Slow down — You move too fast!

Oct. 1, 2003
I've listened to hundreds of my peers and know unequivocally that digital imaging and photography can improve case acceptance.

Paul Feuerstein

I've listened to hundreds of my peers and know unequivocally that digital imaging and photography can improve case acceptance. Learning to use this technology is usually a matter of attending a short, simple training course somewhere fun (Las Vegas anyone?) Take it a step further by mastering Image FX, DICOM, Vipersoft, Digital Dentist, Tigerview, and other fine offerings, as well as Photoshop and similar programs that allow you to take a "before" photo of your patients. Or, if you prefer, take a pre-made "smile," such as one from Dr. Lorin Berland's Library, or Dr. David Hornbrook's, Dr. Bill Dickerson's, Dr. Anthony Vocaturo's, or other catalogs of teeth and smiles, and embed them into your potential "case." Still other programs can send a photo to a lab or company like Smile Vision and pay for the "after" rendering. Then, to really put the icing on the cake, you can put all of this into a PowerPoint presentation, add a few modules of CAESY, and send the patient home with a CD to study and show the spouse. Whatever technique you choose, these cutting-edge technologies allow you, in a few mouse clicks, to definitively illustrate the dramatic benefits of cosmetic treatment to your patients. The expenditure of time, money, and energy will be amply rewarded when your case acceptance rate skyrockets.

People seldom comprehend the extent of dentistry's potential benefits until the tangible evidence is in front of them. And it's easy — a digital image or photograph can be discreetly worked into almost any clinical scenario. Why not take a "smile photo" of a new patient during the initial exam and leave it up on the screen? Or, if you use a Polaroid, put it where the patient can see it while you rattle off clinical findings to your assistant (or if you have voice recognition software, to the computer). If there are obvious problems, such as old, discolored composites, the patient is bound to ask about it. And, after you've piqued a patient's curiosity, it may simply be a matter of giving a brief overview of solutions that are available. Most patients can be persuaded with just one or two photos of their existing teeth.

Yet, with all the evidence that digital imaging and photos are a clear path to profit, many outstanding dentists use it moderately. I've interviewed a lot of these experienced practitioners, and many of them vehemently insist that a good case presentation is all that's necessary. They acknowledge that yes, some patients might want to view the potential results. But they also are quick to point out that some patients just need time to discuss their treatment in depth, have someone listen to their concerns, and answer their questions. I think I understand where these dentists are coming from. We live in a beep-me-text-me-scan-it-so-I-can-look-at-over-the-Internet-and-email you about it world. Human interaction is in danger of being swallowed up by technology.

Dr. Rick Coker of Tyler, Tex., is one dentist who has built an extraordinary cosmetic practice through a precise blend of cutting-edge technology with a back-to-the-basics philosophy that values one-on-one relationships. Dr. Coker wisely promoted his chair side assistant, Cindy, to the position of Treatment Coordinator. In this practice, Cindy uses her experience as an assistant to talk patients through procedures while taking photos, digital radiographs, or showing them the screens. When Dr. Coker comes in to do the exam, Cindy has already mentally prepped the patient; all he needs to do is show smile photos of similar cases or before and after shots.

Not every office has the luxury of hiring a Treatment Coordinator. It therefore falls to dentists to tailor their use of technology to the needs of their practices. Some practitioners, in their excitement to convince the patient, may use imaging to overstate the results. Be sure that you can deliver the case, since the patient will have elevated expectations of the result.

As I mentioned previously, often the best avenue to patient acceptance is an indirect one where the patient discovers and then asks. Then, put the icing on the presentation with some electronic wizardry and education. Also, those dentists — or assistants — who are adept at imaging can have a simulation on the screen in minutes. Keep in mind, as Coker says, that it is still critical to sit, explain, and more importantly, empathize with the patient to get that final acceptance. There's no technological substitute for old-fashioned caring.

Dr. Paul Feuerstein installed one of dentistry's first computers in 1978. For more than 20 years, he has taught courses on technology throughout the country. He is a mainstay at technology sessions, including annual appearances at the Yankee.Dental Congress, and has been a part of the ADA's Technology Day since its inception. A general practitioner in North Billerica, Mass., since 1973, Dr. Feuerstein maintains a Web site ( and can be reached by email at [email protected].

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