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Practice transitions: Considerations for incorporating digital dentistry

Oct. 26, 2016
Dentists working from a digital platform have distinct advantages that dramatically impact communication and patient care.

It can be hard for us as dentists and business owners to make the right decisions when it comes to investing our limited funds in new technology. These purchases will, in the lingo of finance, provide an attractive return on that investment. How we make those decisions depends to a great extent on our own practice and career stage. New graduates who are handling a heavy debt load must balance the prospect of adding to that debt against the need for a good start with the right tools.

There are different considerations at midcareer. That's when we ask, "Am I where I want to be? Am I growing professionally? What do my patients want? Do I have the competitive edge I need in today's market?" Finally, as retirement nears, we may want to modernize as a transition strategy. This is not only to retain patients and continue to grow professionally during our final 10 or so years in practice, but also to offer a more attractive value proposition to potential practice buyers.

Dollars and sense

Whether your strategy is to launch, grow, or sell, every modern dental office, at every stage, should be poised to deliver the services patients expect and deserve in the current competitive environment. Right now, that environment includes offering patients information about their treatment using digital images, and offering convenience and new options, such as same-day and chairside dentistry using modern ceramics, smile design, and immediate implants.


It is important to consider how an investment will pay you back. For example, it's a no-brainer that when digital imaging replaces film, it saves the cost of chemicals, time, and space. There are also savings and production increases from technology that offers speed, efficiency, and the ability to do more procedures. But these benefits hinge on making a commitment to actually use it, which means investing the time and training needed to reap those returns.

Tax advantages

There are also tax advantages in buying new equipment. The Section 179 tax deduction allows you to recover all or a portion of the expenses for new equipment that is purchased for at least 50% business use, and that is placed in service before the end of the taxation year. However, to receive the maximum deduction of $25,000, the cost of eligible equipment is limited to $200,000.

Where to start

To effectively incorporate new technology, the office must be computerized, and have a practice management system and digitized records. There should also be a digital imaging solution, either direct using solid-state sensors, or indirect using phosphor storage plates, to diagnose and plan treatment.

Doctors who want to take the first step into the modern digital workflow can do so with an intraoral scanner, which is available as a stand-alone unit or as part of a complete system, such as the Planmeca FIT open architecture CAD/CAM system. In addition to the PlanScan intraoral scanner, FIT includes PlanCAD for designing restorations and PlanMill 40 for milling restorations. The advantages of using an intraoral scanner are the ability to quickly view and share images, which can be enlarged and enhanced to aid diagnosis and improve patient education. These images can be easily stored in the practice management system and transmitted securely via STL file to the laboratory or other third-party collaborators.

Considerations for opening a new practice

Although likely saddled with debt from school, new doctors need to start out with the right image services and technology. The estimated cost of starting a practice is anywhere from $350,000 to $500,000. This is to acquire and outfit a new office and purchase needed equipment and supplies. This is at a time when the "basics" include a computer and practice management software system, a digital radiography system, as well as dental units, furniture, instrumentation, and an efficient sterilization system. Dentists need to keep their future needs in mind, and at a minimum they should make sure they have the space and ability to add technology.

Considerations for midcareer dentists

Whether you're thriving or struggling in the new competitive environment at midcareer, there is much to consider at this juncture. This can be a time to break out of that comfortable routine and refocus on practice goals. Many of today's general practitioners are successfully offering patients services previously restricted to specialists, including endodontics, implants, and related procedures such as ridge and tissue grafts. Those who focus on cosmetic dentistry might emphasize "smile design" staples such as veneers and the much-desired tooth whitening. With the growing issue of sleep deprivation, sleep programs are becoming more common among dental practice offerings. All of this can be enhanced and provided more efficiently with dental imaging. Providing the services patients need and want can affect midcareer dentists' ability to maintain and grow their patient bases.

Considerations for retiring dentists

Dentists who are nearing retirement might consider investing in new technology as part of a transition and exit strategy during their last 10 to 15 years of practice. This is even more important if they want to first attract a new associate, who may be accustomed to the technology used in dental school. What's more, adding innovations can energize even well-established practices and position them as modern, thus impressing existing patients and attracting new ones. There's no reason not to raise your game at this point in your career. Using technology to add procedures and services can increase the value of the practice. However, it's best to do it early enough for patients to become aware that their "old" doctor has made some new changes.


All practitioners have objectives they want to achieve in both the short and long term. Therefore, they should make an effort to be aware of the tools and technologies that can help them meet these goals for themselves, their staff, and their patients.

Dentists working from a digital platform have distinct advantages that dramatically impact communication and patient care. They can quickly and easily share patient information internally, transfer files to the lab and collaborating specialists, and increase case acceptance by being able to "show and tell" patients about their diagnosis and proposed treatment. With CAD/CAM, they can expand into new areas to challenge themselves, and to offer patients the treatments and services they want and hear about from friends, social media, and online.

Marvin Berlin, DDS, is the heart and soul of mckinneydentist.com, one of the most productive and profitable dental offices in America. Dr. Berlin was a pioneer in CAD/CAM, working with E4D/Planmeca, and is extremely proficient with CAD/CAM technology. He's part of the Heartland Dental family, and was recently appointed as director of Heartland's Aesthetic Continuum. Contact him at [email protected].

Editor's Note: This article reflects the opinions of Dr. Marvin Berlin. Please consult your financial advisor or accountant for advice on your particular situation.

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