March 1, 2013
The stories and aftermath of Hurricane Sandy are still with us. Once we get past the destruction and personal tragedies, we can look at rebuilding.

by Paul Feuerstein, DMD

The stories and aftermath of Hurricane Sandy are still with us. Once we get past the destruction and personal tragedies, we can look at rebuilding.

Before I proceed, I must digress and acknowledge the amazing fund-raising organized by Howard Klein, Mike McCarthy, and the Lanmark360 organization. Using a fun premise to provide a smile during a tough time, male employees organized the "Shave the Shore" campaign, not shaving until they received $10,000 in donations to help those in New Jersey. Their goal was quickly met with an outpouring from the dental industry, and a big push from Darby Dental. So the ante was increased to $20,000. The shaving has been done and the goal has been reached, but the campaign continues to collect contributions. More information is available at and

Many businesses, including dental offices, were destroyed by Hurricane Sandy. Among the lost items were computer systems, patient records, appointment books, financial information, and more. In the aftermath, the term "backup" has had a significant meaning. This was critical for offices that lost power for days or weeks and had no access to information.

In New England where I'm located, we often have power outages (Sandy affected our office for only two days). With some foresight, we've made it a point to take home a printed appointment schedule for the next couple of days. Thus, patients can at least be alerted that the office is closed.

After these couple of days, though, it gets more complicated. We do have backups on disk and USB drives, but these contain only data that has to be read with the actual practice management software. Some PM systems have "lite" versions that run on mobile devices, but most of these require some connectivity to the servers (which are obviously not on during a power outage).

As it turns out, many offices use remote services for appointment confirmations, reminders, birthday cards, and office notices. While there are too many companies to list here, many of them keep a copy of the appointment schedule on their servers. After Hurricane Sandy, offices were able to contact them, and these companies were able to stay in communication with scheduled patients, as well as the entire database in terms of the status of the office. Unfortunately, this does not include the rest of the information, images, etc.

Some offices use online backups that again, for the most part, contain only data. If you have the installation disks for the PM software and load them on a computer at home or somewhere with power, the data has to be downloaded or installed. This is not a simple task, and it can take a long time if there is a lot of data and a normal Internet connection.

Of course, in reality, you have not lost everything, and you can continue to operate once new computers are in place, installed, and re-networked. In recent years, backup strategies have changed with the introduction of Cloud-based solutions.

One answer is to use new Cloud-based systems such as CurveDental, ICE, and PlanetDDS. The majority of us, though, are on other systems. These systems are trying to get more of this information online, but they still depend on in-office hardware servers.

An interesting answer is something called a virtual machine (VM), which is a copy of the entire server, operating system, programs, and data in the Cloud. It acts as if there is a computer running right in your office, and depends on constant backups to keep it updated. Thus, if the office server is down, the office (or home or offsite) computers can run as if nothing happened by simply flicking a software "switch." This can be as quick as a 10-minute process. So for the time the office is out, the virtual server is running the show.

Once a new computer/server is physically installed, old information as well as newly input data can be reinstalled and updated on the physical machine. The downside here is speed, as well as keeping a stable connection. But today, cable and other systems, such as FIOS, are faster and cheaper than old T-1 lines.

There are a myriad of other backup solutions supplied by the PM companies or independent systems, such as DDSRescue (, or remote administration by several dental and nondental technology companies. The point is that no one is immune to a disaster. In addition, today's offices cannot truly function without a fully operational computer system. Our data is more comprehensive and more complex, and requires a fresh look in terms of backup and restore. I think it's time for some homework.

Paul Feuerstein, DMD, installed one of dentistry's first computers in 1978, teaching and writing about technology since then while practicing general dentistry in North Billerica, Mass. He maintains a website (, Facebook page (Paul-Feuerstein-DMD-Dental-Technology), is on Twitter (@drpaulf), and can be reached via email at [email protected].

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