A conversation with ... Lorin Berland, DDS

By Jeffrey B. Dalin, DDS

In a wide-ranging conversation, Dr. Lorin Berland shares with Dr. Jeff Dalin thoughts about the innovations he has pioneered, including spa dentistry, the Lorin Library Smile Style Guide, the digital Lorin Library, and denturewearers.com Web site. He also offers some surprising takes on the importance of new dental technologies and the future of the dental spa.

Dr. Dalin: I’d like to talk with you about the role of technology in a field that you pioneered, which is “spa dentistry.” But before we get into that, I’d like to know more about you and your practice. You have a busy practice in Dallas, but you still have found the time to develop the Lorin Library of digital cosmetic images, the Lorin Library Smile Style Guide, and www.denturewearers.com. Can you talk about these achievements?

Dr. Berland: Basically, I’ve developed all of those things - the dental spa concept, the Lorin Library, and www.denturewearers.com - as a result of listening to my patients. Everything we do daily in my practice, and in the ideas I’ve developed, comes from that. I’ve been listening to patients for 25 years. I take what they say seriously, and try to act on it. Patients will tell you what needs to be done, if you’re really listening to them. And, along the same lines, it’s important to ask patients what they think.

The whole dental spa concept came from recognizing that people were often uptight and a little nervous when they came in for treatment. So I started thinking, “How can we make dental appointments more pleasant?” The Smile Guide came about because everybody thinks cosmetic dentistry is easy. But, in fact, it’s not easy. There are many variables that nobody ever really looked at closely, including incisal shapes, incisal lengths, and several others. People would complete a cosmetic makeover, their teeth would be perfect, and they wouldn’t be happy.

So I started developing some ideas about how to make sure I could get results that were natural for people, and that they would be comfortable with. The Smile Guide was the result. Before the Smile Guide, patients had to look through magazines to try to find something they liked. It just made sense to help them more directly with the planning and decision-making process. This way patients could be much more confident in knowing that what they were going to end up with would really be what they wanted.

And www.denturewearers.com ... well, the world is filled with people who need new dentures. They have five-, 10-, 15-year-old dentures. Most of these people don’t know that the dentures should be replaced, so they walk around thinking they’re just going to have to live with the discomfort and inconvenience of dentures that don’t fit right and don’t look good. So, again, it was very much a matter of just listening to my patients.

When somebody would bring one of their parents with these decrepit dentures, I began to wonder, “Why are we not telling these people that there are better alternatives?” Basically, that became the impetus for the denturewearers.com Web site - to educate and inform denture wearers of what they could be experiencing and how to achieve it.

I just came up with these ideas because I run an almost ridiculously busy practice. It’s busy because I listen to my patients, and these new ideas grow out of that one thing that I make a point to do - listen to my patients.

Dr. Dalin: Can you talk about spa dentistry, especially your role in its development; what it is, what it’s become?

Dr. Berland: Spa dentistry has become something of a monster today. It’s crazy. For me, probably the first step in spa dentistry came in 1996 when I brought a massage therapist into the office. It started when I was at a conference. While there, I had some free time so I decided to get a massage. As I was getting the massage, it just occurred to me that making this service available to patients might go a long way toward lessening their fears and relaxing them. Also, I needed another person in the office. I had been doing some reading about meridians, trigger points, and other therapeutic processes associated with massage. I thought, “Why not bring in a massage therapist, and he or she can do other things around the office when they’re not giving massages?” So I did it.

I took a lot of heat for that. People laughed at me for several years. They thought I was crazy. But then they started realizing that, hey, maybe this isn’t such a bad idea after all. The whole concept just took off from there. Like I said, today it’s become a monster. It’s borderline out of control. Now, many of those people who were making fun of me want to open beauty salons - with a dental practice on the side. For me, though, it’s all about patient comfort. We just want them to get the best dental care possible, and we want them to be as comfortable as possible.

Dr. Dalin: Can you talk about the role that some of the new technologies play in your practice, and how they fit in with the dental spa concept?

Dr. Berland: People don’t change, but technology changes. People want the new technology. People aren’t saying, “Give me that old-fashioned technology.” That’s not what they want. They want old-fashioned care, but they sure don’t want old-fashioned dentistry. Of course, things like computerized practice management and intraoral cameras are important. But in my opinion, the most fundamental new technology that every office should have is digital radiography.

Our office converted to digital about eight years ago, when the technology really began to mature. I can’t imagine practicing dentistry without it. It is something that really does impress people. Everybody knows they’re going to get X-rays, and everybody knows that X-rays can be uncomfortable. But when you introduce patients to digital radiography, and they see that large-size image up on a computer screen, they appreciate it. The system we use, DEXIS™, has a rounded-edge sensor so people don’t experience the discomfort they did with film. Couple that with up to a 90 percent reduction in radiation exposure as compared to film, and it’s a no-brainer.

Everybody’s worried about radiation exposure except for the dentist! But if they listen to their patients, dentists will realize that they need to adopt this important technology.

And film X-rays really are a time drain in the office. You have to wait while they are developed. It’s just wasteful of everybody’s resources. How about all the time spent fishing them out of a chart as compared to easy, immediate access on any computer in the network? Or duplicating? And the chemicals inhaled? I can’t imagine taking small film X-rays, holding them up to the window, and saying to the patient, “There, can you see that?”

There’s an abundance of technology out there, but digital radiography is one technology that - when it became real - I just couldn’t imagine practicing without. I just couldn’t keep exposing my patients to high levels of radiation, when I knew there was an alternative, and one that was an even better diagnostic tool than film.

Dr. Dalin: Does that go along with your concept of spa dentistry?

Dr. Berland: Absolutely! It’s comfortable. It’s quick ... anything that’s good for the patient fits right in with my original intention regarding spa dentistry.

Dr. Dalin: What advice would you give to young dentists, perhaps new graduates, as far as spa dentistry is concerned? Should they be thinking in terms of spa dentistry?

Dr. Berland: I think the concept of spa dentistry is going to fade. There might even be a backlash because it’s getting ridiculous. I pioneered the concept, and now, between my house and my office, there are at least four dental spa offices. I don’t think any graduate should be thinking about spa dentistry.

I think dentists who are starting should be thinking about being the best dentist they can be. Nobody’s a success because they’re a spa dentist. Successful dentists could drop the spa dentistry idea, and it wouldn’t make any difference. People go to see you because you’re a good dentist, because they trust you, not because you’re a spa dentist. People don’t go to the dentist looking for the “spa experience.” They can be pleasantly surprised, but that’s not what they’re looking for. I do believe you can turn people off if you push the spa idea too much.

I would tell a new dentist to focus on caring for your patients. That’s Number One. Put yourself in the dental chair, all day long. This is how you’re going to be a success. There aren’t any shortcuts in dentistry. There are no tricks. It’s every day, every patient, do your best. I don’t think there’s any profession where the Golden Rule applies more than in dentistry - “Do unto others as you would have them do unto you.” Put yourself in the patient’s place and treat him or her as you would want to be treated. Do you want to be exposed to excess radiation? Do you want comfortable and fast radiographs? A new practice trying to establish itself simply must have digital radiography - for better diagnosis, better treatment. As a new dentist, you want to send a message to patients - in a new practice, patients are all new patients - that you are an up-to-date, caring doctor.

Dr. Dalin: In terms of dentists at a more mature practice, how would you recommend that they bring in new technologies?

Dr. Berland: A mature practice must have new technology. It’s that simple. When you’re a mature practice, you’re busy. All the new technology makes your practice run more efficiently - from digital X-rays to computerized practice management to intraoral photography. In my practice, we do it all digitally; it’s all integrated.

It’s even more important for the mature practice to have up-to-date technology because time is so valuable. In a beginning practice, you have more time because you have yet to develop a patient base. In a mature practice, you have patients coming and going. You’re always in a hurry. It seems that the more mature your practice is, the more mature your patients are. They have things to do. They want to get in and out in a hurry. So you need to really rock and roll. The new technology enables you to do this.

Dr. Dalin: Thanks, Lorin, for an informative and, I might add, somewhat surprising interview. Thanks for sharing your insights on these subjects.

Dr. Berland: Thank you, Jeff. It’s been a pleasure.

Dr. Lorin F. Berland, a 1981 graduate of Loyola University School of Dentistry, maintains a private practice in the Dallas Arts District. A Fellow of the American Academy of Cosmetic Dentistry, Dr. Berland created The Lorin Library Smile Style Guide and www.denturewearers.com. He can be contacted at (214) 999-0114 or via e-mail at [email protected].