By Bill Busch, DMD, MAGD
For more on this topic, go to www.dentaleconomics.com and search using the following key words: technology, necessity, E4D CAD/CAM, CEREC, software, Bill Busch, DMD, MAGD.
Success in practice is in the eye of the beholder. I believe in order to be truly successful one must be both professionally and financially successful. To be professionally successful, one needs to provide the best, most appropriate treatment possible for every patient, period. To be financially successful, one needs to collect the appropriate fees for services rendered, and invest them wisely for family, staff, and patients. This goal is a daily commitment.
It is possible to be very good at one aspect of success or the other, but focusing on both daily will allow us to have complete enjoyment from our occupation. To me, dentistry is one of the greatest professions in the world. There are not many professions that allow the preventing, curing, and repairing of disease in a single appointment that may be only a few minutes.
This leads me to talk about my view from the chair with regard to using CAD/CAM technology to gain both professional and financial success in your practice.
I started practicing dentistry in 1989. I knew that technology could advance the practice of dentistry by leaps and bounds, just as it has done in other professions and industries. The key is being able to understand IT (information technology), learn IT, buy IT, and then use IT. This is my simple strategy with dental technology.
The other part is to know when to add the technology. I add in small increments so it can be completely used in my practice. Every year I do a technology evaluation of my practice to know what works and what does not and to refine the choices. My good friend and coach, Blair Kolkoski (A2 Business Coaching), taught me if I want to earn more, I have to learn more.
In 2001 I purchased CEREC CAD/CAM in-office milling systems for my practice. That decision has been one of the best professional and financial investments of my career. It transformed my practice into performing better dentistry, and at the same time has been an incredible financial boost. No more single crown cement visits.
I gain at least 16 clinical hours per month, and I do not need patients to come back for a seat appointment. Let’s face it; most of us dislike single tooth dentistry. We are taught quadrant dentistry, and we try to help our patients accept and complete that.
But the reality is that about 75% of crowns are single tooth procedures. I found that I can be more profitable and the patient more willing to accept treatment if it can be accomplished in a single visit. I watched the CEREC technology for 20 years before I purchased it.
I loved the concept, but until the software went to 3-D and in the Windows environment, I did not believe it was ready for prime time. That was in 2001, when I bought the CAD/CAM technology for the office and never looked back.
In 2009, I needed another machine. I chose the E4D from Henry Schein because it offered some significant advantages over the CEREC technology. So now I have both machines in my practice and use them constantly. If a patient comes in with an emergency broken tooth, we can fix it that day. Patients love that. They exclaim, “You can do it now?” “You mean I don’t have to come back for a second visit?” “This is awesome.”
I had the CEREC for three months when it broke. It took three days to get parts from Germany (Sirona). My patients who were scheduled for the single visit crowns postponed. They told the front office staff that they would wait until the machine was fixed because they did not want to come into the office twice. I figured out that patients are just like me. Technology makes us impatient, and the more we’re exposed to it, the more we want it, and the more we demand improvements, speed, strength, and more.
Since that incident I have not been down for more than one day. Both companies provide great customer service to keep things running smoothly. Patients love the technology, and it sets me apart from the competition. Also, it is nice to have two machines because now I am never down.
The accuracy of this technology has become as reliable as the lab-fabricated restorations. In fact, the laboratories use the same technology to construct restorations in their labs. Start looking closely at your mail.
Every day I receive a solicitation for an e.max crown for a $99 intro offer, and in the background of the postcard picture I see an E4D mill or a CEREC mill. They are taking your impressions and scanning them at the lab. So we can now dismiss labs as “gold standard” because many of them are now building your lab work the same way you are.
The CAD/CAM technology offers dentists many choices. I like a do-it-yourself system. I like being able to complete the whole restoration in one visit. The CEREC system, and soon the E4D, has the ability to send the digital impressions to the lab directly from your office.
Kind of a hybrid function, CEREC calls this CEREC Connect, and E4D calls this the Sky Network. This allows us to send bigger cases to the lab for fabrication, such as bridges, implant restorations, and more.
If you are not a DIY person and you want to get into digital dentistry, then 3M C.O.S., i-Tero, or 3Shape might be in your future. These are digital impressioning systems that capture and send digital impressions directly over the Internet to the lab, which bypasses the lab pickup truck, and is in fact the “green” way to do things. The best part is you can still use your favorite lab.
I suggest that you consider this for your practice. E4D has a wonderful full-day preview course in Dallas each month. You can attend and receive three CE credits. Learn the system, build your own crown, and learn to stain and glaze in a single day.
There are classes also available at the Scottsdale Center in Arizona for CEREC. Visit www.scottsdalecenter.com. The 3M C.O.S. (Chairside Optical Scanner) and i-Tero are available for demonstration at your nearest Henry Schein dealer.
Last year I added the Instrumentarium Scanora 3-D cone beam CT to my office. I wanted a higher degree of accuracy for implant treatment planning, placement, and surgical guided implant placement. I started placing implants about three years ago and found that I needed more information to be comfortable in placing more implants quickly and efficiently.
Cone beam technology allows for predictable implant placement. It is the “call before you dig” technology. (This is the slogan the power company uses to make sure homeowners don’t short out the neighborhood when they plant that new tree in their front yard.)
I chose Scanora because it had a true 2-D digital panoramic built in. To my knowledge, no other system has this. All the others have a rendering (computer generated) panoramic derived from the cone beam CT scan.
This is important because I am in general practice and I take a lot of digital panoramic X-rays. My office does not have room for both a cone beam CT and a digital panoramic. The Scanora offers it all in one convenient machine and footprint. I just removed my OP 100D from Instrumentarium and placed it in the same footprint. The Scanora integrates with the implant planning software offered through E4D.
This allows the dentist to plan his or her entire implant case from beginning to completion, including the prosthetics. The Sirona Galileos cone beam CT integrates with the CEREC system to allow for implant planning.
I have the CT software loaded on all my workstations so I can discuss the findings immediately with each patient. It requires a high quality video card with at least 1 gig of video memory. But this can be added to an existing computer for about $100.
Being able to do this immediately improves workflow and gets patients to say “yes” to treatment quickly because I can cotreatment plan with them and give them a cost analysis immediately through Dentrix Dental Systems (or a similar system).
If you’re not networked throughout your office with computer workstations, you are missing out. It allows you to create your own private office in each operatory, improve multitasking, and do more dentistry with less effort.
What’s working well in my office now
• I have my own app for my dental office and you can, too! You get Apple and droid platforms. Patients can download your free app to their smartphones. It is the new virtual business card. It will even navigate your patients to your office! All for $995. You can download my app at iTunes or the droid market. Just search for Dr. Busch. www.yourdentistapp.com.
• Social networking from Demandforce. You can sign up through Henry Schein or go to Demandforce. It’s the same price either way. They will even set up your Facebook page for $295. They will also do email and text messaging reminders for patients.
• Text messaging to patients directly from Microsoft Outlook 2007 or 2010 with Message Media www.message-media.com. It’s $10 per month for 1,000 text messages a month. It is great when you have a patient you need to confirm quickly or who is running late.
• Microsoft Exchange Service on the Cloud. They will host all your email for $5 per month per email address. They do all the virus protection, spam, filtering, etc., before it even gets to your office Outlook. Remarkable! Visit http://www.microsoft.com/online/exchange-online.aspx.
• Giving back. A great way to give back to your community is to join TeamSmile Dental Outreach. It requires one day a year volunteering with your local sports team to give underserved children the experience of a lifetime. It’s dentistry and sports at the same time, and it’s fun and easy. Check it out at www.teamsmile.org. Treat needy kids and go to the game with all the volunteers. Oh, and get a one-of-a-kind set of free team scrubs to wear!
Technology is wonderful if you put in the time to learn it. So get moving!
Bill Busch, DMD, MAGD, director of the North Kansas City Dental Group, has been practicing for more than 20 years in the Kansas City, Mo., area. He has a high-tech, green dental practice. He cofounded and created TeamSmile Dental Outreach for Children, which provides free dental care to uninsured children across the country with professional sports teams. Visit www.teamsmile.org, www.drbusch.com, or www.thedentrixdentist.blogspot.com. Contact Dr. Busch at [email protected].
