By Mark E. Hyman, DDS, MAGD
In 1986, I bought a small dental practice. It was moving right along, but it really wasn't advancing with the technology boom. My vision was to turn it into a thriving, enthusiastic practice where optimal comprehensive care was the mission, and employees would enjoy coming to work each day. I wanted a place where patients would experience efficiently produced, quality care. I realized that the right marketing coupled with a complete upgrade to new high-tech equipment were essential for success. In addition, my modus operandi was based around the question: "Is there a better, faster, less painful way to do things without sacrificing quality?" When the answer is "yes," implement the new technology, process, or procedure.
First, I purchased two intraoral cameras. I assured my supply representative that I didn't need cameras — I was already "busy" as it was. Nevertheless, I was stunned to see a case acceptance explosion, superior diagnostics, improved documentation, and the move away from insurance pre-denials. This technology set our practice free. I never would have believed that anything could impact our practice like cameras. I was wrong. Case in point: I had just completed a quadrant of partial crowns on one of my favorite patients. Unfortunately, the provisionals broke four times. His wife came in the next week. She had always conveyed an appreciation of me and my work and always said "yes" to my treatment recommendations.
Well, I saw some changes going on in her mouth and offered my care in helping her deal with these changes. She said, "I just can't do it. I can't come back four times like my husband did."
Her words broke my heart because she never had a problem with my treatment recommendations. I said to myself, "There's got to be a better way." But I didn't know of a better way — not until my visit to the 1997 North Carolina State Dental Meeting. That's when I met CEREC 2.
After the meeting, I considered purchasing a CEREC System. Everyone I talked to said, "Don't do it," and that it was too much money. My accountant was concerned about the depreciation. Resistance and negativity continued.
Finally, the decisive factor turned out to be my father, who sees the world differently than I do. I said, "Dad, could you imagine one visit, no temporary, no impression, and placement of a finished restoration while the patient is still numb? What do you think?"
He replied, "Son, why would you do it that way? People are used to coming in for two visits."
I said, "Great!" Then I bought the machine.
I went with my gut instinct. Within six months, the CEREC had paid for itself. Every subsequent restoration lab fee went into the practice. I've heard others describe CEREC as an ATM machine, and while I think that's true, the reinvention of your care for your patients is life-changing.
Yes, the initial investment may seem prohibitive. That's the way it is with most dental high technologies. Look at digital radiography, air abrasion, and laser systems — they're all big ticket items. We don't think twice about purchasing things we don't normally consider high-tech, such as a dental unit, but they're necessities. That's how I feel about implementing all technologies into my practice — they're necessary for growth and professional development. The CEREC System cost more than my first house, but you must put that aside and think, "Why do this? Doesn't it make sense to pay yourself instead of a lab?" Think about what you could be doing with that money. Chairside CAD/CAM restorations have been incredible since patients don't have to come back, and we're able to cement their restorations while they're still anesthetized. I've had many patients say, "Don't you charge more for this? I'm willing to pay for it if you can just keep me from coming back a second time. I can't get time off from work."
Practice makes perfect ... and profit
I teach several brass-tacks seminars for dental teams who want motivated patients who understand, appreciate, and ask for optimal care. I teach that one mistake will never kill you, but the same mistake over and over will. If you hold on to old ways of thinking, you'll never grow. If you buy a piece of equipment that doesn't work out, you must move on. A lot of spectacular preparation produces spectacular results. When I hear about practitioners failing with new technologies, it's usually because they don't understand or won't accept the learning curves. Beginning intraoral camera photos aren't optimal, and your first CAD/CAM case won't be, either. Don't expect a perfect restoration the first time you sit down with any CAD/CAM system. There are no shortcuts. Pay your dues and prepare, then, if you follow the parameters, you'll get exquisite restorations.
Revitalize your career — enhance your outlook
Frankly, I got a little burned out. Reinventing my career humbled me. I'm about to start my 19th year of private practice. I became bored with technical care repetition. I'm from the generation that missed the computer boom. I had to learn a lot, but it's been gratifying and fun.
Motivate your staff — get them more involved
Depending on your state's laws, your staff may be able to assist you with certain procedural aspects of your new high-tech equipment. For example, they may be able to capture the image of the prep with the infrared camera, then design the restoration for you. New technology can do so much more than what you currently get from it. Some doctors just want to prep and place the restoration, allowing his or her staff to get involved with interim design steps. I take part in each step because that's how I learn and become a better dentist. When I look at an infrared scan of a tooth, I think, "Oops, that's not a great prep — I left a sharp angle there; I left an undercut; I over-prepped; I under-prepped; I didn't smooth the margin as well as I could have." Show these things to assistants so they learn, too. Technology has a lot to do with elevating the quality of my dentistry, but not as much as how I use technology to provide optimal patient care.