Ed Rabinowitz

A picture is worth a thousand words. But in the case of dental photography, a picture could be worth a great deal more — such as increased case acceptance, and enhanced doctor-patient relationships.

Dental photography is not new. Scott Cairns, DDS, of Colorado-based 

Fountain Modern Dentistry and Orthodontics

, says that dentists have been using photographs to document cases for decades. The challenge back in the day was waiting a week or two to have the images developed.

“And then hoping that you got all the pieces to the puzzle well documented so you could use it in case presentation,” Cairns says.

But digital photography has changed the playing field.

Cairns says that in addition to documentation, dental photography can be used as a patient education tool. In years past, dentists would take photographs of a patient’s mouth, and the patient would be invited back for a consultation with the dentist using the large, glossy prints as a way of explaining the patient’s case. Digital photography, however, has made this process much more efficient.

“The benefits are tremendous,” Cairns says. “Universally, patients are curious about themselves. And when they see themselves they want to learn more.”

Of course, there are patients who are embarrassed of images of their mouth, so it’s important to be cognizant of that and provide them an opportunity to review the images on their own terms.

“But in general, patients love to learn about themselves,” he says. “I think that’s part of the human condition. We’re curious, and when we see a part of ourselves from a different point of view than we have ever looked at before, it’s fascinating. And that fascination lends itself to a conversation.”

That conversation, rather than the dentist pointing to a bad crack in a tooth that requires repair, enables patients to connect the dots on their own. And the conversation can lead to a discussion of how the break may have occurred, and what habits the patient has that may have contributed to the break.

“That’s how I use (digital photography) in my practice, as opposed to it solely being patient education,” Cairns says. “I think it lends itself to credibility and trust, which is one of the things that greases the skids towards case acceptance, especially in new patients.”

Cairns says using digital photography enables the dentist to play the role of tour guide in a process called co-discovery. That’s where the patient and dentist learn about the patient’s mouth at the same time. And the easiest way for that to happen is to go on a journey with the camera in hand. Cairns says it’s like being the tour guide at a museum.

“You can walk around the museum and read everything and pass by things that might be interesting, but you don’t know that it’s interesting,” he explains. “But if you have someone there to tell you a story of what’s going on in your mouth and involving you, it becomes a richer experience. It leads to a richer conversation.”

Cairns acknowledges a learning curve in digital photography, but says it’s not that steep. The bigger challenge, he says, is getting used to the process of using the technology. For many dentists, if the tool isn’t accessible right at the moment and they’re not set up for it, it becomes too difficult to incorporate into an already busy day. But if it’s handy and you begin practicing with it, the transition is a quick one.

“And, you can train or have your assistants trained to use it.”

A decent camera doesn’t cost an arm and a leg, Cairns says.

“It’s within everybody’s reach,” he adds. “It’s not a luxury item. It’s something any office can get a return on.”

The difference between a good camera and the best in price point is not great, Cairns says. And he stresses that the key is not so much about the cost of the camera as it is the capabilities.

“If all you all you want to do is use it as a patient education tool, you could probably go with a lower-priced camera,” he says. “But if you also want to get the benefit of using it as a lab communication tool, then you’re going to need a camera that can be color balanced so that you can get true color, so the lab can use it to get the details it needs.”

So think through how you plan to use the camera, as well as how committed you are to using it.

“It’s not a difficult skill to learn, but it does take time,” Cairns says. “And like everything it takes deliberate practice to get good at it. But, once you get good at it, it’s easy to do if the system is set up well.”

Articles

Scott Cairns, DDS, says that dentists can use digital photography to be a tour guide of sorts for the mouth: showing, rather than telling patients what the issues are. This can lead to increased case acceptance.

Use Dental Photography to Enhance Your Practice

“We say that the team is everything,” says Wes Jankowski.

No, he’s not the head coach of an elite college football program. But Jankowski knows just as much, if not more, about the importance of teamwork as any coach in the country — especially when it comes to creating a winning dental practice team.

, a global leadership-training institute for dental professionals, says that doctors don’t start a private practice because they want to build a good team. They do so because they want to take care of people.

“But in their environment, if they don’t have the right team around them, they’re always distracted from their mission,” Jankowski says. “We help our practices and the doctors understand how to build a self-led team; one that is built on personal accountability, and personal responsibility.”

Jankowski says that the hiring process at a dental practice, just like the idea of team, is very important. Team leaders, those at the practice responsible for running various departments, are part of the hiring process — or at least the interviewing portion. And other team leaders support them because it’s part of the culture.

“It’s not about whether they would do a great job on the front and front desk, or that they would be great chair side,” Jankowski points out. “It’s how do they fit in with the rest of the organization.”

Jankowski encourages doctors, when building a practice team, to look for people who want to be something bigger than just receiving a paycheck. It’s not just about manning the front desk. There are handoffs, and communication between team members so the patients feel like they’re being taken care of at every touch point in the practice.

“People who are coming in for a paycheck have their own agenda,” he says. “But the agenda is the one the practice puts together. I want them to be paid well, and I want them to feel personal fulfillment. But we are here marching in one direction together.”

Communication, Jankowski says, is critical. It’s about asking great questions, and doing a lot of great listening. He says many people believe that great communication is how well they can talk, but instead it’s getting others to talk so you can better understand them. Then you respond.

Communicating also helps staff understand expectations. Jankowski says that when a new employee is brought into a practice they’re put through a 90-day orientation period, not a probation period.

“If you’ve already made it to our team we believe you can do the job,” he says. “So you’re not on probation, but the orientation process is very structured.”

That means sitting down with the new team member after the first few days to discuss what’s working and what needs improvement. It’s called a growth conference, not an appraisal.

“It says we’ve already decided you’re the one,” Jankowski explains. “Now we’re going to walk you through the process of being great on this team. Let’s work on a plan together with accountability, with measures.”

Those conferences occur regularly during a team member’s first month, especially at the end of every week. During their second month the conferences are usually held every two weeks, and then again at the end of the 90-day period.

“My belief is that if a team member is ever fired from the practice and they were surprised by it or didn’t know they were tracking poorly, that's a leadership issue,” Jankowski says. “That's not an employee issue.”

Building a winning dental practice team can provide substantial monetary benefits. Jankowski recalls a team member who was a great hygienist, but she fell and broke an ankle, taking her away from being a hygienist. She was moved to the front desk because of her considerable people and communication skills, and a new hygienist was hired. The doctor liked the new hygienist so much she was moved to a dental assistant position, but could still overflow into hygiene. A third hygienist was then hired.

“We found when we had those three people on the team, we actually generated $1.4 million in revenue,” Jankowski recalls. “And even with three hygienists our percentages were always under 22 percent. So they outperformed the practice.”

They key, Jankowski says, was that the hygienists all worked well together, had excellent communication skills, and were committed to the program.

“Month after month we were in the 21 to 21.5 percentile,” he says. “And I believe that has a lot to do with having the right team.”

We help our practices and the doctors understand how to build a self-led team, says Wes Janowski, CEO and founder of CEODentist. One that is built on personal accountability, and personal responsibility.

Reaping the Dividends with a Winning Dental Practice Team

Sometimes it just feels right. Sometimes, everything falls into place.

That’s the way it was for Michael Milano, DMD, a clinical associate professor at the 

University of North Carolina School of Dentistry

, with a specialty in pediatric dentistry.

“From the moment I started dental school, I knew the only thing I wanted to do was specialize in pediatric dentistry,” Milano explains. “It was something I always wanted to do and couldn’t imagine working in any other field.”

And so it just seemed right that last November, during the opening ceremonies at the Special Olympics N.C. Fall Tournament, Milano was named as the recipient of the Golisano Health Leadership Award for his tireless work in bringing special smiles to those with intellectual disabilities.

“That connection, and the opportunity to change someone’s life for the better is just a wonderful thing,” Milano says.

But that doesn’t mean pediatric dentistry is without its challenges. Milano says that one of the main challenges is working with a population that has either no experience visiting a dentist, or worse, a negative experience. The challenge is getting those children past that initial fear.

And then there are the parents who themselves are afraid of visiting the dentist.

“Even if they try not to, they share that fear with their child,” Milano says. “So now you have not just the child’s anxiety, but the parent’s anxiety on top of that.”

The rewards, however, far outweigh the challenges. Milano says he doesn’t know anyone who went into pediatric dentistry thinking they were going to make a lot of money. They went into the field, much as he did, because they love working with children and making a difference in their lives.

“You take this child who’s incredibly fearful, and with just a few visits he suddenly is now comfortable being there, looking forward to coming to the dentist,” Milano says. “It’s an amazing impact you can have on these children. That’s sort of the ultimate goal.”

For more than 20 years, Milano has volunteered his time and his talents to Special Olympics. He has also recruited more than 1,000 dental professionals to do the same. He sees it as a natural outgrowth of pediatric dentistry, and a natural progression from the work he did with the organization as a general volunteer even before he was part of the dental profession.

“What we find is that many adult patients with intellectual developmental disabilities are not treated by general dentists,” Milano says. He explains that a general dental office isn’t really designed to see a patient over a long period of time. That staff has to see patients and turn chairs over. Pediatric dentistry, however, has the flexibility of adjusting schedules more easily. “You’ll find that many individuals with intellectual developmental disabilities are actually treated by pediatric dentists in the first place, regardless of the patient’s age.”

Milano had an opportunity early in his career to participate in a training program where he learned not only how to be a clinical director in treating patients with intellectual disabilities, but how to engage, recruit and train others as well.

“It sort of doubles your impact,” he says. “These individuals now go off to different parts of the country and start doing the same thing you are doing.”

That’s one of the reasons Milano has had significant success recruiting dental professionals to volunteer their time with Special Olympics. The other reason, he says, is learning how to ask.

“One of the basic lessons is such a simple one,” he says. “You have to ask for help. So often I think people are afraid to make that first request. In academics, dental students, pediatric dentistry residents and faculty surround me. I send one or two emails, and before you know it I’ve got 50 or 60 people wanting to help. And then you multiply that by the number of events we do each year over the course of 20 years, and it’s amazing how many people you actually end up meeting.”

Milano says the need that exists for treatment within the intellectually disabled community is no different from any other population. The challenge, however, is that so many rely on assistance from others — assistance with home care, flossing and brushing, and getting to and from the dental office.

“I don’t have a lot of difficulty finding someone to treat our athletes, because dentists are incredibly caring and they’re incredibly giving,” he says. “The difficulty sometimes is getting the athlete to the office — because they do have fear-related behaviors like everyone else, plus, they rely on someone having to transport them.”

That’s where events like the Special Olympics NC Fall Tournament last November come in. The day after receiving the leadership award, Milano and 40 volunteers he recruited provided free dental exams, oral hygiene instruction, and mouth guards to 165 Special Olympics athletes.

“The goal is to get them in as central a location as you can, and that’s exactly what the competition does for Special Olympics,” Milano says. “It allows us to be there to help them.”

Milano says the two things that stand out most from his work with Special Olympics are all the volunteers who give their time, and the connections he has made with the athletes as well as dental practitioners.

“When these volunteers leave and go back to wherever they’re going to be practicing if they’re dental students, they start doing the same thing that we’re doing here,” he says. “I just asked them for help — but they continued to do these events long after I was in contact with them.”

In addition to his time spent with Special Olympics athletes, Milano points to his role as an examiner for the American Board of Pediatric Dentistry. Years after an individual has passed his or her exam, they still come back and talk with him.

“That's probably the thing I’ll take most with me long after I’ve retired,” Milano says. “It doesn’t have to be something huge; it doesn’t have to be a major change that changes the world. You change the world for that one person, and you’ve made an incredible difference.”

From the moment I started dental school, I knew the only thing I wanted to do was specialize in pediatric dentistry, says Michael Milano, DMD. It was something I always wanted to do and couldn't imagine working in any other field.

Pediatric Dentist Relishes Role as Change-Maker

Reports indicate that the Chinese dental market is poised for rapid growth.

Entrepreneurial dental school graduates may be heading east to find work, if prevailing market trends bear out. And that doesn’t mean setting up shop on the East Coast — much farther east than that.

China, where a growing economy and demand for treatment are fueling growth in the dental care and product market, is on its way to becoming a new land of dental opportunity.

Consider there were more than 29,000 dental care delivery organizations in China in 2014 generating U.S. revenue equivalent of slightly more than $4.4 billion, approximately half of which was from the private sector, according to an October 2016 KPMG report, “Commercial Opportunities in the Dental Care Market in China.” At the market’s current growth rate, it’s estimated there will be more than 42,000 dental care delivery organizations by 2020.

Those numbers suggest significant opportunity, but the market is not without challenges. A shortage of skilled practitioners and access to quality care are among the most prevalent problems. For example, the number of registered dentists in China nearly tripled between 2010 and 2013 to 130,000. Despite that growth, there was still only one dentist per 10,000 people in 2013.

“A lot of Chinese (dentists and dental students) want to travel abroad to learn,” says Robert Ord, DDS, MD, FRCS, FACS, MS, chairman of the Department of Oral-Maxillofacial Surgery and professor at the University of Maryland School of Dentistry. “The problem is that not all of them go back.”

Despite those and other challenges, the Chinese dental care market is expected to grow significantly as competition within the market increases.

In addition to the shortage of dentists, the treatment rate is low. The most recent National Surveillance Studies of the Population Dental Health, conducted in 2005, indicate that the prevalence of caries in China was 66 percent among children aged 5; 28.9 percent among children aged 12; 88.1 percent among adults aged 35-44; and greater than 98 percent among adults aged 65 to 74. However, treatment rates were as low as 3 percent for children aged 5, and 11 percent for those aged 12.

The challenge of reducing those incidences could become more pronounced given China’s 2015 decision to scrap its one-child policy after 35 years in response to an aging population.

“I suspect that’s going to bump their birth rate,” Ord says. “There could be a sort of mini-explosion.”

But Pei Feng, MD, PhD, a professor in the Department of Oncology and Diagnostic Sciences and director at the University of Maryland School of Dentistry, isn’t sure, given how expensive it is to raise children. However, she says the booming Chinese economy and expansion of the middle class has been accompanied by an increased focus on the importance of oral hygiene.

“The older generation of Chinese people previously lacked routine dental and dental hygiene care,” Feng says. “But for many years they were allowed only one child per family, so they really focused on children’s dental care, dental hygiene, and early correction of orthodontic treatment for children.”

That growing middle class, says Yen Li, public relations manager with Oral Care RBU Communications, an affiliate of Proctor & Gamble of Greater China, is increasingly demanding professional oral care.

“They care more about their health and quality of life, and chase forward-looking and revolutionary knowledge and products,” Li says.

Public hospitals address much of the need for dental care in China.

Part of the access to care problem stems from the structure of China’s social insurance program, where coverage is limited to basic treatments. Patients are encouraged to choose private clinics — where there are shorter wait times and more flexibility in appointments – versus public hospitals when having to foot the bill themselves. However, the shortage of dentists is more severe in the private sector where the facilities are seen as less prestigious.

Private clinics also represent a smaller portion of the overall care delivery market: 42 percent compared with 57 percent for stomatology departments in general hospitals. Consequently, these public hospitals experience 50 percent of the overall dental patient volume compared with 20 percent for private clinics.

“In China you have places like Shanghai where you can go and get the best healthcare in the world, including dentistry,” Ord explains. “On the other hand if you go to rural China it’s back 200 years.”

In that respect, Ord says China is not unlike the U.S. where there’s a doctor or dentist on every corner in Washington, DC, but it’s vastly different in rural North Dakota. These disparities are more magnified in China.

“The country only started to grow and take off in the last 30 or 40 years, and they’re trying to catch up now with areas that have been established in the west for 100 years,” Ord says.

There’s also the cost factor. Dental services, the KPMG report indicates, are paid in three ways: social insurance, commercial insurance and out-of-pocket payments. With social insurance covering only basic treatments, and demand growing for orthodontics and dental implants, some insurance companies are collaborating with dental implant service providers on a plan with a fixed fee, usually around the U.S. equivalent of $1,300 per tooth. These plans are gaining popularity, and dental practitioners indicate they are contributing to a “significant effect on the dental implant market.”

But the Chinese are also willing to pay to alleviate the pain associated with dental problems, Feng says. As a result, even though profit margins for dentists in China are relatively lower than in the U.S. for the same or similar procedure, the need for treatment and size of the population offset the smaller reimbursement.

“The patient flow at a dental clinic is much heavier than in the U.S.,” Feng explains. “Each dentist can probably see 20 patients a day.”

In 2014, Chinese dental schools graduated more than 5,200 students. That number is expected to grow by 4 percent a year to more than 6,600 in 2020. But there is clearly a need, and opportunity, for more growth in this area.

As one might expect, all registered dentists in China need to participate in continuing education courses. They are required to earn 25 credits annually to maintain their license status. But there is also a need for higher education among dental school graduates.

According to the National Health and Family Planning Commission in 2012, nearly 47 percent of registered dentists held a professional degree at bachelor’s level or higher. However, fewer than 10 percent of those degrees were at the master’s level or above. As such, the majority of registered dentists (53 percent) work in less developed regions and clinics.

In an effort to fill that education need, in October 2015 a team of faculty from Harvard School of Dental Medicine’s Division of Periodontology offered the first continuing education course at the Harvard Center Shanghai. The course, “A Comprehensive Guide to Advanced Implant Dentistry,” enabled dentists to participate in a collaborative learning environment. A series of courses is planned to expand educational programs in China, including “a comprehensive Approach to Esthetic Dentistry” which is planned for April 2017.

The University of Maryland School of Dentistry also has an exchange program. In December 2015 representatives from School of Stomatology Shanghai Jiao Tong University had a 10-day visit that included an opportunity for hands-on experience with the School of Dentistry’s Computer Aided Design/Computer Aided Manufacturing equipment.

“They know about this technology, but they are not exposed to it during their dental education,” said Gary Hack, DDS, clinical associate professor in the Department of Endodontics, Prosthodontics and Operative Dentistry at Maryland.

During the same month, a contingent of 17 dentists in private practice from across China toured the University of Maryland School of Dentistry, as well as campuses at MIT, Harvard and Columbia Universities, as part of an effort to find continuing education opportunities in the U.S.

Feng, who took part in the visit, says the university’s “major goal is the global engagement of dental education.”

The door remains open to new entrants to the traditionally internationally dominated Chinese dental equipment market.

The size and growth potential of the dental equipment market in China is significant. According to the KPMG report, the market, which is estimated to have reached more than $1.8 billion in equivalent U.S. currency in 2015, is expected to triple in size by 2020, thanks in large part to the rapid growth of dental care organizations.

The dental equipment market is currently dominated by international brands, including Sirona, Kavo, Yoshida and Morita. However, the door remains open for new entrants in the dental equipment market, particularly in the area of dental implants — a relatively new and growing segment of the market. Specialists in this market believe that new entrants with lower prices will be able to win market share.

On the consumer side, a growing middle class that is paying increased attention to quality of life is a prime target for oral health products. An article on ChinaDaily.com indicates that American oral hygiene brand Oral-B has introduced a new intelligent electric toothbrush priced at the U.S. equivalent of $302. “One thousand sets were sold within three hours after it launched on Alibaba Group Holding’s Tmall.com,” which is one of the country’s largest e-commerce shopping websites, according to the article.

P&G’s Li says one of the keys to success of the intelligent electric toothbrush, called the iBrush, is understanding Chinese consumers’ oral care habits.

“P&G scientists in the Beijing Innovation Center are responsible for conducting research in different directions,” Li explains. “For example, Chinese consumers’ habit of brushing teeth, the average time of brushing, the status of oral health, and how to help keep consumers brushing for a longer time to develop better habits are studied.”

Consumer preference for receiving information is also an important consideration. Li says that in order to better understand these habits, Oral-B engaged the services of Wangkai (an A-list celebrity in mainland China) as the brand spokesman.

“We’ve leveraged the influence of Wangkai through social media, network media and e-commerce platforms to effectively build a strong relationship with consumers,” Li says.

Given that only two percent of Chinese residents currently use electric toothbrushes, compared with between 35 and 40 percent in the U.S., the opportunity for future growth is significant. A report from Radiant Insights indicates that China’s oral care products market should reach more than $3.2 billion in the coming years.

Ord says the Chinese may be more focused on research rather than clinical work.

“(The Chinese) have many excellently trained individuals who are researching aspects of oral health prevention, oral healthcare,” he explains. “We’re looking to set up that liaison and form research collaborations.”

Despite the opportunities that exist, and the growth that is occurring, one obstacle that may always remain is China’s political environment. Ord recalls a conversation with the chairman of a medical college in Peking. The associated hospital is multi-storied and state-of-the-art, and includes a VIP tower.

China's burgeoning middle class is demanding oral healthcare. A KPMG report estimates that there will be more than 42,000 dental care delivery organizations in China by 2020.

China Emerging as a Land of Dental Business Opportunity

Ever wonder where the phrase “Work smarter, not harder” came from? It has actually been around longer than you might suspect.

, the phrase originated with Allan F. Mogensen, the creator of Work Simplification, back in the 1930s. So in essence, the thought process is nothing new. It just evolves over time.

Part of that evolution can be attributed to technology. Steven Spitz, DMD, founder and principal of 

Smileboston Cosmetic and Implant Dentistry

, has embraced technology by way of integrating digital workflow into his practice.

“We are in the best profession ever,” Spitz says. “There’s so much money and so much time going into the different technologies to make our jobs easier, to make our jobs better, and to make them more fun.”

Spitz says his personal philosophy is the same as the one coined by Mogensen nearly 90 years ago. He uses technology to accomplish the goal of that philosophy. Where digital workflow is concerned, that means removing all of the areas of inherent error due to the materials used. The result, he says, is better quality dentistry.

“If you think about impression material, first it expands and then it contracts,” Spitz explains. “And (the materials) have improved greatly over the years so they’re pretty accurate, but it’s not a hundred percent. Then we pour it into a stone, and the stone also expands and contracts. So immediately, you’ve got some error built in there. Once you go to a digital workflow, you’re eliminating all of those errors, because what you have is what you get. It’s a more precise medium as far as the quality.”

There are also considerable savings. Spitz points to the materials that no longer have to be purchased, as well as dental assistants’ time saved because they’re no longer standing chair-side taking impressions. Dental assistants can take the necessary scans, which frees up the dentist’s time.

“From a dentist standpoint, digital workflows, by far, are better,” he says. “They’re more controlled, they’re more accurate, and they’re cost effective. “And every day the technology keeps getting better and better.”

Spitz believes that digital dentistry is also “fabulous” from the patient point of view. For example, being able to create a crown on the same day enables the patient to avoid multiple trips for the same procedure. And being able to show a patient his or her mouth on a large screen while discussing their diagnosis helps them see exactly what the dentist is explaining.

“The days of just saying you need treatment are over,” Spitz explains. “The days of asking a patient what they would like, and how they want to be treated, and presenting them options or opportunities for them to achieve those goals, what they want for themselves, are where today’s medicine is.”

The residual benefits are significant as well. Spitz says he regularly receives new patients who found his practice on social media. They’re attracted by the positive reviews, and the use of new technology. When patients are comfortable and happy with their experience, they’ll share it.

“I had a patient today who said, ‘I’m not going to see you until March? I’m going to miss coming here,’” Spitz says. “It’s like, who says that? It’s just that we’re able to build really nice relationships with patients because of their experiences.”

Spitz says that one of the keys to successfully integrating digital dentistry into a practice is being willing and able to delegate. That means the dentist is not responsible for doing everything. Certainly, dentists want to oversee the processes and make sure all the right steps are being taken. But training staff to perform many of those tasks enables the dentist to be more productive.

“You need multiple people trained to do the same thing and to understand the technology,” he says. “That does take time, and it does take training to get everybody up to speed, or enough people up to speed so that you’re not stuck if somebody decides to move out of state, or if somebody gets sick.”

It’s also critical to step back and assess whether your practice is ready to step into a digital workflow. Spitz recalls that decision-making process when his practice was smaller.

“We eliminated the impression materials, we eliminated the steps of conventional dentistry, we were able to get into the digital world, but we didn’t go to that next level of making crowns in-house,” he explains. “You’ve got to be ready for change. With any technology, there’s a learning curve. You’ve got to be willing to give it the time to master the new technology in order to be successful.”

How you can make use of technology in your dental practice to work smarter, not harder.

The Costs and Benefits of a Digital Dental Workflow

Both of Daniel Kubikian’s parents were dentists, so it was pretty much a done deal that Kubikian himself would follow in their footsteps, right? Well, that’s not exactly what his initial intentions were.

	However, it was during Kubikian’s third year as a pharmacy major at St. John’s University that he realized he didn’t want a career in pharmacy. But he still had to figure out what to do next.

	The pennding battery of three qualifying exams made him rethink his career choice. So Kubikian decided, “Alright, let me be a dentist.”

	As for periodontics, he didn’t intend to go down that pathway, either. But several of his mentors had done dual degrees programs in periodontics, and periodontal prosthesis. So, he followed in their footsteps, to some degree.

	“Most of them practice both as periodontists and prosthodontists, which basically means that they’re acting as general dentists,” Kubikian explains. “For me, I only specialize in doing the periodontics.”

	And specializing, as it turns out, has paid off.

, Kubikian specializes in a procedure called Teeth-in-a-Day. He believes he is the only periodontist in his area to own and combine two unique, advanced technologies in order to ensure a more accurate diagnosis and treatment placement.

	“The idea of putting an implant in, and then attaching a tooth to it the same day has been happening for about 12 or 15 years,” Kubikian explains. “What’s changed is, over a period of time, certain technology has evolved allowing the process to be a little bit quicker, more predictable, and hopefully more time and cost efficient.”

	What Kubikian does is use a 3-D technology machine called a cone beam computed tomography that provides detailed 3-D views of the patient’s face and teeth by projecting a cone-shaped beam of x-rays that are digitally compiled into 3-D radiographic images. The information is stored in a computer and can be reformatted into multiple views, allowing all the necessary information to be obtained from one scan.

	“This is not new anymore,” Kubikian acknowledges. “Almost anybody who does surgery relies on it for diagnostic purposes.”

	What is unique is when Kubikian combines the information from the cone beam scanner with a digital scanner. This allows him to practice more guided, precise surgery with a more predictable outcome by increasing the success of implant placement.

	“This digital scanner … takes so many pictures so fast that it essentially captures your mouth in a model,” Kubikian says. “And because it’s digital, that can be superimposed over the 3-D x-ray. The laboratory can then custom-make teeth for anybody’s face, shape or position, in advance of doing the surgery.”

	The result, he says, is the ability to put the implants in the preselected position with high accuracy so that the pre-made tooth or teeth can sit exactly in the specified space. The entire procedure takes approximately three to four hours.

	There is, however, an argument against the procedure: Cost. Kubikain says he spent upward of $30,000 for the digital scanner, and approximately $120,000 for the cone beam machine.

	“So,” he says, “you had better be doing a lot of these so that you can sort of absorb the cost. But if you want to be able to offer more services, it helps you get a reputation of being able to do more complex types of cases.”

	Is Kubikian doing many of these procedures? His goal is to be able to look back and say that he’s doing more in the current year than the previous. For example, in this, his first full year doing the procedure, he’s performed between 15 and 20 of them.

	“With a technology that’s so new that almost nobody is doing it, I think that’s a lot,” he says. “But if we have the same conversation next year, I’d like to think I’d be telling you, ‘Oh my, I did 15 last month,’ as opposed to 15 in a year.”

	The patients who have had the procedure have had very positive comments. But Kubikian knows his main audience is general dentists who serve as his main referral source. That’s one of the reasons he founded the 

	“Like any profession, there’s a certain amount of continuing education credits that are required so you can renew your license,” he explains. “I wanted to have access to top lecturers in our hometown, so that people could attend these lectures after work and not lose time from their office.”

	And as these dental professionals become familiar with each other, they transition from competitors to colleagues. That, Kubikian says, helps his practice and his business model.

	“I don’t typically advertise, and I don’t have any coupons in the newspaper,” he says. “I’m really relying on the education of the doctor to refer their patient. So, I might not be their number one referral choice, but I want to be there.”

	Kubikian played a great deal of baseball and basketball when he was younger. Now he says he’s mostly a spectator -- except on Tuesday nights when he’s not taking his three daughters to dance classes, you can find him playing recreational basketball.

	“Frankly, most people would say I’m not the right person for basketball, because I’m 5-foot-6,” Kubikian admits. “But I really like it.”

	But if you recall NBA players like Spud Webb and Nate “Tiny” Archibald, it’s more about heart than it is about size. For Kubikian, it’s all about heart when it comes to his family and his practice.

	“I feel like I’m such a lucky guy,” he says. “The people who work in my office are like my second family. And it makes me feel good to be on top of stuff with technology. I may swing and miss a lot, but I don’t think about that. I think about the hits. And it’s nice when you can put a period at the end of a sentence that you accomplished something before you begin that next sentence.”

Daniel Kubikian, DMD, specializes in a procedure called Teeth-in-a-Day. He believes he is the only periodontist in his area to own and combine two unique, advanced technologies in order to ensure a more accurate diagnosis and treatment placement.

Technology Helps Periodontist Take Service to New Level

In days gone by, when people needed a dentist, they either asked a family member or friend, or they let their fingers do the walking through the Yellow Pages (remember them?). The dentist who had the largest marketing budget stood a good chance of standing out more with full-page ads.

Then Google came along — and eventually social media – and turned everything upside down. That put information at everyone’s fingertips. It also leveled the playing field, if you took advantage.

Social Media is the New Word of Mouth for Dentistry

Dentists, studies show, are not taking full advantage of social media. According to the 

, 59 percent of respondents reported using 

. But effectively marketing your practice means doing more than simply posting your profile.

“It’s a mindset many business owners have,” says Naren Arulrajah, president and CEO of 

, a custom website design firm. “They think of everything from their point of view. They don’t think of things from the customer’s point of view.”

Arulrajah says that thanks to search engines like Google and various social media platforms, people are educating themselves about whatever interests them. That could be finding the right car, remodeling their kitchen, or picking the right dentist. And a huge part of marketing in the Internet and social media world is to 

“Your job is to keep showing up so they see you again and again,” Arulrajah says. “You want your business stuck in the back of their mind.”

Improving Your Practice’s Google Search Ranking

But your dental practice is not the only one trying to occupy space in consumers’ minds. Why should they pick you? Are you providing them with the information they need?

“If I’m interested in crowns, are you talking to me about crowns?” Arulrajah asks, rhetorically. “People are very impatient. They want information quickly. So if I want information about crowns, and I pull up a page about crowns, I want to see some information and some testimonials right there on page one. I don’t have to figure out what it’s about. You are giving me the information I need to start liking you.”

That, he says, is what social media is all about. When consumers go to your website, and they like your Facebook page, they’re giving you permission to keep them updated on what your practice is doing—so you stay at the top of their minds.

“Social media has replaced traditional newsletters and email newsletters because people carry Facebook in their pocket all day long and they use it 1.7 billion times every month,” Arulrajah explains. “So, it’s a great way to keep in touch with people without knowing them.”

Use Social Media to Retain Dental Patients

If your computer gets a virus, that’s a bad thing. But if news or information about your practice goes viral, that’s positive — and that’s where viral marketing comes into play.

“When I like something (on Facebook), other people who are my friends notice it,” Arulrajah says.

But it goes way beyond simply having a Facebook page for your dental practice. Because let’s face it — who’s scouring Facebook looking for a dentist. However, if a patient has a beautiful crown done and the dentist takes a photo of it, posts the photo on his or her Facebook page and tags the patient, every one of that patient’s friends will see it.

“It’s seen as something good that happened to them,” Arulrajah says. “It’s marketing that’s subtle, and done in a tasteful fashion. It’s a very smart way to do viral marketing where I get in touch with your friends without you having to lift a finger.”

And it addresses the person the consumer feels most concerned about: himself.

Keeping Your Dental Practice’s Social Media HIPAA Compliant

“Nobody cares about you, they care about themselves,” Arulrajah emphasizes. “You have to post things that people will care about.”

Does that mean you should dedicate one individual at the practice to solely focus on social media?

“Having a dedicated person just for social media is overkill,” Arulrajah says. “Because the problem with social media is nobody goes to social media to find a dentist. So alone, it’s useless. Social media is great combined with other things, like your website and mobilization, and videos and other stuff that gets them to want to do business with you.”

In other words, social media can have a very positive impact on your dental practice as part of an overall marketing strategy.

“Without the overall strategy you’re wasting money,” Arulrajah says. “It’s like connecting dots. Alone, (social media) is not a very powerful dot.”

Social media has replaced traditional newsletters and email newsletters because people carry Facebook in their pocket all day long and they use it 1.7 billion times every month, says Naren Arulrajah, president and CEO of Ekwa Marketing, a custom website design firm.

Harness the Power of Social Media for Your Dental Practice

Jason Champagne, DDS, knows a thing or two about growing and expanding a dental practice. He took his father’s legacy of a solo practice and built it into 

, a thriving multi-doctor, multi-specialty practice that’s been around for more than 40 years.

“The biggest key trend is our ability to promptly appoint new patients, and what our recall system looks like,” Champagne says.

Champagne says that if new patients are booking into the following month, perhaps some six weeks out, it may be time to look at your existing space and ask, is it time to free up some space by moving certain practitioners to another location? But he also considers the demographic of where patients are located.

“If we’re finding that a lot of people are driving from maybe four or five miles away, does it behoove us to free up some space in our current location to capture the new patients who are calling in from some of the closer zip codes?” Champagne asks, rhetorically. “That is always going to be one of your first indicators as to whether or not you need to be in that area, especially if you are finding that you are starting to outgrow your existing space.”

The biggest key trend is our ability to promptly appoint new patients, and what our recall system looks like, Jason Champagne, DDS, says.