Lasers take your practice from good to great

Nov. 1, 2007
I recently read the business book Good to Great by Jim Collins, which has concepts that apply to our practices.

by David S. Eshom, DDS

I recently read the business book Good to Great by Jim Collins, which has concepts that apply to our practices. The author examined businesses that were average for many years and then suddenly became great - businesses like Wal-Mart and Circuit City that suddenly outperformed their competitors by an average seven times. Dental practices are not much different. We dentists meander around doing the same things we were taught in dental school and wonder why our production and profits never increase. Take a lesson from the companies in Good to Great and use what the author calls “technology accelerators” to take your practice to the next level.

Four years ago, I bought a technology accelerator called a hard-tissue dental laser (Waterlase MD by Biolase) and have never looked back. Originally, I bought the laser so that I could do operative dentistry without giving the patient an injection. The Waterlase MD allows me to do injectionless fillings and treatments of multiple quadrants in a minimally invasive manner. We do fillings immediately after a recall exam when we have openings in our schedule, because the patient can go back to work without a fat lip and tingly tongue. Because of the laser, the increase in monthly production just by doing fillings not originally on the schedule is more than $2,500. Taking the shot and drill out of 80 percent of operative procedures makes your patients happy and takes your practice from good to great.

The acceleration in my practice didn’t just stop with operative dentistry. Laser technology can be applied to bone and soft tissue as well. With inlays, onlays, and crowns, we often deal with the deep interproximal amalgam or a fractured cusp. In these situations, getting an impression is difficult and the biologic width is often compromised. You can do a bony crown lengthening to restore biologic width, take a clean impression, and place a perfect temporary all in the same day, without waiting for healing or a periodontal referral. (View the article at This is a dental miracle compared to the old cut, suture, and wait. This technique takes good restorations to great restorations. You probably have at least two of these situations come up in your office monthly. That’s $900 of production each month that you would not have without a laser.

Like most of us, I have a passion for cosmetic dentistry and enjoy presenting the benefits of a beautiful smile to all patients who are interested in looking better. As I have become more astute in treatment planning the perfect smile, gum levels are an issue in more than 50 percent of my smile designs. Moving gum levels to create a symmetrical background for veneers previously required a referral to a periodontist. This hurdle to the final improved smile consisted of a consultation, gum surgery, increased cost, and a wait time of at least eight weeks. Patients often balked at this extra step and expense. Treatment was often deferred or compromised. Learning the one-appointment, closed-flap, crown-lengthening technique with the laser took me and my patient out of the “perio penalty box” and allowed the veneer case to proceed uninterrupted. If you do just one anterior crown lengthening each week, it will translate to $1,800 in production monthly.

The technology of a hard-tissue laser “accelerates” your practice. You can see that routine procedures such as Class I and Class II fillings become high-tech miracles to your patients, because you do them without the shot and drill. Your patients’ “Little Shop of Horrors” nightmares are comfortably transformed into the caring, conservative, and gentle place you call your office. Referrals from these laser-converted patients come in regularly. The laser eliminates the annoying biologic width invasions and referrals to the periodontist, while at the same time reduces your stress. Your cosmetic dentistry becomes better because you effortlessly idealize your patients’ gum levels at the same appointment that you prep their veneers. Profitability increases because you are doing procedures that you have never done or previously referred out. Your office becomes special in everyone’s eyes - for your patients, your team, and you. Your office will change from good to great!

David S. Eshom, DDS, is a general dentist who emphasizes dental health and beauty for his patients in his private practice in San Diego, Calif. He is a sustaining member of the American Academy of Cosmetic Dentistry and served six years on its Board of Directors. He is currently a cosmetic dentistry advisor to the World Clinical Laser Institute and the World Congress of Minimally Invasive Dentistry. His practice of 22 years uses high-tech instruments to make his patients’ dental experience comfortable and special. Contact Dr. Eshom at [email protected].

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