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Economy got you down? Think again!

March 1, 2011
It's everywhere you look. It's everything you hear on the news. The radio talk shows go on and on about it.
By Dr. Kevin Winters

For more on this topic, go to www.dentaleconomics.com and search using the following key words: economy, goal setting, expanding services, intangibles, mindset, Dr. Kevin Winters.

It's everywhere you look. It's everything you hear on the news. The radio talk shows go on and on about it. What is IT? IT is the ECONOMY.

For the last several years, the country's economic challenges have been at the top of everyone's discussion list. The negative emotions associated with this can be really overwhelming. It's very easy to be dragged down into the vast dark hole of gloom and doom. The effects weigh on us both personally and professionally. Relationship problems can intensify. Situations with employees can escalate. Why? It's really a matter of choice.

I feel that our attitudes about situations help us form our realities. If you approach things from a negative standpoint, chances are that's exactly what will happen. There is a phrase that really rings true here. "You become what you think about." In other words, your attitude toward life, your practice, and your relationships will create that reality.

Have you ever wondered why some practices are thriving and others are dying? Many times they can even be right across the street from each other. Why does this happen? Of course there's not one answer to this; it is a series of many events. But underlying all the other intangibles, in most cases you will find the successful practice has an overall positive vibe. Usually there is a strong leader and a team who "gets it."

Setting the foundation for success begins with the decision to be successful. It doesn't just happen. People make decisions, even sometimes subconsciously to be successful or not. Focusing on what you want instead of on what you don't want prepares you to head down the road you want to be on.

Goal setting is another huge step. The majority of people who talk about wanting to be better, wanting to lose weight, wanting to be successful, never do anything more than talk about it. Rarely is there a plan of action to direct them where they want to go. Writing down goals and how they will be achieved begins the process of actually making it happen. Something is not going to just magically appear.

Write down goals and plan them with very specific language. Don't write, "I want to collect $100,000 per month." Write "I will collect $100,000 per month by doing x, y, and z." This is a specific goal written with positive language that gives you a road map to follow.

After your goals and plan have been written, display them so you can see them every day. If this is for your practice, make sure everyone on your team is aware of them and can see them. Hopefully, your team has been influential and personally involved in establishing the practice goals, as they will be the determining factor in making the goals happen. Your leadership is required to transfer your vision to them.

Creating a mindset similar to what I've described is essential. When we deal with patients, many of them may not be fortunate enough to be able to make a good living and have some control of their destiny. There is no doubt jobs have been lost and retirement funds have been affected. Discretionary income has decreased. So, what does that mean for us, and how can we position ourselves to help our patients get what they want while continuing to grow our practices?

While most of us may not be doing as many full-mouth reconstructions or 20-unit veneer cases as we did a few years ago, there are still ways to keep the practice numbers up. Dentistry is really fun right now. Yet I talk with so many colleagues who have nothing good to say about our profession. Are you kidding me? How can you not enjoy using the "toys" and incredible materials we have available today?

Expanding services is another avenue that everyone should explore. Implants using 3-D technology are amazing. So much precision with our implant placement is available using the imaging and stent fabrication that the surgery is actually pretty simple now. More time can be spent treatment planning and preparing. Check into systems from GALILEOS, Gendex, iCat, Kodak 3-D Imaging System, Planmeca, Sirona, Suni, and others. (See Fig. 1)

Fig. 1

Another area is endodontics. Fast, one-appointment, primarily automated root canals have become the norm. Great systems allow everything from the simplest single canal incisor to multicanal curved molars to be done with considerable ease. Check out the complete systems from DENTSPLY Tulsa Dental Specialties, Discus Dental, Medidenta, or Sybron Endo. Courses and the necessary equipment are available. (See Fig. 2)

Fig. 2Unless you have had your head in the sand for the last several years, you should be aware of one of the most exciting advancements in dentistry in quite some time – digital impressions. The technology for digital impressions makes these models so accurate that they may exceed traditional polyvinyl impressions. Through the coordination of companies, dentists, and lab technicians, we are able to do full-mouth restorations without
Fig. 3any trays or impression material. Once the images are taken, they are sent via the Internet to the labs, who then treat them just like a normal case. Check out the iTero by Cadent or Lava by 3M. (See. Fig. 3)

Another aspect of this same technology is one appointment, in-office crowns and onlays. Using porcelains like e.max from Ivoclar, dentists are able to prep, picture, design, manufacture, and seat a crown all in one appointment. CEREC AC by Sirona or E4D by D4D Technologies and Henry Schein are time tested and work exceptionally well. (See Fig. 4)

Even though some of our patients are spending more carefully now, they still want to look good and have great smiles. Maybe the 10- or 20-unit cases are not coming through the door as often as they used to, but you can still do some amazing things with less dentistry. Here is a photo of a case that was simply bleaching with Opalescence (Ultradent), and four e.max (Ivoclar) veneers adhesively bonded with OptiBond Solo Plus and 3M ESPE RelyX Veneer Cement. Cosmetic dentistry is not always about crowning or veneering all the teeth. This produced a great result! (See Figs. 5 and 6)

There is a type of cosmetic dentistry becoming more widespread that is
Fig. 4esthetically beautiful and functionally beneficial for the tooth. Posterior direct placement fillings, either done initially or to replace worn-out mercury fillings, are thankfully being placed more often. So many materials are available that make dentists' lives easy. Composites such as Premise or Ultra by Kerr, Filtek Supreme Ultra by 3M ESPE, EsthetX by DENTSPLY, Artiste by Pentron, Empress Direct by Ivoclar, and Vitalescence by Ultradent are just a few of the many choices dentists have to make posterior teeth both beautiful and strong. (See Figs. 7 and 8)

These composites can be beautiful anteriorly as well. Can your patient not afford porcelain? How about closing the diastema and lengthening the laterals with composite? (See Figs. 9 and 10)

Finally, there are two areas where our unique abilities as dentists position us to be able to really impact the daily lives of our patients, and potentially even save their lives.

Using techniques to address the signs and symptoms of TMD can dramatically improve our patients' well-being. There are several ways to approach these problems, but I have found neuromuscular principles have provided predictable and profound results. Relaxed and comfortable muscles help patients feel and function much better. This concept has been around for years, but the most comprehensive place to learn about it is through the Las Vegas Institute.

Fig. 5 (left)

Another area of dentistry that is exploding is obstructive sleep apnea. Dentistry's role is becoming more important because we can help screen potential patients with this problem, as well as help those in the mild and moderate categories, and those who cannot or will not use their CPAP machines. This is something that can literally save someone's life. Many courses and several appliances, such as the SomnoDent, are available to help our patients.

Fig. 7 (left)

I have tried to share just a bit of encouragement as you start 2011. Create your own reality. Use the materials and technology that are available today in our wonderful profession. Never stop learning. Isn't it interesting how so many of the most successful dentists are the ones attending courses and growing professionally? We are lucky to be dentists in 2011. Our futures are limitless if we open our minds.

Fig. 9 (left)

Dr. Kevin Winters has operated successful dental practices for 20 years. He recently opened a new practice in Tulsa, Okla., focusing on general, cosmetic, and neuromuscular dentistry. While serving as one of the original clinical instructors at LVI, Dr. Winters has also lectured internationally and written multiple articles for dental publications. Dr. Winters is also a state championship high school football coach. He may be reached at [email protected] or (918) 528-3330.

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