THE #1 RESOURCE FOR NEW DENTISTS
TOP TIPS from
DENTAL LABS Your Ideal Practice Purchase Patient Communication Video Marketing FALL 2018
Wells Fargo Practice Finance
Thinking about starting a practice?
Wells Fargo Practice Finance provides professional support and financing that can help you: • • • •
Buy, start, or expand your practice Grow and optimize your business Deliver a better patient experience Make the most of your financial future
Download a complimentary workbook to plan your next steps. Inside
Visit wellsfargo.com/thenewdentist
• Planning and building your facility • Building your patient base • Establishing systems • Managing growth
Practice Success Series for Dentists
Starting a Dental Practice
Call 1-800-326-0376
Wells Fargo Practice Finance is the only practice lender selected especially for ADA® members and endorsed by ADA Member Advantage℠.
All financing is subject to credit approval. ADA® is a registered trademark of the American Dental Association. ADA Member AdvantageSM is a service mark of the American Dental Association. ADA Member Advantage is a program brought to you by ADA Business Enterprises, Inc., a wholly owned subsidiary of the American Dental Association. © 2018 Wells Fargo Bank, N.A. All rights reserved. Wells Fargo Practice Finance is a division of Wells Fargo Bank, N.A. IHA-6132701
FROM THE PUBLISHER’S DESK Dear Readers, Welcome to the Fall issue of The New Dentist™ magazine.
E
mbracing the role of practice CEO doesn’t come naturally for many dentists, but it’s vital to running a successful business. You’ll quickly learn you can’t just focus on providing top notch dentistry and expect your practice to thrive (as nice as that would be). You have to become a leader, and that means guiding your team and learning how to expertly manage all 22 practice systems. Don’t let the thought of this intimidate you. There are ways to become a better leader, including taking classes to improve your leadership skills and boost your confidence. For now, here are a few tips to help you grow into a more effective CEO: Create a vision for your practice. Don’t skip this step; crafting a vision is vital to your long-term success. Use your vision to articulate where you see your practice in the future, and be sure to include team members in the process. This not only shows them you value their opinion, it gives them more ownership of the goals you set—motivating them to excel. Give your team direction. No matter how experienced they are, team members still need guidance from you. This should come in the form of detailed job descriptions, training and continual feedback. Make your expectations clear. When given clear direction, team members become more efficient and satisfied with their jobs. Performance improves and they’re more confident, and this all shows in the way they interact with the rest of the team and your patients. Be open to suggestions. This is an important part of being an effective leader. Let team members know you want to hear their ideas on how to improve the practice and create an environment where they know they can come to you with concerns. Take team members seriously and use these conversations to make improvements that help move the practice forward. In this issue… We’ve put together a variety of articles that will help you lead your practice to success. Turn to page 6 for a look at products that help improve patient communication, and page 22 for tips from dental labs on how to strengthen the dentist/technician relationship. On page 10, Dr. James Anderson, CEO of eAssist, outlines how outsourcing dental billing stabilizes practice cash flow. Read about the best time to purchase practice equipment on page 12, and how to choose the ideal practice on page 16. Kevin Barnett, CEO and owner of Hi5 Practice, goes over the benefits of video on page 20, and Dr. Benji Dhillon, MD, explains why it makes sense to combine cosmetic dentistry and facial esthetics in one practice on page 26. Finally, learn how to alleviate patient anesthesia anxieties on page 29.
Advisory Board
Christopher Banks, DDS Inwood, WV WVU, 2011
Rebecca Berry, DMD Oakland, ME Tufts, 2011
Julie Boerger, DMD Patchogue, NY University of Montreal, 2010
David Carter, DMD Zachary, LA University of Mississippi Medical Center, 2014
Hal Cohen, DMD Haverford, PA Temple University, 2010
Larry Dougherty, DMD San Antonio, TX Nova Southeastern, 2008
Dennis Frazee, DDS Mooresville, IN Indiana University, 2012
Lindsay M. Goss, DMD, MPH Chandler, AZ ASDOH, 2010
Erica Haskett, DDS New York, NY NYU, 2008
Crystal Johnson, DDS Powder Springs, GA University of Tennessee College of Dentistry, 2009
Aaron Layton, DDS Fort Collins, CO Indiana University, 2010
Leah Massoud, DMD San Jose, CA Tufts, 2009
Michael Potter, DDS Quincy, WA University of Minnesota, 2014
Tyler Scott, DDS Loudonville, OH Ohio State, 2009
Matthew Silverstein, DMD, MPH West Hartford, CT University of Pittsburgh, 2012
Nicole Smith, DDS Newport Beach, CA NYU, 2009
Gregory Snevel, DDS Cleveland, OH Ohio State, 2011
Bryan Stimmler, DDS Brooklyn, NY University of Southern California School of Dentistry, 2009
Here to help,
Sally McKenzie, Publisher
2 THENEWDENTIST.NET FA L L 2 0 1 8
TABLE OF CONTENTS
FALL 2018
26
FA L L 2 018 PUBLISHER
Sally McKenzie Sally@thenewdentist.net DESIGN AND PRODUCTION
Picante Creative www.picantecreative.com EDITOR
Renee Knight renee@thenewdentist.net SALES AND MARKETING
Contact 877-777-6151. Visit our digital media book at www.thenewdentist.net/ mediabook.htm The New Dentist™ magazine is published quarterly by The McKenzie Management Company, LLC (302 N. Chestnut St., Barnesville, OH 43713) on a controlled/complimentary basis to dentists in the first 10 years of practice in the United States. Single copies may be purchased for $8 U.S., $12 international (prepaid U.S. dollars only).
FE AT U R ES Products that Improve 6 Patient Communication
Copyright ©2018 The McKenzie Management Company, LLC. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, without permission in writing from the publisher. Authorization to photocopy items for internal or personal use is granted by The McKenzie Management Company, LLC for libraries and other users registered with the Copyright Clearance Center.
20
How Outsourcing 10 Dental Billing Leads to Stable Cash Flow
Disclaimer — The New Dentist™ does not verify any claims or other information appearing in any of the advertisements contained in the publication and cannot take responsibility for any losses or other damages incurred by readers’ reliance on such content. The New Dentist™ cannot be held responsible for the safekeeping or return of solicited or unsolicited articles, manuscripts, photographs, illustrations, or other materials. The opinions, beliefs, and viewpoints expressed by the various authors and contributors in this magazine or on the companion website, www.thenewdentist.net, do not necessarily reflect the opinions, beliefs, and viewpoints of The New Dentist™ magazine or The McKenzie Management Company, LLC.
Matching Your Equipment 12 Budget to Your Practice Phase How to Choose the Ideal Practice
16
The Power of Video
20
Top Tips Dental Labs Want You to Know
22
Combining Cosmetic 26 Dentistry and Facial Esthetics Under One Roof: Is this the Future? Reduce Anesthesia Anxiety
29
4 THENEWDENTIST.NET FA L L 2 0 1 8
DEPARTMENTS 2 Publisher’s Message 32 Skinny on the Street 32 Index of Advertisers
Contact Us — Questions, comments, and letters to the editor should be sent to renee@thenewdentist.net. For advertising information, contact ads@thenewdentist.net or 877.777.6151. Visit our website at www. thenewdentist.net to download a media kit.
Products That Improve Patient Communication A
By Renee Knight, Editor
s you grow your practice, it’s important to focus on building patient relationships. You won’t be successful if you don’t have patients to treat, making it crucial to maintain a strong base of loyal patients who accept treatment and refer.
Providing top-notch dental care is one way to do that, but it’s not enough. You also need to develop connections with patients and to make it easy for them to schedule appointments, as well as to accept treatment. To do this, you have to find ways to effectively communicate. There are plenty of products that can help, particularly software designed to automate various types of communication—improving the practice’s connection with patients while also freeing up team members to focus on other tasks. Dentists can choose to invest in cloud-based practice management software, like Henry Schein’s Dentrix Ascend, that come with communication tools already integrated, or software designed specifically for patient communication like Lighthouse 360. There are various options on the market, and it’s important to find a solution from a respected company that offers support. When you invest in one of these systems, it
Dentrix Ascend is set to release two new patient communication features soon: online booking for new patients (it’s available for current patients now) and two-way-texting. Both features will be included in the monthly subscription fee at no extra charge. Visit henryscheinone.com for details. PHOTO COURTESY OF HENRY SCHEIN.
will reduce the administrative work that can bog practices down, which is important for any dentist, but especially for new dentists just starting their careers. “As a new dentist, you’ll need to focus on providing care and building trust with patients,” said Micah Dickerson, Lighthouse 360’s VP of Product Development. “These tools take the burden off you so you can focus on being an amazing dentist.”
THE FEATURES Through these systems, doctors can automatically send patient appointment reminders via text, email, telephone call or postcard—whatever the patient prefers. Other features can include two-way texting, treatment planning reminders for patients with unscheduled treatment, customizable e-newsletters, online scheduling, digital health history documents patients fill out before appointments, and recare reminders to help get inactive patients back in the chair. Dentrix Ascend offers customized power reports that enable dentists to look at anything in their practice, said Paula Austin, CONTINUED ON PAGE 8 >>
6 THENEWDENTIST.NET FA L L 2 0 1 8
Ascend to the Cloud
Break free from software hassles and come with us to the cloud. Imagine a new way to manage your practice. Where you can work on a PC, Mac or iPad. Pull patient information anytime, anywhere. Know your business status as it happens. Spend less time managing your practice and more time caring for your patients. Elevate your practice with Dentrix Ascend. This is practice management reimagined.
www.DentrixAscend.com Call 1.855.232.9493 Get Your Practice Off the Ground
Patient Communication continued from page 6 Product Marketing Manager for Dentrix Ascend. The recare reports, for example, tell doctors which patients haven’t been in for a while, giving them the opportunity to target these patients with customized messaging at different time intervals. That’s one of the features Dr. Elliott Brennan has used since he invested in Dentrix Ascend in 2015, texting or emailing every patient who is four weeks overdue for a cleaning to remind them they need to make an appointment. The software continues to update with new features that help with patient communication, and one of the latest is online booking. Patients are busy people and don’t want to call the office every time they need to make an appointment. Online scheduling gives current patients an easy way to communicate with the practice without ever picking up the phone. “Through those recare reminders or on our website, patients can click through to a link to book live in our schedule,” he said. “It’s not a form that generates an email. They can see what blocks are available, so they can book their appointment without ever having to engage with a staff member.” Lighthouse 360 offers all the automated features as well as two-way texting and email marketing options, Dickerson said. Dentists can send out general newsletters to a large group of patients or more personalized emails to a smaller group. Earlier this year, Lighthouse 360 introduced Fill, which is a feature that detects last-minute cancellations and then finds patients to fill the openings. It doesn’t send a note to every patient in the system; just those who would most likely be interested in the appointment. A second new feature, Patient Fast Track, is designed to minimize the time it takes to register new patients. They receive a form they can fill out on their mobile device, where many of the answers are auto populated with data from the phone.
8 THENEWDENTIST.NET FA L L 2 0 1 8
“This shortens the process to about 10 percent of what we saw with paper and clipboards,” Dickerson said. “The patient gets seen more quickly, which keeps delays from happening in the practice and the domino effect that can happen if somebody takes too much time filling out paperwork.”
THE BENEFITS Before investing in Lighthouse 360 five years ago, the front office staff in Dr. Michael Hasty’s pediatric practice spent time calling 50 to 60 patients a day to confirm appointments. Of those, they’d be lucky if 10 or 11 called them back—meaning they’d have no idea how many patients would actually show up. Now, team members have more time to focus on other tasks throughout the day, and don’t have to deal with broken appointments as often as they did in the past. “Calling 50 people takes three or four hours,” business team member Elizabeth Cruz said. “With Lighthouse 360 we can reach out to hundreds, if not thousands, of patients in a matter of seconds.” This proved to be beneficial a few years ago during a snow storm that made it impossible to get to the office. From her house, Cruz was able to send an email to everyone on that day’s schedule to let them know the practice was closed. Patients appreciate this kind of communication and the appointment reminders, Dr. Hasty said. But, if patients want to opt out or receive fewer reminders, they can. And if they prefer to receive their communications via snail mail or telephone call, those are options, too. The practice also can send out customized newsletters and birthday emails to recognize patients on their special day. The automated patient communication features Dentrix Ascend offers help make Dr. Brennan’s practice more efficient, and he also likes the fact these features are included. The cloud-based software is constantly updated with new features at no extra cost. In the past, practice management software companies offered communication tools, but for an additional fee. “With Dentrix Ascend, you don’t have a huge financial burden,” Dr. Brennan said. “You can get started right away with a low monthly cost. They don’t nickel and dime you for add-ins, making it more cost effective for new dentists trying to get cash flow going.” Dentrix Ascend also can help with patient communication chairside. When dentists click the imaging icon within the software, four boxes show up with intraoral photos, radiographs and pans. The fourth section will eventually show 3D scans, Dr. Brennan said. “I can use this as an educational tool to show patients what’s going on in their mouths, whether it’s with x-rays or images from an intraoral camera,” Dr. Brennan said. “Dentrix Ascend is the only solution that has patient imaging in the cloud. I can access images from my office or on the go without bogging down a server that needs backups.”
OTHER PRODUCTS THAT IMPROVE COMMUNICATION While patient communication systems can help you connect with patients outside the office, there are other products that do the same chairside. This includes patient education modules and intraoral cameras, said Dr. Lorne Lavine, owner of The Digital Dentist. Patient education modules can be effective, but gone are the days of turning on a video, leaving the room and coming back in 10 minutes to discuss the video. Instead, dentists should use interactive patient education, such as ConsultPro, to walk patients through recommended treatment. These tools should be used as an adjunct to the treatment plan, Dr. Lavine said. Intraoral cameras also help improve communication and offer your practice the “best return on investment of any HENRY SCHEIN ONE To improve their practice management solutions, many larger companies are starting to work with smaller companies that already have robust patient communication tools. Henry Schein One is an example of that. This joint venture between Henry Schein and Internet Brands integrates webbased practice management solutions such as Demandforce, Sesame Communications, Officite, and DentalPlans.com into Henry Schein software.
technology out there,” Dr. Lavine said. When patients can see what you’re seeing, they’re more likely to accept treatment. “Intraoral cameras were popular in the mid-90s up until 2000 or so as cone beam and 3D scanners were taking off,” Dr. Lavine said. “Those are the hot technologies and now intraoral cameras have taken a back seat, which I find disappointing. The cost of a decent intraoral camera has dropped significantly over the years. It used to cost $2,500 to $3,500 for a decent camera. Now you can go on eBay and find cameras for $150, $200 that are quite acceptable.” Social media is another cost-effective method to communicate with patients, Dr. Lavine said. Platforms like Facebook and Twitter make it easy to keep in touch with promotions and updates, and should be part of a new dentist’s marketing strategy.
MAKING CONNECTIONS No matter what software you invest in or what products you use chairside, it’s important to effectively communicate with patients. This will help them feel a connection to your practice that will keep them loyal. Automated reminders also make offices more efficient and keep patients from flaking out on their appointment times. All of this leads to a more productive practice and a more robust bottom line. “For new dentists trying to build a practice, every new patient is precious to them,” Austin said. “The last thing you want to do is spend marketing dollars on getting a new patient in and then never following up with that patient.” FA L L 2 0 1 8
THENEWDENTIST.NET
9
How Outsourcing Dental Billing Leads to Stable Cash Flow
By James V. Anderson,
M
DMD, CEO/Founder of eAssist Dental Solutions
any dentists know production is not cash in the bank, yet they focus on daily production with the assumption the cash comes later in insurance and patient portion payments. Today’s pressure to join PPO plans to boost production can backfire when the reimbursement process becomes a marathon of hurdles and pitfalls, only for dentists to receive a reduced reimbursement for covered patients. In the once perfect world of indemnity insurance plans, we could put in a CDT code and bill our fees and get paid 100% for diagnostic and preventive, 80% for basic and 50% for major services. The number of dental indemnity plans has dropped to between 5% and 10%, with the majority now innetwork PPO, HMO or federal funded Medicaid plans that are fraught with restrictive provisions, no standard coverage base and a myriad of frequency limitations, such as allowing only one cleaning per 12 months. There are plan provisions in every policy that cause more claim denials than insufficient information. These provisions are provided to the patient, but aren’t readily available to the dentist. Patients typically don’t read through the provisions, yet they expect the dental office to know all about their plan. This system of billing insurance without understanding the full coverage picture doesn’t work in favor of the dental practice. I discovered this myself when trying to establish a stable cash flow in each of my practices based on the production I was seeing. The insurance policy write-offs and plan provision denials were reducing my income from these patients some 30%. I needed a solution to this problem so I developed eAssist Dental Solutions, a national dental insurance billing company. Through this company, I recruit the best billers in the nation to not only help my practices with insurance 10 THENEWDENTIST.NET FA L L 2 0 1 8
collections, but to help all dental practices get paid for what they have legally earned.
WHY OUTSOURCE You might be thinking, “Why should I outsource dental billing when I have an Office Manager to do that?” The answer is simple: “Because the Office Manager doesn’t have the time or the expertise to handle billing, and should be focused on taking care of your patients.” Traditionally, front desk employees handle insurance billing. It takes 3-4 hours of an 8-hour day for the average practice (20-26 patients) to discuss insurance, verify eligibility and benefits, file claims, complete attachments and narratives, appeal claims, make phone calls or go online for follow-up. They often fall behind and cannot finish important tasks, such as filling the schedule and presenting treatment. You could hire another team member to manage the billing tasks, but that is shown to be much more costly than outsourcing to a billing company. Let’s compare dental lab technicians to dental billing experts. According to Steven Pigliacelli, CDT, MDT, in his February 26, 2015 article for Dental Economics: “In the late 19th century, Dr. W. H. Stowe, a Boston dentist, was such a talented technician that other dentists
asked him to do their work as well. He was so popular that he opened the first commercial dental lab in 1887. From that day forward, dental technicians opened labs and did the lab work while dentists focused on their patients. Outsourcing lab work freed the dentist to do more dentistry and to become more profitable.” Outsourcing dental billing offers the same built-in value of increased profits.
ACHIEVING STABLE CASH FLOW Investing in a professional billing company can help you establish stable cash flow in your office. Here are three keys to making this happen: 1. Know your collection financial numbers. The bench-
mark is 100% of adjusted/billable production. Look at your net collections daily. Rebalance your practice fees annually to maximize insurance reimbursement. Run your daily reports and review all procedures to assess accuracy in reporting and to detect errors in posting. 2. Submit your full practice fees on all insurance claims including PPO in network. The insurance company will
complete the adjustments. This will benefit you in several ways, including higher payouts. Professional dental billers
can post and correctly complete write-offs. Outsource your dental/medical insurance billing to people with the expertise and dedicated time to file, appeal and follow-up (which sometimes requires hours on the phone) to get claims paid to ensure cash flow. 3. Know your gross and adjusted production numbers.
Establish clear and friendly collection policies and financial arrangements for all your patients. Collect the co-insurance and deductibles at the time of service to achieve a stable cash flow. Make use of outside funding services such as CareCredit. A professional billing company can take over patient portion collections as well, freeing up your front office to collect at the desk and promote dental treatment. Outsourcing billing offers a variety of benefits for your practice, including establishing stable cash flow. If you’re interested in learning more, feel free to reach out to eAssist for guidance. We are here to help you.
James V. Anderson, DMD, is a practicing dentist in Syracuse, Utah. He has built nine dental practices in the last decade and is the CEO/Founder of eAssist Dental Solutions (dentalbilling.com), the largest, national dental billing company in the U.S. He can be reached at james.anderson@eassist.me.
FREE Online Dental CE Earn live interactive and self-study credits from the comfort of your home or office • ADA CERP Provider • World-respected Speakers • Instant CE Certification
www.vivalearning.com
FA L L 2 0 1 8
THENEWDENTIST.NET
11
MATCHING YOUR
EQUIPMENT BUDGET
to Your Practice Phase By John W. McPeek President, ASI Dental
T
here is a cautionary tale I have heard numerous times during my talks with dentists over the years. While setting up their practice, they were advised that, to “do it right,” they should fully equip all of their planned space right now. That way, they won’t have to worry about it later when they are super busy, and they can readily expand without delay. Reps tend to say something like this: “You won’t have time then to make these decisions, so let’s just get them all taken care of for you now.” These dentists not only realized later this advice was not financially beneficial, but found it was actually detrimental—and, in some cases, held their practices back. They often say they wouldn’t take this advice if they could do it all over. As a new dentist, you shouldn’t take this advice either.
BUSINESS SENSE AND PITFALLS Good business sense indicates that entrepreneurs shouldn’t over indebt themselves on nonproductive expenditures, as it simply takes away cash reserves from other uses and ties up borrowing capability that might be needed in the future. To a new business venture, cash is king. When opening a startup practice, you can never fully anticipate all of the unintended expenditures you will need to make or how long it will take to get your practice cash flow positive. You always want to ensure you have cash and/or borrowing ability if needed. 12 THENEWDENTIST.NET FA L L 2 0 1 8
Having credit lines tied up in unused equipment in extra treatment rooms won’t do you any good in a crunch. Dentists who purchase all their equipment at once often realize they spent everything in their loan for equipment but didn’t leave sufficient funds to hire marketing consultants or to invest in advertising to grow their practice. The higher monthly payments for excess equipment loans constrains them further, as these loans take more of their working cash created by practice revenue. Not only that, additional borrowing can impact your personal credit rating and your ability to take out personal loans for cars or houses. It also might put you into a higher interest bracket than you deserve. So it’s very important to only borrow what you need to productively launch your dental practice.
MADE IN
U.
S. A.
PHILANTHROPIC
LEADER $ 75,000
2018
HOW TO SELECT EQUIPMENT TYPES THAT EASILY ADAPT AND CAN BE DROPPED IN AS GROWTH REQUIRES.
PHOTO COURTESY OF DR. M. OSKOUI, NORTHEAST ENDODONTICS
Think like a large manufacturer that is planning to grow. These companies need to be able to easily ramp up their production lines in the future, but don’t want to over spend until their sales numbers justify the expansion. So while they would consider finding a large enough facility that allowed for planned growth, pre-wiring it and completing some of the interior finish, they would not buy additional production line equipment until it was required. The trick is to ensure construction is completed and readily allows for equipment to be moved in, set up and easily connected. There are now handy in-wall and floor junction boxes that facilitate running electrical wiring, IT cabling and plumbing. These built-in boxes come neatly enclosed and don’t detract from an empty treatment room’s appearance, yet they make it very easy to connect equipment as needed. To maximize your office space cost, it is important to get the most from your space. Building leases are based on a price per square foot, which is the horizontal dimension. Keep in mind you pay nothing more for the vertical space. Large dental cabinets require a big horizontal footprint without adding to treatment capability. Modern dental equipment is more compact and can integrate instruments, computer systems and monitors into one console, reducing the footprint and taking advantage of the vertical space. You can design smaller treatment rooms yet achieve an open and spacious feeling for you and your patients. Modern modular dental equipment is much easier to set into place and connect without a lot of installation difficulty. This equipment easily adapts to expansion and even different operators’ requirements, including ambidextrous or multispecialty needs. No matter what equipment you invest in as you start your practice, don’t feel like you have to buy it all at once. Take a phased approach instead.
Designer Flex assistant system with ambidextrous capability is placed at the 12 o’clock wall in a dual entry modular treatment suite.
HOW TO PLAN YOUR EQUIPMENT BUILD-OUT AND THE GROWTH PHASE OF YOUR PRACTICE. The first step is to plan well and to only purchase the equipment and supplies you can put into production right away. This may mean avoiding supply stocking programs and fully equipped offices unless you really believe they will be used from the start. Planning out your office and expenditures is more than just getting the right look. Use discernment when reviewing preformatted budget templates, and consider the importance of each area to generating initial practice revenue. Before you purchase equipment, ask yourself if it’s really necessary for you to open your practice. This will help you get down to a much more realistic overall budget that isn’t filled with excess equipment, supplies or post construction décor. 14 THENEWDENTIST.NET FA L L 2 0 1 8
John W. McPeek is a former CPA turned entrepreneur. He has started a number of successful ventures and began ASI Dental, a division of ASI Medical Inc., 25 years ago. ASI Dental has helped numerous dentists by providing equipment solutions that enable them to begin their practice in a cost-effective manner.
Choose to keep learning. Choose the ADA. Because learning doesn’t stop when you leave the classroom. ACCESS Access the latest evidence-based policies, guidelines and recommendations, including the new caries guideline with silver diamine fluoride recommendations.
LEARN Learn how your colleagues practice with insights on new products and treatment techniques from the ADA Clinical Evaluators (ACE) Panel.
READ Read cutting-edge research published in the Journal of the American Dental Association (JADA).
WATCH Watch all-new videos on how to integrate the latest in evidencebased dentistry into your practice to optimize patient care, address misleading information patients encounter and more.
When you choose to join, you become a part of world-class clinical excellence. Visit ADA.org/chooseADA to learn more.
Visit ADA.org/ChooseADA to learn more.
How to Choose the
By Sally McKenzie, CEO of McKenzie Management
IDEAL PRACTICE A What new dentists should think about when acquiring a practice.
cquiring a practice can be both an exciting and stressful time for a new dentist. There’s so much to look forward to, but there’s also a lot that can go wrong. That’s why it’s so important to have a plan in place, and to really understand what it takes to be successful. Achieving success starts with preparing to become a business owner (which is something many dentists struggle with) and surrounding yourself with a talented team that can help you reach your goals. Your team should be made up of experienced professionals who specialize in dentistry, including an accountant, an attorney, a dental consultant, a transition broker and an equipment supplier. These professionals can help guide you as you look for the right practice to acquire, and then continue to offer support as you begin your journey as that practice’s new owner. 16 THENEWDENTIST.NET FA L L 2 0 1 8
Buying a practice isn’t something you should just jump into. You must develop a plan and carefully consider the pros and cons of each location, as well as make sure you’re emotionally and mentally ready to become a practice CEO. As a dental consultant, I’ve seen what can happen when dentists buy a practice before they’re prepared, or without doing any due diligence. They find problem after problem, and instead of enjoying success and profitability, their days are full of stress and frustration as they struggle to make ends meet. I don’t want that to happen to you, and have put together this article to help ensure it doesn’t.
POTENTIAL PROBLEMS When dentists first decide to purchase a practice, they tend to focus on the many advantages acquiring an existing office has over starting a new office from scratch. The seller already has a mature patient base and may be willing to help you
transition into a business relationship with those patients. A team is already trained and in place, and should be ready to make your transition to the new owner dentist as smooth as possible. You might even have the opportunity to take on cases the seller chose to refer out—leading to increased productivity and profits. Equipment is already in the office and ready to use, so you won’t have to worry about investing in anything right away, which helps ease the financial burden that comes with practice ownership. Yes, there are a lot of positives to acquiring a practice but there are also negatives you must consider. Remember that mature patient base you were so excited about? The number of active patients the practice actually has might be less than what you think. Why? The true definition of an active patient is one who is due for a periodic exam in the next 12 months. So some of these “active” patients you’re counting on likely aren’t doing anything to contribute to practice production. And while there’s a trained team in place, there’s a good chance they’ll be resistant to a new owner. Some might opt to leave before you officially take over, and those who stay could be difficult to work with. Don’t be surprised if you find out some long-term employees are overpaid (and these employees won’t exactly be happy if you suggest a pay cut). There also could be problems with outdated equipment, meaning you’ll have to make some significant investments
after all. And, if all that isn’t concerning enough, there’s always a chance the revenue the seller reported isn’t exactly accurate. This is just a small sample of the potential problems you might have to deal with after acquiring a practice. To avoid these issues and to help ensure the practice you’re considering is the right fit, I suggest you ask a few questions before signing on the dotted line:
Starting a Practice or Buying a Practice? Your first time being a business owner will take more knowledge than getting the margins right on that 3-unit bridge. Prepare yourself for the role of CEO, Operating Officer, HR Manager, Financial Wizard, Marketing Director, IT Specialist, Etc, etc, etc…
Contact our New Dentist specialists at 877.777.6151 | info@McKenzieMgmt.com www.McKenzieMgmt.com FA L L 2 0 1 8
THENEWDENTIST.NET
17
• • •
• • • • • •
How does the practice get new patients to walk through the door? What do team members and patients expect from a provider and does that align with your direction? What type of procedures are being referred out? Which of those procedures can you incorporate into the practice? How much will you charge? How will you prepare team members? How well are the business systems functioning? Who is the competition and where are they located? How many active patients are in the practice? How will the practice be financed? What percentage is the recall to overall practice production? Perio? How do you get started?
Getting the answers to these questions will help you avoid making a bad investment, ensuring you eventually find a quality practice that’s also the right fit.
MORE TO CONSIDER Before purchasing a practice, it’s important to be aware of any business system weaknesses that could hurt your revenue potential. Your dental consultant can help with that. Look at patient retention numbers over the life of the practice and determine the potential for new patients based on the practice’s demographics. I know this probably isn’t your favorite topic, but it’s also important to look at what marketing the selling dentist has done and how much you’ll 18 THENEWDENTIST.NET FA L L 2 0 1 8
need to invest to attract new patients and to keep current patients loyal. As you might imagine, practice productivity is also an important factor. Ask the selling dentist how the practice handles case presentations and find out the case acceptance rate. If it’s low, you know you’ll have a lot of work to do to turn it around. You also need to understand the seller’s practice philosophy. If it’s a lot different than yours, it could lead to problems with current team members—and that could affect your vision and keep you from reaching your goals. Then of course there’s insurance and fees. Yes, insurance relationships are already established, which is a plus, but you need to know if the practice has PPO plans and if they have re-negotiated in the past year. Look at fees to make sure they align with the area’s demographics and determine if you might need to lower or raise them.
AVOIDING FAILURE There really is a lot to consider before you invest in a practice—and it can all seem a bit overwhelming. If you find out systems are weak or there isn’t enough patient flow after you make the investment, you’re stuck figuring out how to turn a struggling practice around, which could keep you from the success you envisioned. But if you develop a plan, ask the right questions and surround yourself with professionals who can offer you guidance, it will be much easier to find a practice you can thrive in as the new CEO.
Purchasing a Dental Practice? Do you know what to analyze with the historical data and potential revenue in a practice purchase? How do you integrate your philosophy and vision into someone else’s business?
McKenzie Management’s Acquisition Coach begins with a thorough due diligence process to help determine if the practice you are considering is right for you. Once the practice is purchased, we continue paving the way for a smooth transition as the “new owner”. Teaching you what it takes to be a CEO, we’ll help position the current business operational systems to reach their full potential and accelerate the practice’s growth. We take pride in implementing a smooth transition of the staff and their new owner by establishing great lines of communication from the first day. Allow McKenzie Management to teach you the business side of dentistry enabling you to be a strong, independent business owner of your practice. It all begins with a solid foundation.
877.777.6151 info@McKenzieMgmt.com www.McKenzieMgmt.com
The Power of
VIDEO I
By Kevin Barnett, CEO & Owner, Hi5 Practice
t’s important to keep your marketing up-to-date, but there’s one thing you may be overlooking: video! Video is a powerful communication tool that could exponentially grow your practice. Videos allow you to humanize your practice and show off your team’s personality so you stand out amongst your competition. You can explain your services in-depth, address common concerns and even capture patient testimonials. WHY VIDEO? Using video can help increase patient retention and is guaranteed to attract new patients. But how? Every day, we’re inundated with more than 10,000 marketing messages, but video stands out in the sea of written material and still images. Unlike reading uninteresting copy, patients can see and hear from you and your team in a more personal way. Television advertisements have been the most effective way to get people’s attention for decades, but the internet allows you to reach a broader audience for a fraction of the cost. For example, Facebook videos reach more than 500 million viewers every day. And that’s just on Facebook. Spread your message through video on social media platforms like Instagram, YouTube, LinkedIn and Twitter and you could attract a new audience that might even turn into new patients! Also, be sure to incorporate video on your website. According to Forbes, the average user spends 88% more time on a website if it has video. We all know users prefer to skim copy on websites, but if you have videos, people will take the time to watch and see if it meets their needs. Videos are the new way viewers want to consume their information, and it’s an easy service you can provide to your patients. CREATE PROFESSIONAL VIDEOS AFFORDABLY Videos are a vital part of your practice’s growth, but it can be intimidating and expensive. If you want to go the professional
20 THENEWDENTIST.NET FA L L 2 0 1 8
route, hiring a crew to create a single educational video costs about $5,000, on average. If that’s out of your price range, don’t let it hold you back. Just dip your toes in and start with your smartphone. Take Dr. Rich Constantine, for instance, who has a dental practice in North Carolina. His dance video went viral and has 57 million views and counting! In his interview with Good Morning America, he said “I just propped my camera up and I filmed it in our hallway.” The day after the video was posted, their team was “extremely busy on the phones.” Facebook Live videos, which broadcast live to your followers, are a great way to showcase your team’s personality, make special announcements and educate viewers on how you are different. For buttery smooth shots, consider buying a hand-held stabilization gimbal (you can find one online for between $150 and $250) to keep your phone steady and eliminate the shaky effect from your videos. For lighting, grab a case with front-facing LED lights ($20 online) to give you a professional glow. Ready to tap into the power of video? Here are five types of videos you can try to get started:
1 ABOUT US Using an About Us video in your email marketing or on your website is a great opportunity to show off who you are and how you’re different. Introduce your team, explain your services, showcase your office, and get your patients excited about visiting your practice. You can even include testimonials from your patients. 2 FAQS Answering frequently asked questions over the phone can slow your practice down, and your team members may not have a chance to completely address some concerns. With FAQ videos on your website, you’re able to say exactly what you want. Plus, these videos give you the opportunity to educate patients about topics they haven’t considered, or may be embarrassed to ask about.
3 REACTIVATION It’s likely that most of the patients you’ve treated aren’t coming back for regular appointments, meaning your patient base has more inactive than active patients. But they’re not lost forever! Using video with communication software like RevenueWell, Lighthouse 360 or SolutionReach can help you get these patients in the chair by reminding them why they need to come back to you.
R
R
4 FINANCIAL OPTIONS Money is a factor for every patient. Use the financial options video on your website to clarify payment and insurance options. Plus, if you have an in-office savings plan, let patients know how it benefits them to alleviate any concerns. 5 CELEBRATIONS/HAPPY BIRTHDAY This is one of the most valuable types of video you can make. By using video to celebrate milestones or wish patients a happy birthday, you’re staying top of mind, connecting with your patients on a personal level, and increasing retention. Plus, it’s so much fun for everyone! ACHIEVE THE BEST RESULTS Don’t hold off on videos any longer. The best advice is to get started. Assign someone in your office to make sure you are posting videos regularly. Once your team and patients get used to being in front of the camera, it’ll become second nature—and we promise your patients will love it! Also, get signatures. If you record patients on video, you need to have their consent. You can keep the release form with their patient records. Lastly, don’t forget to post the videos. Designate a central device (a camera, phone or tablet) in the office to use for all recording. That way, all videos will be in one place so they’re easy to find and post online. Now that you have some tips on getting started, you can begin implementing videos into your marketing plan. To learn how OLIVE (On-Location, Interactive, Video, Experience) from Hi5 Practice can help, give us a call at 615-656-8551 or visit videosbyolive.com to schedule a demo. Kevin Barnett is the founder of Hi5 Practice and the inventor of OLIVE (On-Location, Interactive, Video, Experience). Through Hi5 Practice, a Nashville-based patient retention marketing agency, Kevin has been able to hyper-focus on the dental industry, working with general dentists, orthodontists and endodontists to reclaim their relationships with their existing patients and increase production. As video became the forefront of Hi5 Practice, Kevin saw a demand for them to be more accessible. He invented OLIVE to make it easier than ever to shoot professional videos, anytime, directly from the dental office.
Breakthrough! Daily remineralization, Relentless protection. Award-winning BioCoat with SmartCap™ Technology delivers: • Relentless protection – daily remineralization from extended release of fluoride, calcium and phosphate ions • Bioactive sealant – strengthens enamel and helps provide defense against acid attacks • Outstanding handling and adhesion – easy application ensures sealed margins and excellent retention
Premier® Dental Products Company • 888-670-6100 • www.premusa.com
FA L L 2 0 1 8
THENEWDENTIST.NET
21
TOP TIPS
Dental Labs Want You to Know
Professionals from three top-notch labs offer their best advice to new dentists. When patients come to your office for restorative treatment, your intention is to meet all their expectations by providing quality, esthetic and well-fitting restoratives along with a great patient experience. Of course, on occasion, complications can arise that make meeting expectations a challenge. Working with an established and experienced lab that can provide good case planning support can be a great comfort to dentists. A collaborative lab relationship can help you avoid unanticipated chair time that costs you money and inconveniences your patients. While it’s easy to put all the blame on the lab, the quality of work the lab can provide is dependent on what information and materials they have been provided. There are steps you can take to help ensure you receive consistent high-quality restorations that make you, your patients and the lab happy. The New Dentist™ magazine recently spoke with owners and clinical professionals from three dental labs about common challenges they see and what new dentists can do to help their lab provide better results. Here are their tips:
Take accurate impressions. This is a challenge labs encounter every day. James Forgeng, CDT, who 22 THENEWDENTIST.NET FA L L 2 0 1 8
heads the ceramic side of Interchrome Dental Lab’s fixed department, said getting the accurate impressions required to produce a high-quality restoration, along with all the other pertinent information, is one of their biggest struggles. The key to a great impression lies in following impression material guidelines and knowing the specific impression techniques for different restoratives. A quality lab can help with this. Dr. William Roe, DMD, who founded Tuscaloosa Dental Arts so he could blend the clinical aspect with the lab, also sees this as a challenge. “Dentists ask us to produce a high-quality restoration but they don’t give us the impression and bite registration we need to actually do that,” Dr. Roe said. “I’ve had dentists give me horse-shoe shaped impressions of the upper arch for a denture, or barely use enough material to fill the tray when taking an impression for a full-arch implant restoration. If you’re a little more particular on the front end, it will save you a lot of time at delivery.”
Focus on education. There’s a lot
Give labs everything they request. This includes bite registrations, diagnostic wax-ups, temporary models, and desired tooth color, for example. If you don’t send the lab what they need, their technicians are impeded from starting the case or are left in a position to take a “best guess.” That makes it difficult to give you a predictable result. Many dentists tend to skip some of these items because they think it will save them money. Maybe at first, but it actually ends up costing more, said Eddi von Schlichting, CDT, and Interchrome co-founder who heads up the removable department. Why? There’s a good chance they’ll need to redo the entire case, costing money as well as time. “We do a lot of big esthetic cases and instead of giving us a model, the dentist often just writes ‘make it ideal’ on the script,” Forgeng said. “No one knows what that means. It’s like telling a builder to build the ideal house. A lot of times we’re missing the architectural plan of what we need to get a consistent result.”
Go back to basics. For example, don’t take an impression in a pool of
they didn’t teach you in dental school, and restorative materials and techniques are constantly evolving. Taking CE classes and joining study clubs can help fill those gaps, said Benni von Schlichting, CDT, and Interchrome cofounder who heads up the digital side of the fixed department. Keep your lab up to date with what you are learning, as your lab should do with you, so you are always on the same page. One of the areas von Schlichting and Forgeng suggest dentists focus on is photography. Images can be a huge help to labs, but only if they’re taken properly. Learn how to capture images that give labs important information, such as smile line, lip height and buccal corridor. Remember to always blood and expect it to fit, Dr. Roe said. Isolate the tooth and keep it dry. Getting the fundamentals correct will get you the best results.
Communicate. While it’s vital to provide your lab with all the pertinent information, sending the lab script and materials isn’t enough. Take the time to call the lab to go over the case and ask questions. As a new dentist, you’re still learning, and your lab can be a wealth of information. “A lot of dentists fail to realize how many different things come to the dental lab case wise,” Dr. Roe said. “So when they get into something difficult they’re afraid to call and ask ‘hey have you seen this before’ or what do you think about this.’ Dentists really need to look at their lab as a partner versus just a vendor.” And when a lab calls you, always call them back, said Dr. David Allen, Clinical and Quality Control Advisor at Centric Dental Lab. The lab can’t move forward on the case until questions are answered, so not returning calls because you get busy or forget will only cause delays. FA L L 2 0 1 8
THENEWDENTIST.NET
23
include a shade reference and name photos clearly. No matter what courses you take, it’s important to be a life-long learner, Dr. Roe said. Seek out classes that go beyond the bare minimum at respected organizations like The Pankey Institute, The Dawson Academy and Spear Education.
you have to admit it to the patient— and that’s OK. They don’t expect you to know everything, and they can tell when you’re not telling the truth. Tell them you don’t know but you’ll find the answer.” Mentors can help you find those answers, and that includes your dental lab.
Find a mentor. As you begin your
Visit your lab. Many dentists don’t
career, it’s important to have mentors to guide you. Experienced dentists are great mentors, as are dental lab technicians, Dr. Allen said. Build a relationship with your lab and turn to them when you need advice, whether you have questions about a case you’ve never seen before or aren’t sure what material is best for a certain situation. “Don’t be embarrassed of what you don’t know,” Dr. Allen said. “You have to admit it to yourself first and then
really know what actually goes into producing a high-quality restoration or why it can take so long, Dr. Allen said. Before hiring a lab, interview them about their procedures and then set up a time for a tour. This will help you understand the process and appreciate what happens once a case leaves your office. “Rushing cases on a consistent basis puts a strain on resources and may end up in errors or inconsistencies,” said Lisa von Schlichting, Interchrome office manager and co-founder. “If the lab and the doctor agree on a turnaround schedule the clinical staff always knows how long to schedule out a case. If true rush cases come up due to emergencies, the lab is more easily able to handle those because the day to day is scheduled with the required time.”
Invest in quality materials. Instead of focusing on saving money, Dr. Roe suggests purchasing the best materials possible. While it might cost you more up front, it will save you money in the long run. Why? You won’t have as many issues with the material or need as many remakes. If you’re not sure which material is best for a particular case, consult your lab.
Do your research. Not all labs are created equal, and it’s important to find one that can create the high-quality restorations your patients deserve. Remember, the focus should be on value rather than cost, Forgeng said. “Work with a lab that cares about the product and that follows up, not one that just puts the restoration in a box and is never heard from again,” Dr. Roe said. “The biggest thing is looking for a lab that will help you grow your practice and that makes your work chairside easier. Develop relationships and become a partner with your lab. If your dental practice succeeds, they are going to succeed.”
Choose a quality lab. When
Have a plan. When treating a com-
you are seeking out a lab, take the time to meet with ownership and key technical members to clarify and set expectations. Listen and ask questions about the materials they use and why, the protocols they use to achieve predictable results, and what education, support and value added services are available to you. Not all labs are equipped to offer the same level of support. Finding the right fit for your practice is key to a successful relationship.
plex case, involve your lab in the process, just like you would any specialty doctor, Dr. Roe said. This will ensure everyone is on the same page and that you’re able to provide the final treatment the patient is expecting. Bottom line: Communicating with your lab and providing them with the information they need is key to delivering your patients the best care possible. Think of the lab as your partner and a resource and it will lead to better patient outcomes. “In general, the dentists who get the best results are the ones we have an open dialogue with and a good relationship with,” Benni von Schlichting said. “Having an open dialogue and forming a relationship with your lab is huge. It leads to more money in your pocket.”
Be accountable. If you delegate duties, such as impression taking, to team members, it’s important to evaluate their work before you send it off to the lab, Dr. Allen said. Hold team members accountable and have them
24 THENEWDENTIST.NET FA L L 2 0 1 8
retake impressions or digital images if they aren’t up to your standards.
When people need treatment now, they also appreciate options now. The CareCredit credit card is a payment option that lets your patients choose the care that’s best for them and helps them get started now — without delay.*
e: Ideas in Practic
st Overcoming Co re as a Barrier to Ca
Request your new FREE Overcoming Barrier to Care Kit Practical resources to help more patients get care when cost is a ent. barrier to treatm
Already accept CareCredit? Call 800-859-9975, option 1, then 6. Yet to add CareCredit? Call 866-246-6401.
Courtesy of
®
*Subject to credit approval.
ND1018DA
Combining Cosmetic Dentistry and Facial Esthetics Under One Roof: Is This the Future?
By Dr. Benji Dhillon, MD
A
s a British Plastic Surgeon, I admit I was ignorant of the positive esthetic and emotional impact of cosmetic dentistry for the majority of my career. Embarrassingly, this is despite treating the same ‘real estate’ as my dental colleagues on a daily basis. However, I am confident that most, if not all, of my medical colleagues involved in esthetics are equally naïve. Despite this, events over the past nine months have transformed my understanding and appreciation of cosmetic dentistry, leading to significant changes within my facial esthetic consultations and my business.
26 THENEWDENTIST.NET FA L L 2 0 1 8
MY JOURNEY My background is somewhat unconventional. After undertaking plastic surgery training, I moved into pharmaceutical medicine to develop an understanding of the ‘health care business.’ Given my background, joining Allergan, the manufacturer of Botox® and Juvederm® dermal fillers and the leader in medical esthetics, represented the perfect opportunity for me. As Medical Director for Europe, Middle East and Africa, I was responsible for all post market clinical studies, new product evaluations, medical education and physician interactions across the region. The role, which I held for three and a half years, gave me unprecedented access to how the esthetics market is evolving and those within it adapting. Following this spell, I decided to head back into full time clinical practice, and I now primarily focus on non-surgical and minimally invasive esthetic procedures. KEY LEARNINGS One of the most striking discoveries during my time at Allergan was my observation of how dentists were beginning to take up injectables in large numbers. They either added them in addition to their dental procedures or, in some cases, they solely focused on soft tissue esthetics. This behavioural shift is not surprising, given that dentists are in a unique position to treat the ‘whole face,’ both the teeth and soft tissue. By providing injectables, they were preventing patients from going to other clinics, thereby strengthening the dentist-customer relationship as well as maximizing patient profitability from a procedure that takes 15 to 30 minutes.
The other advantage of adding injectables into a dental clinic is the regular repeat business it provides. Botulinum toxin lasts, on average, three to four months and dermal fillers six to 18 months, meaning patients must come back regularly. The dentists who grasped this opportunity were clearly able to capitalize on a rapidly growing market. The American Society of Aesthetic Plastic Surgery data report of 2017 revealed there was a 40.6% increase in injectable based procedures (botulinum toxin and dermal fillers) from 2012 to 2017. Suddenly, these dentists were able to maximize profitability from their existing database without having to rely on recruiting new patients.
NEW BEGINNINGS One serendipitous conversation with a cosmetic dentist led me to undergo a consultation myself. This was the beginning of my dental journey. The consultation was a revelation; where I had spent years focusing on the development of static forehead lines or chronic volume loss in my medial cheek worsening my tear trough, I was now all too aware of the poor esthetics of my teeth, which as it turns out superseded any of the soft tissue problems! After being convinced that my concerns of ‘fake’ looking ‘super white’ teeth were unfounded, I agreed to undergo a smile makeover with a mixture of porcelain veneers and minimally invasive orthodontics. After treatment, I was surprised how natural the result was as well as the immediate impact it had on my confidence when smiling. The experience and outcome also highlighted the limitations of my clinical consultations, an experience I firmly believe should address facial esthetics holistically. My ‘old’ consults took into account three key principles: First, Proportions of the face, followed by what Emotions I believe were being projected by the face (tiredness, anger, sadness, for example) and finally skin quality and whether it has lost its ‘Glow’ (PEG assessment). At no stage did I ever take time FA L L 2 0 1 8
THENEWDENTIST.NET
27
to appreciate the importance the smile has on an individual’s facial esthetic. Although good dentition is essential to anterior projection of the lips, esthetically pleasing teeth can improve the smile whether or not a lip augmentation has been performed. Most negative emotions can be corrected with dermal fillers or botulinum toxin, however bad teeth in the presence of corrected negative physical emotions of volume loss only brings down the quality of the corrective treatments to the soft tissues. Consequently, I now incorporate a very basic assessment of the dentition and smile purely in terms of its cosmetic appearance. I may decide to refer patients to a dentist before they undergo treatment with me, particularly if they are looking to rejuvenate the peri-oral area. I also may advise a dental consultation with a colleague to complement any facial soft tissue augmentation. PEG has now evolved into PEGS(mile)! The profound impact of cosmetic dentistry on myself and my patients has led me to open a clinic that brings the worlds of facial and dental esthetics under one roof. The difference with this office is we will have dedicated staff for each field, allowing true expertise to be put into practice. This will be the first center of its kind in the U.K. I believe this model is the blueprint for the whole face approach in our quest for greater patient satisfaction.
Dr. Benji Dhillon has been involved in all aspects of esthetics for 6 years and has acted as the Medical Director for Europe, Middle East and Africa for Allergan, the company that manufactures Botox and Juvederm. He has maintained an interest in research in his clinical practice, leading clinical studies of new body contouring devices, dermal fillers and Botox. Some of his research has been published in peer reviewed journals such as Dermatologic Surgery, Journal of Plastic and Reconstructive Surgery and the British Medical Journal, as well as being presented at international and national conferences.
1
#
Website for
New Dentists Blog | Article Library | Magazine Library | FREE Podcasts | Resources W W W.T H E N E W D E N T I S T. N E T
28 THENEWDENTIST.NET FA L L 2 0 1 8
REDUCE
ANESTHESIA ANXIETY M
By Renee Knight, Editor
ost patients panic when they hear they need local anesthetic before a dental procedure— especially if they’ve had a negative experience in the past. The fear of the dental needle even keeps some patients from getting the care they need, and is one of the reasons dentists and manufacturers have been looking for ways to reduce injection pain for years. There are plenty of products on the market that help reduce injection pain, including vibrating devices like the DentalVibe® or VibraJect®, topical anesthetics, and dental cartridge warmers and dispensers like the one from Premier Dental Products Company, said Dr. Jason H. Goodchild, Director of Clinical Affairs for Premier® Dental. While these are all great tools that can help improve patient comfort, before incorporating them into their practice, new dentists must first learn proper injection techniques and how to determine which anesthetics are best, and when. “In a lot of ways, this is one of the most anxiety and fear producing parts of the dental experience, so dentists should really practice and perfect the skill of giving good local anesthetic injections that are comfortable and effective,” Dr. Goodchild said. “If dentists can master
FA L L 2 0 1 8
THENEWDENTIST.NET
29
FROM THE ADVISORY BOARD
Leah Massoud, DMD San Jose, CA Tufts, 2009
Larry Dougherty, DMD San Antonio, TX Nova Southeastern, 2008
CHOOSING THE RIGHT ANESTHETIC There are various types of local anesthetic on the market, and everybody has their own recipe for what works best, Dr. Goodchild said. In general, the anesthetic you choose should be patient specific. You should consider many factors, such as how long you want the anesthetic to last and how quickly you need it to take effect. Be sure to look at specific patient factors as well, such as medical history. “Just like with any medication you would give a patient, you need to match the right drug at the right dose at the right time for the right indication and the right procedure,” Dr. Goodchild said. “That’s how you set yourself up for success. Be safe and effective.” THE BENEFITS OF WARMING CARTRIDGES Reducing the needle size, pre-cooling the injection site, adding topical anesthetic, incorporating vibrating devices and warming anesthetic cartridges are all ways to make the injection experience more pleasant for patients. While warming cartridges isn’t new, there are studies that illustrate it can help improve patient comfort. In a study that recently appeared in the journal Local and Regional Anesthesia, researchers conducted a split-mouth randomized clinical trial (RCT) to assess the effects of administering warmed-up local anesthetic compared with room temperature local anesthetic on pain during infiltration. The participants who received the warmed-up anesthetic reported a lower pain score than those who didn’t.
30 THENEWDENTIST.NET FA L L 2 0 1 8
-Dr. Leah Massoud
“I think technique is so much more important in this area than the anesthetic choice as far as the patient having a good experience.” -Dr. Larry Dougherty
“Anesthetic is top priority. We need our patients to be comfortable.”
PHOTO COURTESY OF PREMIER DENTAL PRODUCTS COMPANY
that skill, and it is a skill, it’s great for the patient and can be a practice builder. If dentists don’t give good injections, it can harm a practice. You don’t want to be known as the dentist who gives painful injections.”
“This is perhaps the most important part of the procedure. If they are in pain they are likely to have more dental phobia and refuse future treatment.”
David Carter, DMD Zachary, LA University of Mississippi Medical Center, 2014
Matthew Silverstein, DMD, MPH West Hartford, CT University of Pittsburgh, 2012
Rebecca Berry, DMD Oakland, ME Tufts, 2011
-Dr. David Carter
“I’ve found the anesthesia administration can set the tone. Once someone achieves profound anesthesia with minimum discomfort, it seems patient anxiety levels ratchets down quite rapidly.” -Dr. Matthew Silverstein
”Any anesthetic works but making sure profound anesthesia is achieved is vital to the patient experience. No one wants to feel pain.” -Dr. Rebecca Berry
Top anesthetic considerations for the advisory board: The New Dentist™ magazine advisory board members want to invest in anesthetic that is effective, safe and that gets patients to profound numbness. They also want a product that not only meets patient expectations, but that is best for the patient and the procedure.
Other studies have shown cooling has some benefits as well, Dr. Goodchild said, but warming the cartridges seems to help even more. Why? That’s still unclear, but Dr. Goodchild believes it has something to do with the solubility of the material and how well it passes through the nerve membranes once it’s warmed. There isn’t really an accepted temperature for how warm the anesthetic should be, but Dr. Goodchild said dentists typically should heat the material to between 37 and 43 degrees Celsius. The Premier® Dental cartridge warmer and dispenser uses a light bulb to heat the anesthetic to the desired temperature. It’s a pretty inexpensive device and is effective, but some dentists opt for an even lower tech version: heating the cartridges in their hands.
FINDING WHAT WORKS No matter what anesthetic or device you choose, you have to invest in products you’re comfortable working with, Dr. Goodchild said, which takes some trial and error. He suggests trying different anesthetics as well as devices to determine which one fits into your practice. Look at the literature and what evidence exists to support the effectiveness of these different products.
“Dental school isn’t the end of our learning. It’s the beginning,” Dr. Goodchild said. “You’re set up with the basics, now you have to translate that into the business and what works best for you, your team and your patient. Getting exposed to as much as you can to find out what will help your practice is really important.” Many patients fear injections. They’re anxious about the pain, but you can help alleviate those fears with the right techniques and products. When you do, you’ll have loyal patients who might even be inclined to refer.
;-) (made you look)
Getting potential patients to look at you is what we do. Find out how we can do it for you.
www.madeyoulookat.me
FA L L 2 0 1 8
THENEWDENTIST.NET
31
SKINNY
on the Street
The latest news on products and services for new dentists and their practices American Academy of Dental Sleep Medicine Obstructive sleep apnea (OSA) is an epidemic that seriously impacts the health of more than 30 million Americans. Sadly, only a small percentage have been diagnosed. Dentists can help by screening their patients for OSA and adding oral appliance therapy (OAT) to their practice. The American Academy of Dental Sleep Medicine (AADSM) provides training for dentists to become qualified to provide OAT. We’ll enable you to help your patients improve their health while adding another income stream to your practice. Join the AADSM and you’ll receive a discount on our very popular AADSM Mastery Program. New sessions begin in April 2019. For more information, call 630-686-9875 or visit aadsm.org/join.
PHOTO COURTESY OF AADSM
Online Essentials
New Traxodent® Unit Dose Hemodent® Paste Retraction System
To successfully compete in the realm of dental marketing, there are some services you must be performing if you want to climb the ranks and dominate your local area. These services are called Online Essentials: • Search Engine Optimization (SEO) • Social Media Marketing (SMM) • Directory Listings Management • Google Business Optimization • Google Maps Optimization • Review Generation • Press Releases
Dentists now have a choice: use Premier Dental’s Traxodent in the original sleek syringe or in the new Unit Dose. This is the same Traxodent hemostatic retraction paste, just in a new dispensing style. Award-winning1 Traxodent is the No. 1 choice2 among dental professionals because it works fast, helps capture accurate impressions and rinses away easily. No film residue—no worries! Use it alone, with cord, or a retraction cap for greater gingival deflection.
Online Essentials are key to generating an aggressive dental marketing strategy that focuses on increasing website traffic and obtaining more patients.
References 1. Traxodent is the winner of the Dental Product Shopper ‘Best Product’ award for 2018. 2. Traxodent is the No. 1 choice among dental professionals. SDM Data 2017.
Are you ready to get serious about dental marketing? Call Affordable Image today at 866-961-4412 or visit affordableimage.com/seo
PHOTO COURTESY OF AFFORDABLE IMAGE
PHOTO COURTESY OF PREMIER® DENTAL PRODUCTS COMPANY
INDEX O F A D V E R T I S E R S Advertisers in this issue of The New Dentist™ have made it possible for you to receive this publication free of charge. Please support these companies. Contact information can be found below, or visit The New Dentist™ Resources at thenewdentist.net to receive information from more than one company. Affordable Image.................................31 Affordableimage.com 866-961-4412 American Dental Association.............15 ADA.org 312-440-2500 Army........................................................ 3 healthcare.goarmy.com/mc34 800-431-6712 Arrowhead Dental Laboratory..........IFC Arrowheaddental.com 877-358-0285 ASI Medical...........................................13 asidental.com 844-880-3636
CareCredit.............................................25 carecredit.com/provdercenter/dental/ 866-246-6401 (new enrollment) 800-859-9975 (already enrolled) Centric Dental Laborarory..................22 Centricdentallab.com 800-522-1193 Dentrix Ascend....................................... 7 dentrixascend.com 855-232-9423 Henry Schein Professional Practice Transitions............................ IBC Henryscheinppt.com 800-988-5674 Interchrome Dental Laboratory.........23 Interchromedental.com 757-271-5811
McKenzie Management.......... 17, 19, BC mckenziemgmt.com 877-777-6151 PNC.......................................................... 5 Pnc.com/hcprofessionals 877-566-1355 Premier® Dental Products Company....21 premusa.com 610-239-6000 Tuscaloosa Dental Arts........................24 Tuscaloosadentalarts.com 205-562-3231 Viva Learning........................................11 vivalearning.com Wells Fargo Practice Finance................. 1 wellsfargo.com/practicefinance 888-937-2321
The New Dentist – New Dentist Resources, New ... http://www.thenewdentist.net/resources.htm
Scan the code with your mobile device to receive more information from these advertisers. Or visit www.thenewdentist.net/resources.htm http://kaywa.me/b4u2c
32 THENEWDENTIST.NET FA L L 2 0 1 8
Download the Kaywa QR Code Reader (App Store &Android Market) and scan your code!
Henry Schein® Professional Practice Transitions knows how to keep a secret.
Confidentiality is important during a practice sale. That’s just one reason why thousands of practitioners have entrusted their practice sale, purchase, valuation, and transition planning to us.
Shouldn’t you? www.henryscheinppt.com
1-800-988-5674 © 2018 Henry Schein, Inc.
n
PRACTICE SALES
n
VALUATIONS
TRANSITION CONSULTING/ PLANNING n ASSOCIATESHIPS n
REALIZE YOUR
GROWTH OPPORTUNITIES
Essential
Business Lesso ns For New D entists
McKenzie Management, your coach for building a more prosperous future in Dentistry.
MCKENZIE
MANAGE
MENT Help ing New Dent ists Reac h Succ ess
FREE
877.77 7.6151 info @m cke nzie mg mt.com ww w.m cke nzie mg mt.com
DOWNLOAD
http://mckenziemgmt.com/NDBusiness.php
877-777-6151 info@McKenzieMgmt.com www.McKenzieMgmt.com