By Ronald D. Perry, DMD, MS, and John Orfanidis, Orfan Laboratories, Inc.
An extra set of eyes to review clinical work provides numerous benefits. Overseeing all aspects of a patient's treatment increases professional pleasure, and the added perspective can build patient confidence. When dentists and laboratories work efficiently together, the benefits appear. Our approach emphasizes personalized interaction and embraces the latest technology while it relies on old-fashioned customer service. This approach leads to increased practice efficiency, profitability, and patient satisfaction.
• A team approach
We began working together more than two years ago after spending much time using a series of U.S. dental laboratories. Within a relatively brief time, we've worked out a system that helps us streamline our practice and increase the amount of quality attention we give to patients. The template we designed is outlined below. It keeps our system as flexible as possible to accommodate varying patient needs.
The initial visit occurs with both of us present. We gather as much patient information as possible — details that determine the best treatment. (While we're available to each other regularly throughout the workweek, we typically reserve Wednesdays to be in the office together.) Depending on the type of restoration, we develop ahead of time a checklist of bites needed, such as protrusive and lateral. It's important to get a good impression. We share opinions about impression qualities so they may be adjusted accordingly.
After working out any problems in the provisionals, we make copies to share. Shade, shape, and bite adjustments can be made in the laboratory depending on patient feedback about the provisionals. We use X-Rite's ShadeVision™ system and a digital camera to share information between the dental office and the laboratory. This helps eliminate costly, time-consuming re-dos.
Too often, dentists receive back from the laboratory beautiful porcelain work they destroy with adjustments. Because of something as simple as an improperly taken impression, a restoration — through no fault of the laboratory technician — may not fit properly after being returned from the laboratory. It also may risk fracture once seated. Issues such as these may be avoided through open communication and by using only high-quality impression materials.
Next, the patient returns to the office and meets again with both of us. This helps the patient understand his or her case clinically and technically. We discuss directly with the patient whether we need to reduce more to get a better aesthetic result. It's a confidence builder for the patient, knowing that two parties are equally interested in his or her oral health. By clarifying, we help the patient realize those differences between expectation and reality that often occur with aesthetic and reconstructive dentistry.
• Embrace technology to maximize efficiency
Embracing CAD/CAM systems for all-ceramic restorations has helped us maximize practice efficiency and enhance patient results. The CEREC System allows dentists to provide singe-visit, all-ceramic restorations.
When it comes to the juncture between the pontics and abutment teeth, using 3M ESPE's Lava™ all-ceramic system allows us to move electronically where connectors will be and calculate the connector cross-section to ensure proper strength. This results in aesthetically pleasing restorations that last a long time. The technology also allows laboratory technicians to design proper frameworks for effective crowns and bridges.
Unlike other systems, the Lava all-ceramic system helps us pre-plan because we can make changes as we go. The Lava all-ceramic system eliminates wax-ups and subsequent alterations. You get a better overall fit while matching form with function.
Once we get photos and all the information we need from the patient, we're more than halfway there. We're confident we'll develop the restoration in a timely manner that will meet the patient's aesthetic and functional needs. Both of us listen to the patient so we can find the type of restoration he or she wants. Then, we make an appropriate recommendation.
Patients ask if we can twist a tooth a certain way or have teeth appear longer, but certain patients risk breaking longer restorations because of their occlusions.
One patient, for example, wanted extremely white restorations, yet had light hair and typically dressed completely in black. In these situations, we make every effort to guide patients toward appropriate treatments.
Backing each other up makes our jobs easier. Because we both meet with patients, we keep their original visions in developing restorations. Patients become complete individuals with unique wants and needs, as opposed to just cases.
We save tremendous time using technology such as the ShadeVision system and the Lava all-ceramic system. The systems eliminate guesswork, multiple try-ins, and costly re-dos, helping us gain clear understandings of patients' desired outcomes.
• Gaining trust ... and referrals
Unnecessary chair time limits profitability, but you can't rush the patient out of the chair. We set aside at least 45 minutes for each patient. How well you use this time will determine your success. Sometimes, little things make the difference. Each patient considering an aesthetic or reconstructive restoration is shown a short DVD that explains treatment and the procedure. The patient takes home this DVD, which features our practice's logo and Web site. Often, the DVD becomes a discussion piece with a spouse or significant other.
Beyond marketing purposes, we use our practice's Web site — particularly the "Patient Education" section — to answer questions and alleviate potential concerns. We ensure staff members know aspects of each patient's case. When a patient calls, his or her concerns are handled immediately. Dentists avoid unnecessary, time-consuming involvement while saving time for patient visits.
We employ a "tag team" approach. Some patients feel uncomfortable asking us questions, but they don't have problems asking lab technicians. Laboratory technicians can field aesthetic questions we referenced earlier, such as those concerning length and shade, while dentists can answer questions regarding clinical procedures. We let patients meet with both of us together and separately, then confer in private. If a lab technician meets with a patient, the dentist can be double-booked, again increasing the practice's efficiency and profitability. The patient knows he or she is getting a high level of customer service. Gradually, you gain trust.
Patients respond to this team-oriented, consultative approach. Within the past year, we've done more full-mouth reconstructions than before. When we work in the office together, we're more apt to have "day-of" closes than those in which patients take weeks to consider treatments. Patients usually accept without question the final work once restorations are complete because they remain confident in their decisions. Also, patients who leave your office happy are less likely to question their financial investments. Putting time toward a personalized patient approach that involves interaction with the dentist and lab technician provides long-term returns on investment. Patients who work with both of us are more likely to become referral sources. With some larger cases, we may get two referrals from each patient. Establish a comfort level with the patient, dentist, and lab technician, earn the patient's trust, and build upon it.
• The courage to be different
If you have everything else in place — open communication between the dentist and lab technician, a willingness to embrace technological advances, and a streamlined approach to patient consultations — the money will follow. The joint approach, if implemented properly, leads to satisfied patients who generate referrals. Several payoffs cannot be measured in dollars. Too often, dentists and lab technicians operate like horses wearing blinders, paying close attention to their respective tasks and, while acknowledging the importance of the other, not grasping the true connection. Working together, however, provides the patient with two perspectives, each of which is germane to the particular treatment. By exchanging ideas and opinions about a particular case, we're able to find synergy between clinical and technical dentistry. We're also able to gain understanding and appreciation for what the other is trying to accomplish.
Patients gain comfort from personalized treatment that shows them they're more than numbers or names in an appointment book. Answering their questions in an honest, direct manner and clearly presenting treatment options will enhance their perceptions of your practice and, quite possibly, the dental profession in general. There is something satisfying and fulfilling about viewing a patient as a whole package — a distinct individual whose unique needs you want to meet. Personal interaction puts the fun into practicing dentistry. Dental professionals need to separate themselves from the competition. Our approach isn't for everyone. Regardless of which path you choose, continued success can be achieved only by constantly uncovering ways to add value to your practice. For example, use the latest technologies to achieve better aesthetics and functionality while you increase patient satisfaction. In a world where so many are the same, there's something to be said for being different.
