Get Busy!

Aug. 1, 2012
Dentists complain to me often that they're just not busy enough. Their complaint is always the same: "I have a full-time practice and there are significant holes in my schedule. No matter what I do, I have holes in my schedule."

BY Louis Malcmacher, DDS, MAGD

Dentists complain to me often that they're just not busy enough. Their complaint is always the same: "I have a full-time practice and there are significant holes in my schedule. No matter what I do, I have holes in my schedule." The first question I ask every dentist is, "What services are you offering?" The answer I get almost immediately is, "Everything." When I hear this, it reminds me of when we ask patients what their insurance covers and they say, "Everything."

Here's what I mean. I question these dentists about their practices - Do you do crown and bridge and restorative dentistry? Yes. Do you do endodontics? Well, most endo is referred. What about periodontal treatment? The periodontists prefer to do everything in their offices. Do you offer no/minimal prep veneers? I do one to two cases per year because I'm not sure how to do them well. Do you do implants? No. Do you offer dental esthetic and therapeutic treatment with Botox and dermal fillers? No. How about short-term orthodontics? No.

Of course these dentists aren't busy!

Let's talk about the most common needs of patients, such as restorative, periodontal, and endodontic services. Laser dentistry offers every dentist the opportunity to treat patients, while eliminating the No. 1 reason patients hate visiting the dentist - the local anesthetic injection, the dreaded shot. The advanced technology available today in dental lasers is the best it's ever been. Approximately 90% of the restorative dentistry currently done in my office is performed without a single injection, and that includes adult and child dentistry. Our practice is very productive because we don't have to wait the five to 20 minutes most dentists must wait for local anesthetic to kick in. Many times I'm done with a restorative procedure before most dentists even get started, because they're waiting for the mandibular block to work.

The prevalence of periodontal disease is high, yet many general dentists still provide only the minimal level of periodontal services. General dentists do not regularly perform something as simple as a crown lengthening when the restorative margin has violated the biological width. I recommend getting an all-tissue laser such as the Waterlase iPlus Laser (Biolase) to help eliminate injections for many procedures, and you'll also learn how to do a closed crown lengthening without having to raise a flap. This is a vital service needed in many restorative cases. You can also learn how to do laser endo, which will give you the cleanest canals on the planet and a higher rate of endodontic success.

No/minimal prep veneers, such as Aurum Ceramic's Cristal Veneers, have been one of the fastest growing laboratory esthetic restorations in the last decade. There is a technique to them, and I recommend learning how to do them. It is not clinically difficult at all once you learn the proper technique.

Cosmetic or short-term orthodontics, such as Six Month Smiles, have become very popular with adults because they don't want to wear braces for three or four years, but they do want their front teeth straightened quickly and economically. These provide a turnkey system for general dentists that do not involve any of the bad dental school memories of bending wires for orthodontics, and they are faster and more predictable than aligners.

It's great to be able to provide these great clinical services to patients, but this will only work if they are able to afford the services. Patient financing is crucial to case acceptance. With millions of patients having access to hundreds of millions of patient financing dollars through CareCredit, it is imperative that you offer financing to your patients. CareCredit will help you get busy immediately!

All of the dental therapies mentioned here are more tools in your toolbox and should be on the menu of services you offer your patients. If your patients are not ordering what is on the dental service menu in your office and you are not busy enough, then you need to change the menu items to what people want and are paying for somewhere else. Stop complaining, get trained, and get busy!

Louis Malcmacher, DDS, MAGD, is a practicing general dentist and internationally known lecturer, author, and dental consultant. An evaluator emeritus for CLINICIANS REPORT, Dr. Malcmacher is the president of the American Academy of Facial Esthetics at Contact him at (800) 952-0521 or email [email protected]. His website is, where you can sign up for a free monthly e-newsletter.

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