ByScott Pope,DDS

Taking CAD/CAM same-day dentistry to a new level of ease and profitability

March 1, 2013
CAD/CAM has changed the game for dental offices that strive to provide same-day dental care. This article will discuss some ways dentists can further reduce ...

CAD/CAM has changed the game for dental offices that strive to provide same-day dental care. This article will discuss some ways dentists can further reduce treatment times, deliver better care, and increase take-home pay.

The CAD/CAM system makes it possible to deliver single-visit service even for complex restorations, and this is sometimes referred to as "same-day dentistry." When a dental office incorporates CAD/CAM into its daily routine, the practice must commit to mastering the imaging, software, and ceramic materials necessary to create dental restorations that equal lab fabrication.

Once the fundamental technology is mastered, the next step is determining how to optimally schedule patients to deliver same-day dentistry and fit these restorations smoothly into the practice flow. This requires knowing how much time to block out for a procedure, and how to make both treatment rooms productive by using the same-day dental care model. This is where buffering local anesthetic using Onset makes a huge difference.

If you are a CAD/CAM user, making your dental anesthetic work optimally is where Onset®, another dental game changer, will make your practice truly hum as you deliver same-day dental care more efficiently. We face delay and uncertainty when we wait for local anesthetic to take effect. This prolongs restorative appointments 15 minutes or more, and adds even more stress to the office on days when things are running behind schedule.

Stress and inefficiency are not an issue for those who have adopted this new technology, which gives predictable profound anesthesia within two minutes. Eliminating latency and the start-and-stop dentistry that comes with it will allow you to complete an additional hour of dentistry per day while working the same number of minutes and in a less stressful atmosphere.

Buffering your anesthetic just prior to normal injection has several benefits. You can achieve reliable profound anesthesia within two minutes. When you have a missed block, which occasionally happens, you will know in less than two minutes. Then you can reinject and get to work two minutes later as compared to losing 20 or 30 minutes.

Confidence levels increase when you know your anesthetic will work. Thus, you can go to work without leaving the patient. This is a revolution in time savings for those dentists willing to move tasks such as hygiene exams and answering emails to the back-end of an appointment (after they have finished the procedure and said goodbye to the patient).

Dentists appreciate the time savings and efficiency, and patients will feel like VIPs when the dentist stays with them for the whole procedure. Patients also will appreciate the shorter appointments.

Not every dental office has the aptitude to make changes in their routine in order to take advantage of the technologies that will make life better and the practice more profitable, such as CAD/CAM and Onset. My office had no difficulty beginning to buffer our anesthetic. In fact, once my team discovered how smoothly the practice operated when I started "staying in the chair," for the first few days they would not let me leave the treatment room (as usual) after I delivered the injection. This happened until I got used to not immediately leaving. Peeling my gloves off immediately after handing the syringe to my assistant was practically second nature after 19 years in practice.

For more than a year now, I've been using this buffering agent in my practice. I appreciate how it feels to finish what I start with every procedure. This would have been the natural state of affairs if we were not waiting for the anesthetic to work. The difference is remarkable. But I'm not the only one who notices. Patients and the team appreciate the improvement, too.

My CAD/CAM restorations benefit most from the "stay in the chair" efficiencies. Buffering the anesthetic gives a predictable block of time for each type of restoration that is not muddied by an anesthetic latency period that can last anywhere from 10 to 30 minutes. We now schedule most of our procedures for a one-hour appointment. This includes crowns, inlays, onlays, and veneers. When we do more than one restoration, we add 15 minutes per restoration.

With CAD/CAM and buffering, we dedicate the first half hour to doctor time with the patient. This period lets us anesthetize the area, prepare the tooth, image the prep, and design the restoration. Once the restoration is ready to send to the mill, the initial doctor time is finished.

At this point, my assistant continues the restoration until milling is complete. Meanwhile, I spend 15 minutes checking hygiene, seeing another patient, or taking care of other office tasks. I then return for a final 15 minutes to cement and complete the restoration, discuss postop, and say goodbye to the patient. My next appointment begins immediately in my second treatment room while the dental assistant finishes with the first patient and turns over the room.

The materials we predominantly use are Empress, Sirona, Lava Ultimate, and e.max porcelain restorations. We add 15 minutes for oven time to the standard appointment when we make an e.max crown or when custom staining is required.

By incorporating Onset by Onpharma®, we can complete one to two additional CAD/CAM procedures in each practice day with the same amount of doctor time on the schedule. Two additional procedures per day are worth more than $2,000 to the practice. Reducing your practice stress is priceless.

Scott H. Pope, DDS, is a dental professional with an accomplished background in managing comprehensive dental cases. The Bay-area native is a CEREC trainer who lectures on CEREC and Galileos 3-D Cone Beam integration. He has a practice in Walnut Creek, Calif. Contact him at (925) 939-4989 or at [email protected].

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