Driving Practice Profitability Through Prosthetics

In challenging economic times, the first reaction of a business owner is often to cut expenses ...

By Shaun Keating, CDT

In challenging economic times, the first reaction of a business owner is often to cut expenses; however, a more practical solution is to focus energy on and invest in the aspects of your business that are the most lucrative.

In a restorative-oriented general practice, it is common that crown and bridge procedures take 13% of the doctor’s chairtime and generate a whopping 33% of total practice revenue. Imagine the increased revenue for your practice if you could add another crown prep and delivery into each workday. Crown and bridge procedures can also build your practice. It is widely accepted that 75% of new patients in a general practice are referrals from friends and family who are current patients. Levin Group Data Center research shows that for every 10 patients treated with crown and bridge in the general practice, the practice will generate an average of 1.3 patient referrals. Therefore, if you double crown and bridge production, you should also double this important source for new patients. So when the case is accepted, how do you ensure a WOW experience with patients with each laminate, crown, or bridge delivery? I suggest taking continuing education classes regularly and bringing along your clinical team, including auxiliaries and your technical team.

There are many beneficial programs today. Because the ratio of population to dentists has been increasing nationally, many doctors are delegating more duties to their auxiliaries and lab technicians. What better way to ensure that you’re on the same page with your clinical and technical teams than to take continuing education together?

When your technicians take the same courses that you do, you can help one another implement desired changes and benefit from the new restorative protocols. Today’s dentist does not have to practice alone. This team approach to restorative dentistry can be a win-win for the doctor and technician if they learn and implement their new skills together. You should use a great lab with consistent quality and technical depth. If you love crown and bridge, which many of our clients do, you deserve a great laboratory. Technicians should share your passion for restorative dentistry, provide consistent workmanship and service, be effective communicators, and have the training and experience to support you.

Also, use the best materials and preparation kits (a standard armamentarium in autoclavable blocks) that are specific to each restorative procedure. Each tooth is unique, but using a standard armamentarium of burs and material will ensure that your preparations and impressions are consistent. The results will be consistent, efficient delivery appointments, and you will provide a foundation for your technician to do his or her job effectively. All impression materials are NOT created equal. We suggest using a polyether that is hydrophilic, provides the clinical team with adequate working time — even with multiple preps — and sets to a rigid state. This rigid set is important because it allows the polyether material to support the plastic triple tray commonly used for these fixed impressions.

Polyether material dispensed from an automixer is best for the busy, restoratively focused practice. The result is usually a clear impression on the first attempt, and is worth the relatively minor drawback of preparing a patient for the slightly unpleasant taste of the polyether material. As with any triple tray impression, it is important to take a separate bite registration before anesthetic and preparation. Include this registration along with the triple tray impression. This step allows you to double check the accuracy of the bite registration in the lab and save time adjusting occlusion at the delivery appointment.

Tooth position is dynamic. There is often more movement than one might expect. Using a quality provisional made from wear-resistant material that fits precisely will save chairtime and money in the long run.

Always check to make sure that the provisionals are in occlusion and have broad interproximal contacts. This is to minimize movement of adjacent and opposing teeth. Minimal adjustment time will also add to your patient’s WOW factor.

Knowledgeable technical representatives can assist with the training of your clinical team to maximize the results from their products. This training should be scheduled periodically to help ensure that the clinical team is proficient in your preferred protocols for impression taking, provisionalization, and cementation.

There will always be a market for quality care at a fair price. Make investments in yourself, your practice, and your employees that will increase the number of restorative procedures you’re completing.

Shaun Keating, CDT, is owner and CEO of Keating Dental Arts (KDA) laboratory in Irvine, Cal. Shaun is a recognized leader in the field of dental technology. He is active in the National Association of Dental Laboratories, and lectures and publishes nationally. Shaun can be contacted at shaun@KeatingDentalArts.com.

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