With the mass success of the Apple iPhone and iPad, a lot of PC users have considered installing Apple Mac computers in their homes and offices. As with most technology, there is a compromise when considering a product that has a smaller user base. Detailed below are a few of the common questions and considerations to evaluate when looking at using the Apple Mac for your practice.

What are some of the pros of the Apple Mac?

The Mac’s sleek and attractive design is the first thing that draws people in. They look great just about anywhere. The operating system is very dependable, and the chances of being infected with a virus are much lower than those with a Windows-based PC.

I thought that Mac’s do not get viruses?

That a myth. Mac’s can and do acquire viruses, but there are significantly fewer viruses out there that infect the Mac. Why? Hackers typically create viruses to attack the masses, and Mac users are not the masses. A major drawback here is that fewer resources are devoted to Mac virus protection, and thus the resolution of new viruses can take much longer than that of a Windows-based PC.

What are my options for Practice Management with a Mac?

MacPractice is widely considered strongest player in the field, but there are additional options that are available, such as MacDentPro. Curve Dental leads the web-based software field and is Mac friendly. Compared with the Windows-based PC, you have fewer options to consider.

hat are my options for Digital Imaging with a Mac?

This is where your options start to dwindle. MacPractice promotes the Suni sensor as their product line of choice. There is also support for ScanX and Planmeca devices. Unfortunately, with the very small user base, most of digital imaging companies are not investing in native support for the Mac. In English, that means if you want the latest and greatest in Digital Imaging you’re limited to the Windows-based PC environment.

Can’t I run Windows on my Mac using Parallels or VMWare?

Yes, you can, but what is the point? Running Windows on the Mac allows you to utilize mainstream Practice Management and sometimes Digital Imaging software, but it takes away all benefits of utilizing a Mac in the first place. Since Windows operates in a separate environment than Mac OSX, it will naturally run more slowly than it would on a comparable PC. In addition, using Windows on the Mac further complicates your network environment and opens the door to all of the consequences of a PC network. Lastly, you will never want to mention to your software provider that you are running Windows on a Mac because they will simply blame everything on an “unsupported configuration.”

What are the differences between PC and Mac hardware?

At one time, the Apple Mac was a completely different device from the PC. Now, they use the same processors, RAM, hard drives, and video chipsets. So when investing in a Mac, you pay more for approximately the same product that you may purchase from Dell or HP.

Are there any other cons with moving to the Mac?

Since the user base is much smaller than that of the Windows-based PC, there is a much smaller support base. You simply have fewer choices for a support partner. Additionally, Apple does not offer same business day on-site hardware replacement and does not guarantee next business day on-site hardware replacement. This can create a bigger obstacle on mission critical equipment like your server. Windows-based PC manufacturer’s like Dell offer these options. Most practices cannot afford to be down for hours, let alone for days.

Is the Mac right for your practice?

Each practice has specific needs that it must evaluate before selecting an IT solution. Both options present both unique benefits and challenges. By assessing the value of each possibility and its integration into your practice, you can better determine which choice will optimize your practice’s efficiency and productivity.

Do you Use Macs or PCs in Your Practice?

Repeat after me:
“I will be better organized.”
“I will figure out how to be more productive.”
“I will get a handle on my debt.”
“I will get the most from my technology.
“I will get training for my team.”

Any of these sound familiar? If they do, do you follow through with these resolutions? Many of you may say, “No,” and that is not uncommon.

Know the Power of Planning

Perhaps the biggest reason our New Year’s resolutions peter out after the first two weeks of January is because we do not make a PLAN to support them. An idea can only take you so far without establishing detailed steps to make it successful. These same concepts translate to the business world, and a major annual strategic planning session is crucial for the success of your practice.

The dental business can also throw us curve balls, and our survival depends on whether we have a well thought-out annual plan — or fly by the seat of our pants. It’s not unlike airline pilots, who always fly with emergency plans in place.

On January 15, 2009, US Airways Flight 1549 took off from New York’s LaGuardia airport for Charlotte, N.C. Shortly after takeoff, the plane went through a flock of geese at 3,000 feet, and both engines were knocked out. Captain Chelsey Sullenberger had not landed on water before, yet his training and the emergency plans allowed him to take appropriate actions in an extreme situation and make a safe, successful landing on the Hudson River.

Though many of us have faced crises (economic, professional, or personal), surprisingly few organizations are ready with a plan. Don’t let your dental practice be one of them.

That said, what is your annual plan, and how will you make it a reality? How can you ensure your plan is successful, makes a positive impact on your practice, and offers the highest profit on your bottom line?

The answer: By working with an expert practice management coach. Don’t wait until the New Year. Our coaches are ready to help you PLAN and discuss these questions now. Do this, and allow yourself to enjoy the benefits of a well thought-out plan — even when life just happens.

Take These Steps to Your Success

1. Decide on New Year’s resolutions for your practice.

2. Schedule an appointment with a dental practice expert who can help you make a strategic plan — and ensure it’s a reality in 2012.

3. Schedule a date to meet with this expert before 2012 arrives.
-Discuss your plans for 2012.
– Put this on the calendar before December 31, 2011.
– Count this as your “Team Annual Planning Session.”

4. Assemble a P&L (Profit and Loss) statement of the past 12 months
– Collaborate with a dental expert who is trained to turn your P&L into a management tool for increased profits in 2012

5. Determine with your dental practice expert (consultant/coach) if your overhead stacks up against the true dental industry standards.

6. Project your expenses and goals with the guidance of your practice expert.
– Base these on history, expenses, and potential.

7. Have an annual planning session. Discuss with your team how many working days will be needed to meet your budget needs.
-What services will you provide? (e.g. same-day services, new services, standard of care services, etc.)
-What products can you offer and sell to add value and benefit your patients’ oral and total health?
-With the guidance of your dental practice expert, determine your practice potential and identify your obstacles.
-Brainstorm with your consultant/coach and team to plan how to move beyond these obstacles.
-Finally, develop an action plan.
– This is the step that pulls your plan together and will make your resolutions stick!

Getting Expert Guidance Pays Off

Planning is your ticket to success, but make sure it’s done right. Even the dental practices that do have annual plans often lack a well thought-out strategic plan. Add to that poor execution, and many of these weak plans derail, leading to lost patient appointment time, loss of practice profitability, wasted money, contentious patient issues, and even legal quagmires.

The solution: Have an expert dental consultant guide your annual planning so you leave no stones unturned. Asking for help is the key to creating a profitable year in 2012! Don’t delay. Put this appointment on your calendar today! A ten-step plan will find your practice’s untapped potential and successfully manage your profitability.

The rewards you can reap from New Year’s resolutions don’t occur in a minute. It takes a series of successive milestones as you work toward the change that you seek. This is the reason you need to begin planning today. So, mark your calendar, get set, Go!

How are you preparing your practice for the new year?

Referral cards sent with newsletters can be an effective way to get dental marketing tools into the homes of existing patients and motivate them to take action. Since most dentists depend heavily on referrals to grow their businesses, nothing is more important to a dental office than making it easy for satisfied customers to refer their friends and family.

Up to 70% of Your Business is From Referrals

As much as 70 percent of a dental office’s business can come from referrals, according to some statistics, but receptionists and cashiers often have too many other tasks on their minds to remember to ask patients to make referrals.

When patients are asked, they often simply brush off a request to refer their friends, never giving it a second thought once they leave the office and return to their busy lives. Even those who are willing to take a card or two often forget about them.

Include Referral Cards in Newsletter

Inserting a professionally designed referral card into an equally well-designed and enticing newsletter can be an effective dental marketing tool for many providers, however.

A good newsletter brings the dental practice to the minds of patients, reminds them of the things they like about the office and the professionals with whom they have established relationships and creates a good feeling about the dental office. When they see a referral card inside the newsletter, they may be willing to pass it on.

Even more importantly, mailing cards in newsletters gets the cards into people’s homes where they can be seen by family members and left around for friends to see. Because these referral cards include complete contact information, they can be passed along without much explanation.

Include Referral Card in E-mail Newsletters Too

While e-mail newsletters may not be quite as effective for distributing referral cards, they can also increase good feelings about a dental office and can be forwarded to others if the text encourages readers to do that. Customized e-mail referral cards can also be used by practices that don’t send print newsletters to help spread the word.

When sent directly to existing patients rather than distributed at the office, referral cards can be an important part of a complete dental advertising plan.

While nothing will cause an unwilling or dissatisfied patient to spread goodwill about a dental practice, referral cards help customers who are so inclined easily provide referral information to their friends and family members who are looking for a new dental service provider.

Has this worked for your practice?

If you’ve included referral cards in your newsletter, what were your results? Do you have any additional tips for maximizing the effectiveness of this tactic? Please share in a comment below.

Is there a foolproof way to achieve your big goals?

For more than two decades I have personally watched practices set big goals and work toward achieving those goals. Some meet and even exceed their goals while others fall short. In closely monitoring and evaluating the reasons practices succeed, seven essential steps to achieving big goals have emerged.

1. Set a BHAG

Every successful dental practice possesses a Big Hairy Audacious Goal, or BHAG. We highly encourage every practice we work with to set a yearly BHAG. It has to be Big because small goals lead only to small results. It has to be Hairy and Audacious – meaning it must be stretch your team enough to motivate, challenge and excite them. In addition to setting the goal, achieving practices make setting the goal itself a special staff occasion established during an annual gathering or short retreat.

2. Clearly Articulate Expectations

The number one failure of practices that do not meet their BHAG is expectations surrounding the goal have not been clearly articulated by the practice leader. When expectations are not clearly communicated, frustration and anger among all parties involved is the inevitable result.

Beyond sharing expectations verbally, the doctor must show staff how to meet those expectations by walking them step-by-step, detail-by-detail through every element connected to the goal. If you want a five-star experience for your patients, your staff must be fully acquainted with what that looks like, feels like, and how to achieve it in your practice.

In setting and achieving a BHAG, realize that higher goals require higher expectations.

3. Visualize

Visualizing the outcome of a BHAG provides motivation to stay focused and tenacious during the journey. A shared reward, like a vacation trip, for achieving your practice BHAG provides a great visualization opportunity for your entire team.

To visualize the reward, we encourage practices to place fun reminders throughout the office, keeping the goal and the reward continually in front of the staff. For example, if you are planning a reward trip to Hawaii, you may have Hawaiian leis, beach pictures, bathing suits, helpful snacks for developing a beach body, and other fun connections to Hawaii.

In the end, beyond the shared adventure of the vacation, the significant long-term benefit to the practice is that the team learns how to set and achieve a goal. They grow to expect success, causing them to look forward with confidence to next year’s bigger and better BHAG.

4. Change Your Words to Reflect Your BHAG

Tony Dungy, the former Super Bowl winning coach, would begin every year by telling his team that he expects to win the Super Bowl during the coming season. He would then use the goal as a standard by which every practice and game would be measured. If it did not rise to the level of Super Bowl Champions, changes would be made.

If your BHAG is to grow to a $1 million, $2 million or $10 million practice, you must begin to use words that reflect that reality. Would a $2 million practice say that? How would a $3 million practice talk about hygiene, power blocks, or patients?

I recall serving a rural practice that began referring to itself as a provider of “World Class Dentistry.” Within five years, people began flying in from all around the country to receive “World Class” treatment. Your practice will reflect the words you use to describe it.

Start talking now as if your BHAG has been achieved. One of two things will happen as you change your words to reflect your BHAG. You will either change your behavior to align with your new words or you will stop saying it and give up on your BHAG.

5. Take Appropriate Action in Line with Your BHAG

If your goal is $2 million and your reward is a trip to Hawaii, your actions should reflect your belief that you will achieve that goal. Have you cleared the week for the trip of hygiene and other appointments? Have your staff members acquired passports and made family preparations? Have you published an itinerary for the trip?

With a BHAG you are either fully-in or not in at all. If your BHAG is big enough, anything less than one-hundred percent will never bring achievement. You cannot say you will make preparations if you get closer to the goal. You must align your actions now and let those actions fuel your drive to the goal.

If you are serious about losing weight and getting fit, try burning your old clothes every time you move down a size. That is an action aligning with a goal.

6. Change Your Habits to Support Your BHAG

You must change your habits to support, not sabotage your goal. Habits become auto-conscious and routine in such a way that we do not have to think about them. Like driving a car, we no longer think about all the details involved in driving, we simply drive. Habits are like a computer operating system; they free us to think and do while our habits run in the background to manage our lives.

Evaluate whether or not your current habits support your new BHAG. Chances are good that you may have to change some personal and practice habits to achieve your BHAG. Although your habits were originally put in place to serve you well, some may currently control you and your practice in unhelpful ways.

How do you change a habit? Here are four steps:

1. Pick only one or two habits to focus on at a time.
2. Choose a supportive habit to replace your existing habit. Habits are not broken, they are replaced with habits of equal or greater strength.
3. Find a reinforcement mechanism. Sometimes the best mechanism is a person rather than a thing. Chances are that your mom taught you habits and became your reinforcement mechanism to establish those habits.
4. Commit to implement your habit 100% of the time every day for ninety days. It takes ninety days to fully own a habit to the point it becomes auto-conscious and routine.

7. Monitor Your BHAG

You will never achieve your BHAG unless it is consistently measured, monitored and analyzed. In the same way that an airline pilot guides a plane, regular measurements and monitoring along the path serve to keep you on course while helping you make necessary adjustments. Course corrections will be needed along the way and you may not know it unless you stay in touch with your progress.

Go Big or Go Home

Just as world-class athletes and professional teams set challenging goals, we encourage our clients to shoot for the moon. If you haven’t established a BHAG for this year, now is the time. If it is too small, make a huge adjustment. Do not settle for small goals and small results.

Have some goal-setting tips?

If you have some tips for goal-setting that you believe helps you to achieve them, let us know in a comment below.

Over 60% of Dentists Experience Embezzlement During Career

You’ve heard the rumors – “Dr. So-and-So was embezzled.” You’ve read the statistics “Over 60% of dentists will experience embezzlement during their career.” So, what do you do to stop it from happening in your office?

My Top Recommendations

1. Use passwords

Dentrix allows you to set up an individual password for each dentist and employee, so use them! Tell your staff scary stories of tales you’ve heard about how sharing passwords can get them fired – what if another team member knows your password and the two of you have a falling out? That person can log into Dentrix using your password and do terrible things – that will be tracked right back to you. Don’t let this happen. Never share a password. Plus, set one month every year where every employee (and dentist) must change their password. Yes, I know it’s a pain in the neck – do it anyway.

2. Assign specific password rights to each employee

You can assign specific rights to each staff person. Look at the list and only assign the rights that the staff person needs. For example, deleting rights in Dentrix are reserved for only the top level secretaries – why would any clinical staff person need to delete anything? This is an easy way to reduce your exposure to problems.

3. Run your adjustments report – and do your research

In Dentrix’s Practice Analysis you can run an adjustment report for any clinical provider. Run this report for all your providers for all amounts for a month – it will show you the patient name and the $$ amount as well as the type of adjustment entered into Dentrix. Start at the top of this report and look into each adjustment – do you offer a 10% senior citizen’s discount? Then go into the ledger for your patients that show up with senior citizens discounts and check the math – is the adjustment for 10%? If it’s for 20%, you should find out why. Were there any large adjustments – over $100? You should know why for each one. Look at the insurance withhold discounts – to check these, get a copy of the patient’s insurance EOB and then make sure their withhold matches the one entered into your computer. Again, this takes a fair amount of time, but what if you did this one month out of each quarter – and you knew that no one was using adjustments as a way to cover their tracks and steal from the practice?

4. Run the audit trail

If you suspect something strange on one of your adjustments, then run the audit trail report in Dentrix. This report is a serious tree-killer because it shows you every transaction made by every staff/dentist in Dentrix at the exact time. It will show you every moved appointment time, every scheduled appointment, every note added. So, see if you can target by date this audit trail report and then you can scan it, not just looking for the strange adjustment, but also in general you can see what your staff is doing on Dentrix throughout the day.

5. Listen when your patients complain

The next time you have a patient that complains saying “I already paid you, so why am I still getting a bill?” Or the patient is upset that the insurance paid more than the original estimate so why isn’t the dentist sending more money back to the patient? Listen carefully to the concern and check the Dentrix ledger for this patient. Does the story the patient tell match the ledger? This is a great way to catch embezzlement – listen to your patients who keep track of their insurance and finances and take the time to contact you when they believe an error has occurred – they may be right.

6. Compare Staff Hours Worked vs Their Schedule in Dentrix

The last way to stop embezzlement is to compare staff hours worked vs. their schedule in Dentrix. Padding hours is an easy way to steal from a practice. You can easily sit down and scan through your Dentrix schedule for your clinical staff to compare when they saw patients and what hours they earned in payroll. Do you have a policy for having a staff person leave early if a patient no shows? Look for this on the schedule – and then check the staff’s timeclock for that day – what time did they actually leave? If they didn’t have a patient for the last hour of the day – what did they do?

Final Thoughts

Don’t let your practice become a victim of embezzling. It’s more than a crime against the dentist. It’s stealing from all the honest, hard-working staff who may have achieved a bonus if the financial goals for the practice were being met. It’s an abuse of trust for everyone in the office. By investing some time and following these recommendations you can make it incredibly difficult for someone to steal from you. Is it worth it?

Your Thoughts

Do you have any additional tips for preventing embezzlement in your practice? Any Dentrix-specific tips? Please post them in a comment below.

The search engine wars are over, the people won!

And it wasn’t an occupy movement parked in Google’s portico or a flash mob sit-in at Microsoft that led to the lay down of arms.

We did it to ourselves.

This continental shift in social local search and corresponding groundswell of opportunity favors the prepared and rewards the diverse.

How does the above average dental practice capitalize on this local search opportunity to increase online visibility?

Location, location, location.

As we covered in the intro post to local search optimization for the dental practice, the foundational elements in need of inspection with regard to properly communicating essential information about the practice are: Google Places, Yahoo Local, Bing Local, and MapQuest.

We should throw AOL in there too, just for semantics – AOL owns MapQuest at the time of writing this article, but it was astutely pointed out last week by a keen observer that AOL should be included. So, foot in mouth disease made an appearance somewhere in San Diego last week…mea culpa.

With the interest of keeping this local search series diatribe informative and educational we’ll KISS (Keep it Simple Stupid).

Because if we get into historical hodgepodge of where your practice info was ever entered online, if it was correct, if you’ve moved in the past few years, if you’ve had any legal issues, if you were a victim of unscrupulous marketing, and much more, you’d really be sick of reading.

We couldn’t possibly cover every contingency with respect to the individual dental practice, but the following tips should hold water whether your practice high and dry or bailing buckets.

Consolidate Don’t Procreate

Trust is a huge factor with regards to how your practice listing is represented. If it’s Google Places or MapQuest, the communication of verifiable practice information is essential.

There are lots of variables given the industry; is it a group, is it multi-location, is it corporate, and so on.

As we’re talking about a singular dental practice here, for matters of example, we’re dealing with one location. Don’t let the section header fool you, we’re not going off on some ranting tangent, and we won’t show up at your door later.

The point being stressed is, confirm, consolidate, and control YOUR practice listing.

Don’t worry about falling victim to the impetuous allure of confirming and controlling multiple listings within one environment.

For example, if your practice has 3 listings in Google Places (for one location), all of varying benefits…confirm them all, and then look to consolidate the listings to one primary pimped out profile with all correct info listed and benefits represented.

Multiple listings for one location within one environment is no good, it hurts the trust factor at the very least. And don’t think you’re the first dentist to think if you confirm every listing in your area, you’ll dominate.

You could actually get penalized, and that could hurt your online practice visibility for an indeterminable period.

A Thousand Words

We’re not talking about pedantic digital dental marketing blog scribes; we’re talking about first impressions.

If you were a new patient seeking a dentist online, would you rather visit the website – because that’s what consumers are doing before they call you – of a dentist that communicates a bland message replete with zero pictures, no video, invisible new patient offers, and nothing in the way of digital word of mouth?

Wouldn’t we all choose a dentist that engagingly communicates exactly what the new patient is seeking on their search – professionalism, comfort, and familiarity?

A succinct highly ranked local search profile is professional; it comforts people and transmits the message that you know what you’re doing and you’ll take care of us.

Reading reviews from people that have sat in your chair and experienced dentistry a’ la you, allows us to achieve some level of familiarity with your practice.

Same goes for photos, videos, links to your Facebook page, Twitter, business description, accurate hours of operation, and enticing call to action offers!

The Tips

• Add photos – as many as allowed, you don’t want a clinical pic scraped from a CE forum as your welcome message to people that land on your local search listing.
• Add video if possible – again, as many as you can, doesn’t have to be Scorsese-like.
• Write Engaging Business Descriptions – and don’t be afraid to test different versions.
• Offers or Promotional Messages – calls to action are essential in new patient recruitment.
• Social Links – if applicable, it soon will be.

Here are 10 more basics to follow courtesy of local search oracle – David Mihm:

1. Your physical address matching/listing the city where you’re located.
2. Manually verifying your ownership of the company’s Google Places page.
3. Having proper category associations for your page and citations.
4. Having a large number of “traditional structured citations” for your business (on sites like Internet yellow pages and local place aggregators).
5. Having your address listed on your company website, and make sure that address is crawlable.
6. Having a well-ranked (PR) company website.
7. Having high-quality inbound links to your company website.
8. Having your phone number listed on your company website, and making sure that phone number is crawlable.
9. Having an accurate local area code listed on your Google Places page.
10. Having your city and state listed in the page title for your Google Places landing page.

The items listed above can be treated as a checklist for establishing bare minimums for local search optimization.

You can read the full body of work and 98 ranking factors here – just make sure you read and understand it in its entirety before going out and putting rubber to the road. There are seemingly stupid mistakes to be made that can really negatively impact a listing.

Watch Your Back

In case you haven’t yet had the pleasure of getting cold calls from every marketer from Boston to Bombay promising to get you to the top of Google, or possess the special first-hand experience of having gone through the rip-off mill, social media and local search represent immense marketing opportunity for dental practices.

But there’s probably a bit more opportunity and low hanging fruit dangling in front of the unscrupulous marketing realm. Lots of small business owners don’t know where to start, and some fall victim to the slick words and empty promises.

Do yourself a favor, and rely on common sense when it comes to local search optimization for your dental practice.

Nobody on this planet can guarantee you top search engine placement on the results pages. And nobody can remove negative online reviews – at least legitimately.

The tools are available to do this yourself, and with a little planning and execution it’s certainly possible for you to confirm and begin consolidating your dental practice local search engine listings.

Then you can continue to educate yourself and build the citations and optimization efforts to consistently communicate genuine crawl-friendly easily verifiable info, automatically collect online reviews, and systematically syndicate your dental practice digital word of mouth.

Your Thoughts

If you’ve already dabbled in local seo for your dental practice, what specific issues are the most troublesome?

In the interest of full disclosure, please note that sales generated through these links will produce a small commission for Dental Heroes. These commissions go a long way toward ensuring that Dental Heroes is able to continue providing you with great content.

Top 10 Best-Selling Dental Products by Category

Toothpaste

Colgate Total Whitening Toothpaste

- Colgate Whitening Toothpaste is helps to prevent cavities gingivitis plaque and lasting fresh breath protection.
- It has also been shown to help reduce the formation of plaque and tartar above the gumline.
- Brush twice a day and you’ll know your teeth are cleaner, whiter and your breath will be fresher around the clock.
- Each Colgate Total Formula fights plaque germs for 12 hours and helps prevent: plaque, gingivitis, tartar build-up, cavities and bad breath.

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Mouthwashes

Listerine Antiseptic Mouthwash

- Kills germs that cause bad breath
- 24 hour protection
- The only nationally branded antimicrobial mouthwash to receive the Ada Seal of Acceptance for fighting plaque and gingivitis.
- Has over 100 years of safe use and 50 years of research, making it the most widely used and extensively researched mouthwash the U.s.
- The Ada Council on Scientific Affairs’ Acceptance of Listerine Antiseptic is based on its finding that the product is effective in helping to prevent and reduce gingivitis and plaque above the gumline, when used as directed.

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Flossers

Glide Floss Picks

- Allows you to floss even between teeth in the back of your mouth.
- Patented tension-control design allows floss to surround the tooth surface for cleaning power.
- Silky-smooth texture slides easily between teeth.
- Effectively removes tough plaque between teeth and just below the gum line.
- Gently stimulates gums and helps prevent gingivitis

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Dental Night Guards

Smartguard Night Guard

- Patented Gag Free design with FDA Approved materials
- Patented design has the highest possibility to Reduce TMJ Jaw Pain of any OTC Night Guard available
- Designed by a TMJ Dentist
- Protects the teeth from the affects of teeth grinding. Also reduces clenching and ringing in the ears.
- Reduces Tension headaches 77% out of 82% of headache sufferers

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Powered Toothbrushes For Adults

Philips HX5351 Sonicare Toothbrush

- Soft-grip handle holds charge for up to 2 weeks, ideal for travel
- Rechargeable toothbrush cleans with ultra-high speed bristles
- Removes 80% of coffee and tobacco stains in just 28 days
- Ships in Certified Frustration-Free Packaging
- 2-minute smartimer
- Includes 1 contoured brush head, charger base, and travel case

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Powered Toothbrushes For Kids

Philips Sonicare for Kids Rechargeable Toothbrush

- KidTimer increases brushing time slowly over 90 days, building toward the dentist recommended 2 minutes.
- Kid-friendly power modes provide gentle cleaning that’s right for different ages.
- Age-appropriate brush heads specifically designed to clean and protect teeth at key developmental stages.
- Ergonomic design enables parents and kids to brush together or on their own.
- Interchangeable panels so kids can customize their toothbrush

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Manual Toothbrushes

Colgate 360 Degree Sensitive Toothbrush

- Offers features such as textured tongue cleaner, tapered inter-dental bristles, polishing cups, cleaning tip, soft bristles and a comfort grip
- Contains soft bristles which gently massage your gum-line while giving your teeth a deep cleaning

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Whitestrips

Crest 3D White Whitestrips

- Professional level whitening results that last up to 12 months.
- Advanced Seal technology allows you to talk, drink water and go about your day while you whiten
- Start seeing a whiter smile after just 3 days
- Enamel safe. Same whitening ingredient dentists use
- Give yourself a smile makeover with professional level whitening results at home

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Waterpiks

Waterpik Ultra Water Flosser

- Water jet is clinically proven to be up to 93-percent more effective than flossing
- Advanced control delivers a water pressure of 10 to 90 PSI with 1200 pulses per minute
- Removes debris and bacteria lodged deep between teeth and below the gum-line
- Significant oral health benefit for people who wear braces, have diabetes, and gum disease
- Includes 6 color-coded tips

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Toothbrush Sanitizers

Sunbeam UV Counter Top Unit Sanitizer

- Kills 99% of E Coli, Streptococcus and Salmonella germs
- Sanitizes in just 8 minutes
- Effective UV lamp never needs replacing
- Operates with an AC adapter
- Safe enough for children to use

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We’ll defer to Wikipedia for the background definition:

Local search is the use of specialized Internet search engines that allow users to submit geographically constrained searches against a structured database of local business listings.

Typical local search queries include not only information about “what” the site visitor is searching for (such as keywords, a business category, or the name of a consumer product) but also “where” information, such as a street address, city name, postal code, or geographic coordinates like latitude and longitude.

A search that references a product or service that is typically consumed locally, such as “restaurant” or “nail salon”, is an implicit local search. (source: http://en.wikipedia.org/wiki/Local_search_(Internet))

Now that’s just from the Internet info giant Wikipedia, and it not so succinctly sums up the definition of ‘local search’ for all of us who are used to typing in some keywords and getting answers to our questions. By all means do some more research, but wait ‘til you’re finished reading this article -your practice is worth it.

With regards to dental practice marketing specifically, local search equates to having a highly visible and properly administered digital practice footprint within the localized environments of the Big 3 search engines.

You need to confirm and control your office listings, or else. Maybe ‘or else’ even if you do control your local listings, but we’re getting ahead of ourselves.

Where Can We Witness this Local Search Phenomenon?

Basically we’re talking about the local areas of the search engine results pages (SERPS), complete with map listings, website links, special offers, social links, other business info – and more. Formally (and for now) these local sections of the search engines results pages are: Yahoo Local, Bing Local, and Google Places – we can now add MapQuest to the list too. These local areas allow you to communicate practice information in a totally new and highly visible environment.

The search engines are determining where we’re searching from, geographically, and providing relevant results within these local centers prominent on the first page of most search results.

MapQuest is another area to plant your digital practice footprint and solidify your geolocation as it relates to the internet. That’s all we need to discuss for now, we can get into geo sitemaps and schema compliant files when you need something to help you sleep…or drive you batty.

And keep in mind, this localized directive is all in addition to any existing search engine marketing (SEM), optimization (SEO), e-commerce, or website advertising efforts. When people in your area search online for dental products or services, you want to make sure that you are adequately complementing existing practice marketing with an emphasis on local search optimization.

But again, I digress.

The search engines determine the lay of the land, you just need to provide them with the most trustful, resourceful, relevant, and recent content in order to successfully navigate your dental practice digital visibility course.

What’s the Point, Hooks and Lines?

It starts with your location, and your name, address, and phone number (NAP). This foundational elemental practice info needs to be properly communicated within these local search engine environments. Odds are we’d all be very surprised by the amount of unconfirmed and inaccurate local search listings out there right now.
But that’s only a peek inside Pandora’s Box of local search optimization. We’re at a place where information is at our fingertips, no longer do we let our fingers do the walking – unless it’s across the keyboard.

For younger generations, and the majority of us before the next President is up for re-election, we’re searching online from mobile phones, iPad 2s, Xooms, or PlayBooks…you get the point. We’ve even taken word of mouth online and local; patients are using Facebook petitioning family and friends for dentist referrals!
Speaking social and local, have you used Facebook Places or Foursquare yet?

Can you see how both of these ‘social local’ environments can benefit your dental practice?

It all starts with a solid foundation. Confirmed and controlled practice listings within these primary local search engine environments are the foundation of optimizing, and leveraging, local search visibility for your dental practice.

What Now

But what happens when everyone controls and confirms their practice listing, then what? Are you ready to dive in? In Part II of this post, we’ll dive into some juicy local search tips for your dental practice! You won’t want to miss it.

Your Thoughts

Is your practice leveraging the power of local search? How has this impacted your business?

The following is Part II of yesterday’s post by Debbie Siedel-Bittke titled, “You Decide: Prophylaxis of Periodontal Maintenance.”

Periodontal Maintenance vs. Prophylaxis

The Prophylaxis Appointment (CDT Code D1110 prophylaxis) is only for patients who exhibit healthy gingiva. They have a healthy periodontium. The Prophylaxis (CDT code D1110) definition says “the removal of plaque, calculus, and stains from the tooth structures in the permanent and transitional dentition. It is intended to control local irritational factors.”

The Periodontal Maintenance (CDT Code D4910 periodontal maintenance) is a post-therapeutic procedure used to maintain the healthy results of periodontal therapy, not to prevent disease in healthy patients. The Periodontal Maintenance (CDT code 4910) definition states: “It can only be used “following periodontal therapy and continues at varying intervals … includes removal of the bacterial plaque and calculus from supragingival and subgingival regions, site-specific scaling and root planing where indicated, and polishing the teeth.”

The Periodontal Maintenance appointment is to be used following Phase I – definitive periodontal therapy and for an indefinite time, determined by the patient’s progress over time to achieve stability and the absence of the signs and symptoms of disease. Periodontal maintenance patients who have poor oral hygiene, smoke, exhibit bone loss and/or excessive bleeding, have not achieved an acceptable level of stability and in addition, have various immune deficiencies such as Rheumatoid Arthritis, Diabetes, Arteriosclerosis, etc., etc. When these patients continue to return for dental hygiene appointments and these disease challenges persist they will need to be referred for a consultation by a periodontist.

What are the specific differences between a periodontal maintenance procedure and. a regular prophylaxis? Periodontal maintenance procedures include a predominance of power scaling with thin inserts to access and debride the depths of periodontal pockets. Think scaling SMART not hard! Your patient may need localized areas of local anesthesia. The goal of this appointment is thorough debridement of pathogens that have repopulated in the sulcus. Periodontal pathogens reside in the sulcus and on the plaque and calculus. Biofilm is always present on the root in the presence of calculus or no calculus. Annually, a comprehensive periodontal exam is mandatory. (Six-point periodontal probing is necessary in order to reassess changes that have occurred in pocket depths.) A pre-procedural rinse and irrigation post-procedural with an appropriate antimicrobial, such as Povidone-iodine or Chlorhexidine, is the Gold Standard. You may need to apply desensitizing agents, such as Colgate’s Pro-Relief™, with a rubber cup if your patient has sensitivity and/or exposed root surfaces. If you have a fluoride varnish you can easily apply this for immediate relief from any root sensitivity. There are numerous choices for today’s sensitive dental hygiene patient. Always polish with low-abrasion pumice and/or pastes if your patient has exposed root surfaces. This is often the case for periodontal patients.

Communicating the difference

One way to explain to patients when they need to understand the difference between Prophy and Periodontal Maintenance is to say this: “Your gums are not healthy and this can also affect your total health. Usually, your dental hygiene appointment is only a preventive therapy but today I will need to treat areas of disease. I am recommending that we do something different today. Today I (fill in the blank with your own plan) will let the patient know if you will do a gross debridement, scale and root plan an area, etc.” Ask the patient if they have any questions and find out if they have objections and why. It is at this point in time you will need to address financial issues.
For some patients the most challenging part is the finances. It is well known that most people will buy what they want. This is when you have effective communication skills that you can overcome the financial barriers to accepting non-surgical periodontal care. Most people will find the money when they understand they will live a longer and healthier life!

When patients still don’t comprehend the importance of optimal oral health in relationship to their total overall health, try to explain that you are not providing appropriate treatment with only a prophylaxis appointment. Patients also need to understand they are not there to get their teeth “cleaned”. Dental hygienists are in the business of preventing disease.

One more way to communicate the importance of more than a prophylaxis is to show the patient radiographs of their teeth, the surrounding bone and/or intraoral photographs of the diseased areas, bleeding staining, plaque, calculus, etc. Show them actual tooth mobility if it exists. A loose tooth is not a pretty sight to see!

Some computerized patient management software programs, stand-alone devices and programs, such as the DENTRIX periodontal chart where you can color code areas with different colors, (Red for BOP, green for mobility, etc.) Dental R.A.T.® and PerioPal®, also produce impressive probing charts. Even giving the patient a hand mirror and showing him/her how his/her gums are bleeding can be a powerful, emotional tool. The main point here is that the independent authority has to be highly visual and vivid to counter the emotional belief that they’re being cheated. Some patients will believe “It’s all about the almighty dollar”, when in reality we are in the business to provide optimal health.

It is becoming more common to have Physicians gather systemic information with lab tests, and dentists are beginning to use lab tests as well. Four outside labs have periodontal tests: two are culturing services – Oral Microbiology Testing Service (OMTS) and Oral Microbiology Testing Lab (OMTL). The other two are DNA tests: OralDNA Labs® and micro-IDent®plus. All four tests can detect pathogens that are associated with periodontal disease. There is also a third-party statistical test, PreViser™ based on clinical findings that estimate the likelihood of periodontal disease. In addition to these outside tests, there are two microbiological tests that can be used chair side. BANA™ is an enzymatic test for periodontal pathogens, and the other is a video microscopy test called BioScan™.Any of these above listed tests can provide the type of important information dental practices and patients may consider prudent.

Final Thoughts

The dental hygienist has two important roles. The first role is to determine which type of periodic preventive care is needed, by each individual patient. It is the role of a healthcare provider to educate and communicate to patients exactly what type of care is appropriate for their overall health. Education is the second role.

We are not talking about the almighty dollar. We are concerned about our patients overall health. When you understand and communicate the difference between health and disease. Prevention and treatment, you are providing optimal care.

Disease means Periodontal Maintenance for life. Prophylaxis means the patient is healthy and there is little plaque, calculus and no bleeding.

Sources
1. www.perio.org September 2003 Issue
2. www.perio.org

All throughout the day, we treat them one by one. Each individual patient is treated in a different way. This is our standard of care. Will you agree with this statement? If you don’t agree, then let’s make a “Red Letter Day”- – today!

What is the difference between a Prophy and a Periodontal Maintenance?

Are you scaling more than twenty minutes during a regular continuing care appointment? If you are then it is probably more than just a Prophy.

Periodontal Maintenance

When a patient completes phase one treatment for non-surgical periodontal therapy, they are now and forever considered a “Periodontal Patient”. If you have Diabetes or high blood pressure, you will always be evaluated by your doctor to prevent progression of the disease. A patient diagnosed with cancer, high blood pressure and/ or Diabetes, doesn’t just get treated and then never see their doctor for regular preventive measures. This is the same protocol for patients diagnosed with Periodontal Disease.

One reason hygienists may choose to eliminate the periodontal maintenance appointment is for financial reasons. In the United States and other countries a billing code is used and more money is charged for the service. In the United States code D4910 (Periodontal Maintenance after scaling and root planing has been completed.) is a much higher fee than the fee for code D1110 (Prophylaxis. This means no disease is present.) The other reason dental professionals do not provide the periodontal maintenance appointment or bill appropriately is that many third-party payers do not cover the periodontal maintenance appointment at frequent intervals. (Example: Less than six months interval.)

When we understand the research regarding periodontal pathogens we will understand how to communicate to our patients “Why” they need to return in most likely twelve weeks. The research, the science, reports that periodontal pathogens will repopulate a healthy and recently scaled sulcus as early as nine to twelve weeks, post maintenance.1 A patient can brush and floss all day long and this may not be enough to remove the periodontal pathogens. These pathogens are what will cause tooth loss in periodontal patients.

Following a 10-year study, researchers found that patients who received regular periodontal maintenance had significantly reduced probing depths and lost fewer teeth than patients who did not have periodontal maintenance procedures. Here are the arguments to use regarding regular twelve week periodontal maintenance for your periodontal patients. This is the information to communicate to patients. It is our role as a healthcare provider to read the research, know the science, and share it with everyone who needs to know.

It still happens each day in many dental hygiene treatment rooms throughout the world. No matter how much time is spent removing plaque and calculus, the office still charges the same fee for what are actually a different procedure and a different diagnosis. The problem that is seen most likely is that the hygienist is not individually assessing patients for periodontal disease. The other problem is that the hygienist will do an assessment but there may be a lot more calculus present than is considered a regular prophylaxis procedure. If it has been awhile and if you live in the United States, look at the CDT Codes and read the description for D1110. No matter where you live, review the billing code description. Exactly what type of plaque and calculus does this billing code refer to? Does the code say this is a procedure for a preventive or a disease state? Read this description and see for yourself that (For example, in the United States) CDT Code D1110 refers to a healthy dentition, small amounts of plaque and calculus. If you are spending more than twenty minutes scaling, then you are not adequately treating this patient. Scaling calculus for more than twenty minutes is not the description of a prophylaxis. In the presence of moderate to heavy calculus you have more than a CDT Code D1110. (The Prophylaxis code for insurance billing purposes in the United States.)

No one wants to spend more money! People will pay for what they want not always what they need. It is our job as a healthcare professional to be an advocate for prevention. We need to share the research and the science behind the disease and how to prevent it, with our patients. We are the experts and we want to be an advocate of optimal oral health for our patients. We have a responsibility to spread the word that without good oral health a person will not have a healthy body.
“Working as a team of healthcare professionals, we can conquer the disease process. Together we can make a difference in our world!

Can you effectively explain to your patients why they need to return for non-surgical periodontal treatment? Do you know what to say when a patient returns with heavy calculus? What do you say when the patient had scaling and root planing last year and returned today with a 6-mm pocket? That pocket was there prior to scaling and root planing a year ago but what do you say when it occurs again at the periodontal maintenance appointment?

Tell Your Patients the Truth

You told your patient about the research and science behind the disease and you also need to tell them that periodontal disease is episodic. The disease process can and will most likely return at some point. This is why your patients need to continue coming back every twelve weeks, (or at frequent and the appropriate intervals.) even if they seem healthy for many years after the scaling and root planing is completed.

As mentioned previously, when a patient has Diabetes or high blood pressure, the doctor will ask the patient to be examined frequently because the disease is likely to return. Today, it is all about prevention. Prevention needs to be your message to the patient. When there is a new area of bleeding upon probing (BOP) or a new 5-mm pocket, now is the time to sit the patient upright in the chair and discuss early intervention. This will most likely mean prevention in the future. In dentistry today, during the twenty first century, we no longer “wait and watch”. Waiting is not the standard of care. What are your “waiting” for?

Look for part II of this post tomorrow…

What to look for in Part II tomorrow

In part II of this post, we’ll learn the difference between Prophylaxis and Periodontal Maintenance. We’ll then discover an effective way of communicating the difference to our patients. We’ll see you tomorrow!

In Part 1 of Communication Tips You Must Know to Improve Case Acceptance, we talked about the advances in technology and our knowledge of the current evidence-based science, regarding the oral health and systemic health link.

We understand that dental hygienists have a huge impact on communication and patients’ acceptance to a treatment plan. It is crucial to guide patients to have a healthy body and in return, we are adding value to the services we provide and this will in return increase the dental practice profits.

Critical components for patient case acceptance:

1. Rapport: The patient connection.
2. Visuals: Most people are visual learners. Have these ready to use at each appointment.
3. The words we use.
4. The questions we ask . (Open-ended questions.)
5. Review, repetition and closure with the patient.

Case acceptance is critical for clinical results and the success of all dental practices.
Without patients accepting the treatment plan we cannot provide optimal care and your dental business will not survive and thrive. When we communicate with our patients, it is valuable to ask open-ended questions. Without asking open-ended questions, our patients will be answering yes or no to our questions. We can learn a lot more about our patients needs when we ask questions that cannot be answered with just a yes or no.

Time is a big concern during the hygiene appointment and asking open-ended questions will allow us to communicate the important facts quickly. In Part 2 we will give examples of critical communication for patient case acceptance.

Example of an Open-Ended Conversation:

RDH: “Mr. Jones, Can you see the brown line and discoloration around this composite filling?”
Mr. Jones: “Yes, I can see this.”

RDH: “How do you feel about these dark discolored areas on your front tooth?”
Mr. Jones: “I have never noticed this before you mentioned it today. I don’t like my teeth not being white. What does the discolored area mean for my tooth?”

RDH: “This means there are open areas around this filling. I see from your chart, this restoration was preformed about 15 years ago. There are toxins, bacteria or poisons that will creep under the filling and cause destruction of the tooth. Do you see the small amounts of food trapped in this area?”
Mr. Jones: “Yes, I do see the food trapped there.”

RDH: “The bacteria that creep into this area on the tooth can also get into your blood stream and contribute to disease. This can affect your immune system.” Does this make sense to you?”
Mr. Jones: “Yes, that does make sense. I have never thought about it in this way.”

RDH: “What are your thoughts about restoring this tooth, returning it to a healthy status?”
Mr. Jones: “Well, yes, of course I want to be healthy. How can you do this?”

RDH: “Mr. Jones, the first thing I would like to talk about is your discolored tooth in the front of your mouth. I know you have never noticed this before today and with a new restoration, we can remove the bacteria, which causes oral disease and more destruction on your tooth. The bacteria will get into your blood stream if not removed. The way we fix this tooth for you is to very easily remove the darkened, stained enamel from the tooth and replace it with a new tooth colored material. Of course, all the recommendations for treatment I am going to make will be dependent on your budget. I know that the economy has also affected how you are spending money at this time. The doctor will look closely to make sure all the recommendations make sense for you and what is happening in your life at this time.”

This is the time to take out the brochure regarding restorative treatment. (Circle, highlight or underline the areas which pertain to the patient.)

RDH: “What are your thoughts about this treatment recommendation? Does this information make sense?”
Mr. Jones: “Yes, it does make sense. Although money is tight, I still want to have the healthiest mouth and body as possible. I would like to think about ways I can pay to have this treatment completed.”

RDH: “I can have Mary, our financial coordinator, discuss payment options with you. The second area I can help you with is your dry mouth. I noticed that you circled this on your medical history. This is most likely due to the medication you are taking for high blood pressure. Today, I will show you a few products, which will relieve this situation very easily.”
“Is this something that you will use at home?”
Mr. Jones: “Yes, I definitely want to know more about these products today.” “I don’t want to leave without asking Mary about the financial options you can offer.”

RDH: “I will show these products to you after the doctor completes your exam today. The other area I want to address is the bleeding gums and the areas, which measure 5mms. I completed a periodontal screening exam and I want to review my findings with you at this time.” (At this time if you have an electronic chart, put the perio chart up on the monitor and review with the patient. Also, bring out the periodontal brochures and outline, highlight or circle important areas that relate to the patient.)
“Your oral health is related to your overall health. We need to remove the bacteria causing the periodontal disease. You may have heard about gum disease before today. Some of the factors which can contribute to periodontal disease are stress and various systemic diseases such as your high blood pressure. I am recommending that you return for four appointments to scale and root plane these areas. I will place a chemotherapeutic agent called Arestin in the areas, which measure 5mms. This is similar to what you know as Tetracycline. This is a sub-dose of Tetracycline and will work only on the enzymes, which are causing the inflammation, bleeding and disease process. After the four appointments are complete, you will return four – six weeks later to re-evaluate these areas and make certain they are healthy. Usually with this treatment and the use of chemotherapeutics at this early stage, we can halt the progression of periodontal disease. I will also recommend that you return every three months for supportive therapy to prevent further disease. Does this make sense to you?”
Mr. Jones: “I think it does. I have been hit hard from the economy these past two years and it has caused a lot of stress. My daughter is getting married which adds to the financial problems and my stress. Are you telling me that if I don’t have this gum treatment for the periodontal disease, that I can lose my teeth?”

RDH: “Yes, that is correct. Usually this is a slow disease process but without the treatment, scaling and root planing, the disease process is likely to progress. The scaling and root planing will also help establish good health around that tooth before the doctor provides you with a new restoration or filling in that front tooth. The end result with a new filling is very positive once your gums are healthy. The doctor can add a much better restoration when the gums are healthy.” “I know you have your daughters wedding in a few months so maybe you want your smile to be the very best possible for this big event. Before doctor comes in to do the final examination and make the diagnosis, I want to show you some photos of patients with a similar situation as yours. In our computer, I have some photos of patients who had the same type of slight bleeding and redness around their gumline. (Now have photos of patients before and after scaling and root planing on the monitor) They completed the scaling and root planing and as you can see in this photo here, the patient now has gums that are a light coral pink color. How much difference do you see in the patients’ gums from the beginning to the end of treatment? Can you see a difference between these photos? Do you notice something is different?”
Mr. Jones: “Okay, I see, the teeth and gums look a lot better in this photo on the right. I understand what you mean about improving my oral health. That second photo doesn’t have any blood around the gumline. The front teeth on this patient are also much whiter. I have never even noticed this discoloration or bleeding before today. I never noticed those brown areas around that old filling and I definitely didn’t think anything about a little bleeding on my gums every once in awhile.”

RDH: “Our dental assistant Marcie had an old filling completed for the first time about twenty five years ago, before we had these great materials to restore teeth. The filling was redone few times over the past twenty-five years and last year doctor completed a veneer on this tooth. Doctor also whitened her teeth so they would all be much whiter. This is something very similar to what doctor can do for your teeth. Of course, this is only if you decide to have something more permanent completed on that tooth. It is very simple to complete and not much of your tooth will be taken away, contrary to having a crown placed.”
“I wanted to show you what we did to her tooth because we work for an amazing doctor who can make everyone’s teeth look better than ever. I wanted to show you this other type of treatment because it is longer lasting and all your teeth will look much whiter. Dr. Carter takes us to a lot of excellent educational courses and we just learned about a new procedure which can really make your smile look good for your daughters wedding!”
“Mr. Jones, we have talked about many things today. I want to make sure you are comfortable with your care. What questions do you have for me?”
Mr. Jones: The photo of the tooth after she had the veneer placed looks fantastic! I really like how natural it looks. How long will the restoration last?”

RDH: “With proper home care, the veneers can last over twenty-five years.”
I believe that doctor may want to discuss these various treatments with you at another consultation appointment. If you are interested in having all the teeth look great in the front of your mouth, doctor can talk to you about what you want your teeth to look like. We can make another appointment during your lunch hour next week so you don’t have to be so rushed today. You can take your time to decide on the type of treatment you want to make your smile look the very best. We will accomodate you so you don’t lose time from work. Is this something you would like to discuss with doctor further?”
Mr. Jones: “Yes, I think I would like to find out how all my teeth can look better. Let’s make a lunch time appointment for me to discuss this more.”

RDH: “I am looking at the schedule here on the computer and I see that we have a lunch time appointment next Thursday. Does 12:00pm on March 24th work for you?”
Mr. Jones: “Yes, I think that will work for me.”

RDH: “Before you leave today I will schedule the appointments for the scaling and root planing and a six week appointment to re-evaluate the outcome from the scaling and root planing. I will also review those products for your dry mouth. Here is doctor now.” Now the doctor will come into the hygiene room and complete the exam. Doctor will confirm the initial diagnosis and review the discussion between the hygienist and patient.

Recap for Critical Communication

At this point, the hygienist has talked about stress and the affects of this on the patient’s oral health. The hygienist has talked about something pleasant to continue with rapport building and the personal relationship between patient and practitioner. The hygienist has also used various types of visuals. In this scenario, the hygienist used brochures and individualized these by highlighting, underlining and/or circling important aspects. The hygienist also showed some real patient photos on the monitor. During the verbal communication, throughout the case presentation, the hygienist used open-ended questions. When possible, the hygienist engaged the patient in conversation.

The hygienist explained the purpose for good oral health and allowed the patient to choose the level of health they want. The hygienist allowed the patient to decide if they would like to hear other treatment options. This put the patient in charge of their oral health and options for treatment. The patient took responsibility.

During the case presentation, the hygienist suggested and asked the patient if they would like more time to discuss other options with the doctor. These other options were more permanent alternatives to treatment. The hygienist talked about a more complete treatment plan and asked leading questions to discover if this is the type of treatment the patient would be interested in. (RDH: “Is this something you would like to discuss with doctor further?”)

The Next Crucial Step For Patient Case Acceptance

The next step when doctor enters the room for the exam is for the hygienist to provide a verbal synopsis to the doctor about the discovery during the patient-hygiene appointment. The hygienist will begin with something personal about the patient. For example, Mr. Jones has a daughter who will be married in a few months. Then the hygienist will report to doctor what treatment options were discussed and what the patient felt about the treatment options and if Mr. Jones is interested in moving forward with any of the options discussed.

Another Crucial Step for Patient Case Acceptance

The next crucial step is to get closure before any financial arrangements are made. You need to know if the patient is ready to move forward with treatment. This one thing needs to occur before you will have an answer to this next step to discuss the financials. If the patient is not ready to move forward with treatment, discussing financials will become a losing option for your patient schedule.

If you do not proceed with this next step the patient can most likely make an appointment and then cancel. The patient may also follow through with financial arrangements but they will tell you they will call when they are ready to schedule their treatment. This is why it is crucial to have a commitment from the patient to move forward with treatment.

When presenting the treatment plan both doctor and the hygienist need to be on task. Neither of these two people can miss a step. If doctor misses a step, the hygienist needs to give a verbal cue for doctor to return on task and verbally communicate. Same thing occurs if the hygienist misses a step. There needs to be conversation and a buy in from the patient after explanation of the treatment.

Repetition. Repetition. Repetition.

In real estate, they say this phrase “Location. Location. Location.” When we discuss communication with our patients, we need to understand that, many times a patient needs to hear the information two or three times before, they will say “Yes” to a treatment plan.

When the hygienist and entire dental team understand the science behind communication for case acceptance, the hygienist and other members of the team can increase the chances a patient will move forward with their treatment plan.

It is the responsibility of the hygienist to continually review the periodontal, restorative and aesthetic treatments, regarding the structured process within the Science of Communication each time they see the patient. The time for communicating this will not always be as long; however it is still the responsibility of the hygienist to continue communicating as long as the patient says they are still interested in the information. The dental professionals are the experts and need to continually create a desire for patients to move forward with necessary treatment.

Conclusion

It is important to understand the science behind communication. We are all guilty of talking and not communicating.

Key components to understanding how to get a “YES” for patient case acceptance:

- Understand the patient’s personality style.
- The tone and speed or your words
- The words we use
- Stay away from “speaking in code.”
- Use visuals
- Seat patients upright in the chair and face each other eye to eye
- Focus on the patients concerns and not your own agenda

Once the dental team feels more confident explaining the treatment needs to patients, the patients’ confidence in scheduling their treatment will also increase. In order to improve our patient case acceptance we need to improve the patient experience. To improve the patient experience, we must first improve the dentist and team experience. The goal of communication is about changing what we do. Once we have mastered the Science of Communication, the patients will notice the value added to their appointment and the overall improvement of their experience. With the patient experience improving, so will the referral of the patient’s friends, family and colleagues. When we create a great patient experience, the dental practice will benefit with an increase in the bottom line.

I was a dental assistant for 12 years right out of high school and I have maintained an interest in dental workforce issues ever since. After completing my bachelors and masters degrees, I worked in non-profits where I devoted my time to dental workforce issues. I am now working at a dental school and I’m a PhD candidate in the dissertation phase with a topic focused on dental workforce shortages affecting access to care. I’m interested in finding out if experience with dentistry prior to and during dental school affects how a person feels about their dental skills and abilities, and then finding out if these experiences (such as community outreach) influence practice preference. I believe the results of my study will help with dental admissions processes and with dental clinic recruitment and hiring. I’m focusing on dentists who have graduated between 2006 and 2011 to complete a short (10 minute) survey. I’ll share the results of my research with those who are interested.

Thank you, in advance, for your participation!
Mary Fusco, MA, PhD ABD

Start the Survey

Anyone interested in learning more about the research study and taking the survey please go to:

http://bit.ly/qzg6XJ

Fact: Most Dental Practice Facebook Pages are Boring

In a recent post, you may have read that the having a Facebook page for a dental practice is a definite yes.

Sadly, several of the dental Facebook pages I’ve come across can only be described in two words.

BO-RING.

If you are trying to get your audience (which includes your patients) to be more familiar, interested and engaged with your practice, do you really think they want to see all those clinical photos with retractors and words like “mesio-distal”?

No way.

Turn them off and you may not get a second chance to turn them on.

But, you might ask, why even bother?

What’s in it for you, to either make the time and put in the effort, or pay someone to do it?

1. Social media is mainstream

To begin, social media is mainstream and it’s here to stay. It is fast becoming the primary way people are interacting online today. We all know that word-of-mouth referrals is the best advertising for our practices; so think of social media as its online version.

2. Your practice will be more dynamic

Secondly, a Facebook page adds another dimension to your business persona. To your current patients or to future ones, a website may only offer static content. But with other elements such as a blog, a YouTube page and a Facebook page, your practice becomes a more dynamic entity.

3. Your patients can engage on more personal level

Thirdly, prospective patients researching online may click on your website and view your practice as a business alone. That can be perceived as somewhat impersonal (depending on the quality of your website). Adding a Facebook page can allow you to show your practice’s more personable, and personal, side. This gives you one more area to stand out from every other dentist on your block. Click.

4. Enhances your brand

Fourth and lastly, your page (in combination with other elements) expands your personal branding and, unless it’s changed its formula again, Google likes you a little more. And everyone wants Google to like them.

Now that you have the highlights, what are you waiting for?

I do have one request though.

If you decide to set up a Facebook page, please . . . . no pictures with retractors.

Your Thoughts

Does your dental practice’s Facebook page rock? If so, leave your url in a comment below and tell us why it rocks.

When was the last time you reviewed the cleaning and sterilization procedures for your office? How confident are you that your staff are following the correct steps to keep you and your patients safe as well as meet the required regulations? A great way to get on track is by working with the OSHA Onsite Consultation Program.

The OSHA Onsite program is free

The OSHA Onsite program is free – and completely separate from the enforcement arm of OSHA, so you are not in danger of receiving penalties or punishments. The way it works is that you contact the office and request that an OSHA Consultant visit your practice. Next, talk with the consultant that is assigned to your case and let him know a little about your practice, what you would like him to evaluate and what questions you have. In my experience, these consultants are friendly and helpful, so you can feel safe to ask questions and get the coaching you need. If you use nitrous in your practice, you can ask the consultant to bring the equipment needed to test your evacuation system. You also can ask the consultant to test your x-rays. These are not normally part of the consultation process and the consultant will need to request the equipment (the nitrous testing equipment costs over 6 figures and is shared between several consultants) in advance so they can provide these additional (free) services to you.

To prepare for your OSHA Onsite visit, you will want to have a copy of your bloodborne pathogen and hazardous communications plans, you will want to update your staff (and dentist) hepatitis series documentation, update your MSDS forms and make sure your cleaning bottles are clearly labeled. A visit to the OSHA web page for dentistry to review the regulations is a good idea.

Tips For Meeting With OSHA Consultant

Plan to spend 15-30 minutes with the consultant when he arrives to welcome and thank him for making the trip, to show him around the practice and get him focused on what you would like accomplished during the visit. The consultant will need a table where he can review the documentation discussed above and space to work on his report. Assign your best dental assistant or EFDA to show the OSHA consultant around the office, reviewing the cleaning and sterilization routine and introducing the consultant to the staff. The consultant will probably spend up to a few hours to evaluate your processes, check your documentation and make notes for his final report. It’s best to again plan 30 minutes at the end of this visit so the dentist and the consultant can discuss any concerns or recommendations. This is also a great time for the dentist to ask questions and get solid answers from a reputable professional.

In less than 2 weeks, you should receive the final report from your OSHA consultant. It will let you know if any serious or ‘other than serious’ hazards were identified and include recommendations to bring them up to standard. It also includes forms to submit to the consultant to let them know you have rectified these problems.

Focus on Improvement

This OSHA Onsite Consultation Program is a great way to set the standards for your staff. From beginning to end, your staff is involved with preparing for the visit, meeting the consultant and participating in the evaluation and then with reviewing the report and working to correct any concerns. Your staff should create a checklist based on this experience so they could perform their own evaluation – and be ready for the next time you decide to invite OSHA for a visit.

A Marketing Opportunity

This program is also a great opportunity for marketing your practice. Patients today want to know that they are safe when in your hands – why not tell them you invited OSHA to come in? In fact, this might make a very nice newspaper article – to let the entire town know that you are looking out for everyone’s safety (patients & staff). If you’re kind to your consultant, he may allow you take a photo – and this is a great post on your Facebook page about the visit & how you believe in making sure your practice is as safe as possible.

How to Learn More

If you would like some help to improve your cleaning and sterilization procedures or to learn more about my experiences with the OSHA Onsite Consultation Program, just call me!

Mark Wilhelm, DMD MSD

There are many cosmetic dentists who believe that diagnosing a patient must begin with a close examination of test results and x-rays.

It Starts with “Hello”

With over 20 years of experience to call upon, I beg to differ. While many situations will require clinical research, you might be surprised at how much it’s possible to tell from your first “Hello” with a patient.

Simple Case Study

I recently had a patient visit me to get a second opinion. She was 63 years old and had a lot of dentistry already completed. She had an issue with her front teeth. At a previous provider she was told that she needed a full-mouth reconstruction and went into the details as to what was proposed. After listening I asked her these five basic questions regarding function:

1. Are you able to chew bagels or other tough foods?
2. Are you able to chew gum?
3. Do you sleep restfully?
4. Do you feel as though you have one bite when you close (or more than one place to bite)?
5. Have you noticed any wear, flattening or changes in your teeth in the last five years?

These weren’t trick questions but rather basic ones that could give me any evidence of functional concerns or breakdown. From the five questions I asked her and from what I could see from my position in the consult room, my opinion was that she did not need a lot of dentistry.

Now note that I had not even moved from my seat and already had a good idea of what, if any, problems she had. She brought copies of x-rays and I did eventually get a clinical look at her teeth, but the bottom line is that I did not need an articulator or the study casts that she brought with her. How could I do this? It’s simple. She was 63 years old and told me that she was able to chew and eat just fine, did not have any pain and did not exhibit any appreciable clinical wear on her teeth. This all meant that her chewing system was working fine. It didn’t need fixing! Next I was able to address her needs with her front teeth. Simple treatment for a trusting patient.

This diagnosis began at hello and concluded with an investigation. After she agreed to proceed, I could use the study casts to do the diagnostic wax-up and coordinate it with facial measurements to plan the treatment and the provisional restorations. But my determination that her occlusion was functioning acceptably meant that I did not need to change her bite.

Take a different patient referred by his family dentist because he had a problem with his front teeth. He was also in his sixties and he thought that he just needed to have some crowns on his front teeth and he would be on his way. Well, at our first “hello” I determined that his occlusion was not functioning acceptably and after asking some questions and looking at his mouth I confirmed this. His problem with his front teeth developed because he had a problem in his occlusion with his back teeth. He did need a full-mouth reconstruction, or close to it.

Please note that these are significant conclusions confidently made without an articulator or study casts or anything other than experience and careful observation. Treatment, on the other hand, requires instrumentation and the knowledge that goes with using it. Knowing when to use what will mean the difference between success and failure, and will potentially save you from doing a lot of unnecessary dentistry and still possibly succumbing to failure.

Your Thoughts

What do you think? Can you reliably make an initial diagnosis pre-examination as Dr. Wilhelm suggests?

The attitude and overall feeling of a client can be greatly influenced by the attitude and enthusiasm shown by a dentist or member of the dental team. These qualities are contagious and can lead to much more enjoyable dental experience. After all, there aren’t too many people who really look forward to or feel passionate about a visit to their dentist!

Enthusiasm is Contagious

However, if when they do visit they are met by an enthusiastic team, lead by a dentist who shows passion and pride in what they do, it is more than likely they will be swept along and adopt the very same levels of enthusiasm.

In our practice we feel that the solution is to not bombard all of our clients by telling them constantly how passionate we are, but to demonstrate it each and every day so that it is obvious and almost a pre-requisite for those that visit our website or call into our practice. This is achieved by building a team that cares about the services they offer, a team that is genuine in how they feel about their work and a team that takes pride in helping each and every client. Many clients tell us that this is something that they feel from the moment they first walk in.

Don’t Try to Fake It

Above all, we know that our clients are not stupid and are capable of seeing through any false actions or any of our team pretending to be something that they are not. We speak to all clients using natural language and let our passion for what we do come through naturally – we know that this is something that is impossible to fake.
If passion and enthusiasm is there, it will be impossible for others to not notice it and pick up on it. It will come through in how clients are treated, how the whole team cares for the needs of each and every client and most of all, when they talk about your business. If it isn’t there, it won’t matter how many times you or your team say otherwise, it can’t be faked.

Evaluate Your Passion Level

Now is the time to evaluate your passion and enthusiasm, as well as your teams for the services you provide and for what you do. Go through the pain of asking what your clients think, this will provide actionable feedback you can use to ensure that they next time they visit, they will be leaving feeling as enthusiastic about your business as you and your team are!

Running a successful dental practice can be sophisticated at best and frustrating at worst. The constant dilemma of a dentist is how to have new patients and keep old ones. Naturally, patients would flock to a good dental clinic. By good, the clinic should have a warm and friendly atmosphere, not make patients unreasonably wait and value patient relationships. Although it might seem difficult to work on these three points, there are six simple things that a dentist can do to address these key issues.

Warm Greetings

Patients love to feel welcomed. Having someone artistically write a greeting on an office whiteboard with the patient’s first name is an easy way to make a patient feel special.

Introducing the Staff

It is important that the patients get to know the staff a bit. If they are to see and talk to them whenever they are visiting the dentist, then it is only proper for the staff and the patients to bond a bit. This can easily be accomplished by putting up personal pictures of the staff, and even of the dentist, on an office corkboard. This works as a great conversation piece.

Warm Environment

The dentist and the staff should always send positive vibes to the patient and work towards achieving a warm environment during every visit. Friendly body language will help in this department. Smiling and being interested when patients talk will always do the trick. To highlight the necessity of following this tip, patients who feel uncomfortable with a hygienist or the dentist himself will most likely not schedule a second appointment.

Listen

Patients go to the dentist because they are hurting or uncomfortable. It is necessary for dentists and the staff to listen to them intently when they talk about what’s wrong or else they will get the feeling that the dentist does not care about their pain. An easy way to look interested when listening is to establish eye contact.

Be On Time

Everybody is busy. For that reason, most patients will be ticked if their dentist makes them wait up to an hour. The only way to avoid this situation is to be on time. Go to the dental clinic early and avoid long lunches.

Keep in Touch

There are times when a patient won’t book appointments for months, or even years, at a time. Either they do not have serious dental concerns or maybe they are contemplating the idea of switching dentists. To prevent the latter from happening, always keep in touch with your patients. You can do this by sending newsletters whether in print or by email or if by sending out small gifts.

Your Thoughts

What would you add to this list?

Deb Roberge

I have frequently been asked by dentists to provide them with an ad I’ve used for a clinical dental assistant position or for a hygienist or business administrator. When I’m asked I always respond with “I have many I have constructed over the years, but they were not for your practice, with your specific dynamics, practice culture, or practice style.” It is a known fact that no two practices are alike, so how can we possibly expect that generic verbiage will work for different practice requirements?

6 Great Tips

Here are some suggestions to “personalize” your advertising to narrow your field and attract the best qualified candidates for your practice:

Communicate Practice Standard of Care/Specific Style of Practice

1. Give as much information up front regarding your particular practice standard of care and your specific style of practice.

Examples:
- “Our hygienists treat our patients for a minimum of one hour.”
- “Our clinical team is encouraged to handle all hands-on treatment that is permitted by the board in our state.”

Never List Perks

2. Never list “perks” or any extras. You will find that the majority of the responses to your ad are more interested in what they are going to “get” rather than what your practice is all about or what they are willing to contribute.

Never Mention Salary

3. Never mention salary offerings. You should have a salary “range” in mind, but never determine what the individual will be eligible for until you see them in action.

Communicate Welcoming Attitude

4. Whenever possible, make mention of the fact that the team will be “welcoming” a new incoming team member. Often job candidates are reluctant to respond to an ad thinking that the team will NOT accept the new incoming employee. Making mention of the fact that they will be welcomed makes a huge difference.

Create the Ad with Your Team

5. Try to create the ad with the entire team whenever possible, having them participate in the process really helps them to feel a part of things and be more likely to help with the integration of the new team member.

Always Utilize Skill Assessments

6. Never hire without a Skill Assessment Day(s). What is a Skill Assessment? It is a structured well disciplined way of evaluating a perspective hire. Guidelines on this process to be discussed in future articles.

Please get into the habit of hiring slowly and dismissing rapidly! The longer you take to evaluate the new incoming team members and slowly integrate them (properly) into your practice, the better off you will be.

So please take the time to craft an ad that is specifically designed for your practice, culture and goals and follow it up with a well structured hiring protocol. Taking your time and paying attention on the front end will assure you of hiring the right person, slowly guiding them into the group with a purpose and making sure you continue to appreciate having them on board will give you great long-term paybacks!

Your Tips

Do you have additional tips for advertising an open position within your practice? What has worked especially well for you in the past?

9 Reasons You Need Digital Case Presentation

1. Increase in patient trust. Seeing the photographs and detailed information in language the patient can understand gives the patient reason to trust you.

2. 83% of human learning takes place visually. In order to effectively educate your patients, get your message across and help them see the benefits of treatment, digital case presentation answers this strong need for visual learning and understanding.

3. Build a greater rapport with the patient. The patient will feel more connected to you because it will be evident you listened to his or her needs.

4. Eliminate buyer remorse. Patients will show the presentation to other influencers who will support the decision made.

5. Increase in new patient flow. Because patients are sharing the presentation with friends and families, more people will become aware of you and ask for your name.

6. Show the patient what he/she could look like with cosmetic dentistry. This helps the patient to visualize how their overall appearance will improve.

7. Increase in case acceptance. Patients become enthusiastic when shown ph9 Reaotos and information that they can grasp. The result from the increased trust and rapport results in increased case acceptance.

8. Motivate the team. Teams like to be challenged and add to their skill set. This is an opportunity to spread their wings beyond their everyday duties. The result is an energized team which results in energized case presentation.

9. Help the patient to “sell” the dentistry to the spouse when the spouse cannot be present at the consultation. It is always ideal to have the spouse, or any other decision maker, present at the presentation of findings. However, this is not always possible. The digital case presentation recreates the consultation as best as possible, making it easier for them to understand the treatment plan.

Your Thoughts

How do you incorporate digital products into case presentation in your practice? What has converted the best?

With advances in technology and our knowledge of the current evidence-based science, regarding the oral health and systemic health link, there is a wide diversity of services we can now offer.

One of the significant changes within the business of dentistry is the dental hygienists impact on communication and case acceptance. The dental hygiene department needs to have an integral part in affecting case acceptance. This is one area of the dental business where the team members will contribute to a large part of the total dental practice production and profits.

For many years, oral hygiene and patient education has been an important role as a dental auxiliary. As dental professional’s we spend hours educating ourselves about the best methodologies to educate and teach our patients about improving their home care and oral health.

The science of communication and creating a structure for patient case acceptance is crucial to guide patients towards a healthy body and increasing the dental practice profits. The communication skills need to be defined and refined in order to enhance your patient communication, increase patient case acceptance and add to the total production of your dental business.

Patient Connection Is Key

The patient connection is the first step. As a healthcare professional, you feel passionate about what you do and over seventy percent of all patient case acceptance should come from your passion for the profession and your compassion for the patients.

Utilize Visuals Properly

Visuals are similar to having a third eye. Many of your patients are visual learners. Visuals do not need to take extra time but if thought out, they can be effectively and efficiently utilized during all dental visits. Sit down during a team meeting, discuss and write down the available visuals your dental team can currently use. Pre-determine the logistics of how to use your current visuals, which ones to use, which visuals you would like to implement and how you can have them available to expedite the appointment time.

Case Acceptance Tips

1. Before the patient enters the rooms have the appropriate visual set up. For example if the patient has pending treatment, have the latest digital photo of that tooth up on your computer screen for patient to see when they enter the room.

2. Always have the intra oral camera ready for a tour of the patients’ mouth.

3. As you complete your visual exam, provide the patient a tour of their mouth. This includes restorative, aesthetics, oral and soft tissue lesions and periodontal findings. Show these areas to your patient on the computer monitor in front of them.

4. Use pamphlets and brochures when possible. This will give third party documentation of your clinical findings.

5. Individualize the pamphlet. Highlight paragraphs that pertain to their condition. Outline with a pen certain areas and/or circle specific sentences of importance. You may also want to write notes on the sides of the paragraphs inside the brochure.

6. If you have a video or Casey System have this playing as you are documenting in the chart or doing something else and the patient remains sitting in the chair.

7. Be open to showing patients similar type of work the doctor or a colleague has completed in your mouth. Put it up on the monitor as an example. If you have before and after photos to place on the monitor, have these up and ready to discuss and show the patient. Combine the brochure and your visuals on the monitor.

8. The dental team is the very best testimonial that you can use to provide the patients’ trust in the doctor’s work.

9. The co-diagnosis with hygienist and doctor will be a verbal review of what the patient just saw on the computer monitor in the hygiene room.

10. There has probably been a lot of new information communicated to the patient and comprehension is about 30% of what was just presented. Review your findings a second time while doctor is in the room. Review with doctor what you have reviewed with the patient and review again the specific areas in the brochure, which you have highlighted, outlined or circled.

11. Verbally confirm with the patient that they understand what you have just presented and that they understand the value of completing treatment.

12. At the last transfer of the patient to the treatment coordinator, give a short synopsis about what was provided to the patient today. Hand the brochure or pamphlets to the treatment coordinator instead of the patient. Now the treatment coordinator can use the brochure, which you have personalized to review the case and then the financial aspects of the patient treatment plan for final case acceptance.

13. The final part of this patient visit will be the treatment coordinator handing the patient their personalized brochure or pamphlet as well as their treatment plan and the payment options.

The goal of every successful dental practice is to provide the very highest level of patient care. Spending time with patients and utilizing visuals will provide patients the best opportunity to understand “Why” this treatment plan will best support their overall dental health, systemic health, self-confidence and overall well-being.

If you are still asking “Why” communication and case acceptance are so important, remember that case acceptance is critical for clinical results and the success of all dental practices.

Part II Preview

In part 2 we will discuss the various important questions to ask patients, what type of communication needs to occur between the doctor and hygienist during the examination and how to close the treatment plan before financial arrangements are made.

It is very important that the hygienist thoroughly understands their responsibility to review restorative and aesthetic needs through a structured process of communication each time they see a patient.

Many times a patient needs to hear the information two or three times before they will say “Yes” to a treatment plan. When the hygienist and entire dental team understands the science behind communication for case acceptance, the hygienist and other members of the team can increase the chances a patient will move forward with their treatment plan.

As the dental team feels more confident explaining the treatment needs to patients, the patients’ confidence in scheduling their treatment will also increase.

Your Tips

How do you utilize visuals to increase case acceptance in your practice? Do you agree or disagree with some of the tips outlined above? Why?

How successful is your in-office whitening system? Are you seeing the results that you expect or that your patients want to see? Believe it or not, whitening trays are not all the same. We’ve been taught the same thing for years, leaving us with the same result – sometimes our patients have great whitening results, sometimes not. Why is that? Have you ever whitened the teeth of a teenager and had a great result, and then tried the same thing with a more mature patient where the end result left much to be desired? We feel your frustration – we’ve all been there! It turns out that the focus should not only be on the type of whitening system that you’re using, but also on the fabrication of the whitening trays themselves.

In-Office Whitening = Revenue

In-office whitening is a great way to bring revenue into your practice with little or no “doctor time.” It’s a simple way to cosmetically improve a patient’s smile and instantly boost their self- esteem. Think about how many whitening cases your practice averages each month. As a dental assistant, you are skilled and capable of performing your practice’s in-office whitening sessions. Don’t wait for your patients to ask about whitening – take the initiative! With the right verbal skills and tact, you can present whitening to your patients in a way that won’t offend even the most sensitive person.

The steps we take to fabricate our whitening trays may seem like overkill, but it’s worth your time. Your efforts will result in whitening trays with no distortion, which will lead to a better whitening result for your patients. We suggest practicing by making whitening trays for yourself and other staff members until you perfect the technique. Your own smile can be your best advertisement.

Step-By-Step Instructions

Step 1
Take maxillary and mandibular alginate impressions using a metal, perforated tray. Wrap your impressions with a wet paper towel to keep the alginate moist.

Step 2
Immediately pour your impressions in yellow dental stone. When pouring your models, do not make a base, and do not flip your impressions over. Instead, place the impressions upright on a slab. Be sure that all excess stone is removed from the edge of the tray so you do not “lock in” your model. You also want to be sure your impression is level – if it isn’t, place a folded paper towel under one side.

whiteningtrays2

Step 2

Step 3
After the stone is set, separate the model from the impression. Trim the models as close as possible to the teeth, then level and thin the bottom. Rinse the models and let them dry completely.

Step 4
Use a scaler to “scallop” the gingival margins of the facial and lingual surfaces of all teeth. Defining the margins with a scaler will allow the tray material to form tightly to the cervical areas. This will help seal the whitening trays to the teeth, decreasing the loss of whitening gel.

whiteningtrays3

Step 4

Step 5
Soak the models in a bowl of water until thoroughly soaked through the stone.

Step 6
Mix a “slurry” of stone and water in a small dappen dish. Using a paint brush, place a thin layer of stone on the facial surface of each tooth. Do not let the stone slurry get too thick, or flow into the interproximal areas or gingival margins. The stone is used to create a reservoir for the whitening gel to be placed in the tray. (You may currently use a block-out resin to create a reservoir, but using the stone slurry achieves the desired reservoir depth.)

Step 7
Let the models dry completely. Spray them with a silicone spray and again, allow them to dry. (You may want to do this outside if your dental lab does not have an exhaust fan.) The silicone spray allows the tray material to separate easily from the model after you’ve used the vacu-form or Drufomat scan. The Drufomat scan is a pressure thermoforming unit that can be used to fabricate dental appliances like retainers, night guards, sport guards, and whitening trays.

whiteningtrays4

Step 7

Step 8
Take two paper sheets that separate the tray material in the tray material box, and place the models on top of each sheet. Trace the outline of each model with a pencil. Remove the models and cut just inside the traced line using sharp cuticle scissors or vinyl scalloping scissors. This step can be skipped if using the Drufomat scan machine.

Step 9
Place the tray material in the vacu-form machine and tighten. Place the paper with cut-out on the platform and place the corresponding model on top. Make sure the platform is totally covered and that there are no air holes exposed.

Step 10
Heat the tray material until the “bubble” is drooping half-way down and lower the tray material over the model and turn on the vacuum.

Step 11
Turn off the vacuum and remove the model from the machine. Place the model in a bowl of cold water and let it soak for 5 minutes.

Step 12
Proceed with steps 9-11 for the next model.

Step 13
Remove the models from the water bath and take the tray material off each model.

Step 14
Trim the trays with sharp cuticle or vinyl scalloping scissors. Be careful that you do not “over -trim” into the gingival margins. Trim the models just above the visible clear line. Scallop the gingival margins on the facial, but not on the linguals, as this will add retention.

whiteningtrays5

Step 14

Step 15
Try the trays on each model to check your margins and to be sure they are tight against the teeth and are not flared out.

Step 16
Remove the trays and store them loosely in a case. Do not store the trays on the models.

whiteningtrays6

Step 16

Your thoughts

If you try this out yourself, please let us know what you think of the results in a comment below. Also, are there any modifications you’d make to the process? Don’t forget to tell us why. Thanks!

dentalassistingdivas

The Dental Assisting Divas

ruthjhartman

My first mistake was not measuring the floss correctly. Yep, you read that correctly. Trixie uses waxed dental floss, so I had to, too. I had all my pretty, colored beads on, as well as the fasteners on both ends. I tied the knots around the fasteners and glued the knots in place. I sighed. There. That looked okay. But, when I tried to put it around my wrist, it wouldn’t fasten. Not only that, but the two ends didn’t come close to meeting. So apparently, my first attempt produced an ankle bracelet for my cat. She was thrilled.

My second attempt was better on the length. I made sure the dental floss was long enough to circle my wrist. I didn’t, however, take into account the knot-tying part. I was so intent upon getting my blue, red and white beads in order that I forgot to leave enough room on the end. I could have taken some of the beads off, but I’d already tied my first end in a knot. Once two or three tiny knots are in place on waxed dental floss, it’s very hard to undo. Plus, I had my beads all in nice, tidy color-coded order. And as a person with OCD, I couldn’t take any away. I just couldn’t! The colors were symmetrical. Why would I mess with that? But have you ever tried tying knots in something with only a half-inch to work with? I needed tentacles instead of fingers.

dental-floss-jewelry

My next few attempts were much better. Pleasing to the eye, long enough to wear, and I don’t have to give them to my cat. Mission accomplished!

Get Your Copy of Pillow Talk

This book would make a great addition to your waiting room or book collection.

Head on over to Class Act Books to purchase your copy of Ruth’s book, “Pillow Talk“.

Dentists always play second fiddle to doctors when it comes to pop culture references.

There is no dental equivalent of television shows like ER or Scrubs but dentists still find their way into pop culture and here are five noteworthy examples:

1) Dr. Tim Whatley from Seinfeld

Bryan Cranston played Dr. Tim Whatley on Seinfeld in the 1990s. His performance as Jerry’s dentist is hilarious and you can see how Cranston would go on to be very successful in other TV shows such as Malcolm in the Middle and Breaking Bad. In the Seinfeld episode titled The Yada Yada, Dr. Whatley converts to Judaism, according to Jerry, just so he can tell jewish jokes.

Jerry gets more frustrated with Dr. Whatley as the episode goes on, causing Kramer to call Jerry an ‘anti-dentite.’

2) Nicholas ‘Oz’ Oseransky from The Whole Nine Yards

Matthew Perry plays Oz, the depressed and slightly neurotic American dentist living in Canada in The Whole Nine Yards. At one point in the film, Oz uses his dentistry skills to alter the teeth of a dead cop so the teeth will instead resemble those of hitman Jimmy Tudeski (played by Bruce Willis). Luckily real dentists don’t have to do this kind of work.

3) Dr. Wolfe from The Simpsons

Dr. Wolfe is the Simpsons’ family dentist. Wolfe owns a clinic named Painless Dentistry and he is the person that informs Marge that Lisa needs braces. This event happens to coincide with Mr. Burns revoking Homer’s dental plan at the nuclear power plan. Marge and Homer are forced to purchase the cheapest model of braces they can get; Dr. Wolfe bluntly describes these braces as, “predating stainless steel.” Ouch.

4) Steve Martin in Novocaine & Little Shop of Horrors

Steve Martin seems to enjoy the role of a dentist. He played a sadistic and abusive dentist in Little Shop of Horrors.

Martin also starred, along with Helena Bonham Carter and Laura Dern, in the 2001 David Atkins film Novocaine. He played Dr. Frank Sangster, a wealthy dentist with a loving fiance named Jean, who falls off track when a new client shows up with a tooth in need of a root canal.

The story turns into a dark tale of drug abuse, cheating, and violence. Why can’t Steve Martin play a nice dentist?

5. Doc Holliday

John Henry “Doc” Holliday was born in Griffin, Georgia on August 14, 1851 and died November 8, 1887 in Glenwood Springs, Colorado. He is the only real person on this list of pop culture dentists but he is a significant one nonetheless. Not only was Holliday a dentist but he was also a gambler and a gunfighter of the American Old West. He is often remembered for his involvement in the Gunfight at the OK Corral and for his friendship with Wyatt Earp.

Earp had this to say about his friend Doc:

“Doc was a dentist not a lawman or an assassin, whom necessity had made a gambler; a gentleman whom disease had made a frontier vagabond; a philosopher whom life had made a caustic wit; a long lean ash-blond fellow nearly dead with consumption, and at the same time the most skillful gambler and the nerviest, speediest, deadliest man with a six-gun that I ever knew.”

There you go – five of the most famous dentists from pop culture. Medical doctors may still have a greater representation in television, movies, and books but we’re pretty keen on these five dentists.

Your Thoughts

Who are your favorite dentists from pop culture?

As dental professionals we’ve known for some time that there is an ‘oral-systemic’ connection. Unless we’ve graduated in the last 10 years, we weren’t taught about it in school and, sadly, often know little more than our patients.

Dentistry Has Changed

Dentistry has changed dramatically since I graduated in ’84. Over the years we went from believing disease was caused by calculus, then too much plaque, then specific plaque and today realize it’s a combination of specific plaque organisms under the influence-specific environment and host.

Oral diseases are bacterial disease – bacteria group together to form plaque. In combination with their by-products these bacteria cause decalcification and caries, left untreated leading to root canals or tooth loss. Bacterial plaque populations as they grow, change in composition, tipping the balance form good to bad, leading to gingivitis, periodontitis, halitosis. As if this isn’t bad enough we now know they have serious systemic consequences.

Bacterial populations that get out of balance initiate an immune response that results in an increased permeability of the tissues and bacteria and their by-products can then travel through out our system. Most are familiar with the association between bacteria and heart problems/valve replacements/joint replacements and the need for pre-medication prior to procedures that may result in an increased likelihood of bacteria getting into the blood stream via the sulcus(1). Remember the last time you gave blood? A recent visit to the dentist will now screen you out of being a donor – because you may be carrying oral bacteria in your blood and the costs to run additional tests on all the samples is just too costly. It’s easier to exclude these people(2).

Oral bacteria and periodontal disease has been associated with an increased instance of stroke and other coronary conditions, especially in persons with known high cholesterol(3).

Most clinicians will also be familiar with the association between low birth weight babies and premature births (4). Bacterial plaque from the oral cavity can travel to the placenta. In research earlier this year the journal of Obstetrics & Gynecology reported the first confirmed instance of oral bacteria responsible for stillbirth.

Research involving institutionalized elderly has identified a connection between oral bacteria and increased respiratory infections (5).

Periodontal patients have shown to exhibit an increased instance of a variety of cancers (6,7).

An out of balance oral bacterial population can also result in premature death (8)!

How do we combat this issue?

We need to take a more medical approach to diagnosis, prevention and treatment. This means looking at the problem not just treating the consequences (disease). We need to deal with the bacterial origin.

This is done with simple microbial screening. A BANA test is a quick, easy, affordable way to show clients/patients that ‘bad’ bacteria are present in the mouth and can be confirmed and further diagnosed with a simple microbial slide. In most instances you would perform your normal protocols, retest and if the slide results are still showing bacterial imbalance, a topical antibacterial is likely indicated.

With objective, microbiology results you can custom treat the bacterial infection with appropriate topical medication, metronidazole is often most appropriate. (Systemic medications would require a much larger dosage and the medication is delivered to every cell in the body, when in fact it’s only needed in one specific area – topicals are much more efficient and effective) The Novora system offers a rinse, topical cream and subgingival gel of varying concentrations, each geared for a different situation.

Other instances may call for antifungals, different antibiotics or other products designed to re-balance the once harmonious bacterial ecosystem. These might include chlorohexidine, chlorinedioxide, oral probiotics etc.

Because bacterial infections are transmissible – by close contact like kissing, tasting each others food – retesting is important to prevent future flare-ups of infection or the risk of transmitting the infection to a love one – infant or aging parent perhaps – who may not be as resistant to the negative effects of these bacteria.

Learn More

To learn more about oral-systemic dentistry and a more medical approach to treatment visit www.novorabiomed.com or www.novora.blogspot.com and please do follow us on twitter www.twitter.com/novorabiomed.

Sources
1. http://www.cda-adc.ca/_files/position_statements/antiobiotic_prophylaxis_joint.pdf, http://www.ada.org/sections/publicResources/pdfs/patient_75.pdf

2. http://www.blood.ca/centreapps/internet/uw_v502_mainengine.nsf/page/E_Can_I_Donate

3. http://www.novorabiomed.com/health-connection/heart-stroke/

4. Han YW, et al., Term Stillbirth Caused by Oral Fusobacterium nucleatum Obstetrics & Gynecology: 2010;115(2):442-445. http://www.novorabiomed.com/health-connection/pregnancy/

5. http://www.novorabiomed.com/health-connection/others/ Scannapieco FA, Mylotte JM Relationships between periodontal disease and bacterial pneumonia J Periodontology 1996 Oct;67(10 Suppl):1114-22. [abstract]

6. Michaud DS, et al., , Periodontal disease, tooth loss, and cancer risk in male health professionals: a prospective cohort study Lancet Oncol 2008; 9(6): 550-58. [abstract]

7. Cesar A Migliorati C, Periodontal diseases and cancer Lancet Oncol 2008; 9(6):510-512

8. J Periodontal Res. 2007 Aug;42(4):361-6. http://www.ncbi.nlm.nih.gov/pubmed/17559634

The link between diabetes and oral health is clearer than ever. In fact, it is generally accepted that diabetes sufferers are prone to tooth decay, periodontal disease, xerostomia and salivary gland dysfunction and infection. However, more research exposing this link is required, and dental professionals need to learn how to properly educate their diabetic patients about their unique oral care needs.

Online Community Explores Link

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JPEC Dental Care Center Highlights

Additionally, the JPEC Dental Care Center offers dental professionals the opportunity to:

• Earn continuing education credits (CDE, CE or CME)
• Participate in case discussions monitored by Joslin clinical experts
• Interact with colleagues: Exchange ideas and participate in patient case discussions with colleagues from around the country on the dedicated Dental Discussion Board, monitored by Joslin clinical experts.

The Dental Care Center will go live with “Diabetes, Oral Health, and Nutrition: Interrelationships, Innovations, and Interventions,” JPEC’s web-based educational program designed to help primary care providers and dentists understand the connection between periodontal disease and diabetes and develop practical screening strategies for their practices.

If you would like more information or would like to register with the JPEC Dental Care Center, please visit the official JPEC website.

1. Closeup Flavalicious Chocolate Toothpaste

Image source: Chodka

This sounds both incredibly good and incredibly awful at the same time. I think I’d be tempted to frost a cake with this stuff rather than brush my teeth with it. However, the idea isn’t entirely without merit. Back in 1997, a researcher at Tulane University determined that the cocoa powder found in this toothpaste is an “effective natural alternative to fluoride in toothpaste”. That being said, I don’t see this product catching on any time soon.

2. Bacon Floss

Image Source: mcphee.com

MMM…Nothing spells fresh breath like…B-A-C-O-N…or something like that. To be fair, this product is sold as a novelty item, but I found it fitting to be included in this list nonetheless.

3. Jawels Removable Tooth Jewelry

Image source: Jawels.com

When that giant piece of lettuce stuck between your teeth isn’t getting you noticed enough, try Jawels. Before you know it, you’ll be the talk of the office!

4. Teeth & Hair As Jewelry

Image Source: Coolhunting.com

It’s hard to fault someone for being resourceful, but this is taking it too far. The designer of these disturbing pieces, Polly van der Glas, gladly accepts hair and teeth donations from family members to perfect her craft. Something tells me, we won’t be seeing celebrities wearing these pieces down the red carpet anytime soon.

5. The Kami Kami Sensor

Image source: ubergizmo.com

This modern-day torture device is an electronic bite sensor. It beeps after 30 chews to train children to chew their food well before swallowing. I don’t know about you, but there’s no way your going to get me to smile like the kid in the picture with that contraption on my head.

Any Others?

Have you seen a product that belongs on this list? Give us a heads up in a comment below for everyone to enjoy.

We all know about the many foods that are bad for our teeth, but you may not be aware that there are actually several foods that keep your teeth healthy. Eating foods that are high in sugar or carbohydrates can produce nasty bacteria that feed on the bits of food that are left behind. As these bacteria feed, they produce an acid that causes your teeth to decay.

However, a number of different foods that you eat can help you fight off the bacteria. Specific foods are effective in preventing these harmful little critters from producing acid. Once you are able to suppress the acid production in your mouth, you will be able to smile brightly with pretty, healthy teeth.

Here is a list of the top ten foods that can help you keep your teeth healthy:

1. Celery

Celery is an effective weapon against the bacteria inside your mouth. In addition to the obvious health benefits of eating celery, it also causes you to chew more, producing additional saliva. As you generate saliva, it kills the bad bacteria present in the mouth. Celery may not taste as good, but is a healthy alternative to plaque-producing potato chips. The extra water contained in celery is a good way to clean your teeth, sort of like naturally brushing your teeth.

2. Onions

You may not think so, but eating onions is a great way to eliminate harmful bacteria inside the mouth. When you eat an uncooked onion, the substances in the onion work to destroy the bacteria that are eating away at your teeth. You may be concerned about stinky breath, but the benefits are worth it. Simply follow up with some sugar free gum and you are good to go.

3. Shitake Mushrooms

Shitake Mushrooms work similar to onions in destroying the harmful bacteria, but they also prevent the buildup of plaque, which can turn into cavities if you do not take care of your teeth properly.

4. Cheese

A tasty option for keeping your teeth looking great, cheese contains elements that are good for keeping your teeth healthy. Cheese makes you produce additional saliva, which destroys the harmful bacteria inside your mouth. In addition, cheese also works to prevent discoloration of your teeth.

5. Strawberries

Strawberries are a great natural way to whiten your teeth. Brush your teeth daily with strawberries as a healthy alternative to potentially harmful whitening gels.

6. Oranges

Like strawberries, oranges are also fantastic tooth whiteners. Rub a little of the skin of an orange rind on your teeth after brushing to take advantage to the benefits.

7. Milk

Milk is a tasty way to keep your teeth healthy. The calcium in dairy products is effective in keeping the teeth strong. In addition, the Vitamin D helps the calcium to be absorbed more efficiently.

8. Meat

Meat, fish and eggs are an excellent source of phosphorus that is needed for tooth enamel formation.

9. Bananas

Bananas are high in magnesium, which is also needed to help the enamel of the teeth form properly. Whole grain foods and spinach are also good sources of magnesium.

10. Carrots

Carrots and other orange-colored vegetables and fruit are great sources of beta-carotene, which is turned into Vitamin A by the body for strong teeth and bones.

Your Thoughts

Are there any foods that you would add to this list? Please leave them in a comment below.

Children Don’t See Dentist Early Enough

The survey of 914 primary caregivers revealed that the average age children first visited a family dentist was 2.6 years of age. Furthermore, the study found that 34% of those sampled had children under the age of 11 that had never been to the dentist!

Common Excuses

Those surveyed commonly responded that their children were “too young,” or “didn’t have enough teeth” to visit the dentist. A number of others cited a lack of dental insurance as the reason they delayed their child’s dental visit.

According to Jed J. Jacobson, DDS, MS, MPH, chief science officer and senior V.P. at Delta Dental:

“Many Americans don’t understand how important their children’s baby teeth are to lifelong oral health. There’s a continuing need for more education to teach practices that will ensure lifelong oral health. And, since people overwhelmingly prefer the dentist and dental hygienist as their primary oral health information sources, dental benefits that encourage visits to the dentist are crucial.”

The American Academy of Pediatric Dentists (AAPD) recommends that a child go to the dentist by age 1 or within six months after the first tooth erupts.

Baby Teeth Matter

The AAPD also states that proper care of baby teeth are critically important for the following reasons:

• Help children chew properly to maintain good nutrition.
• Are involved in speech development.
• Help save space for permanent teeth.
• Promote a healthy smile that helps children feel good about the way they look.

Proper Care

Furthermore, the AAPD advises caregivers to gently wipe the baby’s gums with a soft, wet cloth after each feeding. When primary teeth begin to appear, they should be cleaned with a soft, child-sized toothbrush and a pea-sized dab of children’s toothpaste, twice a day.

Additional Information

For additional pediatric dental care tips, Delta Dental has a number of educational videos that caregivers of small children shouldn’t miss.

Your Thoughts

Were you aware of these guidelines recommended by the AARP? What are your thoughts?

Step 1: Submit Video

To enter the “My Smile Bites!” contest, 1-800-Dentist asks that you submit a 2 minute video of yourself discussing what you like about your smile, and what you don’t like about our smile. Additionally, you should discuss how your smile affects your self-image and interaction with others. Oh yeah, and don’t forget to smile!

Step 2: Promote Your Video

Once you have received confirmation that your video has been received successfully, it’s time to start promoting your video. Each contestant will have their own video page complete with a short bio. Have your friends and family visit your personal page and cast their vote each day beginning at noon on 11/10/09 until noon PST on 12/01/09.

How Judging Works

Be prepared to win over the hearts of your fellow Americans because they’re going to determine your fate. Once the top contestants have been selected, 1-800-Dentist will select the winner of the $30,000 smile makeover on December 15, 2009 at noon PST. “As the winner, you must be willing to have your smile makeover process captured on film, including dental visits and before and after experiences(1800dentist.com).

Enter Now

Ready to enter? Visit the My Smile Bites! $30,000 Smile Makeover Contest Page on 1800dentist.com to review official contest rules and submit your entry.

Those of you who selected a dentist based solely on your proximity to them, or based on who sent you the prettiest postcard in the mail can especially benefit from this post.

Positive Signs

The following are signs that the dentist you chose is a good one. Please note that these are generalizations, no a litmus test for determining the quality of a particular dentist.

• They are prevention-oriented
• Chart their findings in detail
• Clearly outlines maintenance and recall schedule
• Takes their time – paying close attention to detail – as opposed to a Henry Ford-style assembly line approach
• Clearly outlines treatment options and risks and benefits associated with each

Negative Signs

The following are signs that you may want to find another dentist – or forever hold your peace.

• Distributes flashy or flamboyant advertising
• Routinely use risky intravenous sedation
• Sell vitamins or other dietary supplements
• Automatically recommend replacement of amalgam fillings or removal of teeth that have root canals
• “Specialize” in treating headaches, backaches, myofascial pain, or TMJ problems
• Practice “holistic” or “biological” dentistry
• Attempt to diagnose diseases other than those of the mouth, gums, teeth, and associated tissues

Additional Selection Criteria

The Consumers Research Council of America has listed a number of tips for choosing the right dentist. Their first recommendation is ensuring that your dentist is properly qualified to be practicing dentistry:

…Make sure your new family dentist has completed the necessary requirements to be a dentist. For instance, dentists must be state licensed and recognized by the American Dental Association (ADA). Also, their training must include three or more years of undergraduate school and an additional four years of dental training at a dental school.

These are the minimum requirements needed to obtain a dental degree. Make sure your dentist has completed these requirements, or begin looking elsewhere.

Ask Yourself These Questions

The Consumers Research Council of America has also assembled a series of questions to ask yourself after being treated by a dentist to judge their quality level.

• How does your bite feel?
• Is any of the dental work irritating your gum?
• Does the treated tooth look like a tooth?
• Does dental floss or your tongue catch on the tooth?
• Did the dentist take time to polish your fillings?
• Do you feel pain when drinking hot or cold liquids?
• Was any debris left in your mouth after treatment?
• Does the dentist use a water spray to cool your teeth while drilling?

Sources: Quack Watch

Your Thoughts

What are your measures for determining the quality of a dentist?

A recent discovery by Japanese scientists could reshape the embryonic stem cell debate. The scientists claim that “wisdom teeth could be a suitable alternative to human embryos as a source for therapeutic stem cells.”

Stems cells are important because some studies support their ability to fight numerous life-threatening diseases. In recent years, the proposed usage of embryonic stem cells has caused heated debates between pro-life and pro-choice groups. However, this recent finding could have big implications in the future, and perhaps quiet the embryonic stem cell debate.

Unfortunately, it’ll be at least 5 years before these findings will be used in “medical applications,” according to National Institute of Advanced Industrial Science and Technology (AIST) researchers.

The researchers said that they:

…had identified a form of stem cell in the wisdom teeth which had the capability to develop and be grown successfully into other forms of cell outside the body.

My thoughts

This is a finding with huge implications. If these findings are accurate, then the ethical issues surrounding embryonic stem cells will be a non-issue. Perhaps that’s wishful thinking. But, wisdom teeth as a source of important stem cells should be less controversial. But, who knows, People for the Ethical Treatment of Wisdom Teeth may be up in arms. Let’s hope not for the sake of humanity.

Your Thoughts

Do you think stem cells taken from Wisdom teeth will quiet the embryonic stem cell debate?

Source: Stem cells ‘created from teeth’

Your Reactions

Could you envision yourself ever resorting to Do-It-Yourself dentistry? How do you deal with rising dental care costs? How have you and/or your family been effected?

If you’ll remember way back to June of this year, I wrote a short article about the causes and remedies for halitosis. Alexandr Bo, a good friend of Dental Heroes, recently wrote an extensive article on his blog, Worldental.org outlining the potential causes of halitosis and the medical issues that could arise from the condition.

Halitosis is nothing to be ashamed of. It’s pretty common, actually. So, if you know you have a problem with halitosis, or suspect that you do, simply follow Alexandr’s advice: brush your teeth and use mouthwash after meals, and floss at least daily.

Alexandr’s article can be found here: http://worldental.org/oral-hygiene/chronic-halitosis-causes/

Does it smell in here?

Have you ever had halitosis? If not, what do you personally do to prevent it?

Just when I thought fluoride’s reputation couldn’t possibly take another hit, it gets hit with what could be a knockout blow. What sent fluoride possibly down for the count was the discovery by a Canadian Toxocologist that fluoride may indeed lower a person’s IQ! The Toxicologist, Dr. Vyvyan Howard was so convinced by the results of his study that he has joined the growing movement calling for an end to fluoride use in areas where it has been strategically introduced into the water supply.

The fluoride debate has picked up in recent years, as more and more evidence suggests that fluoride is toxic, and could be hurting us more than it helps. I think the mounting evidence is beginning to convince me. If you’ll remember back to the video I posted back in June(See video below) which featured a dentist speaking out against the use of fluoride, you’ll hear several compelling arguments.

Fluoride is Toxic

For example, the dentist in the video points out the fact that under the “drug facts” heading on the back of a tube of toothpaste you’ll probably notice fluoride is there. That’s not news. We know fluoride is a drug. What is interesting is that the tube of toothpaste probably also says to “contact poison control” if a large amount of toothpaste is swallowed. Hmmm. If the only drug in most toothpastes is fluoride, and we have to call poison control if swallowed, doesn’t that mean that the manufacturers of toothpaste are admitting that fluoride is a toxic substance?

Ok, so you’ve heard some of the other arguments made against fluoride in this video, but let’s get back to the IQ lowering properties of fluoride. In the study conducted by Dr. Howard, he found that:

Children’s IQ are likely to be lower in high natural water fluoride areas, said Howard. These studies are plausible because fluoride is known to affect the thyroid hormone which affects intelligence and fluoride is also a neurotoxicant.

Additionally, In 2006, the U.S. National Research Council’s (NRC) expert fluoride panel reviewed recent fluoride toxicology and concluded, “It’s apparent that fluorides have the ability to interfere with the functions of the brain.”

Sadly, recent surveys have confirmed that most dental professionals are unaware of the negative effects that fluoride can have on the brain. Apparently, the anti-fluoride campaign has some work to do yet, but it appears as if the mounting evidence may begin to convince even the most stubborn dentists that fluoride has to go.

Source:http://www.bestsyndication.com/?q=20080814_flouride_lower_iq_study.htm

To Fluoride or Not to Fluoride?

What do you think of fluoride? Should it stay, or should it go?

Human Mouth Crawling with Bacteria

The human mouth is home to many fun creatures, such as protozoa, fungi, viruses, and bacteria. Sexy isn’t it? Of these creatures, “The bacteria are the most numerous: there are 100 million in every millilitre of saliva and more than 600 different species in the mouth. Around half of these have yet to be named and we are trying to describe and name the new species,” says Professor William Wade from King’s College London Dental Institute.

If you’d like to read about the study details, the remainder of the article can be found on ScienceDaily.com.

Your Thoughts

What would you have named the new bacteria?

Your thoughts

What do you make of this video? Are you a Simpsons nut, and know what the point of this video is? I’d love to know, as would a lot of other people, I’m sure.

Study Results

The study, conducted between 2004 and 2006, determined that Australians from poorer suburbs were twice as likely to have 21 teeth or fewer. Twenty-one teeth is considered the bare minimum necessary. The study also found that those utilizing concession cards(Australian version of food stamps) were 4 times more likely to have fewer than 21 teeth.

Who’s to blame

Experts fault the inefficiencies in the Australian Public Health System for the problem. Specifically, they point to the out-of-control waiting lists many poor people are stuck on to see a public dentist.

Just to put into perspective how bad the waiting lists are for poor Australians, check out what the acting Health Minister, Jay Wetherill, had to say:

… we’ve reduced waiting lists from 49 months for treatment in 2002 to 19 months now. And we aim to reduce that to 11 months next year,” he said.

Solution: More Funding

This problem, as you probably know, is not unique to Australia. Britain is also experiencing widespread oral health issues due to the inefficiencies of their public health system. The solution many have proposed to remedy the situation is typical: just throw more money at it. Well, I’m a firm believer that throwing money at a problem time and time again will not produce different results than the first time you threw money at it. Therefore, the system needs to be overhauled. It’s pretty apparent to me that socialized medicine is not working in the majority of the places it’s operating. Privatization has to be an option on the table.

Question of the Day

What solution would you propose for improving the oral health of the poor?

Source: http://www.news.com.au/story/0,23599,24139795-421,00.html

At least that’s the claim made by Brooklyn dentist, Mohinder Mayell. The superhuman dentist even claimed to accomplish this feat in one dental visit – between 1 and 2 hours in fact.

There’s only a couple problems with Mayell’s story. The first problem is that it’s virtually impossible for any dentist to complete 52 fillings in “an hour or two,” says an unidentified dental professor at the University of Buffalo. Further casting doubt on Mayell’s claim is the fact that the typical human mouth only has about 32 teeth in it. So, the idea that a dentist could fill 52 teeth is pretty hard to swallow.

“In addition to uncovering the 52-filling claim, auditors found 96 other instances in which Mayell claimed to have provided Medicaid recipients with 24 or more fillings in a single visit, said New York state Comptroller, Thomas DiNapoli. In all, DiNapoli believes Mayell has defrauded the Medicaid Program of more than $124,000.

DiNapoli’s office recommended that $46,000 in pending reimbursements not be paid, $78,000 in prior reimbursements be recovered from the doctor, his other claims not reviewed during the audit be examined and that he be kicked out of the Medicaid program.

Sadly, the health department didn’t initially catch the absurd charges – suggesting that Medicaid fraud may be more prevalent than we think. However, I think they’re is already plenty of evidence to suggest that.

Give us your thoughts

This Medicaid fraud story is pretty bad, but some of you have probably heard of worse. If you have, please share it with us.

-Source: Cosmo’s Blog

Why have gold prices risen so much

Why? Well, that has been debated by economists because it really transcends the law of supply and demand. The demand for gold has actually dropped as the U.S. economy has slowed in recent months. According to Slate.com, the reason for the increase in price of gold is primarily the result of speculation.

While consumers are reacting to expensive gold by demanding less of it and recycling more, investors are reacting by bidding up the price further…

What do rising gold prices mean at the dentist’s office

This is probably pretty office, but you can expect your fees for fillings, crowns, or other dental work requiring precious metals to take a sizable bite out of your pocketbook. For example, in an article I read in the Houston Chronicle, Dr. Frank Incrapera said, “A gold crown that would have cost $600 three years ago can cost as much as $1,000 today, said Houston dentist Dr. Frank Incrapera.” Ouch! It’s important to note that dentists aren’t inflating the prices of these precious metals, they’re simply passing on the increase in acquisition costs to you, the consumer.

How to avoid paying top dollar for gold dental work

Simple. Don’t buy gold crowns or fillings if you want to avoid paying an arm and a leg. You can opt for porcelain materials, but most dentists will still use some gold underneath the porcelain crowns. So, it’ll be tough to completely avoid gold, but you can reduce your cost significantly by using other materials.

How do you reduce expenses at the dentist

Do you have any specific methods for reducing expenses at your dentist?

Every Monday, I’ll be posting a dental-related video to get the week started on the right foot. My goal is not to make us thing too hard by reading a long article. Hey, it’s Monday! Anyway, the video topics will range from dental procedures to dental care tips, and even some funny clips to lighten the mood a little.

Bohemian Rhapsody Parody

Tonight’s video is a hilarious parody of Queen’s Bohemian Rhapsody. Many of you are familiar with the Queen song, but a parody crew by the name of The Madow Group has produces a hilarious look at the life of a dentist in a little video they call “Bohemian Dental Rhapsody”. Enjoy.

What did you think?

As I was watching this video, I was wondering if some people watching it, mainly dentists or other dental professionals, would find it offensive. However, I think we’re all intelligent enough to see the parody. Am I wrong?

Each Sunday I will be writing about a wacky or weird dental-related news story I’ve come across on the internet. If you’ll remember, back when I started Dental Heroes I promised to include some content that lightens up the dental care discussion a little bit, and I think Sunday posts will do just that.

Avril Lavigne to get vampire teeth removed

You may think that this post title was simply made up to get your attention. Believe it or not, according to Stv.tv,

“Avril Lavigne is set to have significant dental work because she is so self-conscious about her “fangs”…

Fangs? Take a look at a picture of Avril Lavigne, and see what she’s so worried about. If you ask me, those are hardly “fangs”. Besides, take a look around you. Most people have very pointy and large canine teeth. It’s not abnormal, and certainly nothing to be ashamed of. In fact, the canine teeth have a very specific function, which is to hold food in place so that it can be torn and chewed.

However, it is certainly easy for me to tell Avril to suck it up, but I’m also not performing in front of thousands of people like she is. I probably wouldn’t feel comfortable with that many people staring at things I’m sensitive about, either.

How do you feel about cosmetic alterations?

So, that brings me to the question I want to ask you about her conundrum(believe me, it was not to talk about Avril Lavigne). What do you think about cosmetic alterations of the body? Are they helpful, harmful, or are you indifferent?

P.S. For those of you who are worried about how Avril will pay for the dental work, you can stop worrying, because reports claim that she has pocketed more than $1 million dollars from her latest video, Girlfriend, available on Youtube.

Further transitioning into the new format explained in Tuesday’s post, I’ve decided to dedicate Wednesday to writing about financial and insurance issues affecting both dental professionals and consumers. In the economy that we’re all operating in today, I expect to have some interesting information to share with you in this area. Even if you loathe the idea of a financial focus, I’ll do all I can to make it as relevant and interesting as possible.

Free Dental Clinics Struggling to Meet the Need

The inaugural “Financial Post of the Week” focuses on a piece run recently by CBSNEWS.com, entitled, “Lining Up For Free Dental Care“. As part of an ongoing series, appropriately called “The Other America,” this piece highlights the efforts of volunteer dental professionals to meet the bigger-than-ever demand for free dental care services

Why is the demand so high

Well, this one’s easy. Unless you’ve been living under a rock(I’m assuming you haven’t been), you probably understand that the economy is struggling in virtually all areas. Unfortunately, the Health Care is one of the hardest hit.

What is the demand?

Once simply inflated, healthcare prices are now borderline unaffordable for many Americans. Sadly, dental care is often the first healthcare services to go when money is tight. In fact, more than 1 in 3 Americans are living without some form of dental insurance. That’s more than 100 million Americans!

Who’s Helping?

Volunteers from across the country are organizing free dental care clinics for patients in need. Bruce Bergstrom, head of America’s Dentists Care Foundation, is one such volunteer who organizes free dental clinics around the country. At a recent stop in Loveland, Colorado, Bergstrom recalled seeing patients who had lined up at 1am to ensure their chance to receive free dental care services. “At 5 a.m. the line wraps around a block,” says Bergstrom. “Isn’t that tragic?” Bergstrom said. “It really is. To me it’s tragic.” However, for just one day, Loveland, Colorado was blessed with the help of eight hundred volunteers, including 113 dentists, who donated both their time and skill.

My Thoughts

It’s certainly a shame that so many Americans(not to mention in other countries) are unable to afford something so basic as dental care. Unfortunately, while I believe that organizers of these clinics are to be commended for their efforts, I believe this approach is more of a band-aid than a solid, long-term solution. Policymakers will have to reform the Health Care Industry so that healthcare is affordable and accessible to everyone. I honestly don’t know what shape such a bill would take, but it’s the only way to ensure that everyone receives the care they need at a price they can afford.

Feedback

How would you reform the Health Care System to make dental care affordable and accessible?

With the Little League baseball season in full-swing, I thought it would be prudent to provide you with some tips for handling knocked out teeth – God forbid this should happen to your child. But, really these tips apply to anyone with freshly knocked-out teeth.

The Essentials

If you take away anything from this post, it’s this: the longer a permanent tooth is out of the tooth socket, the less chance that tooth will survive. Experts predict that you have approximately 15-30 minutes before the tooth begins to slowly die. So, the idea is to place the knocked-out permanent tooth back into the tooth socket and call a dentist as soon as possible for the best possible chances of saving the tooth. According to Colgate.com:

When a tooth has been knocked out, the nerves, blood vessels and supporting tissues are damaged, too. The nerves and blood vessels can’t be repaired, but if your dentist can put the tooth back in place within an hour after it was knocked out, there’s a good chance that the supporting tissues will reattach and hold the tooth in place.

First Aid for Permanent Teeth

• Handle the tooth by the crown not the root.
• Gently rinse the tooth in milk or normal saline solution if it has debris on it.
• Replace the tooth in its socket, make sure it is facing the right way around.
• Once the tooth is in the socket, try to keep it as moist as possible -Saliva is best.
• Hold the tooth in place with some foil or by getting the injured to gently bite on a handkerchief.
• Contact your dentist immediately.

What if you can’t put the tooth back into the tooth socket

• Wrap it in glad wrap or store it in milk or normal saline solution.
• Contact your dentist immediately.

What not to do

• Do not try to clean the tooth with vigorous scrubbing or cleaning agents.
• Do not wait to contact a dentist. This is critical.

Special Thanks

Thanks goes to Better Health Channel for these great tips for treating a knocked-out tooth. For additional tips, please visit their website.

Those of you who know of the Mayo Clinic know it’s consistently ranked within the top 3 health care centers in the world. So, I turned to them to provide us with some easy tips to follow on a daily basis to maintain the healthiest mouth possible. The great thing is, anyone can follow these tips.

Mayo Clinic Brushing Recommendations

• Brush your teeth at least twice a day and ideally after every meal
• Use a fluoride-containing toothpaste.
• Use a soft-bristled toothbrush — it’s gentler on your gums.
• Hold your toothbrush at a slight angle against your teeth
• Use short back-and-forth motions.

Visit the Mayo Clinic website for more daily tooth brushing tips.

Mayo Clinic Flossing Tips

• Gently ease the floss between your teeth.
• Pull the ends of the floss against the front and back surface of a tooth
• Form a “C” as the floss wraps around the tooth.
• Gently pull the floss from the gumline to the top of the tooth to scrape off plaque.< li>
• Floss the backs of your teeth.

Additional May Clinic Oral Care Tips

• Use an interdental cleaner specially designed to clean between your teeth.
• Use a mouth rinse to help reduce plaque between your teeth.
• Use oral irrigators (such as a water pik) to remove food particles.

Following these tips provided by the Mayo Clinic will help to ensure that your mouth is a healthy mouth. But, remember, as with all tips we provide on Dental Heroes, consistency is key. These tips need to be built into your daily routine to be effective.

What do you think?

Do you disagree with any of the tips provided by the Mayo Clinic? Would you add any to the list?

Recaldent Innovation

The magic behind Trident Xtra Care™ is a unique, little-known form of calcium known as Recaldent®, which has been clinically proven to protect, strengthen, and rebuild teeth. Furthermore, according to a Cadbury press release,

…Recaldent® is a unique form of calcium derived from milk that increases tooth remineralization (strengthening) over and above just the salivary stimulation from regular sugar-free gum…Recaldent® is a powerful ingredient that actually replenishes calcium and phosphate to remineralize and protect teeth by filling in the tiny crevices where cavities can form2. The result is that teeth become stronger and less vulnerable to future damage…

Make it Healthy, Exciting, Easy

Brad Irwin, the President of Cadbury North America said that Cadbury had 3 main goals with the development of Trident Xtra Care™; “make it healthy, make it exciting, and make it easy.” The growing buzz within the industry regarding this product creates the impression in my mind that Cadbury has been able to satisfy all three.

Currently, you can purchase Trident Xtra Care™ in 2 flavors, Peppermint and Cool Mint at stores everywhere.

What do you think

It’s easy for a company to make a product sound promising, and I believe Cadbury has, but does Trident Xtra Care™ truly live up to the hype? Have you tried the product? If so, what can you say about your experiences? If you haven’t tried the product, will you?

David Jackman, of the Bishop’s Stortford Citizen, reports:

“Smile and Wellbeing Dental Care, in South Street, Bishop’s Stortford, is claiming a first’ for the area after patient Leslie Mason had two teeth and roots removed, without any pain-killing drugs.”

Dr. Bhavin Bhatt, the dentist present during this hypnosis session claims that hypnosis is a great solution for people who are nervous about having pain-killing drugs administered to them. I have to wonder how a nervous person would fair any better under hypnosis – a phenomenon that still has a great deal of skeptics – me included.

However, doctor Bhatt claims that hypnotic therapy is gaining momentum in the dental world, and based on what I’ve read for some time now, he’s right. As with many areas of our lives these days, people are seeking alternatives to traditional ways of thinking – this includes the use of drug treatments.

The vast majority of patients who have undergone hypnosis at the dentist’s office are reporting little or no pain at all. Just a slight “twinge,” says one patient. The results are undeniably positive, but you won’t see me undergoing hypnosis the next time I need some dental work done. I’m opting for the more tried-and-true methods.

- Source: http://www.guardian-series.co.uk

For an inside look at hypnotherapy at the dentist’s office, this video provides a great first-hand account:

What about you? Will you give hypnotic therapy a try the next time you have dental work done?

“An oral irrigator (or water pick) is a device that is used to clear away food debris from teeth using a pulsating water jet. It is mostly used by people with braces (to replace dental floss), or periodontal problems (or for the prevention of periodontal problems, cleaning the gingival sulcus)

Several reputable companies offer an oral irrigator product, including: Panasonic, Conair, Oral-B, and Waterpik. Prices for water picks typically run between $25 and $150. In my experience, the $25 model has performed every bit as well as the $150 model – so shop accordingly. I will also caution you that a water pick is not meant to replace dental floss, rather to supplement it.

To learn more about oral irrigators and how to use them, I dug up another great video from Expert Village. If you have more questions about water picks after watching the video please ask in a comment.

Oral Irrigators 101: The Video

[pro-player width="350" height="344" align="center"]http://www.youtube.com/v/VgmckVHja4M&hl=en[/pro-player]

Have you used an oral irrigator? What were your results?