HOW TO PROFIT — interview with Dr. Claudio Levato

Tremendous changes have taken place in dental technology in the last decade.

by John Jameson, DDS

Tremendous changes have taken place in dental technology in the last decade. When dental radiography and intraoral cameras were first introduced, there was no software to control the retention and retrieval of images. If not printed immediately, images were simply lost. Companies responded to this market need, and there is now a host of products that not only capture and save images, but also allow practitioners to aesthetically enhance the images to better illustrate the many care options available to patients. And the products keep getting better. We are seeing daily an increase in the quality of images, image control, and utilization in the dental practice.

As practice-management software packages gained in popularity, technology integration became an issue. This in turn sparked an initiative to create comprehensive software that bridged these images with patient files and other data. However, many products are selectively programmed to bridge with some software, while blocking others. The perpetual issue of which imaging software integrates with which practice management package is still evolving.

For the clinician, these changes can be difficult, but also exciting. The myriad options available can be overwhelming; practitioners must closely monitor the market to determine which level and type of technology best suits their needs. Practitioners just beginning to navigate the maze of technology should network with those who have successfully incorporated technology for advice and guidance.

It's an exhilarating time to be a dentist. Technological advances have catapulted dentistry into a new era. Statistics prove that technologically savvy practices are the most profitable. Those dentists who hesitate or take a timid approach to technology will simply get left behind. I hope, with this edition of Dental Economics, that readers will be inspired to seek out those technologies that will help propel their practices to even greater levels of satisfaction, professionalism, and profit.

This month's interview features Dr. Claudio Lavato, one of the foremost authorities on dental technology today.

Dr. Jameson: Hardware development has slowed; yet software development is full steam ahead. What do you see as the core consideration for doctors as they integrate the various technologies into their practices?

Dr. Levato: The first thing dentists need to do is to have a clear idea of the type of practice they want to create for themselves. Once they have established a vision, they must carefully research and evaluate the types of practice-management software that will assist them in achieving this vision.

A great many options exist. Practitioners are wise to consider issues such as the stability and longevity of the company producing the software. Hardware will come and go, but the right practice-management software is the glue that holds a practice together.

Dr. Jameson: Practice management isn't the only software needed to run an office. It seems every function within a practice has its own software. X-rays, cosmetic imaging, and radiography all come with their own technology. Do you see any emerging trends in the software industry that will help us bridge or link these technologies into a compatible whole?

Dr. Levato: The industry has been listening to doctors and is responsive to what they want. The three biggest players — Dentrix, Eaglesoft, and Practiceworks, Inc. — are all solidly focused on this issue, as are companies with a more regional focus like and MOGO. Companies are striving more than ever to become multipurpose, offering proprietary versions of digital X-rays, intraoral camera hubs, and cosmetic imaging incorporated into their practice-management packages. Softdent even offers PowerPoint capabilities!

Dr. Jameson: Are more practice-management companies attempting to bridge their software packages with other existing companies?

Dr. Levato: We're seeing two things develop at once. The major players seem to be aiming for seamless integration — that is, comprehensive practice management packages that also offer imaging, digital radiography, etc. However, many are also bridging their other software packages. They are building in proprietary capabilities, but are also linking with other packages.

There's a lot of substance out there, and practitioners must approach a software purchase from a long-term perspective. $10,000 may sound like a lot, but not if the package meets a variety of needs for your practice over a long period of time. Clinicians must also evaluate their hardware regularly — about every three years is the mandate in my practice — to ensure that it meets the requirement of any software upgrade they implement.

Dr. Jameson: What should a dentist just beginning to practice aim for in terms of technology?

Dr. Levato: Dentists just graduating from school have a great advantage. They are more computer savvy and have none of the phobias about technology that our generation may have had.

Younger dentists will set up a different type of practice. They know how to utilize technology to maximize efficiency and will likely set up a practice with one operatory and a very good computer system, rather than a practice with two operatories, yet still achieve the same level of profitability.

Dr. Jameson: As a visionary, what do you see as the future of dental technology?

Dr. Levato: We still have fewer than 50 percent of practitioners with computer workstations in their offices. However, most will gradually realize the important benefits of technology. I see the next five years as a time when more dentists will become comfortable with technology, with more clinicians incorporating technology into their practices. The central workstation model will remain the primary set-up for most clinicians. However, within 10 years, wireless solutions will come into vogue. Rather than hardwiring to the Internet, we will use cellular and satellite connections. Palm or Pocket PC use will increase exponentially and will interface with this technology. We will still need larger units in the operatory to capture images, etc., but data systems and back-ups will probably be offsite. Wireless systems are going to offer greater flexibility and freedom to access information when and where we need it.

We're moving beyond the intraoral camera as a separate entity, digital radiography as a separate entity, and cosmetic imaging as a separate entity. We're evolving instead toward an image-management center. Any kind of image gathered from a patient — a photograph, X-ray, or a slide from the microscope — will be stored in one database. Since we are such a visual society, the management of that data is critical. Ease of use is phenomenal, as are the capabilities. Imaging is fast becoming totally software-driven.

The other trend I see is the evolution of intraoral cameras. Their use is a permanent fixture within almost every practice but will be primarily therapeutic. For communication purposes — with insurance companies, with dental labs — digital cameras are the wave of the future. They give 35 mm quality and produce a fantastically clear image. There are so many good cameras out there — Nikon D-1, the Cannon D-30, and the Fuji S-1. These are excellent cameras that give doctors a very large image file.

If you take a few standard images — the full face, full smile, retracted smile, full upper arch with retraction, and full lower arch — you have all the basic information you need for your patient in one file, at your fingertips.

Dr. John Jameson is chairman of the board of Jameson Management, Inc., an international consulting firm. Dr. Jameson lectures internationally on high-tech dentistry and its integration into the dental practice. He provides research for manufacturers and marketing companies. Dr. Jameson may be reached at (580) 369-5555 or by email at

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