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

Renee Knight

This is your chance to become part of something that’s bigger than you and your practice.

Today, you can make a difference in the international dental community, helping people who otherwise wouldn’t have access to the care they so desperately need. And, through The SmileTree©, you can do this while growing your practice at the same time. 

The SmileTree© funds oral health education and treatment projects overseas and provides practices with ways to ensure their good works are not kept a secret, either from their patients or their community.  

To become part of the SmileTree, you agree to a subscription of $75 per month per clinic. Branch offices have the option of sponsoring any or all of nine clinics: three in Guatemala, three in Nepal, two in India and, starting in 2012, one in Vietnam, said Daniel A. ‘Danny’ Bobrow, president of AIM Dental Marketing and SmileTree©founder.  SmileTree is an affiliate enterprise of Climb for a Cause, a non-profit foundation that combines mountain hikes with fundraising. Bobrow founded Climb for a Cause in 1992, but decided to expand his efforts to something that wasn’t quite so limiting.

“Not everyone can climb. We wanted something everyone could get involved with,” Bobrow said. “The need is important and the opportunity this gives dentists to grow their practice is too great to limit it to only people who want to climb. This allows any practice to become involved by becoming a branch office of SmileTree.”

Patients like to know their dentist is involved with supporting worthwhile causes, Bobrow said. Studies have shown that, given a choice, a consumer will choose a company demonstrating social responsibility over one that doesn’t.  

 (ADM) makes it easy for you to share your involvement with SmileTree© at no cost.  Because of your status as a branch office, ADM helps you with your cause-related marketing, from lapel buttons, to posters to press releases to event organization.   

All the financial support doesn’t have to come from your practice; get your patients involved, Bobrow said. And remember, because you’ll have posters and information up throughout the office about SmileTree©, you probably won’t have to ask many patients about it. They’ll likely ask you.

Not comfortable with the idea of talking to your patients about this type of program? AIM Dental Marketing also provides branch offices with tips for communicating the message with patients and the media, so you and your team can feel comfortable and confident about discussing it with patients if they don’t ask, as well as with patients who do. Simply ask them, for instance, if they’d like to “round today’s treatment up a dollar to help grow the SmileTree©.” You’ll be surprised by how many of your patients will ask to round it up $2, or $5 or $10.

“It’s a soft sell and a demand pull strategy,” Bobrow said. “You’re not asking people, they’re asking you. And it’s for something that’s bigger than you. The money is not going to you. “

Before you can implement something like this in your practice, you’ll want your team to be excited and knowledgeable about it. Be the idea champion for your practice and get the rest of the team excited about helping these struggling clinics. Share with them all the information that’s available at 

, and make use of your SmileTree© branch manager (each branch office receives its own branch manager).  The periodic letters and photos you receive from your adopted clinic(s) go a long way to help you further connect with your patients.

Adopting three or more clinics means you receive even more support from ADM, Bobrow said. You also may participate in a future Climb for a Cause without any further commitment, and receive preference in staffing overseas dental clinics.

Promotion for this program really just began this past summer, and already there are nearly 20 branch offices, Bobrow said. Bobrow and SmileTree© plan to have 125 branch offices by the end of 2012, and 1,000 in 5 years.

No matter how many clinics you take on to help grow that number, know you’re making a difference.

“Sometimes people express concern or ask, ‘Don’t you believe charity begins at home?’ To that I answer yes, indeed I do, but I don’t think it ends there,” Bobrow said. “I like to think about philanthropy as one might view an investment portfolio; it’s important to diversify.  And I practice what I preach. I support local, regional, national and international causes. I feel most strongly about third world countries, and anyone who has traveled overseas understands why. The level of poverty in these counties is, in most cases, incomparable. They’re in desperate need.  The good news is that, the greater the need, the greater the benefit and that indescribably warm feeling one gets knowing they’ve made a big difference in someone’s life. ”

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This is your chance to become part of something that’s bigger than you and your practice. Today, you can make a difference in the international dental community, helping people who otherwise wouldn’t have access to the care they so desperately need. And, through The SmileTree©, you can do this while growing your practice at the same time. 

Give thanks and give back

	Getting children interested in their oral health isn’t easy, but it’s important. If they develop good oral hygiene habits at a young age, they’re more likely to take those habits with them to adulthood.

	But if you want children to get excited about brushing their teeth, you have to make it easy for them and, of course, fun. Manufacturers have to find the right balance between what’s most effective for a child’s oral health needs and what’s most appealing to that child. Philips Sonicare, Oral BioTech and Tom’s of Maine all have found that mix with a power toothbrush, a series of kid-friendly products and natural toothpastes. Each manufacturer took popular adult products and made the necessary modifications to make them work for the youngest consumers. Here’s a breakdown of what they did and why you should be talking to their parents about these kid-friendly options.

	How it’s different from the adult version. 

 features two kid-friendly power modes and brush heads: one for 4-to 7-year-olds and another for 7- to 10-year-olds, said Linda Blackiston, RDH,BS, Manager, Mid-Atlantic Professional Education Philips Consumer Lifestyle Makers of the Philips Sonicare. Children have a tendency to bite down when brushing, so designers decided to add a rubber over mold on the back side of the brush. The brush itself features a different design that is ergonomically correct for the child brusher who typically holds a toothbrush near the brush head, yet is designed so a parent can comfortably use the toothbrush as well. There’s also an anti roll feature so that when a child sets the brush down to put the toothpaste on, it won’t roll around.

 The adult Sonicare signals the user when 30 seconds is up and it’s time to move to the next quadrant. The child’s brush does this, too, but this version uses a musical note to let the brusher know it’s time to move on. At the end, a congratulatory melody let’s the child know he or she did a great job and is finished brushing.

Two-minutes of brushing can seem like an eternity to a young child, so the 4- to 7-year-old setting starts at 1 minute and gradually moves the child to two minutes of brushing in 90 days.

	“We took the best features of the adult brush and adapted them to make them fun for children and to enhance compliance,” Blackiston said. “It’s designed to grow with the child.”

What you should tell your patients about it. 

Blackiston said the key feature is the timer, which makes brushing fun while also ensuring the child is brushing the right amount of time. That itself is a huge step in helping children achieve optimal oral health.

	“Children’s oral health is a serious matter,” she said. “To have a product that will help develop those good habits is critical. We want to instill healthy habits in children early.”

 The Xyli-Tots line includes Oral Wipes, Tooth Gel, Mouth Spray, Anticavity Rinse and Lollies. All are designed to be age appropriate and feature fun flavors you wouldn’t find in adult products, said Carri Cady, RDH and VP of Sales and Marketing for Oral BioTech’s CariFree. Here’s what they do and why they’re for kids only:

 Parents can use the oral wipes, which contain xylitol and a high pH saturation, on infants rather than just wiping their gums with a washcloth and water.

 This is designed for toddlers, and can be used throughout the day to neutralize their mouths and deliver xylitol after eating, before naps and at bed time.

 This fluoride-free gel has a high pH xylitol saturation. It can be used in place of toothpaste with a brush or can be applied with a finger.

 Children can use this as soon as they’re old enough to rinse and spit. This rinse combines fluoride with a high xylitol saturation and a high pH.

Instead of sugar, these fun treats feature half a gram of xylitol and come in five flavors.

	How it’s different from the adult CariFree line. All of the products in this line are alcohol free, dye free and fluoride free (except for the rinse) so they’re safe for the youngest children, Cady said. They also come in fun, sweet flavors such as watermelon and grape, that may not be as appealing to adults. They also have a higher xylitol concentration.

	“We know xylitol is very therapeutic and really sweet, and that’s something you have to take into consideration in terms of flavoring in adult products,” Cady said. “Adults typically don't want a dental product that is overly sweet. Where kids are concerned that’s not a problem. The sweeter the better for most kids. If we can increase the saturation of xylitol and keep the flavoring desirable for kids, that’s a nice benefit.”

	What you should tell your patients about it. The fun flavors and fun packaging make children want to use these products. And as an added benefit, the tooth gel doesn’t foam like regular toothpaste. It doesn’t contain the ingredient that causes the foaming because it has no therapeutic benefit, Cady said. If kids don’t associate this foaming with toothpaste from a young age, that’s a good thing. Adults often look to the foam as a sign the toothpaste is doing its job, when in fact it is just an unnecessary additive.

Children’s Natural AntiCavity Toothpaste

How it’s different from the adult version.

 Again, flavor is key to making kids want to use any toothpaste. Both fluoride and fluoride free versions of this toothpaste come in 

 and Outrageous Orange-Mango flavors. And being from Tom’s of Maine, the flavors are natural-no artificial sweeteners, dyes or sparkles-making them even more appealing to mom and dad, said Ellen Saksen, Toothpaste Brand Manager for 

. No harsh mint flavors or smells are found in these toothpastes, and the fluoride versions carry the ADA Seal of Acceptance.

	“Kids mouths are different and their teeth are different so with our kids’ toothpastes we have to make sure the kids really like the flavor,” Saksen said. “They’re not going to brush if they don’t like the taste. Adults can look beyond a mint flavor they don’t like because they know the benefit. Kids have to like it right away.”

	But flavor isn’t the only consideration when developing a toothpaste for children. It also has to be gentle enough for a child’s mouth, Saksen said. Finding the right combination of flavoring, fluoride and all the other ingredients is key to ensuring kids get an effective toothpaste they’ll want to use.

 Tom’s of Maine looks at children-specific products as a way to get kids excited about keeping their teeth and mouth healthy.

	“We have an opportunity to start good habits early, and if we get the toothpaste right and if the kids like it, they’ll want to brush,” Saksen said. “Being a partner to parents and establishing good brushing habits early on is really important to us.”

	What you should tell your patients about it. These toothpastes make brushing fun, but parents can go beyond that and make it a family event. Encourage your adult patients to brush with their children, Saksen said. Tell them to make it a fun experience and to encourage their kids to brush on their own. Remind them it’s important to talk with their children about what it means to have fresh breath and a healthy mouth. They have to make it fun, but they also have to make sure they understand the benefits, too.

	It’s easy to forget that children look at the world differently than adults. But if you want them to develop good oral health habits, this is something you, parents and even manufacturers have to consider when it comes to kid-friendly dental products. They like bright colors, they like fun, fruity flavors and they like cartoon characters. It only makes sense to incorporate these things into kid-focused products.

	“Kids like having fun colors and fun characters, things they can identify with,” Cady said. “We need to have products that identify with that fun side of what kids are looking for. Making oral health more fun for kids rather than just a chore or a routine is something we should look to do.”

	Renee Knight is a senior editor for DPR. Contact her at 

 Getting children interested in their oral health isn’t easy, but it’s important. If they develop good oral hygiene habits at a young age, they’re more likely to take those habits with them to adulthood.

Adult products made kid-friendly

	Konishi Dental Laboratory is based in Santa Fe Springs, Calif., staffs eight dental technicians and works with about 20 dentist clients. Owner Rob Konishi, CDT, describes the lab as a crown and bridge lab that mostly does porcelain and gold, some implants, some composites and a few pressables. Konishi opened the lab 35 years ago.

-Vest Investment brings proven high reliability and advanced technology to the dental laboratory. A fine-grain, phosphate based, carbon free investment, Aur-

-Vest is compatible with all dental materials: castable precious and non-precious alloys for ceramic or crown and bridge applications, titanium alloys, and pressable ceramics.

-Vest is easy to mix. Its high strength and exceptional thermal conductivity permit the time-saving burn-out procedure, and a quick set time before burnout promotes efficiency. It is suitable for quick burn-outs (less than 20 minutes), ringless technique when wax sprues are used or conventional burn-out and paper-lined metal rings. It comes in both 100g and 60g packages with special liquid and instructions for all applications.    

	Konishi was looking for something to help make his lab a little more efficient. At the time, about six or seven years ago, he was using multiple investments in his lab-a few just for gold and a few just for ceramic alloys. He decided he wanted to switch to a universal investment, one go-to product he could use for all his casting and pressable procedures.

-Vest Investment at the time, an investment that can be used with all types of metal alloys and all types of pressable ceramics. Konishi decided he’d give it a try. Since then, Aur-

-Vest has become that go-to investment for Konishi Dental Laboratory, and he hasn’t even considered trying anything else.

	So what are the main benefits, bringing in the ROI for this lab? The accuracy that comes from a precise fit regardless of the material used, and the time it saves him and his technicians.

	“It’s basically the ease of use and also the accuracy,” Konishi said. “The accuracy has been very good for us. If we do need to make any kind of adjustments the water/powder ratios are easy to adjust. We also like the quick burn-out technique that we use with the investment. We save a lot of time using it.”

	Because the investment is so accurate the number of remakes coming out of his lab has been significantly reduced, which of course equals savings of both time and money. Not only that, it makes his clients and their patients happy, avoiding the many headaches that come along with remakes.

	Other benefits? Konishi’s lab doesn’t have as many recasts as they did before they began using this product. The non-adhering characteristics of the investment makes devesting easier, Konishi said, offering even more time savings for his lab. Beyond that, it’s easy to pour and mix, while it features extra fine grain for exceptionally smooth castings. 

	“Things come out very clean,” Konishi said. “Margins are very sharp and everything works out very well with it.”

	The reduced number of remakes, the accuracy and the fact that this product is so easy to use are all great benefits that have meant ROI for Konishi, but the fact that he only has to buy and store one investment product is the biggest money and time-saver this product offers.

	“We can invest a lot of things together. We might just have to change the water/powder ratio for the different items we’re casting,” Konishi said. “But the storing and the inventory of just one investment makes it worthwhile for us both dollar wise and time wise.”

	If you’re using multiple investment and looking for something more efficient that saves you time and money, Konishi recommends you give Aur-

	“We’re really pleased with the company (Aurident) that we purchased Aur-

-Vest from. We’ve been with them for quite a long time and the product is just working out fine for us,” Konishi said. “We have no thoughts of trying any other investment because it’s been working out so well.”

 The Lab  Konishi Dental Laboratory is based in Santa Fe Springs, Calif., staffs eight dental technicians and works with about 20 dentist clients. Owner Rob Konishi, CDT, describes the lab as a crown and bridge lab that mostly does porcelain and gold, some implants, some composites and a few pressables. Konishi opened the lab 35 years ago.

Aurident's Aur-i-Vest Investment

Finding It Early | Image Credit: ©  Kirsten Davis/peopleimages.com - stock.adobe.com

Performing a conventional white light oral cancer screening exam will help you discover potential problems and is something you should do for every patient. The exam itself only takes a few minutes and is easy to incorporate into routine appointments. But, even when you perform a thorough exam, it doesn’t mean you’ll see everything in every patient’s mouth that might be suspect. That’s where adjunctive devices come in. They can help you see what the naked eye might miss with light reflection alone, and catch subtle lesions before they become a threat.

These devices are easy to incorporate into your exam routine; you just have to do it. Depending on what adjunctive system you use, you’ll likely only add a few minutes to the appointment time. That’s not much, and patients appreciate those extra minutes-especially if you catch a problem early enough that something can be done about it.

“When I studied my own practice, I found 10 lesions that were pre-cancerous on the same patient base over one year’s time that I had not found by a conventional white light exam alone,” said Dr. Kevin Huff, who uses the VELscope in his practice of about 950 patients and published the results of his study last year. “So in my mind, direct tissue fluorescence visualization is a very effective adjunct.”

As with any technology, you need to do some research before deciding which device is best for your patients and your practice. Dr. Mark Bride, former VP, Medical Affairs for Zila Pharmaceuticals (maker of ViziLite Plus with TBlue), said the Internet is a great place to start to learn more about these discovery aids and what they offer.

Peer-reviewed articles can be found on the Internet and provide a wealth of information. Talking with manufacturers and actually seeing the products in use at tradeshows also is a great way to compare the different options and determine which one will best fit into your practice. Beyond that, there are some good online courses and dental lectures available that thoroughly cover the pros and cons of all of the adjunctive screening devices.

Every practice is different, so you have to choose a device that you know you and your team members can easily incorporate into the patient exam, said Dr. Andres Zuluaga, VP of R&D at Trimira, the company that makes the Identafi 3000 ultra. If you can’t get out to a show, contact the manufacturer directly and ask for an in-office visit. Make sure you feel comfortable with the manufacturer and that the company offers the necessary training to get you and your staff up to snuff on using your new discovery tool.

Once you make the decision to purchase one of these devices, you next have to determine how you’re going to charge for it, or even if you are going to charge for it, Dr. Huff said. Some doctors charge a flat fee that could range from $40 to $200, while others raise the price of the exam $4 or $5 to cover costs rather than charging an additional fee. The route you go likely will depend on the tool you choose and where your office is located, but if you want patients to agree to the extra screening you have to keep it affordable.

It’s easy to buy one of these devices with every intention of using it only for it to end up collecting dust somewhere in the back of the office. But that doesn’t do your patients or your practice any good.

Incorporating these adjunctive exams into your routine is easy. For ViziLite Plus, making sure you put it on the tray before the patient even gets into the office acts as a reminder to do the exam, Dr. Bride said. Don’t look for reasons why you can’t use it.

“It’s just changing the mentality of the practice that there’s one additional step to do,” Dr. Bride said. “And the time it takes (about 90 seconds) isn’t an excuse not to do it.”

Dr. Huff uses his VELscope for every new patient, and his hygienist uses it during every recall visit, working it in to the exam routine immediately after the conventional oral exam. If you know you’re doing the exam regardless of risk factors, which are changing, you and your team members won’t forget it needs to be done. You’ll just do it because it’s part of the normal exam routine. And with HPV 16 now a known cause of oropharyngeal cancer, you can’t limit your screenings to your older patients who smoke and/or drink. Your younger patients are at risk now, too.

While you’ll have some patients who come to your office specifically because they know you have one of these devices, there are others who have no idea what a VELscope or ViziLite does or why they should care. This is where patient education comes in.

Patient brochures in the reception area, educational videos and even posters are great ways to educate your patients about oral cancer and adjunctive devices like the Identafi 3000 ultra, said Jerry Trzeciak, VP of Sales and Marketing at Trimira. When they’re in your chair ready for the screening, take the time to explain to them what you’re doing and why. Let them know this is just a screening aid that helps you see what you can’t see with a conventional exam alone, and that it’s painless and something you offer every patient.

“Educate patients about the disease and about the technology so they look at it as a real opportunity for early detection as opposed to fearing something,” Trzeciak said. “Have your staff use the technology prior to offering it to patients so they can experience the technology themselves. They can then share that experience with confidence and say it is uninvasive, easy to use and patient friendly.”

If you find something suspicious during one of these exams, do exactly what you would do if you found it during the conventional screening. First, try to figure out what the cause could be. If you find an ulcer or a lesion on the roof of a patient’s mouth, ask the patient if there’s anything that could have caused the trauma and if he or she knows how long it’s been there. Ask questions and look around the mouth to determine the source and eliminate the possibility that it’s a sign of cancer.

It’s also important to photo document your findings, which is something Dr. Huff said is easy to do with the VELscope with a simple camera attachment and a point-and-shoot camera. This also is the time a suspicious lesion can be marked with Zila’s TBlue, Dr. Bride said.

“No matter what you do, try to avoid scaring your patients. If you find something that’s suspect, avoid using the word cancer,” Dr. Huff said. “Take a closer look at the area and if you can’t rule cancer out, tell the patient you found something that’s irregular or unusual and you’d like to see him or her back in two weeks.”

If the suspicious lesion is still there when the patient returns in two weeks, it’s time for a referral. Sometimes cytology with a brush can be helpful as a tool for patient education or to strengthen your reason for a surgical biopsy, Dr. Huff said.

Remember, making a diagnosis is not your job as a general dentist, but recognizing something abnormal is. Unless you are comfortable performing biopsies yourself, you need to refer the patient to an oral surgeon for biopsy. The tissue sample should then be sent to an oral pathologist to find out exactly what you’re dealing with, said Brian Hill, Executive Director of the Oral Cancer Foundation.

There are a lot of things that can go wrong in a person’s mouth, and while you’re not expected to learn everything about every lesion out there, it is your job to discover abnormalities and refer the patient to someone who can make a diagnosis. You don’t have to know what it is you’re looking at, but you do need to recognize abnormalities. Is it a different color than surrounding tissue? Does it bleed easily when you touch it? Is it hard or raised above the surrounding tissue? All of these are characteristics of lesions that need to be biopsied if they persist.

“Nobody is going to laugh at you if you refer something out that is benign. You need to refer all suspicious and persistent abnormalities,” said Hill, who also is a stage 4 oral cancer survivor. “As a dental patient, I would much rather someone biopsy something they thought was suspect, and later say it turned out to be nothing, than guess, or watch and wait. A biopsy would yield a gold-standard, black-and-white answer. I would have been anxious while waiting for a couple days to get the pathology report, but to hear that it’s nothing serious is a golden moment. That’s better than having someone tell you it doesn’t look like oral cancer, and then do nothing to find out for sure.”

No matter which tool you decide to go with, your staff has to be on board, Dr. Bride said. Depending on the statues of each state’s Dental Board, the majority of the time a staff member executes the exam and then alerts the doctor if there’s something suspicious. That’s why team training and education is so important, Trzeciak said. The staff should be educated about the disease state, the risk factors and what can happen if a patient is diagnosed with this disease in a late stage. They have to know how to use the screening tool and why it’s important.

Patients diagnosed with oral cancer often have to undergo severe treatments to survive. If they do survive, they often have to go through life without their voice, or the ability to eat solid foods. The realities of this disease can be harsh, and the earlier it can be detected the better the chance of survival and minimal treatment-related complications.

And with news of celebrities like Michael Douglas battling this disease, more and more of your patients are becoming aware of oral cancer and what it can do. They’re asking for thorough screenings and often are appreciative when a clinician or hygienist takes the time to perform an extra exam that may end up saving their life.

Whichever adjunct you choose, incorporating it into practice is easy. Make a spot for it after the conventional exam. You’ll soon discover you’re finding lesions you never would have seen before. While most of these won’t be cancer, the extra effort will be well worth it for the ones that are.

“Dentists are so much more than drill, fill and bill kind of people. As custodians of their patients’ oral health, they should be involved in everything that goes on in a patient’s mouth,” Hill said. “Oral cancer is only one. But it’s probably the only one that’s going to take a life.”

You don’t want to catch it when it’s easy to see. By then, it may be too late. As a dental professional, you need to spot possible problems in the early stages, when treatment is less invasive and chances for survival are higher.

Finding it early

	Just because the economy is down doesn't mean you shouldn't offer your patients the best possible care, or that you should assume they can't afford that care. It just means you and your team have to work a little harder to educate your patients about their options, and that includes veneers.

	Sure, most clinicians aren’t doing as many veneer cases as they did maybe four or five years ago, but they’re still doing them. According to our September 2010 DPR Cosmetic Survey, 57% of clinicians said minimal prep veneers is one of the most profitable cosmetic services they offer in their practice. And the number of patients who want veneers hasn’t changed just because times are tough; those patients are still out there. You just need to take the time to identify them in your practice, educate them about what veneers can do for their smile and be willing to work with them on financing. If you can do that, both you and your patients will benefit.

	“You need this now more than ever,” said 

 Vice President Rob Brenneise, who mentioned that even in this sluggish economy, there are still practices doing 500 to 1,000 LUMINEERS units a year. “When it’s easy, it’s easy for everyone, and everyone is successful and does great. Now is the time when you need to have programs and tools in place that put you and the patient in the position to do 8 to 10 units, which is an $8,000 procedure. Whether you do that once a month or once a quarter, it will have a big impact on your office.”

	Patients want to go to doctors who can offer top-of-the-line procedures, and they want someone who can do those procedures well, Dr. Lisa Kalfas said. To not offer your patients veneers just because you’re not doing that many cases or you think they can’t afford it could cost you now and even more in the future. The economy won’t be bad forever, and once it starts to turn around, patients who are putting off expensive cosmetic procedures today will turn to you when they’re ready to move forward. Take the CE to keep your skills current; don’t let a down economy trick you into thinking it’s OK to coast. If you want to stand out, now’s the time to learn and enhance your skills, and Dr. Kalfas recommends the 

Las Vegas Institute for Advanced Dental Studies

	“It’s very competitive out there, and you want to be able to offer not only something that’s different, but you want to be the best at what you’re offering,” Dr. Kalfas said. “So I think it’s a mistake to say, ‘Well I’ll never sell a veneer case because the economy is bad.’ If you learn to do veneers and establish yourself as an expert in cosmetics, you’re just opening the door for yourself.”

	Yes, veneers can be a huge practice builder, bad economy or not, but simply offering them isn’t enough. You’re going to have to work for it, and that means having the right tools to educate your patients about what veneers can do for them and their smile. With 54% of survey respondents indicating cosmetic inquiries in their practice have been down over the last two years, you can’t wait for your patients to come to you asking about veneers.

	One of the easiest ways to find out if a patient is even interested in veneers is to do a 10-question smile evaluation, Brenneise said. First, ask your patients if they are happy with their smile. If they  say no, that gives you and your team the opportunity to educate them on all their cosmetic options. This gets the dialogue started, and could spark interest in patients who never really thought about veneers until they came to your practice.

	Another way to get patients thinking about smile enhancements is to show them what they have and where they could go. Dr. Kalfas recommends taking a picture of every patient and then putting it on a computer screen to let them look at their smile in a different way. To take that a step further, Brenneise said DenMat offers the LUMISmile, what he describes as a powerful way to get patients thinking about veneers. It enables you to take a patient’s before photo, and within 20 minutes you can show that patient an after photo of what he or she would look like with LUMINEERS.

	If you want to do more veneer cases, you’re going to have to help make it more affordable for your patients. For some clinicians, that may mean taking a look at your prices and deciding what is reasonable, said Dr. Chris Ramsey, a dentist who makes it a priority to work with high-quality labs and who rarely does prepless veneer cases. If you charged $1,500 a unit before, but someone can afford $1,200 now, is that enough? You have to think about serving the patient as well as making enough money to keep your practice thriving.

	If dropping your prices isn’t an option, enhancing financing is another great way to help make veneers more affordable to patients, Dr. Kalfas said. If you offered three months interest-free before, think about extending that to 12 months. Give a discount for patients who pre-pay. And if you already offer that, think about making that discount larger.

	Even during times when the economy is booming, you have to let current and potential patients know you offer veneers if you expect to do any cases. Start by sending e-newsletters and e-mail blasts to current patients, and by offering in-office presentations with products like CAESY, said Fred Joyal, founder of 1-800-DENTIST. If you don’t make the effort, you might see a patient walk into your office with brand-new veneers that another dentist placed. Other clinicians are doing it, and if your patients don’t know you are, too, they’ll go to someone who took the time to market the service.

	But you can’t stop there. Veneers can be a huge patient draw, so you have to let people outside your patient list know what your practice can offer them. Print ads, a robust website with before-and-after pictures and testimonials, as well as buying keywords on Yahoo, Google and Bing, are all great ways to let potential patients know who you are and what you do. Ask patients who are happy with veneers you’ve placed to write a review on Yelp, and consider advertising on Yelp as well. If you’re a member of 1-800-DENTIST, make sure the fact that you offer veneers is in your profile.

	Whatever you decide to do, it’s a mistake not to do anything. You have to be repetitive with your message to get your patients to remember and think of you when they’re ready to move forward with veneers. And you never know when enhancing their smile will be important to them, Joyal said, so don’t kill your marketing efforts just because the economy isn’t so great. People are still opting for cosmetic services, whether it’s because they’re looking for love or a new job.

	“You don’t know when they’ll suddenly have the money to pay for veneers, or when a divorce occurs, or when they need a new job, or when there’s an important event that will be photographed, or when some kid pointed out their teeth looked yellow and old,” Joyal said. “Marketing is about staying in awareness so when things happen your patients remember your services.”

	For your marketing efforts to be successful, you also have to be where the patients are, said Mark Olson, Vice President of Marketing for 

. You have to find them where they’re looking. Putting a coupon in Val Pak or sending a direct mail piece isn’t good enough any more. These days, many of your patients communicate through e-mail and text messages, so that’s where you need to be. And if you’re not on board with social networking yet, it’s time to get there. From patients liking your fan page to posting reviews about your practice, Facebook and Twitter can be great marketing tools.

	“Social networking is becoming such a big referral tool,” Olson said. “People within social networks are trusted advisors. We know the power of social media.”

	Spending the money to have veneers placed is a big decision, and patients will want to talk with someone they trust about what it’s like and if it’s worth it. Who better to share their experiences with your patients than you or one of your staff members?

	Dr. Harvey Silverman, who has been coaching dentists on cosmetic dentistry since 1984, recommends that each staff member fill out a smile analysis form to determine how they feel about their own smile. You may be surprised to find you have team members who are interested in making subtle smile enhancements. Talk about your findings at your next team meeting, and schedule your team members for the appropriate complimentary cosmetic service.

	“If team members are sincerely excited about the changes you made for them and the improved self confidence they now have, they can be much more effective in power educating patients,” Dr. Silverman said. “Let’s face it, dentists and team members don’t like to sell anything, and they don’t have to. Patients really do want cosmetic dentistry. You can expand your cosmetic practice in any economy if you have a sincere, enthusiastic team that truly believes in and has experienced what you are doing.”

	LUMINEERS offices that follow this philosophy typically will do 81 more units per year than an office that doesn’t, Brenneise said. It sends such a positive message to patients if someone in the practice has experienced the procedure and is happy with the results. Patients can see what they really look like, and having an example right there in the office just makes it easier for the doctor and the team to talk about it.

	If you’re going to be successful, you can’t be the only one excited about offering veneers in your practice. The most successful practices are staff driven, Brenneise said, so staff members need to be educated and excited about what it means for your office to offer veneers.

	You have to have people around you who are excited about what you’re doing and who are willing to have conversations with patients about cosmetic dentistry, Dr. Silverman said. Patients often turn to staff members for advice, and they’re often the ones who provide patient education. It’s critical that they’re on point and in step with you when it comes to what’s best for your practice and your patients.

	“Staff is critical. The whole team has to get across that this type of dentistry can have a profound impact on people’s lives,” Joyal said. “It can change their lives by increasing their self-confidence and making them look better. These are powerful things to do for people, and one of the best investments they will ever make. Every smile, every kiss, every conversation for the next 40 years.”

	Regardless of price, your patients deserve to know all their treatment options. If veneers are going to get their smile to where they want to be, then you have to let them know that, Dr. Ramsey said. Don’t be afraid to suggest veneers just because they’re expensive. Give your patients all the education they need and let them make the decision. Explain their other options and what the compromises are if they decide to go a different route.

	And, of course, you have to remember each patient is different and each case must be personalized, Dr. Ramsey said. “The patient needs to understand all dentists can do veneers, but very few dentists can design a smile that works within the guidelines of your face,” Dr. Ramsey said. “When patients feel like a smile is being designed  for them and you’re not using a cookie cutter approach to putting veneers on, they’re appreciative of the fact you’re putting a porcelain bonded restoration on their teeth that is designed to fit them, their hair, their face, their overall appearance.”

	It’s also important to keep in mind that not everyone is struggling financially. There are people who want cosmetic dentistry and who are willing and able to pay for it.

	“There are still people buying new cars and buying homes. The world hasn’t come to a standstill,” Dr. Ramsey said. “You have to plug ahead and still offer it [veneers].”

	Now isn’t the time to be skittish about offering veneers or even other cosmetic services; it’s the time to build your reputation and your place in the community. Put in the extra time and work. Have conversations with your team members and your patients. Do what you can to bring in a few big cases a month, and remember these patients have put their trust in you to deliver a beautiful smile. Show them they made the right choice, that you’ll do the same for them as you’d do for a family member. Do that, and you’ll be the person people in your community go to when they’re ready, regardless of what kind of cosmetic work they want done.

	“The reality is cosmetic dentistry is extremely rewarding for myself and my patients,” Dr. Ramsey said. “Am I doing a little less than before? Absolutely. But it’s extremely rewarding. With the better materials we have to offer and the techniques that continue to improve and the technology, the future is extremely bright. We have to plow forward, we can’t be at stand still, with the ultimate end goal to do the best thing for our patients.”

The September 2010 Cosmetics Survey was sent via e-mail to general practitioners in the United States. The link was promoted on the DPR Facebook page, where we currently have 5,570 fans. The survey was completed by 182 people.

 You can't use the economy as an excuse.  Just because the economy is down doesn't mean you shouldn't offer your patients the best possible care, or that you should assume they can't afford that care. It just means you and your team have to work a little harder to educate your patients about their options, and that includes veneers.

Exclusive Survey: Make them smile

8 years with the company, worked on the GXS-700™ digital sensor

	From the time an idea begins to take shape until the day the product is launched, Filippo Impieri is there. He gets to help transform the initial idea into something dentists will use to provide their patients with better care, what he describes as a position he’s privileged to be in. As the product manager responsible for the digital sensor and intraoral x-ray business at Gendex, he spent a lot of time and effort getting the GXS-700 digital sensor to market.

	Product development is an exhilarating process, he said, but nothing beats that last stage. Bringing the product to market and watching how it benefits the industry, that’s truly the most rewarding part of his job.

	“There’s really nothing better than that. Seeing the reaction of clinicians across the world to this sensor has been a terrific experience,” he said. “Bringing a product to market and seeing how it makes a difference in the daily lives of thousands of practitioners around the world is the best part of product development. I think it’s just priceless.”

	Plans for the GXS-700 began right after Gendex’s previous generation of the sensor was released. From the market research findings, Impieri said the team decided it was best to focus on image quality, improving diagnostic ability, portability and patient comfort. And that team is a large one made up of individuals with different specialties, something Impieri said is critical to a new product’s success.  

	“We have to make sure no aspect of the product is neglected during the development phases. We focus on things that matter the most,” he said. “It is truly a cross functional and global effort. In the case of Gendex, we have resources and contributors from across the country and overseas. All parts of the organization were involved from marketing to engineering. There’s no department in the company that was left out. It truly is the result of the hard work of every single Gendex employee.”

8 years with the company, worked on the Kodak 1500 intraoral camera

	It’s all about giving you what you want.

	As a product line manager for the Kodak 1500 intraoral camera, that is Wes Newsom’s top priority-to find out what you need to have in an intraoral camera and to make it happen.
	What’s one of the best ways to do that? To actually watch dentists use their intraoral camera of choice in their practice, Newsom said.

	“We stand in the shadows and watch how they do things. We look at what is clumsy and what frustrates them in the workflow,” Newsom said. “We see people with older generation and competitor cameras and find out what they like and what they don’t like about the cameras. We watch the workflow without interrupting, and that seems to give us good information on how to make the product better.”

	When working on a product like the Kodak 1500 camera, Newsom visits between 10 to 20 offices, with most having one or two dentists and five to seven staff members to observe and talk with them about what they need in an intraoral camera to provide their patients with the best care possible. But that’s not the only feedback Newsom and the rest of the product team use in the development process. They talk with key opinion leaders, set up focus groups and involve a variety of people throughout the company, from sales support to engineers, to get their opinions on how to improve the product. All told, there are hundreds of people from inside and outside the company who have a hand in creating and updating products at Carestream Dental.

	And it doesn’t end after the product is released. This intraoral camera originally was released with a docking station. Now it has wireless and direct-to-USB versions to help make the product even more user friendly.

	“Once we actually have the final product working like we wanted it to work, we get it out to larger quantities of dentists and get feedback,” Newsom said. “They say it’d be nice to have this or that, and we work as quickly as we can to get those features put in. We do what we can to make the product fit their needs as quickly as we can and to make sure it’s really the right feature to put into the product.”

Phillip Pasit, Global Product Manager of Clinical Dentistry


	15 months with the company, worked on Nuance

Tell me about your involvement with Nuance. What was your role in its development?

	As you may already know, the composite market has many different players. As Discus prepared to introduce its new composite, we wanted to showcase not only a composite that delivers exceptional esthetic results, but a unique delivery system that is innovative and functional for the user. With any development process, it’s important to acquire Voice-of-the-Customer feedback. This research ensures your feature sets offer true benefits to your audience. I reached out to several Luminaries, well-known for restorative dentistry, to confirm value in our delivery system, and seek a positive response on our nano-hybrid universal composite. In turn, Voice-of-the-Customer research allowed me to develop a solid positioning statement and meaningful messaging that addresses true pain points to the target audience.
	
	

What all goes into the development of a product like this?

	Product Managers are the hub in a new product development cycle. We are in charge of managing not only the product, but also providing guidance to the other stakeholders involved in making Nuance a successful launch. Teamwork with cross-functional departments is essential, and it’s my goal to make sure everyone is singing the same tune in unison. There are many moving parts in a product launch, from designing and engineering, filing regulatory requirements, manufacturing, and quality control, to developing marketing material and communications, advertising, and enabling our sales reps to be solution providers. Teamwork is key, and Nuance was humming on all cylinders when it was released in the marketplace.
	
	

What do you think dentists would be most surprised to learn about the behind the scenes of product development?

	How much impact their voice has in the product development cycle. As manufacturers strive to develop products that differentiate the company from the competition, it’s very easy to get carried away with too many “bells and whistles.” As with many other products (not only in dental) customers frequently ask, “Why did they add that feature, I’m never going to use it?” As Discus develops products, we want to integrate features that are meaningful to our customers. Clinicians may not know there are impromptu market research focus groups that Discus holds. Qualified clinicians can be part of this study, to have their voice heard and further impact the development of dentistry.


	13 years with the company, worked on the BlueView line of transparent matrices


	
	Stacey Buckner typically is the one selling the products Garrison Dental launches.

	This time, she was the driving force behind a product’s development. From coordinating pre-market evaluations with dentists to making sure they had everything needed in house to manufacture the product, she was involved in just about every aspect of the BlueView cervical matrix system’s development. And it all happened because her boss asked her to take a phone call. That phone call led to others, and eventually Buckner was immersed in a different side of the business, something that gave her an even deeper appreciation for the products she sells.
	She loved being part of all the different pieces that go into product development. In particular Buckner enjoyed helping the company capitalize on its leadership position in Class II sectional matrix materials and expand into new innovative materials for Class III, IV and Vs. Her extensive pre-market testing of all the BlueView products gave her confidence that they would fulfill that goal. So far they have, she said.

	And when it comes to product development, Garrison is always open to new ideas to expand the company’s offerings, Buckner said, whether those ideas come from within the company or are from the dental community. 


	3 years with the company, worked on the MultiLED

	That’s how this senior product manager sees product development-you identify a need in the market and you develop a product to fill that need. So what need does the MultiLED fill? It upgrades the ubiquitous six-pin MULTIflex coupler from a halogen bulb to an LED without buying a brand-new LED coupler. The market needed a clean white light in the oral cavity for dental applications, Kher said, which is what this upgrade provides-at a price that’s affordable for existing users of the MULTIflex couplers who want to upgrade.

	Kher and the others on the development team spent about 14 months on this product from start to finish, Kher said. During that time the focus was on innovation, and taking an existing successful product and making it even more user friendly.

	“The whole process from the ideation to commercialization is pretty exciting stuff. In my role, you see the customers’ needs and then you figure out what you can do to solve those needs,” Kher said. “Being a 100-year-old company that has always been on the cutting edge of innovation, it is very important for us to make sure the product is comparable with an existing product and yet brings us a really new technology that can solve an existing problem.”

Laurent Zenou, Product Manager for SOPROLIFE


	21 years with the company, worked on SOPROLIFE


	
	Laurent Zenou remembers the first time he and his colleagues tried the prototype for the SOPROLIFE caries detection device in their own mouths. The look on their faces gave away their surprise as this optical unit kept finding cavities in their mouths, cavities they didn’t know they had.

	Zenou describes this product as one of a kind, “something that’s opened the door to a new generation of products to aid in the detection and treatment of oral diseases.” As product manager, he was involved in the heart of this project from the time the company’s engineers discovered the property of auto-fluorescence on dental hard tissues. He followed the clinical studies, participated in product definition, chose materials, colors and features, and then introduced the SOPROLIFE to the sales forces, users, opinion leaders and dental universities all around the world.

	From the beginning, it was clear to Zenou and everyone else working on this project “that linking fluorescence with intraoral camera would revolutionize the diagnostic methods.” To make that happen, it would take work from a lot of different people in the company and talented people from many different trades, including electronic engineers who specialize in signal processing, precision optics, mechanical engineers, designers and many researchers from the dental world such as professors and specific laboratories. 

Liang Chen, PhD, Senior Research Scientist


	3 years with the company, worked on Z-Prime Plus

What was your role in the development of Z-Prime Plus?

	I have a special expertise in organic chemistry, organic synthesis and organo-metallic chemistry. Zirconia-based crowns and bridges are rapidly becoming the esthetic alternative of choice to traditional PFM. Dentists communicated to Dr. Byoung In Suh (the founder of Bisco) and Bisco of the need to confidently bond to zirconia. Dr. Suh empowered me to develop a material to resolve these issues, which ultimately led to Z-Prime Plus.
	
	

What is involved in developing a product like this?

	Success requires the help of many others. Product development is the result of synergistic feedback between dental professionals and talented researchers.

	It is a two-step interactive process between R&D and product management. It begins with diligent research to provide a scientific understanding of the current clinical results, challenges and possible solutions. The next step is the innovative, solutions-based development of interactive chemistry to address the challenges of current and future clinical direction. Once chemistry is developed, it must be able to pass the rigors of the Quality Manufacturing Process of Predictability and Reproducibility. It is now the creative feedback from teams of dental professionals that will ultimately finalize the formula. The product must then be exhaustively tested per numerous specifications (including FDA) mandated by quality systems.
	
	

	How similar the emotions are. Creating materials is very self-reflective, labor intensive, and I am always challenging my thought process and using a cognitive, pragmatic approach that is very similar to the dental clinician.
	
	

What is your favorite part of product development?

	Accomplishment. When an independent agency replicates my results and Dr. Suh pulls me aside and says “good job.” I feel so much pride in accomplishment when I can be part of a solution by providing clinicians with a material that allows them to address a clinical challenge.


	
	The manufacturer starts with an idea. Lanmark Group helps commercialize that idea and introduce it to the dental professionals who will use it in their day-to-day practices.

	From market research to the integrated marketing plan, this advertising marketing communication group typically is involved with a product launch from day one. “We always recommend conducting preliminary research to determine if there’s a need for the product to be brought to market and to help ensure the proposed product’s features and benefits meet the market’s needs,” Lanmark President Howard Klein said.

	After the marketing research phase, which includes focus groups, surveys, and one-on-one interviews, Lanmark transitions to help build an integrated marketing plan that includes education, advertising and promotion. And that education piece is key to a successful launch, Klein said. “No matter how great a product is, if the manufacturer doesn’t take the time to educate dental professionals about how it can change the way they practice dentistry for the better, it’s pretty safe to say the product won’t get very far from the launchpad. We see a lot of really great products brought to market that quickly fail or that are never fully embraced by the profession because of the lack of education and training, It’s really important for companies to consider this when launching products and budget appropriately.”

	Lanmark has been orchestrating successful dental product launches for more than 30 years, and even introduced the first power toothbrush to the market. A multi-department team of 8 to 12 individuals works with each of the agency’s current 36 clients, work that begins from the beginning, conceptual phases and supports the product throughout its entire life cycle.

	“The best-case scenario is getting involved with clients at the ground level, when they have a new product idea, and then working with them from the beta testing phase, to the actual launch stage, and then beyond to bring their product to market. We also do everything possible from an integrated marketing perspective to create and maintain industry awareness,” Klein said. “Advertising, interactive marketing, public relations, ongoing research, professional relations, events marketing, and social media are all considered before we develop a marketing mix that is appropriate for the client’s strategic and business objectives.”


	Developed the aveoTSD, distributed in the U.S. by Glidewell Dental Laboratories

	For Dr. Chris Robertson, it’s not just a job.

	Dr. Robertson, an orthodontist, became passionate about sleep medicine not long after his father died from what he suspected was Obstructive Sleep Apnea. He learned about this disorder five years later at a conference in Christchurch, New Zealand. At that time, most people had never even heard of Obstructive Sleep Apnea, let alone knew how to treat it. From there, Dr. Robertson began his extensive research.

	“Unfortunately over the ensuing years, it became apparent that these devices in many patients were causing occlusal or bite changes. This led me to undertake a 100-patient longitudinal prospective study over 3 years to demonstrate these changes with the use of cephalometrics,” Dr. Robertson said. “In all, this research took 8 years and resulted in a Doctorate in Dental Sleep Medicine from the University of Otago, New Zealand. The occlusal changes prompted research into a different mode of treatment for these patients. At that stage there was no treatment options available for the treatment of edentulous or semi-dentate patients with oral appliances.”

	Over the years, Dr. Robertson designed several products to treat snoring, with the Aveo Tongue Stabilizing Device (aveoTSD) the culmination of that work. He spent years developing this product, which now is distributed in the U.S. by Glidewell Dental Laboratories as an anti-snoring device. It’s been a long and expensive process to get the product to the international marketplace, Dr. Robertson said, but it’s time and money well spent.

	The aveoTSD uses gentle suction to prevent the tongue from falling against the back of the throat, keeping the airway open during sleep. A result of the all-important user feedback, the device is now configured into three sizes: small, medium and large along with two Uni-Spacer’s of 4 and 7mm for extra titration. There is also a Professional Sizing Kit available for the dentist with all three sizes and Uni-Spacers to fit the patient with the correct size.

	Dr. Robertson has seen how the aveoTSD has helped patients reach long-lasting compliance and how it has helped them sleep better. The benefits are vast, and for Dr. Robertson that’s the best part of product development.

Ann O’Connor, RDH, General Manager Preventive Strategic Business Unit


	5 years with the company (newly rejoined in 2010), worked on the Total Solution Implant Maintenance Kit

How did you determine the Total Solution Implant Maintenance Kit was needed in the market?

	We strive to be in tune with the key opinion leaders. In this case, there was a lot of courses and questions coming up about implants, and the care of implants as the market continues to grow. So, we conducted research with more than 500 clinicians, and found that they had  a lot of questions about what are the best practices for approaching implant maintenance care.
	
	

What are some of the steps involved with product development?

	It certainly starts with discovery and culminates with the product launch. Behind the product launch, there is extensive research to uncover what the clinician wants, needs and desires in their dental product. Then we look at technical merits and its marketability and then we transition to the feasibility phase. That leads us to the development phase, which includes the design plan, the manufacturing plan and the marketing plan. At Hu-Friedy, we put a lot of emphasis on testing throughout the developmental process prior to the actual launch.
	
	

	At Hu-Friedy, we consider ourselves to be an extension of the clinician’s hands. Quality and safety for both the clinician and the patient are of paramount concern to our company above anything else.
	
	

 Gendex Dental Systems Filippo Impieri, Global Product Manager 8 years with the company, worked on the GXS-700™ digital sensor  