Renee Knight is a freelance writer and editor who's been covering the dental industry for 15 years. 

Renee Knight

Going Back in Time: Implant Origin Stories. Photo courtesy of labden/stock.adobe.com.

Advances in implant dentistry have made this treatment more predictable and the process more pleasant for patients, which means more of them are seeking it. For dentists, it is easier than ever to get started with implant dentistry. Adding the service allows you to provide patients with another treatment option and it is a great revenue booster.

We recently spoke with dentists involved in placing and restoring implants about the benefits of offering this treatment and the advances they have seen. There have been many changes, all designed to make procedures more streamlined, outcomes more familiar, and implant dentistry more accessible

About 10 years ago, John Flucke, DDS, decided it was time to start offering implants in his practice. Patients who needed implants often were disappointed upon realizing they would have to go to another office for the procedure—some would even opt for Dr Flucke to place a bridge rather than put their trust in another team. Patients have a strong connection to his practice, and he saw an opportunity to offer another service they needed.

Dr Flucke was just about to begin taking an implant placement course when he interviewed a young doctor to join his practice—a doctor who had placed about 200 implants during her residency. She was hired and took the lead on placing implants, with Dr Flucke involved with every other aspect, from planning to restoration.

“People develop a trust with their primary dental caregivers and don’t want to go to other places for treatment unless they really have to,” Dr Flucke says. “And most things we were sending out were kind of the bread-and-butter cases—they weren’t complicated. We’ve had a great response and have actually done more implant restorations since we started offering implants here, because more of our patients are going forward with the treatment.”

Over the years, Dr Flucke has seen implant dentistry evolve from a challenging procedure to one that digital technologies have made easier and more predictable.

Today’s workflow is software driven, he says. After taking a 3D scan, dentists can plan the entire procedure in the software, simply by dragging and dropping a digital version of the exact implant they will place into the 3D volume. The software also takes measurements to indicate how much bone is available, which is critical information before the procedure. Once ready, dentists can send the digital file to a lab to create a surgical guide, or they can mill or 3D-print it themselves.

“It used to be [that] the really nerve-racking part of the procedure was the placement,” Dr Flucke says. “Nowadays, the real skill is the software piece of it; the surgical part isn’t difficult at all because everything has already been worked out ahead of time in the software. When you’re done, you have a real-life copy of the digital image and treatment planning you completed on the screen.”

Even though Jennifer Sanders, DMD, learned how to place implants after dental school, she has chosen only to restore them in her practice. She would love to add implants to her list of services in the future, and may one day encourage her associates to get the required training and start taking on surgery cases.

Through her research and work restoring implants, Dr Sanders has learned a lot about the different systems—particularly what she likes and what she does not. “The more mature and established I become, the pickier I am about what system I want to work with,” she says. “I’m not afraid to tell my oral surgeon, ‘I don’t like that system, could you use this one instead?’”

The number of implant systems available continues to grow, she says, with each brand offering various styles and parts along with corresponding drivers and wrenches. Smaller companies are starting to emerge, offering cost-effective solutions that make it easier for dentists to offer implant dentistry.

Digital technologies like intraoral scanners and CBCT units have streamlined the entire process, Dr Sanders says. With these advances, placement has become more straightforward and familiar.

One of the biggest trends she has noticed in recent years is the move to a holistic approach, she says. For example, she is getting more requests from patients for ceramic implants because they do not like the idea of putting metal into their body or have discovered they are reactive to titanium. The larger implant companies are starting to offer reliable ceramic options, a trend Dr Sanders expects will continue.

“[Patients] are becoming more aware of the [biological] reactivity,” she says. “It’s not just the shape of the implant or the coating, but also digging more into how a person’s body reacts to it.”

As a dentist who started restoring implants about 20 years ago, Todd Snyder, DDS, FAACD, has seen numerous improvements that have led to enhanced predictability and better outcomes for implant patients.

The first is the healing aspect. Traditional stock healing caps cannot, for the most part, create anatomical tissue shapes, he says. Achieving tissue emergence that looks realistic requires the ability to create a custom healing abutment, which is now an option. “This allows the tissue to contour and heal so when it’s time to take an impression to fabricate the final restoration, the tissue has already healed and matured to the shape you want,” Dr Snyder says. “You also have an impression analog that’s custom and basically maintains the same shape of the tissue. You can pick that up in the impression and send it to the lab, so they don’t have to guess where to put it; it’s already been done. You get a better impression and a better final product.”

The impression parts come together easier now, Dr Snyder says, reducing the time it takes to get an accurate impression. For example, you now have scannable abutments that make the process faster. “The impression component has gotten quicker and easier,” he says, “whether you’re working with a custom, open, or closed tray.”

The restorative aspect is also more streamlined, he says. In the past, implants typically featured external connections. Now, most of them are internal, providing advantages including better seating and durability. New drivers also make it possible to gain access to areas where angled screw channels could not go before, another advancement.

“The restorative aspect has gotten significantly better and easier,” Dr Snyder says. “We used to have to do a lot of cemented crowns onto implants. The ability for the lab to do more screw-retained implants makes the process easier and the implants more durable.”

When Jeff Rohde, DDS, began learning how to place implants about 13 years ago, it was during what he describes as the “era of just trying to get the implant in where there is bone.” He was restoring implants then, so this philosophy often made that task difficult. He found he was getting implants back with angulations that were so off, he knew they would eventually fail. He decided that if he was going to work with implants, he wanted the treatment planning to be prosthetically driven, and that he wanted to do the placing and the restoring.

“It was partially a need for that and partially a diversification,” Dr Rohde says. “I felt like if I really knew the process and really understood osteointegration and how to evaluate [whether] someone has good tissue and good bone, then I would be better as a clinician. I knew it would give me a better big-picture understanding of what clinical possibilities could meet my patients’ needs.”

The implant systems have evolved, with different types of screws and surface treatments among the advances. The biggest change, however, is how easy the process has become. To put in a regular platform on an average-sized implant, for example, only takes 3 drills. Guided surgery protocols also have improved, reducing surgery time to less than 10 minutes.

“We 3D-print a surgical guide in our office, so by the time I get to the implant I already know exactly where it’s going to go,” Dr Rohde says. “There’s no guesswork anymore.”

Navigation systems are available now, allowing dentists to place implants freehand, guided by GPS rather than a surgical guide, he says. That workflow, once laborious and expensive, is becoming more accessible.

Adding implant placement has brought many benefits to Dr Rohde’s practice, allowing him to keep more cases in-house to boost revenue and to alleviate anxiety by offering patients a service they need in an office they know and trust. It also gives him peace of mind to know that when patients return to the office for placement, their treatment has already been planned based on the final tooth.

“The restorative side is a piece of cake now,” he says. “If I can do a digital scan for the final impressions, the crowns just fall right into place and they look great. So, the restorative process is simplified by the fact that we have control every step of the way.”

In the 42 years since Joel Rosenlicht, DMD, an oral and maxillofacial surgeon, began placing implants, he has witnessed tremendous advances in the technology and a huge growth in the treatment’s popularity. With immediately loaded implants now back in favor, things have come full circle.

The first implant he is familiar with, he says, was placed in 1937. The orthopedic bone screw was immediately loaded and lasted for years. Many of the immediately loaded implants placed afterward failed, however, because there was no true understanding of the biology or physiology needed to achieve good bone integration. That has changed. “Because of those failures and the recognition in the late ’70s and early ’80s that titanium was an ideal material because of its compatibility with bone and because you could assure a greater degree of success and integration, there became a strong trend to placing implants in a 2-stage procedure,” says Dr Rosenlicht, a clinical adviser for implant company Ditron Dental. “Now that we really understand the factors that contribute to the success of dental implants, we’re able to go back and place those implants immediately and restore them immediately, as long as we don’t violate any principles [and] contribute to failure.”

New technologies, including surgical guides, virtual navigation, and robotic navigation, have made placement easier and success more achievable, Dr Rosenlicht says. The implants are manufactured with different surface treatments so they can achieve much higher stability in bone. Clinicians now can determine bone density in advance, so they know how to properly prepare the bone, meaning the implant achieves maximum stability. Predictable osteointegration is possible, and that is leading to better outcomes.

Another important advancement in implant dentistry is the recognition that implants, like teeth, can develop periodontal issues. Minimizing peri-implantitis has become a paramount concern, Dr Rosenlicht says, with new implant designs addressing the issue. Platform switching and maximizing bone contact are among the adjustments companies like Ditron are making.

“Having an implant that has very high tolerances and minimal microgaps to maintain an intimate stability with the implant are key factors in minimizing peri-implantitis,” he says. “Some of these newer designed implants with aggressive threads and surface textures that allow for better integration of bone into the implant surface [and] surface platform switching, and these very well adapted components of the implants are all part of the new evolution of implant design.”

Dr Rosenlicht says room remains for growth. As the products continue to improve, so will the success rate. More dentists will be comfortable offering implant dentistry, broadening access to the treatment. Patients who opt for implants will have a better overall experience.

“[Patients] are starting to look at implant dentistry as a mainstream type of treatment,” he says, “and are more likely to choose it over traditional, costly, time-consuming, and sometimes unpredictable restorative dentistry.”

Articles

Clinicians share stories of their early days working with implant cases and what’s changed since, and where they think the future of implants may be going. 

Going Back in Time: Implant Origin Stories  

Designing a Handpiece to Eliminate Old Challenges


When engineers at Bien-Air Dental set out to design the Nova handpiece, they started from scratch, without using a single component from previous iterations. They wanted to develop an electric contra-angle handpiece that every dentist would feel comfortable using, putting to rest any lingering concerns clinicians had about switching from air driven to electric.

Four years later, the team launched a lightweight, yet powerful and durable, electric handpiece that has the positive attributes of an air-driven tool, such as a small head size, giving dentists everything they need in a handpiece. To top it off, they did it using technologies that aren’t typically leveraged in the dental industry.

These technologies answered the opposing engineering requirements that made developing such a handpiece so challenging, leading to a tool that allows clinicians to work faster, providing the power they’re after without an increase in the size of the head or overall weight of the handpiece.

In fact, the Nova features what Daniel Call, Bien-Air director of sales, North America, describes as the smallest head for a 4-port water spray on the market that still supports a standard-length bur, which is a critical component of the design. The larger heads that electric handpieces are known for are bulky, making them awkward to maneuver and difficult to see beyond. Engineers knew they had to design a smaller head and a slim handle for better access and enhanced visibility without losing functionality in the process.

Looking beyond the dental industry for answers just made sense. Bien-Air manufactures handpieces in the heart of Switzerland’s Watch Valley, an area Call says is rich with some of the most prestigious technical colleges in the world, which is a benefit when it comes to product development. The companies that produce the machines Bien-Air uses to make its handpieces are also nearby, providing another source of technical inspiration.

“There’s a lot of new technology being researched and tested, and our company being embedded in this area gives our engineers access to a lot of different engineers from other industries,” Call says. “We’re an innovative, privately owned company, so we have the resources and focus needed to take on a project like implementing these technologies, [as well as] the visionaries to know how they might apply to our products.”

Here’s a look at those technologies, as well as others, and how they set the new Nova handpiece apart in the market.

Cylkro gears are common in many industries and are often found in helicopter avionics and high-end race cars, but Call says the Nova is the first in dentistry to take advantage of the technology. What’s the benefit? Double the service life of the gears. The specific geometry of the gear face minimizes the contact surface needed to transfer the maximum energy. This protects against friction, eliminating vibration. Separate from the gears, the monobloc handle is another design feature that reduces the vibration and sound level coming from the handpiece.

When you factor in the stainless-steel construction, the durable handpiece becomes more resistant to shock. The combined features essentially double its service life when compared with previous generations. It’s also more lightweight, making it ergonomic. Miniaturizing and machining the geometry of Cylkro gears into small scale—small enough to fit inside the smallest dental handpiece—requires technical aptitude only found in Switzerland.

Physical vapor deposition is deployed across various industries, including aerospace, to decrease temperature fatigue on metals. Dentistry is now among those industries, with the technology applied to the chuck inside the Nova handpiece.

“We fuse carbon that’s scratch and heat resistant and use it to coat the little mechanical pieces in our product that have to withstand high operating temperatures,” Call says. “This helps us insulate those tiny components from heat. Temperature fatigue is the culprit of normal wear and tear. This technology adds 30% to the life of the chuck.”

One of the biggest safety concerns posed by electric handpieces is patient burns, which is a problem when they’re not maintained properly and when the soft tissue is retracted during operation. The Nova addresses this issue via its CoolTouch+ technology. The chuck is protected by a ceramic insulated push button, so no heat is transferred and the handpiece never goes beyond human body temperature.

A second safety feature added to the Nova is a sterilizable antiretraction valve, which is another industry first. When the operator steps off the foot pedal, the water pressure in the lines decrease, leading to water being sucked into the lines and potentially transferred to the next patient, Call says.

“The valve is acting as a gate. Everything is still in the handpiece swirling around and the contaminants are attaching to the valve,” he says. “If you don’t sterilize the valve, and let’s say it’s in the motor or the tubing, you’re now swapping spit between patients. It’s important for the antiretraction valve to be sterilized, but they’re spring loaded, so we had to engineer and develop something rugged and sturdy enough to withstand autoclaving.”

Electric handpieces in general also produce approximately 40% fewer aerosol spray patterns than air-driven handpieces, Call says, which is an even more important safety consideration for dentists since the beginning of the COVID-19 pandemic.

The project manager who headed up the Nova design team was trained as a watch mechanic and completed a residency with one of the companies that produce the CAD/CAM machines that build Bien-Air handpieces. He was able to bring insights from another industry and see firsthand the new performance and capabilities the machine offered, as well as how he could apply it to design a new electric handpiece that’s different from anything else on the market.

“We were able to build Nova from the ground up, and that’s because we have these new machines with new capabilities,” Call says. “They can drill more dense material, [such as] stainless steel, so the handpieces are more lightweight and can more precisely reduce the number of components in the handpiece to reduce the noise level and vibration tolerances we want. We could completely rethink and redesign everything.”

The Nova electric handpiece has achieved a long list of firsts, borrowing technologies from other industries to deliver a product that truly meets dentists’ needs. Along with a slim neck and lightweight stainless steel, it features the smallest head for 4-port water spray while still supporting a full-length bur. It offers safety features, including the sterilizable antiretraction valve, that other handpieces don’t, as well as technologies that keep components cool to reduce temperature fatigue and that eliminate the risk of third-degree burns for patients.

The ergonomic handpiece is also designed to reduce noise and vibration, leading to a more pleasant experience for clinicians and patients. The Nova design team thought outside the dental box to address the concerns clinicians have about electric handpieces, giving them access to a tool that has the power they want but with a smaller head size.

“If you’re an air-driven user switching to the Nova, it’s going to completely change [how] you approach dentistry,” Call says. “It’s going to improve the patient experience. It’s going to improve your quality of life, and it’s going to decrease your frustration and the noise in your office. If you’re an electric user switching to Nova, you’re going to notice much better performance with less vibration, more power, less noise, and a small enough head to accomplish any procedure without any limitations of access.”

The new Nova handpiece from Bien-Air leverages technologies from outside the dental industry to help address the challenges associated with electric handpieces.

Designing a Handpiece to Eliminate Old Challenges

All too often, dentists and their team members just accept stress as part of the job. There’s a lot going on, after all, from treating and diagnosing patients to getting a handle on the business aspects of running a dental practice.

But stress doesn’t impact just you and your team; it impacts your patients as well. If you’re feeling run down and frazzled, you can’t focus on your patients as you should.

Download this free e-book to learn how to reduce stress with some help from Eaglesoft.

Sponsored Content: Focusing on these 7 ENERGIES and leveraging Eaglesoft practice management software will improve practice efficiencies and allow you to present your best self.

E-Book Download: Tips to Master Your Energy for Less Stress and Practice Success

As RevenueWell cofounder and CEO Serge Longin puts it: Patient communication is the heartbeat of a dental practice. The company’s marketing software is designed around that core premise, with the goal of making patient communication relevant, timely, and intelligent for dentists and their team members. To that end, RevenueWell’s latest patient relationship management solution addresses a communication pain point dentists have dealt with for years—the phone system.

The phone system should serve as the center of patient communication and is the lifeblood of a practice, Login says. It’s a vital tool dentists can leverage to connect with and engage patients, yet so many aren’t. Instead, they’re using outdated and inefficient systems that frustrate patients and waste team members’ time, translating into lost opportunity and money. RevenueWell Phone changes that.

The cloud-based voice over internet protocol (VoIP) phone and text messaging system is designed specifically for dental practices. As an all-in-one communication hub, it integrates with practice management systems to deliver coordinated voice, 2-way text messaging, email, fax, and video conferencing, with everything tied to the practice’s existing phone number.

This modern, integrated phone system offers a variety of features, including an intelligent caller ID system that, when activated, reveals valuable information about who’s on the other line. Details about scheduled appointments, past treatments, insurance information, and unpaid balances pop up on the screen, helping to prepare team members for the call. The result? More meaningful, positive, and informed conversations for patients and significant time back each day for the office staff.

“When a patient can easily and quickly speak with a practice to get their questions or concerns taken care of, it creates a positive experience and they’re more inclined to keep their dental care top of mind. And when a patient is happy with their dentist/dental practice, they’re also more likely to remain a loyal patient and even refer other patients,” Longin says.

Adding RevenueWell Phone gives you another way to connect with patients and ultimately grow your practice. Adding the solution to your communication mix can help you strengthen patient relationships, enhance efficiencies, drive productivity, and boost your bottom line.

Every patient phone call is an opportunity. When calls go well, potential new patients schedule that first visit, existing patients book treatment they’ve been putting off, and past due patients finally pay their outstanding balances. However, all too often, these phone calls don’t go well.

With traditional phone line systems, patients often end up on hold, hanging up in frustration before they even talk to a team member. In fact, 87% of new patients who are sent to voicemail or put on hold without a proper greeting hang up and never call back, which doesn’t do much for practice growth.

When patients do get someone on the phone, on a traditional line, it takes time and effort to pull up relevant information about the patient to focus the conversation. The wasted time could be better utilized to build connection or helping others.

VoIP systems have “basically unshackled phone conversations and text messaging from their copper-lined origins,” Longin says, providing several benefits for practices over traditional landlines, which include the following:

With VoIP systems, there’s less equipment to purchase. They can also work with multiple devices, such as your phone and computer, which saves the practice money in the long run.

Through the mobile app that comes with the service, team members can connect with patients even when they’re not in the office.

VoIP technology can evolve with your practice as it changes and expands. These systems have more customizable features than a traditional phone, so you can choose what your practice needs now and add more features as you grow.

Your phone, text messaging, fax, and video are all part of 1 system that’s integrated with your patient management system, streamlining your communications. And every patient communication comes from 1 phone number, so patients always know when your practice is contacting them. Traditionally, voice, text, fax, and video conferencing have all ran on separate systems with different phone numbers attached, leading to confusion and inefficiencies.

Powered by VoIP technology, RevenueWell Phone has over 100 features designed to eliminate the communication roadblocks that waste time, lead to extra stress, and cost practices money.

RevenueWell Phone integrates with existing practice management systems, making it easy to access all the patient information needed to make calls go smoother.

“We understand phone systems are the most important communication tools at any practice,” Longin says. “Knowing that, we’ve built a communication hub that’s easy to use, set up, and onboard, and easy for patients to get in touch.”

RevenueWell Phone provides practices with multiple ways to stay connected with patients. Team members can call patients on the phone, text them, or start a video call all from the same place and with the same phone number.

“When patients recognize your number, they’re more likely to answer and/or reply,” Longin says. “With a unified communication system that integrates with a [practice management system], practices have easy access to patient information so every patient conversation is thoughtful and can impact the patient experience.”

Two-way texting is also available so patients can easily respond if they’re not able to or just don’t want to call the practice. Through the app, team members can call patients remotely, which makes communication more convenient for both your patients and team members.

One of the features dentists like best is ScreenPop, Longin says, which he describes as intelligent caller ID. When patients call in, relevant information about them appears on the team member’s screen, better preparing them for the call. With this feature, dental teams no longer have to chase down patient information every time the phone rings, Longin says. Instead, the information is readily available as soon as the call starts, enhancing efficiencies and reducing stress.

“This enables a more personalized and convenient conversation for both parties,” Longin says. “The status quo in this scenario with traditional phone systems involves spending several minutes sorting through papers, files, sticky notes, or clicking around to find a patient’s information. RevenueWell Phone enables personalized conversations with patients, with call quality that’s typically much better than traditional phone systems.”

RevenueWell Phone integrates with existing practice management systems, making it easy to access all the patient information needed to make calls go smoother, Longin says. It also works seamlessly with the company’s marketing platform and forms products, creating that centralized communication hub that drives practice efficiency. “Whether the need is to make a phone call, text a patient, or schedule a quick virtual appointment, it can all be done now, with the addition of RevenueWell Phone,” Longin says.

The cloud-based RevenueWell Phone integrates with the company’s marketing platform, messenger, and forms products to deliver a comprehensive solution for patient relationships and automated practice management. Features include the following:

Robust caller ID that provides patient data via a desktop pop-up every time a call comes in

Integration with practice management software for seamless interactions

Internet protocol–enabled voice calls and 2-way text messaging, all tied to the practice number

A mobile application that allows team members to make and receive calls remotely

Voicemail to text and visual fax to prevent communication roadblocks

RevenueWell also offers white-glove customer support, which is critical when practices are rolling out a new technology, Longin says. The company has a dedicated support person who will answer any questions or concerns you have, making the onboarding process easy and free of stress.

It’s also possible to update the system on your own so you can add customization to your phone as you want. “Customers can control a wide range of phone capabilities based on their individual office needs,” Longin says. “Whether it’s updating holiday hours or changing dial plans, there’s no more waiting to speak to a customer service representative to make those changes.”

Through RevenueWell Phone, office managers and the front desk team can drive appointment scheduling and productivity while minimizing time spent on the phone. Practices can start capitalizing on what once would have been missed opportunities, strengthening patient relationships, generating more revenue, and leading to practice growth.

“Overall, we believe RevenueWell Phone provides a convenient, personalized, and less stressful communication experience for both dental teams and patients,” Longin says. “Convenience is something everyone has come to expect in all areas of their busy lives, and RevenueWell Phone delivers.” 

1. Vet, Ryan C., “Phone calls: Are you losing patients at ‘hello’?”, Dental Economics, Aug. 1, 2018, https://www.dentaleconomics.com/practice/article/16385208/phone-calls-are-you-losing-patients-at-hello

How this all-in-one communication hub drives productivity, improves practice efficiencies, and strengthens patient relationships.

Grow Your Practice With the All-New RevenueWell Phone

These days, hygienists are looking for more flexibility in their schedules. Instead of working traditional full-time hours, they want to have the option to come in just 1 or 2 days a week, or only take Saturday shifts. Freelancing offers that freedom and is an attractive option more hygienists are considering.

For some, they’re looking for flexibility because they want to spend more time with their families. Others decided to pursue a different career path during the COVID-19 pandemic, but still want to be involved with dental hygiene.

Whatever the reason, if you’re among the hygienists ready to go freelance, it’s important to find a platform that can connect you with dental practices that need your help. And right now, with many hygienists opting not to come back after the COVID-19 closures, there are plenty of these practices.

The question is, what’s the best way to find them? That’s where a company like onDiem comes into play. The national, on-demand scheduling platform connects dental hygienists searching for freelance work with practices that have openings, whether they’re looking for someone to fill in for a single shift, an entire maternity leave, or are interested in eventually bringing someone on full time.

Through this platform, you can set your own schedule and hourly rate, but the benefits go beyond that. As an onDiem employee, you also have access to benefits most traditional temp agencies don’t offer, including healthcare, paid time off, malpractice insurance, and employer-paid taxes.

We recently spoke with 2 hygienists who use onDiem about the benefits of going freelance, the process of onboarding with a platform like onDiem, and advice they have for others considering taking the same route. Here’s what they had to say:

After working full-time in a practice for 17 years, Patty Farmer was ready for a change. She loved her patient base and the team she worked with, but she needed more flexibility in her schedule. As a mother of 3, she no longer wanted to miss out on events like school plays, teacher conferences, and softball games. That’s why she made the decision to go freelance.

Farmer began working directly with onDiem about 3 years ago, she says, and first heard about the platform through a Facebook group she was moderating. The company started advertising in the group, and the more she saw it the more she thought it might be right for her.

Of course, she was hesitant to go full-time freelance at first. The thought of temping in practices where she didn’t know the patient base, the protocols or where everything was stored was a little intimidating. She jumped in anyway, and once she started she found the full-time team members were happy to get her up to speed. Most are short-staffed and grateful for the help.

Now, she has complete control over her schedule. If she wants to go on vacation, she doesn’t sign up for shifts during that week. If she wants to take on more hours she can, while working around her kids’ schedule at the same time. It’s pretty much all up to her, and she loves the freedom that provides.

One of the other benefits of working with onDiem, Farmer says, is the fact the company offers insurance policies for the entire family.

“I needed both the insurance and the flexibility,” Farmer says. “I love what onDiem is doing for me on a professional level. A lot of offices only hire hygienists part time, so you don’t even get the option of benefits. With this platform, I can work part time on the days I want and still get paid time off and access to insurance.”

The onDiem app sends text messages to Farmer’s phone when a job opportunity opens up within a certain radius, she says. She can click the link to find out more and if she’s interested and available, she can simply hit the button to apply for the position.

Her request then goes directly to the office. If it’s a good match and they want to work with her, too, they just hit a button to schedule her, opening up the channels of communication. From there, she can ask questions about anything she might need to know for the day and the office can ask her more about her skillset. The office also gets access to her profile, which she described as a digital resume (it’s critical to fill this out completely and keep it updated if you want to get more work, Farmer says).

Before her shift, the customer service team sends a reminder to confirm if she’s still available. Farmer submits her timesheet to onDiem after the shift is over. Once it’s approved by the practice, her check is processed for direct deposit. And because she’s paid by onDiem, she only has to deal with one W-2 form, which makes tax prep a lot simpler.

It’s also easy to search for jobs through the platform, Farmer says. There’s a link attached to her digital profile that she can send to offices looking for coverage, say through Facebook, to let them know they can book her via onDiem, all they have to do is sign up.

“The practice gets to see my resume and what I’m capable of rather than blindly finding somebody on Facebook who said they can come in, and then they have to hope that they actually do,” Farmer says. “These offices have such high demand for hygienists right now that they’re grasping at any way to get somebody to cover, so they might not go through the background check process if they find somebody on Facebook. onDiem does license verification and can run background checks on the hygienists when given permission plus includes malpractice insurance for all providers, so it protects the practices, too.”

Getting signed up is quick and easy, Farmer says, and basically involves filling out paperwork—there’s no extensive interview process. The company verifies your identity and that you have the certifications you say you have. If you get them everything they need quickly, a customer service rep can complete the process in 1 day. You’re able to connect with a practice for a single shift while the paperwork is processing, so you can get started right away.

Right now, Farmer is only picking up days here and there, maybe a few a month, because she’s busy doing other things—and even with that schedule she’s still accruing vacation days and is eligible for health insurance.

“One of the biggest highlights of the platform is the fact you get paid time off and don’t have to put in X number of hours every week to get it,” Farmer says, noting you have to work 1 day every 6 weeks for the health insurance benefit. “PTO accrues with the number of hours you work. They pay out 1 hour of PTO for every 24 hours of work, so every 3 days you get an hour. You can accumulate those hours and decide when you want to take them.”

For others who are looking for more steady work, Farmer says, there are always postings for longer-term opportunities and some that could even lead to full time, if that’s something that interests you. Some practices post for help immediately while others know a month or 2 in advance they’ll need coverage. So, there are plenty of options no matter what you’re looking for, and often at a higher pay rate than what hygienists working full time are making because demand is so high.

When you take a temp job, ask as many questions as you can upfront, such as logistical questions like where to park and practice philosophy questions regarding their approach to care. Every practice does things differently, so the more information you have before you walk through the door, the better. She also suggests packing a bag with all the basics such as water, your face shield, snacks for the day and a change of clothes. You may not need them, but it’s always good to be prepared.

As a freelance hygienist, you’ll work for practices you love and others not as much. When you’re dealing with the latter, just remember it’s only temporary.

“You can do anything for 8 hours, even if it’s the worst situation you can think of. At the end of the day, it’s over and you never have to go back,” she says. “Just try it. You don’t know what you’ll like until you try it, so try not to make assumptions.”

Farmer likes onDiem so much she also started working for them internally, which is partly why she’s taking on fewer shifts right now. She helps them grow their database and finds areas that are looking for more dental professionals.

“I know a lot of people in my situation in dentistry who needed flexibility and insurance,” she says. “I feel a certain love for what I do and know what the pain points are that led me to work with onDiem. I want to help professionals who are looking for answers to the same problems I was having.”

When Candace Clinkscales, RDH, lived in Switzerland, she earned a degree to teach English as a second language. She didn’t really use the degree when she moved to New York, mainly because the pay just wasn’t as good as it was in Europe. But after the COVID-19 pandemic closed down dental practices last year, she wasn’t sure she wanted to go back to dental hygiene full-time. She decided it was time for a career change.

A few years ago, Clinkscales began working with a temp agency in New York to supplement her income with weekend hours (she was working 5 days a week for 2 other offices). With COVID-19 as a concern, she didn’t want to travel around New York City in a subway to different offices anymore, plus she was starting to get a little burnt out on hygiene.

“My plan was to eventually work less in hygiene and more doing something else that’s easier on my body,” she says. “Hygiene was starting to cause aches and pains and of course there was the increased stress of COVID-19. So, I decided to work less in hygiene and a little more in teaching. I was able to do that while I was home during lockdown. I pursued a different career path and made the switch to temp work.”

Now, Clinkscales’ schedule is quite different. She teaches an English as a second language course in the evenings Monday through Friday, works 1 day a week in hygiene at a dental practice, and a few other days taking x-rays for an ortho company.

While Clinkscale doesn’t use onDiem to find temp jobs right now, the platform connected her with the gig at the ortho company last fall. She first saw the job on Craigslist, and when she went to apply, she realized she had to do that through onDiem. And the more she learned, the more she liked working with the platform.

“With onDiem, I have health insurance and they give me vacation as long as I accrue enough hours,” she says. “It’s a different approach than any other temp agency I’ve been involved with for hygiene. Usually, it’s more that you call and they’ll place you with an office that needs you. There’s no other benefit than that. That’s why onDiem is a game changer.”

The ortho company she works with posts the jobs they need filled for that month and she can accept or decline. After every shift she takes, she submits her timesheet through the app and then is paid by onDiem. It’s a seamless process, she says, and so far, she’s enjoying the job and the flexibility it provides.

The number of days she takes on varies from month to month, she says, and if she knows she’ll be working less she gives the manager a heads up so they can find someone else to cover through onDiem. She does try to keep a little structure and usually works 2 or 3 days a week.

Clinkscales receives notifications about other jobs through onDiem but hasn’t found anything else she wants to add to her schedule. There’s also the opportunity to work with the ortho company full time, but that isn’t something she wants to pursue right now.

“I’ve decided I’d rather keep my options open and not be locked into 1 position,” she says. “If I want to take off I have the flexibility to do that. So far, this has been amazing for me.”

Clinkscales has a lot of experience freelancing and always liked coming in fresh to a new practice. She never took any of the office drama home with her and didn’t have to worry about office politics—and that’s true with the way her schedule is set up today. She also learned something new every time she went to a different practice. She might find a new instrument she likes, for example, or a new way of doing something that makes her more efficient.

And whether you’re using onDiem to find multiple freelance gigs or are interested in more steady work, the insurance and vacation benefits are huge—and based on her experiences with other temp agencies, both were perks she was surprised to learn she’d receive.

“For that alone it’s worth it for hygienists,” she says, “especially if you don’t want to be locked into an office and want to keep your life and your schedule flexible.”

If you’re thinking about trying freelancing but aren’t sure it’s the right career move, Clinkscales suggests starting out slow, maybe taking on only a few days a week. That way, you can see if you like it before committing to going full-time freelance.

If it becomes clear you prefer stability, you still may get a benefit from using a platform like onDiem. Many practices turn to the platform for help finding full-time employees as well. They bring you on as a temp, and if it turns out to be a good match, they can hire you full-time down the road.

Of course, if you like the freedom freelancing provides and want to continuing mixing it up, you’ll find plenty of opportunities from offices in your area that need the help.

Clinkscales wasn’t looking for a company like onDiem but couldn’t be happier that she found them by accident last fall.

“I didn’t want to do 8 to 5 scraping teeth all day anymore,” she says. “With COVID everyone had to pivot. It made me change direction a little and finding onDiem in the process was a happy coincidence.”

Demand for hygienists is growing, and that means you don’t have to be locked down into one practice if you don’t want to be. Platforms like onDiem can help you make the switch to freelance, so you can take control of your schedule and enjoy the freedom and flexibility this career path provides.

How platforms like onDiem make it easy for hygienists to take control of their schedules and work more flexible hours. 

Life As a Freelance Hygienist 

For most dentists, patient communication just is not a priority. Busy clinicians spend their days focused on providing patients with the best service and care possible, while front office team members are tasked with keeping the practice running smoothly. So even though it is critical to practice success, communicating with current patients often does not get the attention it deserves—an oversight that can be costly. 

If you are not engaging with current patients on a regular basis, your practice is not staying top of mind. That means patients likely aren’t referring the practice to family and friends and might even be skipping out on appointments. Committing to regular communication will help keep patients thinking about the practice and educated about recommended treatments and overall dental health. And that makes them more likely to schedule treatment, keep appointments, and refer.

Of course, communication needs to be effective and relevant, said Daniel A. Bobrow, CEO of AIM Dental Marketing. He suggests dentists begin with the end in mind, and to think about the objectives they want to achieve with their communication protocol. Is the goal to educate patients, differentiate their practice from others in the area or completely rebrand? How are they currently communicating with patients and how can it be improved? What content do they already have? Communication needs to be overarching and strategic, and can include emails, e-newsletters, text message appointment reminders, surveys, and requests for reviews, for example.

It is also key to communicate with patients via their preferred method. It does not do much good to leave several voicemails to remind patients about their appointment if they rarely check their messages. 

“Most dentists have a multi-generational customer base that prefers to communicate differently,” said Kali Geldis, director of communications for patient engagement platform, Weave HQ. “Millennials are much more likely to prefer text messages as a primary means of communication, but that isn't the same for older patients. So how do you accommodate both? Small businesses of all types, not just dentists, are struggling to keep up with the consumer communications revolution. They want unified, simple solutions that are easy to use and can flex to meet their patients where they are.”

Bottom line: Making time for marketing activities like patient communication can be difficult, but it is essential. Finding the right cadence and implementing methods that work best for your patients and your practice will help boost case acceptance, reduce costly broken appointments, increase referrals, and grow your bottom line. 

Emails and newsletters: Frequency and relevance are key.

While you want to keep patients thinking about your practice, you do not want to annoy them. Sending too many communications can be bothersome for some patients. 

Bobrow recommends thinking about practice communications like a newspaper’s editorial calendar. As part of what he calls a patient nurture sequence, there are some emails you know you are sending well in advance and others you will add to the mix as news comes up. 

All new patients should receive an email welcoming them to the practice, for example. Keep other communications in your sequence time agnostic; you do not want to send an email about celebrating 20 years at your office in 2019 to patients in 2022. 

Dr Gina Dorfman, co-founder and CEO of YAPI dental software, recommends customizing emails to specific groups of patients for best results. Just like if you send too many emails, if what you send is not relevant patients will get annoyed and might unsubscribe. 

For example, toward the end of the year, you can create a custom list of patients who have not used their insurance benefits yet, reminding them to schedule treatment before time runs out, Dr Dorfman says. Patients who have already used all their benefits have no interest in this email and might get annoyed if you send it to them. Back to school promotions are another example. While it is great to send parents reminders to get their kids in before they head back to the classroom, patients without kids do not want to see that type of email in their inbox. 

Of course, some communications will go to everyone, Bobrow says, such as special promotions around holidays or announcements about new technology or services the practice offers. The content in these general nurturing emails also can focus on the links between oral and overall health, as that impacts everybody. 

“And they don’t need to limit the emails to clinical matters,” Bobrow says. “Dentists should take the opportunity to remind patients they’re human beings and are also contributing members of the community. They shouldn’t be afraid to ask patients to help and to contribute.”

Keep the communication to no more than every 2 weeks, Bobrow says, with a bit higher frequency for new patients. This shows them they are appreciated and will go a long way in keeping them thinking about any treatment options you may have discussed. So, send a couple a week for the first few weeks, something on tips for healing if they had a procedure or an email that simply reminds them that they can call the office with any questions, and then reduce the cadence to once every 2 to 3 weeks.

Newsletters should go out monthly to help keep patients engaged with the practice, says David Means, Director of Demand Generation for PlanetDDS. Means also suggests covering issues around how what happens in the mouth can impact the rest of the body, the importance of maintaining oral health, and how keeping up with their visits will help improve their overall health. 

“Newsletters allow you to tell patients about new services you provide that they otherwise wouldn’t know about,” says Ted Teele, CEO of dental and orthodontic digital marketing company Kaleidoscope. “It helps you sell more to existing patients and increases your production.”

Newsletters also can focus on specific topics, Dr Dorfman says, such as patient health during the golden years, pediatrics, and sleep apnea. Maybe you discussed a specific treatment during their last visit, and the newsletter will remind them of their interest. Keep a list of patients who are interested in high-end elective services such as clear aligners and implants and send them newsletters that cover the benefits of these services. When newsletters are targeted and focus on subjects that interest patients, they will be more likely to read them and to act.

“You also can add quizzes, which patients love,” Dr Dorfman says. “Create quizzes to help patients identify themselves as appropriate candidates for services like implants. If they find they’re a good candidate, they might call in.”

The thought of creating content for a monthly newsletter can seem overwhelming to dentists and their teams, Teele says. That is where companies that specialize in dental patient communication can help. 

Reminding patients about scheduled appointments is another important form of communication, but again one you do not want to overdo, Dr Dorfman says. Dentists assume patients do not show up because they are forgetful, so they tend to think that means the more reminder emails or texts they send the better, but that is not the case. 

While some patients do simply forget, others decide not to come in because they no longer want to go forward with treatment. Maybe they cannot afford the expense right now, their spouse talked them out of it, or they lost trust in the practice. Whatever the reason, they have no plans of coming or calling to cancel because they know you will try to change their mind. So, if you are sending reminders to patients who are not responding at all, Dr Dorfman suggests calling them instead to find out why. 

Automation works great for everyone else, Dr Dorfman says. Send a ‘save the date’ message when patients first schedule so they can easily add the appointment to their calendar. For appointments scheduled 6 or 3 months in advance, it is a good idea to send reminders 3 weeks out. If patients realize they can no longer make the appointment, that gives the practice plenty of time to fill the open slot. 

Confirmation emails should go out 3 days before the appointment and then another the day before if they do not respond, Dr Dorfman says. She also suggests sending a text a few hours before they are due in as a final reminder. This will help reduce the number of patients who simply get busy and forget they have an appointment. 

For patients who are not scheduled but are due for a recall visit, Means recommends sending a reminder that says it is time for a check-up. If that does not get a response, reach out again 2 weeks before they’re due. Such communications can go out via text or email, depending on what patients prefer. 

Dr Dorfman recommends including a link to schedule online with every recall reminder. This not only makes scheduling more convenient for patients, but it also reduces the amount of time team members spend on the phone. 

If recall patients do not schedule within about a week, give them a call, Dr Dorfman says. Often, patients are happy to hear from the practice because life got busy, and they just have not found the time to schedule the appointment. 

Sending surveys is another way to keep patients engaged, Teele says, and to get feedback on what they like about the office and what they think can be improved. Surveys can be sent via text or email.

Bobrow recommends his clients conduct an annual survey. Not only is this an effective way to gauge patient satisfaction, it also can be used as a tool to educate patients about the office. 

“It’s a great practice marketing tool,” Bobrow says. “Dentists can ask if patients are using the teledentistry service, for example, and if they even know it exists. Patients learn about services you offer that they weren’t aware of.” 

Dental practices can communicate with patients via text for more than just appointment reminders, Teele says. The open rate for text messages is much higher than for emails, which is an advantage, but patients still need to opt in. Once they do, you can send information about the practice and links to your educational content via text. Teele suggests sending these texts about once a month. 

Two-way texting is another communication tool patients love, Dr Dorfman says, especially for scheduling. Rather than emailing back and forth, practices can text patients with an appointment time and then send the save the date message. Again, this is more convenient for patients who would rather send off a quick text then make a phone call or write an email. 

There are small but impactful gestures you can make to keep your practice top of mind. Sending patients customized text or emails on their birthday or following up with a text or call after a procedure makes your practice stand out, Geldis says, and these types of communications are now easier than ever. 

“Those small, personal touches used to be incredibly burdensome, manual and time-consuming,” she says, “but technology is solving that.”

Practices can now send a text message to a group of patients that looks and feels like a one-on-one text message conversation, Geldis says, making personal communications and interactions scalable for busy offices.

“If patients have a more difficult procedure like a 4 wisdom teeth extraction I will call them, but for everyone else I automatically send a text that says this is the doctor, I want to make sure everything is OK. If you need me, get back to me,” Dr Dorfman says. “Nobody ever does, but the impact of that text is huge. The texts are completely automated and require very little effort, but to the patient, it looks like a real contact. That makes a huge difference for them.” 

Geldis recommends personalizing communications as much as possible to really keep patients engaged and to foster loyalty. 

Asking for reviews and referrals is another way to engage with patients, Geldis says. Most patients who have had positive experiences with your practice are happy to write a review.

Geldis suggests asking for reviews during the 24 hours after their appointment. Make it easy for patients by texting them a link to a review site.

The more reviews you have, the better your ranking will be on Google, Teele says, which is why asking for patient reviews is critical. Potential patients will have an easier time finding the practice and will be impressed with the number of positive reviews they see—making them more likely to become active patients.

Asking patients for referrals is also important, and if you are doing a good job of engaging them with other communication methods and providing an overall positive experience, they will be happy to recommend the office to family and friends, Teele says. 

Part of that is meeting their immediate needs, Geldis says. When patients call in with an emergency, get back to them quickly and make room in your schedule to see them.

“If you can be there when a patient needs you, you'll build the kind of loyalty that not only makes them a lifelong customer,” Geldis says, “but that makes them confident recommending you to others.”

Dentists also can ask for referrals via their monthly newsletters, Means says. Implementing a program that rewards patients for referrals also can help motivate patients to talk the practice up. 

“If you as a practice are staying top-of-mind for your patients, they’re more likely to refer you,” Means says. “And if you do a monthly newsletter they can forward it to family and friends and let them know, ‘Hey here’s my dentist; you should talk to him. He does great work for me.’”

Communicating with patients does not just fall on the dentist’s shoulders. It is something team members must be focused on as well, Geldis said. All team members must be trained in effective communication and know how to use the practice’s patient communication platform. They should be able to respond to text messages and feel comfortable talking with patients about a variety of issues over the phone.

It is also a good idea to involve your team in the practice’s newsletter, Means says. Include short articles that introduce team members or that show their expertise on a certain topic. Such articles will help patients feel more connected to your team while also educating them about dental issues, making them more comfortable accepting treatment.

“Having everybody in the practice involved with communicating with patients is something every practice should be doing,” Means says. “It’s not just one person’s job, it’s everybody’s job.” 

While offices have been open for a while now and restrictions are easing up, there are still patients concerned about COVID-19. Communicating with patients about the precautions you are taking to keep them safe will make them feel more comfortable scheduling an appointment, Geldis says, and that can be done via text or email.

It also can be included in the practice newsletter, Means says. Another option is to send patients an email when they make an appointment that lets them know about the protocols implemented, helping to alleviate any lingering concerns they might have. 

But just like anything else, you do not want to overdo it. 

A look at how often you should be communicating with current patients, and tips to ensure you’re doing so effectively.