to work three days a week and take four weeks off a year, but you are currently working

Effectiveness in business requires a focus on both results and relationships. One without the other is not enough.

five days a week with two weeks of vacation, those gaps begin the process of awareness. People do not particularly like gaps. Once identified, we instinctively want to close them. Some of this is the result of cognitive dissonance. People in general want to be consistent in their attitudes, beliefs, values and actions/behaviors. They want to act in accordance with their attitudes, beliefs, values and goals. When their actions contradict them, they experience dissonance. This dissonance is uncomfortable, and people naturally want to reduce it. The dissonance gap creates a vacuum in which the solution starts to unfold. This strategy is one competency that I implement with my client teams. We discover what the owner/doctor/CEO/team leader, etc., wants to create with regard to time and dollars, and then we walk them through a process called reverse engineering. Reverse engineering is a proven implementation strategy or process for goals, systems and engaging teams. Leaders with effective communication structures, team leaders, morning huddles and other key practice success methodologies will not find themselves in the position of being a hall monitor and policing or micromanaging people. Rather, they can do what they love to do: Practice dentistry and monitor outcomes.

Pack your practice with meaningful purpose Perhaps some readers of this article are members of the drill-and-fill PPO club. Your culture and standards crank out transactional dentistry and experience the daily challenge of outrunning the expenses of your practices. That’s not good, bad, right or wrong; it just is. On the other side of the spectrum, there are practices that deliver complete health dentistry that have a high value proposition and embrace the triple win. The triple win is

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a culture that embodies agreements and systems to ensure the patient, team and practice all win. These triple-win practices are playing a different game; they understand whole-body health and the mouth’s role in preventing chronic inflammatory and brain disorders. Doctors and teams go to work every day with an abundance mindset. They believe there are more than enough patients who value health, and they love to serve them. You may find you are somewhere in the middle. It’s important to identify where you are on the purpose spectrum. No position is good or bad. And, if you want to finish every year strong, you cannot get there alone. Your team wants meaningful careers and workplaces. In

order for you to achieve your goals, your team must align their values and passions with your vision, philosophy and/or guiding principles.

Create sustainable results To create happy teams that implement sustainable results, you as a leader must locate your authentic leadership style. If you are not breaking even and/ or have not consistently hit your financial goals, I invite you to take a deep dive into your leadership style. At Next Level Practice, we have worked with 6,000 practices and researched the personas of thousands of doctors. Communicating solely from your dominant persona often results in your team

not understanding you; their personas cannot yet hear yours. The following are four personalities we identify within doctors and teams: methodical, humorist, competitive and spontaneous. Seventy-five percent of dentists we researched fall into the category of introvert methodical, meaning they know the steps, but they might find it challenging to articulate their ideas. As you read the descriptors below, which one resonates with you? • Methodical. Paralysis analysis, likes step-by-steps, might not consider relationships while focusing on the finish line. • Competitive. Needs it done yesterday; get to the bottom line; you are not moving fast enough.

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PRACTICE POINTS your goals, you may need to move out of your comfort zone. The doctor’s persona overlays the practice’s communication system. Think about what can happen when a competitive doctor/owner wants to talk to his 80 percent humanistic team about numbers. The team is most likely going to view any metrics-and-measurements conversation as the doctor being obsessed with production. They

Another way to determine whether some team members aren’t engaged in your mission, and to better understand your style, is to look at team meeting agendas for 2009 and 2019. If the same items are on both agendas, you need to be open to leadership development. Think about hiring a coach to support your expansion as a leader. Once clear leadership and effective communication style are in place, you are in a better position to lead a happy team that gets consistent results.

If the same items are on both agendas, you need to be open to leadership development. Think about hiring a coach to support your expansion as a leader. Once clear leadership and effective communication style are in place, you are in a better position to lead a happy team that get consistent results.

Now turn to the remainder of the year’s planning and set your practice up to finish strong: • What are your goals for quarters three and four? • Narrowing it down, what are your top three-to-five priorities? • What time is earmarked for planning? • What time is earmarked for team training and development? • What new habits and practices do you want to put in place? • What relationships do you want to focus on? • What is the one thing you can do on a daily basis to move your goals forward? • What needs clearing up? • Where can you get accountability, support and mentorship?

• Humanistic. People pleaser, listens to how any strategy will influence relationships, acquiesces decisions. • Spontaneous. Likes to have fun and, if it is too much work, they won’t do it! Identify which category best describes you. In order to achieve the goals you set and the freedom you deserve, you

may need to disrupt your current modus operandi. You can do so by becoming aware of the way you see yourself and the manner you customarily use to relate to everyone around you. Dr. Marshall Goldsmith, preeminent executive coach and author of “What Got You Here Won’t Get You There,” believes that leaders need “guidelines to help eliminate dysfunctions and move to where you want to go.” He adds, “Often our own success delusion stands in our way and causes us to resist change.” In order to reach

may suspect he only cares about the money. Unless the owner knows how to set the context for his or her humanist team, and understands that KPIs are a way of tracking how they are living their standard of care or helping their community become healthier, the team will disengage. It only takes one person to derail the team. Leaders must be aware of whether or not their automatic leadership (and hence communication style) is alienating team members. The truth is, a team’s perception is their reality!

Successful practices require dedication and strategy. Consider the four strategic steps to implementing effective results and relationships in your practice. Think about which of these areas is the weakest in your practice, and start there. Coaching can be a powerful ally in moving forward to a healthy, thriving practice. Be in touch if I can assist you in making a dash to the 2019 finish line!

Kristine Berry is an international speaker and executive business coach, specializing in enhancing group practices. If you are looking for a speaker or coach, she invites you to email her at kristine@nextlevelpractice.com, or visit www.nextlevelpractice.com.

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First Impressions

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BY DR. KATHERINE SCHRUBBE, RDH, BS, MED, PHD.

INFECTION CONTROL

Engineering and Work Practice Controls BY DR. KATHERINE SCHRUBBE, RDH, BS, M.ED, PHD.

Don’t let your dental customers overlook key elements of the Bloodborne Pathogens Standard.

For all dental practice settings, OSHA’s Bloodborne Pathogens (BBP) Standard (29 CFR 1910.1030) provides the fundamentals for a safe workplace, prescribing safeguards to protect workers against health hazards caused by bloodborne pathogens. The Standard places requirements on employers whose workers can be reasonably anticipated to contact blood or other potentially infectious materials (OPIM), such as unfixed human tissues and certain body fluids.1 All of the elements of the BBP Standard are important and work together to provide a comprehensive plan for dental healthcare worker safety. Most dental team members are familiar with several points, such as requirements for an exposure

control plan and personal protective equipment (PPE), the opportunity to obtain a hepatitis B vaccination and the implementation of universal precautions.2,3 Some elements of the BBP Standard, however, are often overlooked. Based on

personal anecdotal and field observation, the concepts of engineering controls and work practice controls are not always assigned the importance – or the attention – they deserve. Dental healthcare workers not only are exposed to human bloodborne pathogens, but also to toxic chemicals in the workplace. But OSHA makes it clear: Engineering controls, as well as work practice controls, are vital to overall safety.2,4 OSHA’s longstanding policy is that engineering and work practice controls must be the primary means used to reduce

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August 2019

INFECTION CONTROL employee exposure. Wherever possible, elimination or substitution of a hazard is most desirable, followed by engineering controls. Administrative or work practice controls may be appropriate in some cases where engineering controls cannot be implemented, or when different procedures are needed after the implementation of the new engineering controls.

according to OSHA. Work practice controls refer to controls that reduce the likelihood of exposure by altering the manner in which a task is performed (e.g., prohibiting recapping of needles by a two-handed technique).3 In other words, itâ&#x20AC;&#x2122;s product versus process. Engineering controls are products or devices that have been made or manufactured

Controlling Exposure pyramid 5

Personal protection equipment is the least desirable, but may still be effective.5 The pyramid chart below illustrates least effective to most effective methods for reducing occupational exposure. With regard to all healthcare, including dentistry, engineering controls refer to controls (e.g., sharps disposal containers, self-sheathing needles and safer medical devices, such as sharps with engineered sharps injury protections and needleless systems) that isolate or remove the bloodborne pathogens hazard from the workplace,

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to help reduce the risk of injury; work practice controls are strategies or processes that dental team members should implement to reduce the risk of injury and practice as safely as possible.

Engineering controls According to C.H. Miller, engineering controls isolate or remove the hazard from the workplace. In dentistry, this means the use of devices that eliminate or reduce chances of exposure to blood and saliva. These include sharps containers, needle safety devices, red-bags, rubber

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dams, high-volume evacuation, instrument cassettes and mechanical instrument cleaners. The controls used must be examined and maintained or replaced on a scheduled basis.4,6 Although the requirement to utilize engineering controls has been in effect since the 1992 BBP standard, because occupational exposure to bloodborne pathogens from accidental sharps injuries in healthcare and other occupational settings continued to be a serious problem, Congress required modification of the BBP standard. As such, the Needlestick Safety and Prevention Act was signed into law on November 6, 2000, to ensure that OSHAâ&#x20AC;&#x2122;s BBP standard set forth in greater detail OSHAâ&#x20AC;&#x2122;s requirement for employers to identify, evaluate and implement safer medical devices, such as needleless systems and sharps with engineered sharps protections.1,7 The Needlestick Safety and Prevention Act took effect on April 18, 2001, and mandated additional requirements for maintaining a sharps injury log and for involving non-managerial healthcare workers in identifying, evaluating and choosing effective engineering and work practice controls.1,7 In dental practice settings, this is a sound strategy to promote safety and team involvement. As new sharps safety devices become available in the dental marketplace, team members should bring them into their practice and test them out. They should trial the new device for a period of time, ask for feedback from one another, document the safety trial and determine if the device is something that could be implemented to promote a safer workplace.

Work Practice Controls Miller points out that work practices can be used to reduce the likelihood of exposure by altering the manner in which a task is performed; all procedures must

be performed in such a manner as to minimize the spraying and spattering of oral fluids.4,6 Also, work practice controls assist in carrying out tasks in a safe manner to reduce the possibility of a sharps injury. Miller provides the following list of work practice controls, although it is not all-inclusive: • Flush mucous membranes as soon as feasible if contaminated with infectious materials. • Recap dental needles by a mechanical means, such as forceps or another cap-holding device, or by using a one-handed “scoop” technique. • Prohibit the cutting, bending or breaking of contaminated needles prior to disposal. • Discard contaminated needles and other disposable sharps in proper sharps containers. • Prohibit the overfilling of sharps containers. • Place contaminated reusable sharp instruments in containers that are puncture-resistant, leakproof, colored red or labeled

with the biohazard symbol, until properly processed. • Eliminate hand-to-hand passing of contaminated sharp instruments. • Prohibit eating, drinking, smoking, applying cosmetics and handling contact lenses in areas where there is occupational exposure, such as the dental operatory or instrument processing areas. • E liminate the storage of food and drink in refrigerators and cabinets, on shelves or on countertops where blood or saliva may be present. • Store, transport or ship blood and saliva, as well as items contaminated with blood or saliva (extracted teeth, tissue, impressions that have not been decontaminated), in containers that are closed, prevent leakage, colored red or labeled with a biohazard symbol.3,4 OSHA’s mission is to assure safe and healthful working conditions for

all working men and women by setting and enforcing standards and by providing training, outreach, education and assistance.8 When OSHA standards are followed, job-related injuries, illnesses and fatalities decrease dramatically. At times, dental team members may complain that doing so is cumbersome, overwhelming and challenging, but OSHA has made a significant difference in a positive way. Worker deaths in America are down on average, from about 38 worker deaths a day in 1970 to 14 a day in 2017; and worker injuries and illnesses are down-from 10.9 incidents per 100 workers in 1972 to 2.8 per 100 in 2017.9 It is important for all dental healthcare workers to comply with all of the elements of the OSHA standards, and it is imperative that practice owners and management teams are committed to implementing all aspects of the OSHA standards. This is the only way to ensure that dental team members can carry out their duties safely in the practice and that the dental facility is a safe place to work and care for patients.

References:

1. U .S. Department of Labor. Occupational Safety and Health Administration. Quick Reference Guide to the Bloodborne Pathogens Standard. Available at https:// www.osha.gov/SLTC/bloodbornepathogens/bloodborne_quickref.html. Accessed May 19, 2019. 2. U .S. Department of Labor. Occupational Safety and Health Administration. OSHA Bloodborne Pathogens fact sheet. Available at https://www.osha.gov/OshDoc/ data_BloodborneFacts/bbfact01.pdf. Accessed May 19, 2019. 3. U .S. Department of Labor. Occupational Safety and Health Administration. OSHA Bloodborne Pathogens Standard. Available at https://www.osha.gov/pls/ oshaweb/owadisp.show_document?p_id=10051&p_table=STANDARDS. Accessed May 19, 2019. 4. Miller CH, Palenik CJ. Infection Control and Management of Hazardous Materials for the Dental Team. 5th ed. St. Louis: Mosby Elsevier; 2013; 247. 5. U .S. Department of Labor. Occupational Safety and Health Administration. Chemical Hazards and Toxic Substances. Available at https://www.osha.gov/SLTC/ hazardoustoxicsubstances/control.html. Accessed May 20, 2019. 6. Miller CH. RDH. Isolate or remove bloodborne pathogen hazards. Available at https://www.rdhmag.com/infection-control/sterilization/article/16405576/isolateor-remove-bloodborne-pathogen-hazards. Accessed May 20, 2019. 7. U.S. Department of Labor. Occupational Safety and Health Administration. Frequently asked questions. Available at https://www.osha.gov/needlesticks/needlefaq.html. Accessed May 20, 2019. 8. U.S. Department of Labor. Occupational Safety and Health Administration. About OSHA. Available at https://www.osha.gov/about.html. Accessed May 21, 2019. 9. U .S. Department of Labor. Occupational Safety and Health Administration. Commonly used statistics. Available at https://www.osha.gov/oshstats/commonstats. html. Accessed May 21, 2019.

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

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August 2019

PEDIATRIC DENTISTRY

Pedodontists Advanced technology, together with experience and a measure of sensitivity, enable pedodontists to provide the best possible care for their young patients.

For pediatric dentists, patient care can be a fine balance between

treating a child’s oral health and creating a safe, welcoming environment. The recommended age for a child’s first dental visit has dropped from three years to 12 months in recent years, making it more important than ever before for pedodontists to determine a treatment plan tailored to each patient’s needs.

Indeed, pedodontists must approach their patients with a unique level of clinical experience that enables them to manage each child’s behavior while also assessing his or her growth and development. “It is important that we meet each child to determine his or her needs for behavioral management, and put together a treat-

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First Impressions

ment plan that best suits that child,” says Kim Hansford, DMD, a pediatric dentist at Middletown, Kentucky-based Kid’s Dentistree, a Mortenson Dental Partners partner. “We see ourselves as primary care providers, much like pediatricians. Our goal is to provide a dental home for each child.”

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The battle against tooth decay Pediatric healthcare can be frustrating, both for parents who wish for immediate results for their children, and clinicians who are always in a position to deliver. “Dental caries is still the most prevalent childhood disease we see, even in our affluent society,” says Hansford. Most people’s diet includes processed foods, with lots of refined carbohydrates, she points out. “Even crackers break down on the teeth into simple sugars, which can cause decay. “Parents become frustrated,” she continues. They feel they are doing

everything they can to protect their child’s teeth, but to no avail, she notes. While good nutrition helps children avoid tooth decay, there often are overlooked culprits that impact oral health. Medications are a prime example, she points out. “A liquid allergy medicine taken every night by a child has sugar in it,” she says. “Gummy vitamins are made with sugar and stick to the teeth. “Grazing or snacking – and not letting the mouth have time in between snacks or drinks to normalize – can place children at high risk, due to repeated exposure. It is my job to provide parents with the tools they need to avoid these easy traps, and teach them to care for their child’s teeth at home.

changed the way I practice pediatric dentistry,” says Hansford. “In the past 20 years, this technology has allowed pedodontists to provide treatment on one whole side of the mouth safely and comfortably, with less local anesthetic than in the past when we relied more on rubber dam isolation. “Dental materials have also come far, allowing pedodontists to provide more esthetic options, in more instances than in the past. Glass ionomer restorations in children provide fluoride release, good esthetics and are more tolerant in moist environments, where perfect isolation may not be achieved. “General public awareness of the importance of early evaluation is key in helping children get established in a dental

Exceptional technology “Unfortunately, there is no magic bullet for treating children,” says Hansford, noting she makes a point to put herself in these parents’ shoes and be sensitive to their expectations. That said, pedodontists today have some exceptional technology at their disposal for treating patients, she adds. For many years, nitrous oxide has proved itself invaluable in many dental settings, but particularly in pediatric practices. “Nitrous oxide sedation contin– Kim Hansford, DMD, a pediatric dentist ues to be the safest and most predictable at Middletown, Kentucky-based Kid’s Dentistree. way to provide an easier experience for most children,” says Hansford. “We use it for patients of all ages; it can make or home and hopefully lowering their risks of oral health issues,” break a child’s experience under the right circumstances.” She Hansford continues. Children may always have caries, she advises dental professionals against using the term sedation too adds. But, with new treatments like silver diamine fluoride freely. There are a number of options for pediatric patients, and as an adjunct therapy to delay treatment, or decrease need the pedodontist can determine the best method for each patient. in times where it may not be practical due to the patient’s “Some children may do great in a pediatric dental setting without medical status or very young age, pediatric dental practices any additional medications,” she points out. should have greater opportunity to take a preventive stance Equipment such as digital imaging/radiographs are another to oral healthcare. must-have for pedodontists. “Developments in digital imaging greatly reduce children’s exposure to radiation while delivering excellent clinical X-rays,” she explains. “We make a commitment to image gently in our office.” Without radiographs, pedodontists cannot determine an exact number of • Nitrous oxide sedation cavities, she adds. “Hidden interproximal • Digital imaging/radiographs decay can be a big surprise to parents!” • Hands-free dental vacuum suction and isolation systems Hands-free dental vacuum suction and isolation systems have “totally

“ It is important that we meet each child to determine his or her needs for behavioral management, and put together a treatment plan that best suits that child.”

Must-Have Products for Pedodontists

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August 2019

PEDIATRIC DENTISTRY

Kid-friendly dentistry Treating young children requires a unique skill set.

A few generations back, the general consensus was that children should

be seen but not heard. Fortunately, by today’s standards, not only should children be seen and heard, they should be afforded the best possible healthcare, including oral care. Indeed, the recent drive to educate families on the importance of early oral care and the need to make treatment more accessible has paid off, both for pediatric patients and the pedodontists treating them.

Overall, this is great news for dental professionals, and the distributor reps calling on their offices. At the same time, many dental owners are challenged with making their waiting rooms more childfriendly, investing in newer technology and providing their teams with more and better training.

Outreach and education Rolando Mia, vice president of customer success at Zyris, has seen a definite rise in pediatric dental visits among the company’s pedodontist customers. “We believe the increasing population of children in the United States is helping fuel growth among our pediatric customers,

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First Impressions

many who are expanding – adding operatories, personnel and even offices,” he says. “We also hear that more families are realizing the importance of bringing their children to the dentists’ office; This is reinforced by our pediatric and community health center customers via additional and ongoing educational programs, as well as dental education outreach in their local communities. For instance, many dentists today offer on-site visits to schools and provide free dental packs (e.g., toothbrushes, toothpaste, floss, etc.) for the children. “It appears that more children and their families are taking advantage of insurance coverage, as well as special

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pediatric-focused dental outreach programs for preventative dental care, (e.g., the American Dental Foundation’s Give Kids a Smile, America’s Tooth Fairy, etc.),” he continues. “It’s been especially helpful as dental associations have come together to develop a successful ad council awareness campaign promoting the importance of managing children’s oral hygiene (e.g., 2 Min – 2X/Day, which involves brushing one’s teeth for 2 minutes, twice daily). As a result, more children are receiving higher quality oral healthcare today.”

Addressing the need As more and more children are scheduled for dental visits, pedodontists and general dentists who perform basic pediatric care (e.g., checkups and cleaning, preventive care, caries treatment, sealants, education, etc.) are tasked with adopting new technology, remodeling their waiting rooms and offering reward programs to motivate their younger patients. “We’ve observed that many of our customers recognize the need to make their offices an inviting, fun and safe place for children to visit,” Mia points out, noting it is common for dentists to rely on themes to make their offices less intimidating. So, for instance, the office may feature a beach theme or a tropical, jungle, ocean or zoo theme. It’s also becoming more common to have digital or board games available in the waiting room, children’s programming playing on a television and interactive iPads available in waiting rooms, operatories and recovery rooms. Some practices have begun sponsoring special events, such as field trips to the dental office to give children the opportunity to use the instruments, see the operatories and learn about dentistry, he adds. “We also see different engagement and reward systems for children who are

successfully performing preventative oral care, such as the Brush DJ app, a nocavity club or movie passes, awards or toys,” says Mia. Not surprisingly, with an increase in patient visits comes a handful of administrative responsibilities, including recruiting qualified doctors and staff, managing the business and working with parents and caregivers – some who can be overbearing! “Pediatric dentists must be effective in consistently managing issues related to profitability, staffing, expense control, maintaining a high quality of care and managing the team,” says Mia. And, it’s not always easy to secure qualified or experienced dentists, he adds. Many dental school graduates are opting to join DSOs over solo practices. “In addition, we’ve learned from working with our pediatric customers there is a special patience and focus required to work with children,” he points out. “There is a level of communication and patience required to be effective with children, and not all doctors and clinicians have the capacity or talent to do so. “Children are especially difficult to treat due to their decreased understanding of the procedure, short attention span and smaller mouth,” he continues. “Pediatric dentists have a small window of opportunity to treat a child before the patient becomes tired, distracted or simply upset during the procedure.” Sometimes, it’s a matter of working with a difficult parent or caregiver, he notes. “We continually hear that parents can make or break a dental procedure visit. When parents do not cooperate, or they feel compelled to question everything a clinician is doing, we’ve been told this can upset the child and compromise the clinician’s ability to effectively treat the patient. In addition, children key off their parents/ caregivers during a procedure. If a parent is nervous, impatient, fearful, etc., the effect on the child can be negative.

Upgrades “As technology and materials continue to improve, procedures are easier and quicker to perform,” says Mia. That said, incorporating and using new technology, equipment and materials can be challenging, he adds. “We’ve been told the proliferation of computer and digital systems is especially daunting. The challenge is to find clinicians, hygienists and dental assistants with the skills and ability to operate and use these systems once they are trained.” Examples of newer pediatric technology includes silver diamine fluoride (SDF) for

Naturally, there’s a learning curve involved and it takes time for clinicians to become comfortable using new technology. The dental team must also keep up with software updates and on-going training and support. “It requires a dedicated effort, and when technology is set aside and forgotten, it’s a wasted investment.”

Training and education Even as dental care becomes more accessible to many children, some community health clinics continue to face a huge patient backlog, notes Mia. “According to one com-

“ As technology and materials continue to improve, procedures are easier and quicker to perform. The challenge is to find clinicians, hygienists and dental assistants with the skills and ability to operate and use these systems once they are trained.” – Rolando Mia, vice president of customer success at Zyris

caries prevention and treatment, digital Xrays, digital and laser cavity detection devices and aids, hard and soft tissue laser designed to painlessly treat cavities and decay, CAD/CAM impression technology, painless injection systems and improved isolation and retraction devices, such as the Isolite System. At the same time, pediatric dentists today must be comfortable with sedation dentistry, which is now used more routinely. “We’ve heard a number of concerns from our dental customers regarding these newer technologies,” says Mia. For one, there’s an ongoing cost involved in adopting new technology, some of which may quickly become obsolete as next generation systems become available. “Our customers also tell us that new technology can be disruptive to clinicians,” he says.

munity health clinic we work with, some pediatric patients have wait times of one to two years to be seen by a clinician,” he says. “The majority of recent dental school graduates are trained to perform procedures primarily on adults,” he explains. “They often have limited education or expertise when it comes to working with younger children. “Pedodontists must participate in a graduate education program that is focused specifically on treating and managing younger children,” says Mia, noting this requires a much different skill set from working with adult patients. “When a child is experiencing more complex oral health issues or severe conditions, it is imperative that he or she is treated by a specialist – one that is specifically educated and experienced in treating young children and special needs patients.”

https://www.childstats.gov/americaschildren/tables/pop1.asp • https://www.childtrends.org/indicators/number-of-children

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August 2019

QUICKBYTES

Editor’s Note: Technology is playing an increasing role in the day-to-day business of sales reps. In this department, First Impressions will profile the latest developments in software and gadgets that reps can use for work and play.

Technology News Where have all the tablets gone?

PowerPoint critiques your PowerPoint

Google’s reported decision to abandon tablets came as no surprise to those in the industry, reports Venture Beat. “Tablets are dying a slow death anyway,” they write. Tablets did not end up delivering as promised. The form factor never took off like smartphones, and it never replaced computers. In fact, the tablet market peaked at the end of 2014 and has been shrinking

Microsoft has launched a number of updates and new features to help you improve your PowerPoint presentations, reports TechCrunch. In fact, PowerPoint will even critique your presentation. Presenter Coach for PowerPoint is a new AI tool that offers feedback while you’re practicing your presentation in front of your computer. It’ll tell you about your

ideas, which automatically recommends photos, styles and colors as you write your presentation.

iPhone repairs at Best Buy Apple Inc. and Best Buy Co. announced this summer that they have extended a partnership that will allow the Minneapolis-based retailer’s technicians to fix iPhones at any Best Buy store in the United States, reports Reuters. The deal will cover all 992 U.S. Best Buy stores, up from about 225 stores previously. In addition, 7,600 of Best Buy’s so-called Geek Squad technicians are now certified to carry out the repairs using parts directly from Apple. Apple says that it now has 1,800 thirdparty repair providers in its U.S. network – three times as many as three years ago and enough to put eight out of 10 of its customers in the United States within a 20-minute drive of an authorized repair center.

Are you ready for some Folding?

ever since. And yes, the PC market has also been declining, but it’s much, much larger. The tablet as we know it is going to disappear. The market won’t keep shrinking into oblivion, but the slate form factor will get squeezed out. It’s already happening. Smartphone screens have grown to make 7-inch tablets obsolete while laptops have gained touchscreens and removable screens. [Note: Google’s decision does not affect its Pixel phones or Pixel computers, such as the Pixelbook.]

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pacing, whether you are using inclusive language, and how many filler words you use. It also makes sure you’re not just reading your slides. After your rehearsal session, PowerPoint will show you a dashboard with a summary of your performance and what to focus on to improve your skills. This feature will first come to PowerPoint on the web and then later to the Office 365 desktop version. As for the visual design, Microsoft has added new features like Designer theme

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At press time, Samsung Electronics was rumored to be ready to launch the Galaxy Fold, its foldable smartphone whose introduction was delayed earlier in the year, reports The Investor. Reviewers had complained about flickering screens and creases in the middle of the screen after repeated folds. “Most of the display problems have been ironed out, and the Galaxy Fold is ready to hit the market,” Samsung Display Vice President Kim Seong-cheol was quoted as saying this summer. Made from bonded layers of polymer material, the 7.3-inch Infinity Flex Display is engineered to be 50% thinner than other Galaxy displays, according to Samsung.

TECH TALK

Handpieces Dental professionals today have more – and better – handpiece options.

Handpiece technology has gone through a number of changes in recent years. As a result, clinicians today can select from highly efficient, easyto-use models in a variety of styles. Some of the most popular handpieces on the market include electric torque-controlled and air-driven handpieces. High-speed dental handpieces, used in conjunction with friction grip carbide burs, utilize high RPMs for cavity excavation, margin creation and more. They have a small head size ensuring greater access and visibility of the oral cavity. High-speed air-powered handpieces provide steady and consistent drilling while minimizing noise similar to that of an electric handpiece. The cost of a handpiece may range from a couple of hundred dollars to as much as $1,500. Not every practice requires the most expensive unit. Nevertheless, your customers must keep in mind that spending less up front may result in sacrifices down the road. Lowend handpieces are sometimes louder, which can be distracting to patients and staff. They may be heavier, less ergonomic and unwieldy to use. In addition, they may generate less power, the turbine may not last as long and the warranty may not be as comprehensive as that of higher end handpieces.

Proper care and maintenance Given the variety of handpieces on the market, numerous variables can impact their longevity. That said, with proper

maintenance and sterilization, most handpieces last for as many as 500 cycles of use/sterilization. Indicators that a handpiece must be repaired include a high, shrill, grinding noise; worn out bearings; improper rotation; and excessive heat and/or moisture. When the handpiece no longer runs at full capacity or optimal speed, it’s most likely time to replace it with a new unit. The dental practice should purchase a maintenance kit with its new handpiece, which can aid with troubleshooting when small issues arise. Having extra turbines on hand can help prevent downtime when they must be replaced.

Probing sales questions When dental customers are ready to purchase a new handpiece, sales reps

can determine the solution that best meets the needs of the practice by asking a few probing questions: • “Doctor, what features are you looking for?” • “Is power important to you?” • “Would you like the ability to change your own turbine in your office? This will help limit the downtime of your handpiece from a few days to a couple of hours.” • “Can I walk you through the sterilization process for a few types of handpieces? That way, you can decide which handpiece would be most practical for your office.” Some dentists might be surprised at the cost of a new handpiece, or they may object to the maintenance required on new units. Remind your dental customers that investing in new handpiece technology is one of the easiest ways to ensure their dental practice remains competitive and a leader in the community. Indeed, handpiece technology is expected to continue to advance at a rapid pace. A single purchase can yield a huge return on investment for years to come.

Editor’s note: First Impressions would like to thank DentalEZ for its assistance with this piece.

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Manufacturer Reps to Watch Manufacturer reps value their relationship with their distributor rep partners.

Whether they are responding to your call ASAP or

overnighting product samples to ensure you have them for an important sales meeting, your manufacturer rep partners have your back. They respect you and want you to succeed. When they think of their distributor sales rep partners, they feel a sense of commitment, loyalty and, when something needs to be addressed, a sense of urgency. But, you already know that! Following are examples of this year’s finest: seven manufacturer reps who work hard seven days a week to bring value-added solutions to dental professionals. If they agree on one thing, it’s that distributor sales reps are key to a successful sale, as well as a proficient dental practice. Here’s what they have to say:

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Meeting of the Minds Ansell Healthcare distribution sales manager, alternate care, Tony Holm appreciates the insight he gains from his distributor reps.

For seven years, Ansell Healthcare distribution sales manager, alternate care, Tony Holm has learned the glove market inside and out. In 2012, he joined Microflex, which was acquired by Ansell Healthcare two years later. For the last year and a half, he has focused solely on the dental glove market. Not only has Holm worked hard to understand and service his dental customers’ needs, he also has made it a point to see the sales process from the perspective of his distributor rep partners. “For starters, I try to understand my distributor sales reps as people,” he explains. “I look at what motivates them, including their relationships with our customers and the challenges they encounter. Then I ask how can I help. “Additionally, I try to give my distributor sales reps clear insight into how our business is performing,” Holm continues. “I am a fairly analytical person, so I like to give them a clear vision of their book of business, including how it currently looks and any potential for growth moving forward.” That said, he knows very well that distributor reps manage an incredibly robust portfolio. “So, I try to truly focus on just a couple of items that can help them be successful,” he adds. “The distributor reps know their customers better than I ever could,” says Holm. “On average, they are meeting with each of their dental practices two or three times each month. As a manufacturer

have especially helped him develop a greater insight into the dental glove market. “I am considered an expert on our glove product line,” he points out. “But, the distributor sales reps are experts on the dental market at large and they understand the dynamics within the industry.”

“I am a fairly analytical person, so I like to give them a clear vision of their book of business, including how it currently looks and any potential for growth moving forward.”

Tony Holm

rep with Ansell Healthcare, I cover roughly a third of the country. My distributor reps have a much deeper reach into our customer base. They are able to teach me about customer needs or trends, which I may not be privy to, and which I can then translate more broadly across the country.” Opportunities such as ride-days, which enable Holm to spend additional facetime with his distributor sales reps,

Moving forward, Holm anticipates continued consolidation in the dental industry, from both a practice and manufacturing standpoint. “The advantages of group purchasing power will continue to expedite the shift away from independent practices,” he says. “At the same time, the high-performing economy will allow large companies to continue a strong focus on mergers and acquisitions.”

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August 2019

MANUFACTURER REPS TO WATCH

Building Trust Crosstex regional sales representative Anne Tagye makes it a point to help her distributor sales rep colleagues understand the value of the products she sells.

Anne Tagye, regional sales representative, Crosstex, A Cantel Medical Company, may be relatively new to the dental sales industry, but not to dentistry itself. “I grew up in a family of dental professionals and sales reps, and I’ve always known I would one day work as a dental products sales rep,” she says. “When I accepted my first sales position at Crosstex in 2018, I knew it was a perfect fit for me. I’ve been following my passion – dental products sales – ever since.” 36

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Anne Tagye

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Tagye knows that without a thorough understanding of the products they sell, sales reps can’t convey the value to their dental customers. As such, she is committed to keeping her distributor rep partners informed and making herself available when they reach out with questions or concerns. “Distributor reps have a lot on their plate; they must be experts on thousands of products,” she explains. “For reps to enhance their sales, they must be knowledgeable and confident about what they are selling, especially when they are asked product-specific

“Ultimately, I want to make sure my distributor reps feel they can depend on me to get things done.” Tagye has found that strong communications and pre-call planning are particularly helpful in building a trusting relationship with her distributor reps, as well as adding value to their sales calls. “My distributor reps often let their dental customers know ahead of time that I’ll join them on a co-travel, so the offices expect me,” she says. “Even more importantly, my reps let me know ahead of time the products

infection control, it’s important that sales reps are in a position to address this, she adds. That said, spending time with her distributor rep colleagues can be a lot of fun, notes Tagye. “One of my distributor reps once unexpectedly pulled into a parking lot and asked me to stand on my car and pick her some fresh fruit and avocados from the trees! We could not stop laughing!” And, it turned out to be a very productive sales day, she recalls. “Being committed and working together is the key!”

Tagye has found that strong communications and pre-call planning are particularly helpful in building a trusting relationship with her distributor reps, as well as adding value to their sales calls. questions. Therefore, my commitment as a manufacturer rep is to make sure that all of my distributor reps understand the value of the products I am selling. If I can help them bring that value to their offices, this will help boost their sales.” In addition, she makes it a point to be available when her distributor reps need her. “When my reps need something from me, I always make sure to respond in a timely manner. If they need me to get something done, I do so quickly. My goal is to take some of the stress off the reps to help them stay focused on boosting their sales.” When dental customers have a positive experience with their distributor sales rep, they come to trust him or her, which helps enhance sales, she adds.

that the offices are currently using or not using, which helps me plan ahead. This way, when I go into an office, they have a general idea of what I am going talk about, and they are more eager to listen. In general, offices are extremely busy and appreciate the heads up, which helps build trust and value in a rep/office relationship. “I see so much value in co-traveling and spending time with my distributor reps,” Tagye continues. “These are perfect opportunities for me to educate both my reps and their offices. When the reps hear me speak about my products, they can absorb the information and feel more confident speaking about them on their own.” Especially given the many concerns clinicians have regarding

Looking ahead, Tagye anticipates that dental customers will do more online ordering. “It’s similar to what is going on with the rest of the world,” she says. “Dental professionals are trying to simplify matters by using technology. Amazon has made online ordering easier than ever before, and I think that’s the direction many industries are going to take.” That’s not to say that sales reps won’t continue to play an important role, she says. “No one can bring more value to an office than a sales rep can,” she points out. And if reps continue to add value to dental offices, online ordering may actually help make their jobs easier, without diminishing their importance, she adds.

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MANUFACTURER REPS TO WATCH

Teamwork Skip Ellender, a PSA sales rep who represents DentalEZ Integrated Solutions, believes in true partnerships based on communication and trust.

Since joining the dental industry 15 years ago, Skip Ellender, a PSA sales

rep who represents DentalEZ Integrated Solutions, has learned that distributor and manufacturer sales reps provide the greatest value to their customers when they support one another. “By truly partnering and working together, we can create a true team environment,” he says. Not only do he and his distributor rep colleagues provide their dental customers with great sales solutions, they can offer total support for the practice, he points out. “But to do so, my distributor sales reps must be able to trust they can rely on me to deliver vital information and provide professional support to their customers,” he adds.

“I really enjoy spending time with my distributor sales rep colleagues,” he continues. “Our time together helps us cultivate some great working relationships, as well as build mutual trust, create friendships and become better educated about our products.” Although no one particular ride-day stands out in his memory, he favors those that require him and his

lines and to respond as quickly as possible when providing information and answers to my distributor sales reps’ questions.” In fact, it’s extremely important for manufacturer reps to be continuously accessible to the distributor sales reps who depend on them, he points out.

“Having studied biology and chemistry in college, I knew for a long time that I wanted to work in the dental or medical fields.”

Ellender began working in the dental industry in 2004, later joining PSA in 2013. “Having studied biology and chemistry in college, I knew for a long time that I wanted to work in the dental or medical fields,” he says. “Today my goal is to be as knowledgeable as I can about my product

distributor sales reps to problem solve and discover new solutions for their dental customers. “It’s especially rewarding when we visit a practice to solve one problem and end up uncovering and solving additional problems, as well,” he says. “And, as much as I enjoy educating my distributor sales reps and sharing new problem-solving skills with them, I also value opportunities to learn from them,” he adds. In years to come, Ellender believes the Internet, along with evolving technologies, will continue to give dental professionals easier access to products, including the ability to research products on their own. “If distributor and manufacturer reps want to stay relevant, they must discover more creative ways than price alone to bring value to their doctors,” he says.

Skip Ellender

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Count on Me GOJO Healthcare Sales Director Mike Otten lets his distributor reps know they can rely on him.

After 15 years of healthcare sales experience – the last year-and-a half with GOJO Healthcare – sales director Mike Otten continues to depend on his distributor sales rep partners every day. “Distributor sales reps are the key to sales on many levels,” he says. Their constant contact with dental customers makes them “the eyes and ears” for manufacturer reps, he points out. “They provide us with contact information, current product information and usage at the facility levels. Their relationships with the end user personnel provides us with the ability to get in front of the appropriate decision makers to present our products. And they have the ability to present our products when we cannot be present, thereby providing another avenue for us to expand our sales reach.” All that said, Otten knows very well that a successful distributor/manufacturer rep team is based on communication and trust. “I believe the way to build trust with my partners is to do what I say I’m going to do,” he explains. “My distributor reps need to know they can rely on me to get things done.” If for some reason that’s not possible, he’s up front about it, he adds. “One of the most important things I can do for my distributor sales reps is to provide continuous support by sharing information (i.e., product samples, literature and clinical data), providing training or by responding to their emails and phone calls in a timely fashion. “My main objective has always been to make it easy for the distributor reps to sell our products,” he continues. “That means, I am always there to support them and the products. If they have issues, concerns or needs, I am available to handle the situation.” Ride-days have proven to be one of the best ways for Otten to truly get to know his distributor sales rep partners. “Spending time with my distributor sales

Mike Otten

reps is a value on many fronts,” he says. “Just being with them and getting to know them personally helps me build a relationship with them. After all, the better you know someone, the more likely they are to work with you and trust you. “It is great to be able to see what the distributor sales reps do on a daily basis,” Otten continues. “We often don’t realize all of the different tasks they have to accomplish with each customer. By understanding how they navigate all the different aspects of their job, I can develop a plan to make it easier for them to sell our products. In addition, being fairly new to the dental market, I can learn from their end-user accounts about what may work best for them in their facility. As such, I can make modifications to our portfolio or to the solutions GOJO can provide for them.” Looking ahead, Otten foresees a change in contract pricing. “As dental service organizations (DSOs) and larger companies consolidate dental practices, the contract pricing aspect of the business will likely expand,” he explains, leading to more standardized purchasing and formulary creations in the dental market.

“ One of the most important things I can do for my distributor sales reps is to provide continuous support by sharing information (i.e., product samples, literature and clinical data), providing training or by responding to their emails and phone calls in a timely fashion.” www.firstimpressionsmag.com

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MANUFACTURER REPS TO WATCH

Communicate, Collaborate, Commit Ivoclar Vivadent territory sales manager Sergio J. Guzman, Phd, knows a strong manufacturer/distributor rep relationship keeps both of them at the top of their game.

For many years, Ivoclar Vivadent territory sales manager Sergio J. Guz-

man, Phd, enjoyed a career in the financial service industry. But, when the economy began to waiver in the late-2000s, it forced him to re-think his goals. “I suppose you can say I had a spiritual awakening, which led me to make some changes,” he recalls. He wanted to do something that allowed him to make a positive contribution to others, and in 2010 he joined Ivoclar Vivadent, Inc.

It didn’t take Guzman long to recognize the value of a strong distributor repmanufacturer rep relationship. Early on, he focused on supporting his distributor rep partners through strong communication, true collaboration and genuine commitment. “By communication, I mean much more than simply sending and receiving data,” he explains. “It’s important to communicate with a mindset of teaching and learning.” As such, he aims to teach his distributor reps by becoming a subject matter expert, not only on his own company’s products, but on the competition’s products as well. And, he learns by being an active listener, truly understanding the needs of both his distributor reps and their dental customers. Good communication about products leads to collaboration, and it is the key to building trust, according to Guzman. “Good communication draws out the ability to bridge the gap to building trust,” he says. “Building this trust has evolved by knowing the customer and adapting my work style to the other person.” Forging great partnerships makes it possible “to get to the top of our game,”

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Sergio J. Guzman, Phd

he says, adding that he and his distributor reps work hard and play hard. While he relies on ride-days to familiarize himself with his distributor reps’ workstyles and understand their needs, he also regards them as an opportunity to continue building a partnership built on trust. “This trust has led to what I call a warm transfer,” he says. “When my distributor reps have an issue

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or opportunity, they often ask me to speak to the doctor directly. The warm transfer occurs when the two of us have a dialogue with our mutual customers to learn what their challenges are and how we, as a team, can help them address their challenges.” Nor is it uncommon for Guzman and his distributor reps to share a laugh along the way. Take the time they pulled into a gas station and noticed someone attempting to gas up a Tesla. “It was funny watching this person look for a gas tank valve,” he admits. “Yes, we did remind the driver it was an electric car!” Looking ahead, Guzman anticipates a few changes in dental products sales. For one, he expects more dentists will purchase their dental supplies online. In addition, he foresees the growth of dental service organizations (DSOs) as more investors focus on the business side of dentistry, and he notes that female dental graduates will continue to outpace males. Finally, he foresees data analytics fueling predictive modeling of dental professionals’ purchasing behavior. “Informative attributes will help businesses achieve a competitive advantage with the science of data,” he says. As the industry evolves, Guzman stays focused on what’s important: How will manufacturers and distributors respond to this new world, and how will sales reps continue to deliver value to their dental customers.

Value-add Midmark territory sales manager Zach Wehner goes the extra mile for his distributor reps.

After 15 years in dental sales – the past six which have been with Midmark – territory sales manager Zach Wehner still finds he has much to learn from his distributor sales rep colleagues. For one, their multi-product oversight provides them with a diverse industry perspective, he notes. “I get a lot of insight into what is happening within the market from my distributor reps,” he says. “They are on the front lines and can see what the trends are with regard to customers, equipment and more. This helps me determine how to approach our customers and position my products.” At the same time, Wehner goes above and beyond to enhance his distributor reps’ sales as well. “I make it a point to be easy for my distributor reps to get hold of,” he says. “I’ve worked on the distributor side in the past and know very well how frustrating it can be when you can’t get in touch with your manufacturer

Zach Wehner

partners.” Additionally, whenever he has an opportunity to interact with his reps, he tries to leave them with new insights, which may help them better service their dental customers, he points out. Ride-days can be an especially valuable way to become better acquainted with distributor reps, notes Wehner. “The

best thing about ride days is that they’re an opportunity to get to know your distributor rep on a personal level,” he says. “I’ve developed several great friendships that have started with a ride day.” In fact, a few ride-days have led to opportunities to complete a fulloffice project, he adds – opportunities that have come about when he and his distributor reps have worked together to ask the right questions and really understand their customers’ needs.

“I’ve worked on the distributor side in the past and know very well how frustrating it can be when you can’t get in touch with your manufacturer partners.” In Wehner’s experience, technology has been – and will continue to be – a huge industry driver. “I expect technology will continue to drive change, from the way our customers select and purchase their supplies and products, to the types of products they buy,” he says.

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August 2019

MANUFACTURER REPS TO WATCH

Service Over Price Carl Burton, co-owner, Independent Dental Sales, and his colleague, Mary Fadhl, do everything in their power to support their dealer reps.

When Carl Burton, co-owner, Independent Dental Sales, who represents Preventech, joined the dental products industry six years ago, he was confident it would be a great fit for him. He had just left the military and was questioning his next steps. A number of family members â&#x20AC;&#x201C; including several cousins and his mother â&#x20AC;&#x201C; enjoyed careers in dental. He was attracted to the challenges sales reps often encounter, as well as the camaraderie they find along the way.

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Carl Burton

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Indeed, Burton has not been disappointed. “I have never had a dull day!” he says. “I am always excited to see what challenges each day will bring.” Together, with his colleague Mary Fadhl, he evaluates new technologies that have the potential to help his dental customers provide better patient care. “When taking on a new product line, Mary and I ask ourselves how well it will fit into our wheelhouse, and how it will complement our current lines,” he explains. “For instance, we have been pursuing infection control products, as this area is a hot topic in dentistry and an opportunity for us – and our dental customers – to succeed.” Yet, no matter how flashy new technology is, “if a product doesn’t fit into our overall strategy or enhance our current product lines, it will be challenging to succeed,” he adds. “We must have a vision of where we want to take a product and how we can get there.” That said, Burton knows that without a strong partnership with his distributor sales reps, “getting there” will be that much harder. So, he and Fadhl do everything in their power to support the relationship. “Distributor sales reps depend on us to respond quickly,” he says. “Whether they need us to assist with a physical demo or provide a product sample, speed is of the essence. Because Mary and I work together, we can provide office demos more quickly than many others. And a few years ago, Mary and I began overnighting product samples our distributor reps requested. The cost has been minimal and doing so has helped enhance their image and make them look good in the eyes of their dental customers.” In addition, Burton and Fadhl make it a point to respond quickly to complaints. “If something doesn’t go as smoothly as planned, we must do all we can to achieve customer satisfaction,” says Burton. “Our manufacturer partners

must be confident we are safeguarding their business, and our dealer reps must have faith we will make it right.” And his distributor sales reps return that support every day, notes Burton. “As an independent rep, I must know both my own product lines as well as those of our competition,” he says. “Our dealer reps are aware of trends. They know what the most popular products in every category are, as well as why they’re popular and successful. They

nervous, so I sometimes bring some pre-made cold calling bags filled with disposable dental product samples and candy to break the ice,” he says. “I let my rookie distributor reps know I support them – that everyone was new at one time, so there’s no judgment on my part.” This creative approach helps build trust and create loyalty, he adds. In fact, one of his best memories is from his own rookie days. “My distributor rep, Nick, and I had both been in the industry

“ Our manufacturer partners must be confident we are safeguarding their business, and our dealer reps must have faith we will make it right.” also have deep relationships with their dental customers. When our distributor sales reps make an introduction, the sales process is inevitably smoother. “I love co-travel dates with our distributor sales reps,” Burton continues. “Senior dealer representatives are always a joy to work with. They have good relationships with their doctors, so it’s fun to listen to the way the business has evolved. They can teach us more about the industry overall, which has made me a better sales rep, even when it hasn’t involved a direct sale.” And the closer they work together, the better he and Fadhl can support their distributors’ relationships with their dental customers, he adds. Of course, Burton finds it equally rewarding to spend time with newer distributor sales reps. “They’re often

for less than six months and had no idea what to expect on a full day of co-travel. We were used to working with senior sales people who seemed to know everything! “We ended up on the steps of an abandoned church, eating hot dogs and talking about what was and was not working,” he continues. Days like those were extremely nerve-wracking, and a little scary, but they really helped build our confidence.” Burton anticipates the road ahead may be challenging for sales reps, particularly as dentists do more online ordering. With his distributor sales rep partners, however, he will continue to offer the value that can only be achieved by a face-to-face sales call. “It’s never worth sacrificing service for price,” he says.

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First Impressions

August 2019

NEWS

Industry News Henry Schein Dental hosts national sales meeting Henry Schein Dental, the U.S. dental business of Henry Schein, Inc. (Nasdaq: HSIC), hosted its 24th annual National Sales Meeting at the Gaylord Rockies Resort & Convention Center in Aurora, Colorado. The Meeting brought together more than 1,700 attendees, including Team Schein Members (TSMs) and supplier partners who exhibited their products and solutions to the sales team, according to a release. The theme of this year’s meeting was “The Extra Mile.” Stanley M. Bergman, Chairman of the Board and Chief Executive Officer, and Jimmy Breslawski, Vice Chairman of the Board opened the meeting with a corporate overview, highlighting the successes of the past year and reviewing Company strategy. Following the corporate overview, Jon Koch, Senior Vice President and Chief Executive Officer, Global Dental Group, AJ Caffentzis, President, North American Dental Group, Tim Sullivan, Executive Advisor, Global Dental Group, and Dave

August 2019

First Impressions

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Steck, Vice President and General Manager, Dental Sales, led presentations that motivated the team to go the ‘extra mile’ in helping customers adapt to the pace of change accelerating in today’s dental marketplace, while also helping to advance their efforts in delivering high-quality patient care. “The National Sales Meeting is a dedicated time for Team Schein and our supplier partners to come together and harness the skills needed to go the extra mile for our customers,” said Mr. Caffentzis. “Through presentations and breakout sessions, sales consultants receive the necessary education and encouragement to thrive in this time of transformation, while still upholding Henry Schein’s firm belief that relationships and trust are the foundation of customer care.” Mr. Koch’s and Mr. Caffentzis’ presentations about the importance of culture, working as a team, and managing change were further enforced by motivational breakout sessions that covered various topics, from learning about the latest equipment and technology to implementing best practices as a trusted advisor to practitioners. Mr. Sullivan and Mr. Steck built on this momentum during their presentations, encouraging the team to celebrate their successes and embrace new challenges to strengthen their collective ability to enable customer success. During the meeting, awards recognizing 2019’s top performing TSMs in the following categories were presented: Total Solution Provider, Rookie of the Year, Henry Schein Financial Services “Big Kahuna,” Henry Schein Cares, Field Leadership, Region of Excellence, and the McHugh Award. For the second year in a row, Dental TSMs also participated in the We Care Global Challenge, a company-wide initiative in which TSMs at 15 Company locations in four countries assemble comfort kits for people fighting cancer around the world. At the Dental National Sales Meeting, nearly 5,000 kits were assembled to support the American Cancer Society’s Hope Lodge program. These kits will then be distributed to over 30 Hope Lodge locations throughout the U.S. Each Hope Lodge offers cancer patients and their caregivers a free place to stay when their best hope for effective treatment may be in another city. Partnering with Heart to Heart International – to handle the logistics of the We Care Global Challenge kit building events and management of all shipments of the completed kits – the Challenge embodies the Henry Schein Cares mission to “help health happen” for people living in underserved, at-risk, and remote communities.

Solmetex names Bill Gerety as VP of marketing & customer experience Solmetex, LLC announced that Bill Gerety has been named as vice president of marketing & customer experience, a new position at Solmetex, reporting directly to President, Kevin Danahy. Gerety most recently served as VP of marketing at Sirtex Medical Limited. Gerety brings more than 20 years of senior management experience in marketing and sales in the life sciences, consumer packaged goods and financial service industries.

for leading the company’s go-to-market strategy in North America “to provide innovative solutions and clinical education supporting dental professionals and improving patient outcomes,” the company said. In this role, he will be focused on providing strategic direction and driving sales force effectiveness with a strong focus on customers across North America. Bruno most recently was general manager for Vision Care at Alcon/Novartis.

Share Moving Media announces new VP of sales

Dental Health Products acquires Southwest Medical and Dental

Share Moving Media (SMM) announced that Katie Educate has joined the company as vice president of sales. In this role, Educate will oversee the sales teams for both the Medical and Dental divisions. Educate most recently was director of sales for Health Connect Partners, and is returning Katie Educate to SMM following a three-year hiatus. Scott Adams, managing partner for SMM, said, “Katie was an amazing salesperson and very successful in her previous roles with us, selling everything from the MAX to our magazines. We are thrilled she will be returning to lead our sales team and help achieve SMM’s vision and mission.”

Dental Health Products, Inc. (“DHPI”), announced the acquisition of Southwest Medical and Dental, Inc. (“SWMD”). SWMD is a leading equipment supplier to the oral surgery and general dental markets. Based in Dallas, Texas, SWMD will continue to operate as a separate division under DHPI. The location will also serve as DHPI’s 8th fullservice branch. The SWMD oral surgery business unit will service clients nationwide and the DHPI general dental unit will service the Dallas Metroplex and the region. “We are incredibly proud and fortunate to lead SWMD into its next phase of expansion. Having SWMD in our portfolio allows us to grow our oral surgery lines as well as open a new branch location in Dallas. The opening of our newest branch further strengthens DHPI’s position as an industry leader and ensures that our clients will continue to have expanded access to the industry’s top dental supplies, equipment and technology solutions”, said Steve Desautel, DHPI’s vice president of sales and marketing.

Dentsply Sirona names new SVP of North America Regional Commercial Organization Dentsply Sirona named Eric Bruno as SVP of the North America Regional Commercial Organization. He is responsible

Burkhart Dental Supply New Appointees Krisi L. Barker, Account Manager Burkhart welcomes Krisi Barker to its Oklahoma City office. Barker has over 12 years of experience in the dental industry. Prior to joining Burkhart, Barker was a Territory Representative for Benco Dental. She graduated from the University of Central Oklahoma with a bachelor of science degree in organizational leadership.

Randi R. Miller, Account Manager Randi Miller joins Burkhart’s St. Louis, Missouri team with 24 years of dental industry experience. Most recently, she was a Territory Representative with Benco Dental. Miller graduated from Southern Illinois University with a bachelor of science in dental hygiene.

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Michael J. Mulligan, Account Manager Working out of Kansas City, Kansas, Michael Mulligan joins Burkhart’s Oklahoma City branch. He brings 18 years of dental experience to Burkhart. Previously, he was an Equipment Specialist with Benco Dental. Mulligan is a graduate of Washburn University with a bachelor’s degree in business administration. First Impressions

August 2019

NEWS

Benco Dental New Appointees Dan Anderson, Territory Representative Benco Dental welcomes Dan Anderson to the Derby region. Anderson earned a bachelor’s degree in marketing from Purdue University. Dan brings 19 years of dental industry experience to the Benco family. Paul Costello, Territory Representative The Benco team in the New England region is pleased to welcome Paul Costello. Costello earned a degree in History from Providence College. Paul brings nine years of sales experience to Benco. Abbey Fiser, Territory Representative The Benco team in the Dallas region welcomes Abbey Fiser. Fiser earned a bachelor’s degree in communication studies from Kansas State University. Abbey brings two years of sales experience to customers in her region. Shantelle Hayes, Territory Representative Shantelle Hayes joins Benco Dental in the Great Lakes region. Hayes studied at Aquinas College. A Certified Dental Assistant for more than 11 years, she brings her experience to Benco Dental. Alec J. Jarvis, Territory Representative Benco Dental is pleased to welcome Alec J. Jarvis to the Lakeside Region. Lexi Latham, Territory Representative The Benco Dental team in the Desert region is pleased to welcome Lexi Latham. Latham attended Sheridan College and the University of Wyoming. The Registered Dental Hygienist brings 14 years of experience to Benco. Rob Martinez, Territory Representative Rob Martinez joins Benco in the Dallas region. Martinez brings 25 years of sales and dental experience to the customers in his region.

August 2019

First Impressions

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Stephen Morrison, Territory Representative Stephen Morrison joins Benco Dental in the New England region. Morrison received a degree in History from Assumption College. He brings 14 years of sales and management experience to Benco. Bob Pattillo, Territory Representative Bob Pattillo joins Benco Dental in the Cascade region. Pattillo brings 28 years of experience to the customers in his region, including three as an Equipment Specialist with Benco Dental. Matt Scheer, Regional Manager Matt Scheer joins Benco as a Manager in the Cascade region. Scheer earned a bachelor’s degree in architectural engineering from the University of Wyoming. He brings 23 years of sales and management experience to the Benco team. Stacy Tolas, Territory Representative Benco Dental welcomes Stacy Tolas to the Liberty region. Tolas earned a degree in dental hygiene from the New York College of Dentistry and a degree in Education/School Counseling from Alfred University. The Registered Dental Hygienist brings 12 years of experience to the customers in her region. Terre Trottier, Territory Representative Benco Dental is pleased to welcome Terre Trottier in the Dallas region. Trottier brings 10 years of industry experience to Benco customers, including eight as a Territory Rep with Benco Dental. Jamie Wiles, Territory Representative Jamie Wiles joins Benco Dental in the Trailblazer region. Wiles brings seven years of dental industry experience to Benco Dental. Jordan Young, Territory Representative Benco welcomes Jordan Young to the Gateway region. Young earned a bachelor’s degree in biology from the University of Missouri. Jordan brings six years of sales and dental experience to Benco Dental.

Henry Schein New Appointees Mairead Ellis, Field Sales Consultant Mairead will be representing Henry Schein Dental in the Charlotte center and Columbia, South Carolina territory. She has 10 years of experience in the dental field and graduated from Greenville Technical College where she studied Expanded Duty Dental Assisting.

Brian Evans, Field Sales Consultant Brian will be representing Henry Schein in the St. Louis, Missouri territory. He has 20 years of experience in the dental field, all of which he spent working at another distributor. Brian graduated from the University of Missouri Kansas City (UMKC) with an MBA in HR and Finance.

Jennifer Kerns, Field Sales Consultant Jennifer will be representing Henry Schein Dental in the Phoenix, Arizona area. She has 10 yearsâ&#x20AC;&#x2122; experience in the dental field, most recently worked for Apex Endodontics, and graduated from Arizona State University with a BS in Communications.

Anthony Criniti, Field Sales Consultant Anthony will be representing Henry Schein in the Philadelphia, Pennsylvania area. He has 9 years of experience in the dental field, all of which he spent working at another distributor as a Senior Territory Manager.

Michaela Martin, Field Sales Consultant Michaela will be representing Henry Schein in the Baltimore and Northern Virginia areas. She is new to the dental field and previously worked at Fairfax County Public Schools as a first grade teacher for four and a half years. She graduated from Radford University.

Terry Reilly, Digital Tech Specialist Terry will be representing Henry Schein in the Buffalo and Syracuse, New York area. She has 11 years of experience in the dental field, 7 of which he spent working at Dentsply Sirona Implants. She graduated from SUNY Oswego with a BS in Marketing.

Alex Hagge, Field Sales Consultant Alex will be representing Henry Schein in the Anchorage, Alaska territory. He is new to the dental field and comes from Arthrex (orthopedic and sports medicine implants). Alex graduated from Northern Arizona University with a BS in Advertising and Public Relations. Jose Salcido, Field Sales Consultant Jose will be representing Henry Schein in the Albuquerque, El Paso, and Southern New Mexico areas. He has 9 years of experience in the medical field, all of which he spent working at McKesson Corporation. Jose received a BA in Marketing from New Mexico State University.

Kaiakua Tong, Field Sales Consultant Tong will be representing Henry Schein in the Honolulu, Hawaii area. She is new to the dental field, and is a volunteer at Hoâ&#x20AC;&#x2122;ola Na Pua, an organization committed to providing homes with therapeutic services for female underage victims rescued from sexual exploitation. Michael Poppleton, Field Sales Consultant Poppleton will be representing Henry Schein in the Philadelphia region. He is new to the dental field, and previously worked as an Account Manager at Hatteras.

Ben Madarang, Field Sales Consultant Ben will be representing Henry Schein in the Baltimore, Maryland territory. He has 17 years of experience in the dental field, 8 of which he spent working at another distributor. Ben graduated from Salisbury University with a BS in Exercise Science.

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First Impressions

August 2019

WHAT YOU MAY EDITOR’S NOTE HAVE MISSED

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

Together, anything is possible Your manufacturer rep partners have your back! They make you – and your business – their priority. They go that extra mile to ensure your questions are answered as quickly as possible; that you have the product samples you requested in time for tomorrow’s meeting; and that everything is in place for the demo you promised your customer. “I believe the way to build trust with my partners is to do what I say I’m going to do,” says GOJO Healthcare Sales Director Mike Otten. “My distributor reps need to know they can rely on me to get things done.” As Ivoclar Vivadent territory sales manager Sergio J. Guzman, PhD, points out, strong communication is key to building a trusting relationship. “It’s important to communicate with a mindset of teaching and learning,” he says. Just as your manufacturer reps have your best interests at heart, however, they know the favor is returned. “I get a lot of insight into what is happening within the market from my distributor reps,” says

“ If distributor and manufacturer reps want to stay relevant, they must discover more creative ways than price alone to bring value to their doctors.” – Skip Ellender, DentalEZ

Midmark territory sales manager Zach Wehner. “They are on the front lines and can see what the trends are with regard to customers, equipment and more.” As Ansell Healthcare distribution sales manager, alternate care, Tony Holm, points out, “The distributor reps know their customers better than I ever could.” As such, he finds it’s important to see the sales process from their perspective.

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First Impressions

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All that said, the relationship between manufacturer and distributor reps can be much more than just a business partnership. “On one co-ride, one of my distributor reps unexpectedly pulled into a parking lot and asked me to stand on my car and pick her some fresh fruit and avocados from the trees!” says Anne Tagye, regional sales representative, Crosstex, A Cantel Medical Company. “We could not stop laughing!” In fact, it turned out to be a very productive sales day, she recalls. “Being committed and working together is the key,” she points out. If we can depend on one constant in the ever-changing dental market, it’s the manufacturer/distributor rep partnership. Skip Ellender, a PSA sales rep who represents DentalEZ Integrated Solutions, anticipates the Internet, along with evolving technologies, will continue to give dental professionals easier access to products, including the ability to research products on their own. As he points out, “If distributor and manufacturer reps want to stay relevant, they must discover more creative ways than price alone to bring value to their doctors.” No doubt, this dynamic duo will continue to bring new and essential solutions to their dental customers. Together, anything is possible.

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