Dental Products Report spoke with Henry Schein One Product Manager for Patient Experience Andrea Gallimore.

Dental Product Insights: Keeping Up With Patient Communication Expectations – Part 4: Lighthouse 360+


Are there any key features capabilities within Lighthouse 360+ that we haven't touched on today?


Well, you know, we talked a little about reviews. But reviews is super important. And that is one thing that when patients come into the practice and being able to ask them to review your practice, one of the great things about the service is it does automatically follow up with the patient after appointments, and it won't over spam them. You can set parameters around it. So I'm not asking you every week to rate and review my practice. But it will ask the patient to rate and review your practice and send them right out to different review sites to leave a review for you. So it allocates it out based on some percentages you set up in your practice. So you're really getting a broad base of reviews out there in the world. Another thing is just being able to actually even when you're leaving the practice as a patient, and they're talking to the front desk, and they're talking about how great today was just say hey, no, I can send you a text link real quick and write and review our practice. Wonderful tool right there to do that. Another thing that I love, and we didn't talk about, and I call this the set it and forget it feature. It is our email campaigns feature which is where we can set up newsletters and we can educate our patients. And we can be in contact with throughout the year. One of the great things about it, it's done through email. And it is really important to stay stay in contact with our patients but not over contact. But educate them about their dental health. And the set it and forget it. I love it because I can figure out what I want to do each quarter for 2024. Go create those campaigns from templates inside of Lighthouse 360+, schedule them to go out in the different quarters and 2024. Now I've set it and forget it and it's just going and it is communicating with my patients and bringing them back in the door for their treatment.

Andrea Gilmore, do you have any kind of closing thoughts or final things you want people to take home when they're thinking about patient communications today and Lighthouse 360+?

Yeah, well, one thing I love about Henry Schein one and Lighthouse 360+ is you know, we are a company about dentistry and for dental practices. And that's what we build off. We build for best practices within the dental office so that you're not doing extra little things that you don't need to be doing. And you can stay more efficient in your effective in your practice, just going to drive that profitability all around and drive happiness in the team and with your patient. So when looking at different systems out there, keep in mind, we love dentistry and we're about dentistry. So Henry Schein One and Lighthouse 360+ is here to take you to the next level.

Well, thank you so much for sharing your expertise with us today. We really appreciate the time.

Videos

Dental Products Report spoke with Henry Schein One Product Manager for Patient Experience Andrea Gallimore to learn about why it's so important to be ready to communicate and interact with your patients when and how they want to connect. [4 minutes]

Dental Product Insights: Keeping Up With Patient Communication Expectations – Part 3: Customizing Communications

 Now you talked about the phone still being a vital part of the practice, still something that obviously we need to use, but is the phone that a practice can use today the same as the one that you might have been using when you were managing a practice?

It is so different now. You know, when I managed it definitely, you know, you could call it and get it automated attended and route to places, which was great. But now these phone systems and things that we offer within Henry Schein One and tie into our communication service Lighthouse 360+ allows for when the patient to call in, if they do happen to not get an answer, because they're so busy in their practice seeing patients as they're checking them out, seeing them in the door, the newer phone systems and the newer technology tied to patient communications that you're wanting to look for as a practice, is those that will tell the patient through a text message back to the patient, "Hey, we understand you called our office. We want to, you know, take care of you. We're with another patient, you can go ahead and text me what you need." And now the conversation's already started. Instead of waiting for me to check a voice message to see who I missed, I've got a text message already going back and forth. And you can get started communicating much more efficiently, much more streamlined. So having those more robust phone systems are just bringing another layer of communication into your practice with your patient.

Now, it sounds like you know, today's practices have a lot of tools at their fingertips practices working with Lighthouse 360+, obviously have a whole number of things available. But none of that is worth anything. If the staff isn't making use of resources, how do you make sure that your team is taking advantage of the tools that they have at their disposal?

So that is really a good point. Because, you know, we can buy all the services we want, we can buy all the practice management software we want. But if we can't get our team members in the office to utilize the tools, then we're just really having a bunch of screwdrivers and wrenches and all that in our tool chest that we're never pulling out to fix anything. And so one thing we do at Henry Schein One and with our services is we offer training to the team members, that is part of our package of when you purchase one of our services. So if we encourage the teams to get involved, get the training, because then they understand how does this tool that I'm going to pull out of my toolkit actually helped me be more efficient in the practice and take time away that I don't have because I'm so busy. And so really helping the practice understand the importance of the training, the importance of change management within their practice, because it's a difference between what you've been doing. And really helping the team understand, this is going to help your life. So you don't feel like you're writing 50 directions at one time. If you're using your tools properly, you're going to get more efficiency and have more happiness within your job. And within the practice.

Turning back a little bit to the patients and the fact that we've already discussed there's so many different ways that a practice can connect with them. Different messaging might use a different channel, but how do you make sure that the patient has any say in this? Can patients be letting you know, what's the best way to reach them? And should you be asking them that?

And they can. And that's something that's really important. And one thing that I love about Lighthouse 360+ is it's a tool that can communicate with the patient in the way that patient prefers. And that's really important. We talked about not over communicating at the very beginning. Like it's great. One of the best things to do is communicate but one of the worst things we do is over communicate while understanding what's the best method to reach Noah, for the different types of communications that I'm sending out is important. And so having that tool to be able to say Noah prefers text message. So when I send appointment reminders, text messages, my first way to send and he's gonna get a text message. So I'm not gonna send him an email and a phone call. But Andreea doesn't have a cell phone and she doesn't like text messages. She prefers email. And so I would get an email that tries the system can see that kind of information and know the preferred contact method of a patient. So it's really important to get to them that way and then they're going to respond to you because otherwise like we said in the very beginning, they're going to just say why are you contacting me all the time?

Dental Products Report spoke with Henry Schein One Product Manager for Patient Experience Andrea Gallimore to learn about why it's so important to be ready to communicate and interact with your patients when and how they want to connect. [6 minutes]

Dental Product Insights: Keeping Up With Patient Communication Expectations – Part 2: Making the Practice Available

We talked a little bit about texting, but patients probably are getting those texts on a smartphone that can also get phone calls. It can also get a mail. We know that snail mail, regular mail through the Postal Service still has its places too. So how does a practice figure out what methods to use to communicate with patients?

One thing I love and utilizing a service, like we have here at Henry Schein One like Lighthouse 360+, it allows the practice to utilize a most all of these different avenues to contact their patients. And, you know, one way may be good, for example, asking a patient to confirm an appointment, most you're gonna respond pretty much instantly, when they get that text message, they're gonna see it, they're gonna hit that send, and they're gonna respond, you know, or they're gonna say, okay, and they're gonna confirm their appointment. But when you think about it, you really have to start looking at my different ways to communicate, what am I communicating to my patient, because text is one thing, and it's quick and fast. And it's short and simple. But maybe it's about hygiene and getting that patient back into the chair and getting their oral health taken care of. We find emails really respond better with patients in that avenue, because I'm able to educate them a little bit more in that email about why it's important to get back in. And that leads to even allowing them to book directly from an email. You know, snail mail is still important too. You don't want to forget that every once in a while, you might need to get something out to a patient, and really get it in front of their face, and remind them, hey, we're looking forward to seeing you or maybe you're having some kind of special in your practice. But all of those are important. And each one of them really can resonate with your patient in a different ways based off of what you're communicating with them.

You know, in today's world, are patients really expecting to be able to have access to their dental practice pretty much 24/7 whenever they want?

They really are, and just like I was mentioning, you get that email that says I know you're due for hygiene, you need to book your appointment, you're not you haven't scheduled for it, you get that and when maybe you read it in the evening, and we're already closed. In a practice, if you have a book now a button, you're going to book, you're going to click it, you're going to book that appointment, you're going to move right on through and it doesn't require you remembering to call the practice the next morning and asking to schedule that appointment. So think about it, most everything we do nowadays, we are booking online. We expect to be able to do things 24/7. Even when we know the practice isn't open or you know, our business that we are going to isn't open, we want it at our fingertips because we all work or are awake at different times of day.

You talked a little bit about you know, the email with a link and scheduling. But how are some of the ways that Lighthouse 360+ is able to make it so that patients can have access and you know, get in touch with their practice whenever they feel like doing it.

Online Booking is one that is really a key factor. And, you know, allowing those patients to have an opportunity to see the calendar, pick dates and times that the practice has actually said I want to have available for my patients to see and book online. You know, that's important because we're allowing that patient to go out there, see the calendar, pick the date and time and send it back to us and control that in the office to So what's important. Some other technology is just having a great phone system that allows for interactions even when you're not in the practice that can even instigate a message back and text the patient and things like that. It's all about really evolving and how can we keep at their fingertips and remind them to come back and contact us?

Now you mentioned online scheduling. Are there other online services? Are there things that patients really expect now that their practice is going to have available to them whenever they want to visit the website?

Do you know what else they expect? And I know I do. When I call a practice. I expect to go ahead and be able to fill out my patient forms prior to coming in that door. Let me get it all done. Let me do it electronically. Don't ask me to print something, I don't have a printer. But let me do it electronically. Online, get it done, get it sent in. So all of that's done. So on the date of my appointment, I can walk in the door on time and get in the chair and be seen and keep myself on time with the patient and keep the practice on time because we're moving more efficiently through the practice.

Dental Products Report spoke with Henry Schein One Product Manager for Patient Experience Andrea Gallimor

Dental Product Insights: Keeping Up With Patient Communication Expectations – Part 1: Communication Technology

Hello, I'm Noah Levine, Editorial Director with Dental Products Report. Today I'm joined by Andrea Gallimore. She's a product manager for patient experience with Henry Schein One. Andrea, thanks so much for joining us.

Well, to kick things off, can you tell us a little bit about yourself and your background,

I actually was an office manager for 12 years for a practice. And so got that background in the dental industry. I did that for 12 years, ran a multi-doctor practice. Then I moved into full time working for Henry Schein 13 years ago, actually. I just had my anniversary at the beginning of this month. That's it. So I've been with Henry Schein now for 13 years, so 25 years in this dental industry, love it to death and love working with practices to help them be more efficient and effective and productive in their practice.

Getting right to some questions we'd love to ask you about. I mean, it's right there in your title, that you're a manager for patient experience. And I think, you know, practices get things right really well when it comes to providing good communication or good experience for their patients. So that what did they get right? What did they get wrong in general?

Well, you know, one thing they get right is sending electronic communications to their patients, asking the patient to confirm appointments. You know, we live in an instantaneous world nowadays, and we're all busy. So getting that reminder. And confirming right away is something we'll do when we see that come in on our telephone. Now, the flip side of that, too, is what do we get wrong in practices sometimes when we're communicating with our patients is that we overcommunicate with patients, you know. If you think about it, you're with yourself, how many times do you get another message saying confirm your appointment? And you've already confirmed it and you get another one, confirm your appointment? And you're like, Well, I've already confirmed this appointment. And did I not know it, you know, so we have to be very careful. It's a delicate balance, to not overcommunicate, but to communicate and get your patient to respond and confirm their appointments.

Now, we live in a world that has gotten a lot more complex when it comes to how we all communicate with each other and how dental practices can communicate with their patients. Some of the biggest influences on how practices are perceived in public have become very prominent the last few years, I'm speaking about social media platforms, online review platforms, how have the rise of these platforms changed the ways dental practices, communicate and interact with their patients?

Well, it really has, because if you think about it, word of mouth is how we got new patients a lot of times into our practices. And that is still in essence what we're doing. But it's done through social media. Now, you know, you're out there, and you need to find an oral surgeon, for your son or daughter or whatever. And you go out social media and you posted, "Who do you recommend?" You want all your friends telling you. Well, what's important is for the practice, to have those social media accounts, and have reviews on those accounts, and have interactions with their patients basically, on those accounts, because when someone's seeking a recommendation, they're gonna hit right on that social media account, and they're gonna go right over to your website, and they're gonna look for Google reviews. And this all ties together. So having social media, keeping the patient base informed about what's going on in the practice, also will drive a new patients into your practice.

Now, this leads into, you know, kind of the other side of things. This is technology patients are using to interact with practices, but on the practice side, over the years, and you've been, you know, in the practice management side of things for a good while now. How has the technology changed? What can practices do differently, more efficiently now with technology than they could in the past?

Well, you know, it's given us in a practice, really more opportunity to connect with the patient than we had in the past as technology has evolved. And instead of just, you know, calling and leaving a message on the phone for them and expecting them to even listen to our message or respond to that message. image, we now with the many ways that we have to contact them. And especially with texting because we all are have our phones in our hands and we're all looking at that text when it pops in and we're all answering it pretty much instantaneously. It has made the patient, really at your fingertips now for the practice because technology is in their hand. They're utilizing it daily, or every minute of the day almost and you know, and they're right. They're responding because they see it pop up in their face, basically.

AAID President Edward Kusek, DDS, FAAID, DABOI/ID, discusses the event and what's on the horizon for implant dentistry.

The 2023 AAID Annual Conference - Interview with Edward Kusek, DDS

Dr Kusek: Hi, I'm Dr Eddie Kusek, president of the American Academy of Implant Dentistry. I'm here at our annual meeting for 2023. And I'm just here to talk about the different areas that we could offer for education. We have a tier system of education, we have the Associate Fellow, which has a requirement of 300 hours of education, you have to pass a written test, and then there's an oral examination, then it expands to the Fellowship, which requires more [continuing education] CE for that, and then also another area of oral testing. And then the final one from the diplomate of oral implant technology. And the final stage is the diplomate of American Board of Oral Implantology. That requires more testing, oral testing presenting cases, in the all these tiers steps is to test the credentials of you to see the quality of your education, and to see if you really understand how implant dentistry affects both the surgical phase, the prosthetic phase, the restorative element.

So that as far as the education, what we test for is to see if you're trained correctly, for your implant knowledge, know how periodontally This affects the patient, the prosthetics affect the patient, maintenance, how to to maintain implant cases, for long term, all these things come to fruition to be a good Implant Dentist. So the meeting here for the 2023 meeting in Las Vegas, it is very upbeat, it's nice to see everybody here at the meeting in person is the only way to actually learn. You know, you can hear all the speakers and you can listen to them virtually. But then to be able to interact with your colleagues and ask questions about what are you doing on this and then they tell you something about that. And then you probably get into another area of implant dentistry or another part of dentistry and continuously goes on and on and on. So I see people here that I've been friends with for 20, over 20 years. And you know, we're always communicating with each other and it's like being back home. That's what makes it so much different from other organizations that I am a part of and have seen there, those organizations the camaraderie is second to none. Here at our annual meeting. 

What has the world got me excited about implant dentistry? Well, you know, like dentistry is totally changing what I learned when I graduated from school, it was totally changed. And God, you need to keep up on everything. Technology, it just keeps expanding people finding new ways to do things to make it simpler for the clinician, and better for the patient to get things more accelerated, because patients don't want to go through months, years times, to be able to get their prosthetics finished. And everything is on an accelerated pace. So you need to keep up with technology and what's going on it is just expanding. So so much. So you know, me as a clinician, you may think I'm in my golden years of being ready to retire, but I am still learning and I am motivated by the younger people that are showing all these things. And it's like, I've got to do this for my patients. And I'm mentoring some of the younger people too. And when I'm going out and doing surgeries and helping them with surgeries, we're doing this at the high tech level. 

So what is AAID doing in the future? Well, you know, what we experienced during COVID. And now we have the implant Institute, which we will have a number of courses online that you could watch anytime, any part of the day evening, and being able to get CPE credits for that and we have a number of clinicians that are in the top level of implant dentistry. So yes, this is going to be something very exciting. And also if you're an AIA member, you could go back pull off the information. And if your state is requiring to CE you could pull that off, print it out and then Senator your state so this is going to be extremely easy for all of our members in yeah if you want to join aitd you know, we are in the cutting edge of all this technology for you So what can coalition's look for in the upcoming year and 2024? Well, we have a number of regional meetings, we call it district meetings. There's no western district, we have a meeting, northeast and southern have a joint meeting together. And this is a smaller version of our larger meeting, where you may see 200. So clinicians there. Otherwise, there's a lot of young people speaking at these meetings, a lot of energy going on in these meetings. So a lot of cutting edge stuff that's going to be presented at that. So the annual meeting, our crown jewel meeting is November 13, through the 16th. So this is going to be one of the best meetings that we've ever produced. 

For AAID, we're getting all kinds of different speakers from around the US and around the world. And then also invite your auxilary is because we're going to have them come and we're going to have a lot of different courses for them to take to bring back to your office and it's going to be an A very exciting event. Dr. Bernie Dunson is by program chair and Bernie is always top notch and we are really looking forward to seeing everybody in Atlanta, Georgia, so hopefully you can make it there.

At the 2023 AAID Annual Conference, Dental Products Report sat down with AAID President Edward Kusek, DDS, FAAID, DABOI/ID, to discuss the event and what's on the horizon for implant dentistry. [6 minutes]

Quip Launches Night Guards, Sports Guards, and Whitening Kits. Image credit: © quip

Modern oral health company quip has unveiled a trio of custom dental care solutions, bringing professional-grade oral care right into the homes of consumers. The new products—Custom Night Guards, Sports Guards, and Whitening Kits—are set to transform the way people approach oral health, according to a press release from the company.

The process is designed to be simple and easily adoptable. Users can take detailed impressions at home, mail them back using the provided materials, and await the arrival of their custom dental care solution from quip. Whether it's a Night Guard, Sports Guard, or Whitening Kit, each product is tailored to the user's mouth for a personalized and comfortable fit. The package also includes a protective storage case.

Dr Jeffrey Rappaport, Chief Dental Advisor at quip, expressed his enthusiasm for the new offerings in the press release, stating, "Consumer research shows there is strong demand for professional-grade services such as whitening and molded night and sports guards. With quip's simple, three-step process, people all over the country can use professional-grade oral care solutions for lower prices and without leaving their homes. I'm excited to recommend these services to my patients."

The quip Night Guards address the effects of teeth grinding and clenching with 2 lining options: Hard or Hard-Soft. On the other hand, quip Sports Guards provide essential protection to lower the risk of sports-related teeth injuries, per the company.

The quip Whitening Kit, offers 2 different treatment options for daytime or nighttime. Proven to whiten teeth up to 63% after a 14-day treatment, this kit guarantees a brighter smile after a single day.

Quip's commitment to safety and quality is evident in the BPA-free, latex-free, and FDA-approved impression trays included in each Custom Care Kit. Furthermore, quip covers the shipping costs for added customer convenience.

For those interested in the pricing, the Whitening Kit is available for $199 with a subscription, followed by $49 refills every 6 months. The Sports Guard Kit comes in at $159 with a subscription, with $99 for new guards every 6 months. The Night Guard Kit is priced at $159 (Hard) or $169 (Hard-Soft) with a subscription, followed by $99 for new guards every 6 months.

Quip recommends refills and new guards every 6, offering free shipping with a subscription. For those interested in any of these new products, more information is available at 

Articles

These custom oral care products will provide patients with the ability to protect and whiten their teeth, with customization to suit the patients’ needs. 

Quip Launches Night Guard, Sports Guard, and Whitening Kit

Robert Elsenpeter is a freelance writer and frequent contributor to Dental Products Report and Dental Lab Products. He is also the author of 18 technology books, including the award-winning Green IT: Reduce Your Information System's Environmental Impact While Adding to the Bottom Line. As such, he’s particularly interested in the technological side of dentistry.

The Right Cut | Image Credit: © Andriy - stock.adobe.com

Whenever they find themselves in a pickle and need help getting out of the jar, James Bond and Batman can always turn to their trusty gadgets. Whether it’s Bond’s laser watch, pen grenade, or a tricked-out Aston Martin, or Batman’s smoke pellets, Batarang, or Batmobile, there is always a gizmo.

While not a matter of life or death, dental labs are faced with a range of options when it comes to machining and tooling, given different materials and applications. Finding the best tool depends on a variety of factors that lab owners must keep in mind.

In the lab, the tools used by milling machines to carve shapes out of materials share a common form factor.

“Most of these tools are made out of tungsten carbide,” Chris Urist, president and partner at Primotec USA, notes. “That’s the best-quality raw material to use. Different machines have different sizes and dimensions of tools, but for example let’s just say the most common mill is a Roland Mill, and those have a 4-mm shank diameter where the chuck holds the tool. The first tool that the machine will grab is a roughing tool, which is the biggest tool, and removes the most material the fastest.”

The machines that do the heavy lifting of CAM work are the mills themselves.

“First and foremost, you need the mill,” Lisa Aguirre, dental marketing manager at Roland DGA, says. “It’s like if you want to print something at home, you must have a file to send and a device to send it from, but you need a printer to produce the print. It works the same way for dental milling, where the mill creates the final product.”

Milling machines work in wet or dry capacities, depending on which material is used and what is being produced.

“The type of hardware you use is going to depend on the type of product that you’re looking to produce,” Aguirre says. “For example, if you’re producing zirconia or dentures—or for anything removable—you’re looking at a dry milling solution. Whereas if you’re using a glass ceramic material, a lithium disilicate, or a custom titanium abutment, things of that sort, you’re going to be looking for a wet milling solution.”

“There are a variety of mills out there that handle multiple materials,” adds Matt Viens, CAD/CAM training supervisor, Zahn Dental. “Some of the major manufacturers include Roland DGA, VHF, Amann Girrbach, Imes, and imes-icore. Each major manufacturer typically has 1 model dedicated to milling wet-milled materials only, then other models that are suitable for milling multiple materials. This includes dry-only mills or mills that can function as a wet and dry combination. For these combination mills, the best rule of thumb regarding matching the hardware to the materials is to stick to milling either wet or dry materials for as long as possible within the production workflow, before having to switch over to the other.”

While there are mills that can handle both wet and dry applications, they tend not to be very efficient.

“The process of having to clean out the mill between materials can be tedious and time-consuming,” Viens says. “Not to mention that if not done correctly, it can and will lead to premature wear and tear on the integral parts of the mill itself. With wet-only mills, it is imperative to keep up with required daily cleaning and maintenance routines to ensure that any additional buildup is not going to cause issues with the normal function of the equipment. With dry-only mills, vacuuming and minimizing the amount of debris left within the milling chamber will help to reduce the influence that the particles can have on the units being milled and on parts of the mill itself. In short, keeping up with cleaning and maintenance is key, no matter the material type.”

Labs also have the opportunity to select tools and equipment based on whether they can interoperate with other manufacturers’ products. Those pieces of hardware and equipment that work only with a single manufacturer’s products are said to be “closed architecture.” On the other hand, those that can work with other vendors’ offerings are said to be “open architecture.”

“Our solutions at Roland DGA are all open architecture,” Aguirre notes. “This allows you the freedom to choose your preferred materials, whereas a closed system would limit you to using the particular materials approved for that unit. Open architecture means that from scan to design to the actual milling of the material, it’s open, so if a new material comes out on the market tomorrow—as long as it’s FDA validated or 510(k) certified—you would be able to mill that material, whether it be wet or dry, depending on the solution you’re working with. Using a milling solution with open architecture is a good way to ensure you are getting the most bang for your buck.”

There are, naturally, pros and cons to each architectural philosophy. Supports of closed systems tout their solutions as more predictable and reliable. Open systems, on the other hand, allow for more flexibility.

“Obviously, with open architecture solutions, you’re going to have more restorative options and more possibilities as far as materials and also with tooling,” Aguirre says. “As far as materials, for example, if you’re working with a closed system, you may only have 5 or 6 materials to choose from, whereas from a laboratory standpoint, there may be a better material out there that would better suit this case, based on the patient’s function or other variables. With an open milling system, the laboratory would be able to offer that other material to the clinician as a recommendation for their patient.”

There doesn’t seem to be a strong pull, one way or the other, as far as which type of system is most prevalent.

“It’s still 50/50,” Aguirre adds. “For instance, 3D printers. They’re about 50/50 right now. You have some companies that believe if they lock you into materials, hardware and software, it’s a more controlled production environment.

“My background is clinical,” she continues. “I always talk to clinicians about avoiding becoming a cookie-cutter practice. You don’t want a consultant that’s going to come in and cookie-cutter your practice with that solution. You want to be able to make the best decisions for your patients based on their unique situation, because no 2 mouths are the same. It’s like a fingerprint, whether it be the bite, the anatomy, the function, whether they have dry saliva vs more of a wet mouth, or the foods they eat. I could go on and on, but closed architecture really narrows down your options. You’ll see it even more on the 3D printing side, because they’re basically forcing you to buy their consumable materials as well.”

Can any one machine do it all? That is, can a lab get by with just 1 mill that can handle wet and dry cases? The answer is a resounding, “It depends.”

“There are hybrid milling machines which mill both wet and dry,” Aguirre says. “At Roland DGA, we don’t presently manufacture hybrid machines, only because it requires a significant amount of maintenance when you go from wet to dry. Take zirconia milling as an example. If zirconia dust were to enter the milling chamber, because they’re milled in the same chamber, and there’s any amount of moisture left in that machine, which happens more often than you’d think, and you start milling zirconia, you’re going to have concrete in your mill. Anybody who’s ever touched zirconia dust knows what I’m talking about. It is fine. It makes a mess. So obviously, it’s not something that’s meant to be wet milled, unless it’s fully sintered, and there are not too many of those products available.”

Tools seem to be best used with a specific material.

There is no such thing as an all-purpose tool,” Viens says. “There are tools, like carbide tools, that can handle a variety of materials such as zirconia, wax, polymethyl methacrylate (PMMA), and other types of ‘soft’ materials. But due to their composition, these tools are not suited for lasting a long time and they degrade faster than specialized tools for the particular materials. Typically, carbide tools are the cheaper option among the tools available. Therefore, the versatility and advantage of such a tool is quickly overrun by the constant need for replacement. Tools are designed and produced to be effective and efficient against specific materials. Though it may cost more to run multiple sets of tools to cover the variety of materials, the cost over the long run is greatly lessened due to their durability.”

While tools may be able to handle different materials, they can wear faster if they’re not used properly.

“You can have 1 tool that does everything, but that’s one of the least efficient ways of milling, because again, if it’s just that carbide material, it’ll be fine for wax and PMMA. It’s OK for zirconia, but not great,” Urist says. “It does not last very long. And most people are milling zirconia out of their machines the majority of the time. So, with zirconia, we—and most manufacturers—recommend a diamond coating. That diamond coating will make the tools last way longer for milling zirconia; it could be up to 10 times as long as a carbide tool. So, it is more expensive, but it’s a higher-quality coating. It just really makes the surface and the sharpness of that edge last a long time. But that’s specifically for zirconia milling. If you were to go and start milling another material, like PMMA with that, it does not last quite as long.”

Labs can extend the life and the function of their tools by avoiding some common mistakes.

Using the correct tooling for the job tops Aguirre’s list.

“The No. 1 mistake, I would say, is not using the proper tooling,” Aguirre says. “Tooling is so important to the success of the milling job. I think in our industry, a lot of times we don’t put a lot of emphasis on it, but using the right tools and using quality tools are really, really important in the long run. Again, our systems are open, so they can use any appropriately sized tool—and there are a lot of them out there. We can guarantee our Roland DGA, DGSHAPE tools are authentic; they’re high quality. Sometimes users think that they’re saving money by using less expensive tools—kind of the no-name knockoffs. We see these cheaper brands in implant parts, tools, and materials. And they’re less expensive for a reason. There is value in using quality tools and making sure that you’re using the right tools for the job.

“There are actually 3 things to keep in mind when choosing your tools,” she continues. “The first one is, are you using quality tools? Because if you don’t use quality tools, you’re going to be swapping those tools out much more frequently. And that’s something that in any mill is going to require an actual technician to do. Those frequent replacements eat into your profits, reducing your [return on investment] and increasing your overhead. Typically, lower-quality tools also break more frequently, and not when they’re supposed to. Maybe the tool has this many hours and maybe it’s getting close to its estimated lifetime. Lower-quality tools can be unpredictable, which can also cost lab owners time and money.”

Tools, Aguirre adds, should be appropriate for the material being milled.

“The second question to ask yourself is, are you using the right tools for the material that you’re milling?” she says. “For example, are you trying to mill zirconia with a PMMA tool or vice versa? More often than not, when we see chipping in zirconia, for example, we’ll see users using carbide tools. Although there is an indication for using carbide tools, the best tool to mill zirconia with is a diamond-coated tool. And then same thing for PMMA. You’ll see somebody saying, ‘Oh, I don’t know why this tool keeps breaking,’ and they’re milling a PMMA puck with a diamond tool, which is not the right tool for that application.

The third consideration is paying attention to your CAM software. CAM software will always tell the user what tool slot each tool belongs in,” she continues. “Sometimes while setting up their milling session, people are so busy clicking that they may not notice that something changed, because each setup is based on the design that’s created. It’s best to always take the time to ensure that your tool setup mimics what you see on your screen and your CAM software.”

There are several variables at play when it comes to selecting the right tool for a given material and job.

“Relative to tools, the most common issue is putting the wrong tool size in the wrong slot or labeling the tool in that slot incorrectly in the CAM software,” Viens adds. “For example, placing a 1-mm bur in the placement where a 2-mm burr is meant to be or mislabeling a 1-mm bur as a 2-mm bur in the CAM software. Some mills are able to detect the type of bur and will let you know that the wrong one is in the current slot and allows for you to correct this error. But other mills or software are only as capable as the information that is input into them. So, the mill assumes that the correct bur is in the correct slot, and when it goes to mill it either breaks the bur or overmills certain areas because of the difference in size.”

“I would recommend that [dental labs] use a different tool for their different materials,” Urist adds. “Some labs will just use the carbide tools, and they’ll use it for everything that they’re milling. And again, they are the least expensive, but they won’t be the most efficient and cost-effective over the life of the tool. So, if you had one set for zirconia, a diamond coated set, and then another set for the other stuff you’re milling—PMMA and wax—it may be more up front of a cost for them, but it will help them in their tool longevity over the life span of that set of tools.”

He also advises labs to be mindful of bur coating materials.

“There are diamond coatings for zirconia, but there are other coatings as well,” Urist adds. “We make a gold coating for metal milling. Different coatings add different hardnesses to the tool, and they just help milling different materials. So, we have a Blue Line coating, which is good for PMMA and PEEK, and then a Gold Line, which is good for metals. Finding the right tool for the right material really just helps with the longevity of the tool.”

Tooling costs are, of course, important. And while it may seem that the lab will get a longer life out of a more expensive tool, Urist observes that there may be cases where it’s more efficient to buy less expensive tools and chalk up frequent replacements as more efficient for the business.

“It might go in the other direction in that labs will just want to use a set of diamond tools and they’ll end up using that for everything,” Urist says. “But in that case, it would make more sense to also buy a less expensive set of tools for the other materials that you’re milling that don’t need that coating. So, if they mill a lot of PMMA or wax, for example, then there’s no need to buy that more expensive coated tool. It just really depends on the material they’re looking to mill, because I would always recommend a diamond-coated tool for zirconia but not for other materials. But again, there are different types of diamond coating, and they can find much less expensive ones that are manufactured in China or India, but usually the coating isn’t quite as good as other coatings that are done here in the US or in Germany, for example. And that, honestly, doesn’t always depend on where it’s manufactured or what tools you’re using. A lot of it also depends on the CAM software and the strategy that they’re using. Two different labs might have the exact same milling machine and using the exact same tools, but they have one as a strategy from Company A and one strategy from Company B, but Company A’s will be much faster. They will be able to mill a crown out in, let’s say, 12 minutes, and then Company B will sell you one that takes 20 minutes. And typically, when this is the case, the lab that’s milling with Company B, the tools are lasting way longer. They’ll get hundreds of hours out of a tool, and Company A will get, let’s just say, half the amount of time out of a tool. And again, that just depends on the strategy that’s being used in basically how hard and fast that tool is working. There’s no right or wrong answer, because some labs just say, ‘I don’t care. I’d rather go through tools a lot faster and have these crowns milled out in 10, 12 minutes, because we’re a production lab and we need to pump these units out.’ And others would say ‘I’d rather have a higher-quality milled restoration and have the tools last a lot longer.’ So, there are many different variables, but really the longevity comes down to the CAM strategy and how fast you’re manufacturing your parts.”

More expensive does not always mean better.

“The most expensive tool is not always the best option,” Viens says. “You have to look at the yield of the product relative to its cost. If it is able to produce similar-quality units as cheaper burs but last a great deal longer, then it may be worth it. If it cannot match the quality but lasts longer, then it may not be the best option. As mentioned before, the carbides are going to be the cheapest to start out with, but they will not last the longest. The diamond-coated tools or similar are specifically engineered to last longer and are better suited toward all budgets, both in cost and effectiveness.”

Dental labs’ tools may not be quite as cool as James Bond’s or Batman’s, but there is always the right tool for the job.

How to find the best tools for your mill and for the materials you use in your dental lab.

The Right Cut

Dr. Lou Shuman is the CEO of Cellerant Consulting Group, dentistry’s leading corporate incubator and accelerator; a venturer-in-residence at Harvard’s i-Lab; the chairman of the technology advisory board at WEO Media; a long-time contributor to Dental Products Report; and the founder and creator of the Cellerant Best of Class Technology Awards.

In the dental office, especially in the hygiene department, you will find many products that do 1 job. Maybe we don’t like that product but keep using it anyway because we don’t have a good alternative. Chlorhexidine is that kind of product. It is a staple in the dental office, but in my many years in clinical practice working with clinicians and hygienists, no one is satisfied with it. We continue to look for alternative products that do many jobs well. I am thrilled to say that there is a better alternative: OraCare. I know that because I use it myself. I sat down with Kristin Goodfellow, RDH, chief clinical officer of OraCare and practicing registered dental hygienist, to find out the details on this award-winning product.

 Chlorhexidine is a staple in dentistry and hygiene. What’s wrong with a product that has been used for so many years?

 Chlorhexidine is for short-term use only, but many of our patients have long-term issues. It does kill bacteria, but it also causes staining and additional calculus buildup. Chlorhexidine [affects] the cells in the mouth that help rebuild tissue, causing complications with healing.

 Tell me how and why OraCare was created.

 OraCare was developed by 3 dentists, Dr Robert Martino, Dr Richard Downs, and Dr Berdj Kiladjian, who shared other dentists’ frustrations [about] the negative effects of chlorhexidine. Dr Downs recognized how effective and compatible chlorine dioxide, the active ingredient in OraCare, is for use in the mouth. Now thousands of dental professionals use and trust OraCare as an alternative to chlorhexidine. Even better, it can be used for many more applications, from simple issues [such as] bad breath to more complex problems [such as] periodontal disease, cancer care, [postoperative] healing, mouth sores, dry mouth, fungal infections, braces, bleeding gums, and general home care. It has so much function and applicability for day-to-day use.

 OraCare uses a 2-bottle system to create activated chlorine dioxide, a unique gas that is the active ingredient. Chlorine dioxide is versatile; able to kill bacteria, viruses, [and] fungi; break up biofilm; and reduce volatile sulfur compounds. Compare that with chlorhexidine, [which] just kills bacteria. And although killing bacteria is important in dentistry, it’s not the only pathogen that we need to be concerned about. For example, we know that viruses play a role in issues [such as] implant failure and the progression of periodontal disease. OraCare has the ability to do more, something which is much needed in 2023.

Tell me more about the science. Have there been any studies related to the use of OraCare?

 OraCare has many studies, and we are always working toward participating in more. The active ingredient in OraCare, chlorine dioxide, is a powerful yet versatile compound that has gained significant attention in the dental industry. Its study and application have long been applied in other disciplines, including chemistry, water treatment, and health care. This is one of many reasons it has become so popular with dental professionals. It is fantastic at breaking up biofilm but also kills bacteria, viruses, [and] fungi and reduces volatile sulfur compounds. The fact that it has all these qualities makes it ideal for use in the oral cavity when trying to find something to help a plethora of issues from everyday care to periodontal disease.

How does OraCare handle the destruction of bacteria in the mouth differently from chlorhexidine?

 The chlorine dioxide in OraCare is a very selective antimicrobial. It doesn’t destroy the cells that rebuild tissue. There have been [findings from] many studies on chlorhexidine that show that it inhibits a particular type of cell called fibroblasts, which are key to rebuilding connective tissue. In the [management] of periodontal disease, when the doctor’s definition of success may be 1 mm of reattachment, you don’t want to have the patient use a product that completely contradicts your goal of rebuilding the tissue.

 You mentioned that chlorhexidine has a limited life span as far as usage. Can you give us more information on why that matters?

 One of the biggest challenges of chlorhexidine is that we often start using it when our patients really need help. Chlorhexidine can only be used for 2 weeks, and most dental issues can’t be resolved in that time. For example, after an extraction, it takes about a month for the tissue to heal, so the patient needs a product that they can use for at least that healing time to help keep the area clean and not cause any additional issues.

Also, if you want the patient to be [adherent] for a longer period, it has to be easy to use and taste good. Many patients complain about the taste of chlorhexidine, and some won’t use it after trying it. OraCare tastes good, doesn’t cause any stinging or discomfort, and leaves the mouth feeling super clean. Patients can feel a difference.

 I hear that OraCare has gotten involved in humanitarian efforts with patients [with] cancer. Tell me more about that aspect.

 We are incredibly proud of our humanitarian efforts. The OraCare Cares program, offered to offices that carry OraCare, donates a set of OraCare to a patient [with] cancer from that office. All the office has to do is go to our website and fill out the form for their patient. When we get the notification, we’ll send the patient the OraCare with a card that has a personalized message that the patient is receiving a gift from the office.

We had not at first realized how beneficial OraCare was to patients [with] cancer until a hygienist started offering our product to patients [with] cancer [experiencing] fungal infections and dry mouth. OraCare also helps with the mouth sores and burning mouth syndrome that often occur as a result of certain cancer [therapies]. We started getting testimonials from patients [with] cancer that OraCare helped them with their mouth sores from chemotherapy and radiation. Patients compared their first round of treatment when they were not using OraCare with their second round of treatment when they were using OraCare and found that their oral [adverse] effects were significantly reduced. Ultimately, we’re proud because we can provide some relief to patients during an uncomfortable time. We are so pleased that they are able to eat and drink more comfortably and keep their oral cavity healthy.

Dental professionals have an advantage in that they typically see a patient [with] cancer about a month before they start treatment, so they start on this product even before they start treatment to prevent problems [and] not deal with them as they pop up during treatment. They should start cancer [management] with the healthiest mouth possible and no active infection in the oral cavity.

 As a dedicated OraCare user, I have felt the amazing effects firsthand. From perio [and] dry mouth to cancer care [and] everyday maintenance, integrating OraCare into a patient’s hygiene routine can make a remarkable difference in oral health.

OraCare offers practitioners a healthy and versatile alternative to the controversial chlorhexidine. Learn more about it from OraCare Chief Clinical Officer Kristin Goodfellow, RDH.

A Mouth Rinse to Tackle More Than Just a Single Job

Premier Dental recently announced the launch of ProFlare™ articulating disposable prophy angles featuring an innovative cup design that is said to help the prophy angles provide superior quality outcomes at an affordable price.

The ProFlare articulating disposable prophy angle features a unique latex-free, articulating cup, capable of pivoting and flaring to adapt to the specific contours of each tooth surface more easily than a traditional prophy angle. This innovation reportedly reduces the amount of wrist motion required for polishing, thereby enhancing ergonomics and reducing strain on dental professionals.

The patent-pending pivot and flare design of the ProFlare prophy cup ensures maximum surface adaptation. This makes it easier for an experienced clinician to complete an efficient polishing of each tooth's unique contours.The outer ridges of the prophy cup are designed to reach interproximally, which provides effective stain removal between teeth and helps ensure a thorough cleaning process.

The cups feature a more pronounced hourglass shape than a traditional prophy angle cup. This design allows the cup to be solidly attached to the prophy angle, but the top of the cup can flex and adjust to better mirror the shape of the teeth being polished. The cups are designed with interior ridges to clean the surface of the teeth.

The ProFlare features a compact head and neck, which makes it easier for clinicians to see around the prophy angle and maneuver it within the patient’s mouth. Having enhanced visibility and better access to the treatment area can help make the polishing process more efficient. The efficient gearing of the ProFlare is designed to deliver smooth acceleration and eliminate chatter, and it is designed for jam-free performance. Being able to count on the prophy angles to deliver optimal performances allows clinicians to work without interruptions and enhance their overall efficiency.

The latex-free prophy angles are suited for use with patients who have a latex allergy, and they are affordably priced and available in packages of 125 angles. The new angles are designed to be used alongside Premier Dental’s Enamel Pro prophy paste, and AeroPro cordless prophy handpiece for efficient prophy appointments.

Enamel Pro prophy paste is designed to effectively remove stains and also to repair enamel. It features a unique amorphous calcium phosphate (ACP) technology that provides a 31% increase in fluoride uptake, helping patient’s repair their teeth and whitening their smiles. It is available in 4 grits and 8 flavors.

AeroPro is a cordless prophy handpiece that aims to improve ergonomics for dental hygienists while making it easier for them to deliver precise, efficient stain removal. Lightweight and featuring easy to access controls, the handpiece features enhanced sealing for more efficient sterilization processing, and is backed by a 3-year warranty.

Developed to help provide an enhanced polishing experience for both patient and clinician, the ProFlare disposable prophy angle from Premier Dental stands out with its unique cup design.

Premier Dental Introduces Innovative ProFlare Disposable Prophy Angle Featuring an Articulating Cup

The 2023 AAID Annual Conference - Interview with Amam Bhullar, DMD

Dental Products Report took to Las Vegas to cover the 2023 AAID Annual Conference, where attendees and clinicians like Aman Bhullar, DMD, got a first look at all things new and innovative in implant dentistry. [4 minutes]

Dr Bhullar: Hi, my name is Dr Aman Bhullar and I am a diplomat of the American Board of Oral Implantology and a fellow with the American Academy of Implant Dentistry. My practice is in San Jose, California, this meeting here in Las Vegas is great. 

We've got over 1400 participants. We've got the top vendors and the top exhibitors across the country, speakers and lecturers from across the world that are presenting the latest in implant dentistry. It's really important for doctors that are focused in implant dentistry and improving their skills, trying to attend a meeting like this because you've got the greatest the newest ideas and the newest innovations, and, and colleagues that are sharing their successes, their challenges or complications. So we can provide a better service to our public and our customers out there. It's incredibly exciting time to be an implant dentist. At this time, the digital evolution of dentistry and the and the impact that technology is having for us to provide predictable protocols for our patients. And outcomes are very, very exciting. 

Doctors that have been maybe shying away from doing some complex and integrated procedures. Now there's methods and options for these doctors to implement these procedures in their practice with predictability. And with confidence. Definitely, it's really important that as as health care providers and dentists and oral surgeons and prosthodontists, periodontists, that we keep updating our education and adding more skills into our practice. The AAID has options with their Maxi course programs across the world that allow a standard of education to be presented to doctors. The days of going to 1-weekend course and thinking you learn a lot and learn everything you need to learn about the complex field implants are no longer valid. 

There are great options with Max, of course, education and a continuum of education that's available in various cities across the world. We're launching a new program in Dallas. Real good options for doctors to stay current with what the latest and up to date procedures and protocols are in implant dentistry. I've been I was an early adopter in the photogrammetry field had been using photogrammetry since 2019 or so. Or we were using another competitor option for photogrammetry options in our practice. It's an essential tool in our practice on a daily basis for us to get predictable results for our patients. The technology and the accuracy ICam offers for our full arch processes in implant dentistry is is amazing, up to five microns of accuracy for our cases, gives me the confidence to have patients and restorations long term that are going to fit function and stand up to the day to day requirements for the patient long term. I mean for ICam it's we run an education institute 3d implant Institute, we have been able to partner up with a horse and ICam to be bringing these services to underserved communities in various parts of the world. And it really gives us the confidence so that after we leave and do our education programs with these hands on programs, doctors that they can, the practices there can continue to provide a solution to the patient. With an easy print within about 15 to 20 minutes, they can print and provide an economical solution to these people that may not be able to move into their Konya product or more expensive processes. 

The ICam technology and the digital workflows that we implement with printers and syringe re allow us to provide these solutions to patients that normally wouldn't be accessible for them. So we're very thankful for that partnership with 3D implant Institute for us with ICam SprintRay. It really allows the solutions to be available to people that would be otherwise not available to have these types of services. So makes a huge impact in people's lives.