Terri Lively

Perfect Vision is 20/20, as the saying goes. Not only does it allow for reflection of past performances, but it also presents a new, unique perspective and gives us insight and understanding. Vision is key when planning for the future. Every dental practice requires a well-thought-out plan. Proper vision as a concept in the dental practice can provide a clear path forward and correct common problems the practice faces.

You need to understand your business’s core vision,” Jeremy Krell, DMD, MBA, a health care entrepreneur and a member of the board of advisers for Denti.AI, says. “That vision guides the way you market, the way you expand, the types of people you hire, and the policies you have inside your organization.”

A practice’s conceptual vision statement should build off the work of Stephen R. Covey’s book 

 and “begin with the end in mind, ” according to Mark Hyman, DDS, MAGD, an adjunct full professor and special assistant to the office of the dean at University of North Carolina (UNC) at Chapel Hill Adams School of Dentistry and an international speaker. “Creating a vision requires having a deep understanding of your goals, your values, and your mission in life that provides a basis for everything else.”

Dan Traub, vice president of product at Method Procurement, agrees, adding that dentistry is a team sport. Moreover, he says, having the team aligned with the goal of entrepreneurial success can fuel a practice’s growth.

“Having a well-run business that has the financial means [that you] keep the door open and invest in technology and education to pursue that goal. If you have a well-run business, you will be able to make those types of investments,” Traub says.

Roy Fried, territory manager for A-dec in Minnesota, North Dakota, and eastern South Dakota, has worked with the company for 22 years and has been in the dental field for 30 years. He breaks down the importance of vision for a practice into 3 areas:

Having good sightlines into patients’ mouths when delivering care is vital to a dentist’s career longevity.

Using technology such as imaging and other diagnostic tools allows dentists to look further into a patient’s body to assess health in ways that they could not before.

Creating a vision for their practice for 2, 5, and 10 years out is vital for success.

Although all 3 areas are crucial, Fried says, foresight has the most significant influence on business success. “Unless you have a clear picture of the business aspect and what patients focus on, you may not be drawing the patient base you want,” he says.

“You need to have the vision of where the practice is going to ensure that the tactical decisions along the way are in support of that vision,” Mark Greenwood, vice president of imaging product development at Midmark, agrees.

Patients’ needs should also be a part of a dental practice’s conceptual vision. Brian Connolly, vice president of business development Americas at Medit, thinks patients are more involved in dentistry today than they were in the past. Lack of consideration for what patients want and what makes them comfortable accepting treatment could prevent them from returning to a practice, he says.

“From a patient experience perspective, dentistry has always been about ‘This is what you need,’ coming at the patient from a clinical standpoint instead of approaching them more personably,” Connolly says. The issue should be stated “a little differently and through a patient lens,” he adds.

As continually changing and improving technology drives the motivation of many dental practices, Dr Krell believes taking courses, trying new things, and keeping current are critical to providing the best patient care. “You should be thinking about how to create a tech-forward and evidence-based-medicine practice,” Dr Krell says. “We all have a duty to keep up-to-date with current technology.”

“No matter what happens with technology, the vision helps practices get to where they want to be. Technology can help with the vision, but the vision needs to come first,” says Rob Gochoel, vice president of sales for PreXion, a manufacturer of 3D cone beam CT (CBCT) imaging systems.

Pearl’s CEO, Ophir Tanz, says each dental practice is like its own fiefdom. Some dentists have ambitious plans to launch dozens or even hundreds of offices, whereas others aim to pursue education or be a thought leader. As an entrepreneur, first leading computer vision start-up GumGum and then Pearl, which he spun out in 2019, Tanz understands the importance of methodically working toward a long-term vision or goal for a business.

“It doesn’t have to happen overnight,” Tanz says. “But having a clear end goal in mind operates as a North Star—a reference point that helps you keep your focus on the larger objective and makes every day more meaningful.”

Without a clear vision, it is easy for a practice to get lost. Many practices get overly detailed when describing their vision, making it difficult to achieve. Although concrete steps help make an idea actionable, getting too specific leads to a checklist instead of a vision statement, according to Dr Krell. “You have to aim down the middle to best summarize your objectives and key results succinctly,” he says.

“They try to make the vision statement too specific or too broad,” Gochoel agrees. “If you make it too specific, you might not ever reach it or find that you are disappointed with the results. And if you make it too broad, it won’t differentiate you from other practices out there.”

Clearly, having a vision for the practice is excellent, but what actions ensure making it happen? How do practices avoid losing sight of the goal? Here’s what we learned about correcting business-related vision problems and producing visible results.

Anybody can buy technology, Dr Hyman says, but how it is applied and how the team is trained make all the difference. The work of business author Tom Peters shows that without a great place to work, “all this stuff that you buy is worthless,” Dr Hyman says. “You can invest in CAD/CAM, cone beam, digital printers and say you want to be the high-tech leader in your community,” he says, “but what good does it do if you have a lousy place to work? You’ve got to take care of your team first.”

Dr Hyman and his team determined what it means to be a part of the “practice family.” The particulars ranged from being on time and present at work to mandating patient education for every procedure and providing comfortable financial arrangements for every treatment.

Along with involving the team members with creating the vision, Dr Hyman ensured their financial interest in its success by extending profit sharing to the team and maxing out his contributions to their 401(k)s. Many of his employees were with him for several decades and retired with 6-figure retirement accounts.

Dr Hyman credits consultants and other thought leaders in the industry and the strategic coaching they provided him along the way for his team’s success. He recommends dentists struggling with this side of the business consider coaching to help them with their vision strategy and keep in mind the continual nature of change.

“If you don’t know how to articulate the vision for the practice, you have to put your handpiece down, meet with the team, and create it, and realize that it’s a living document,” Dr Hyman says. “It gets revisited because as you and the world and your teammates change, you adjust the vision.”

The best part of the process is that as the profitability explodes, practices can invest in technology such as CBCT, intraoral cameras, CAD/CAM, and 3D printers, Dr Hyman says. In other words, he says, it’s not about the technology purchased; it’s about the effort put into the team. Moreover, team members who are excited and enjoy what they are doing don’t have to be pushed. “They join you in vision to be successful beyond anything you ever imagined,” Dr Hyman says.

Fried identifies poor ergonomics as a significant mistake dentists make regarding long-term career vision. Repeatedly working in a position without minding the ergonomics can lead to injury and shorten a dentist’s career. Fried says 30% of dentists who retire early do so because of physical disabilities acquired because of poor work-related ergonomics.

A-dec’s Angles of Access, available for Android and iOS devices, and complimentary continuing education (CE) training by territory managers can help with ergonomics. The free application allows dentists to choose the tooth and surface they are working on and then see how to obtain the best view of that tooth surface. “It will show them not only where to sit alongside the patient to have better posture but [also] how to adjust the back and headrest of the patient’s chair to get the tilt of their head just right so you can look right down at the tooth surface,” Fried says.

Another common mistake Fried sees in practices involves not listening to the dental team—specifically, the 

dental assistant—when designing treatment rooms and other practice workflows. “The assistant in work-motion studies does about 80% of all the motion in the dental treatment room,” Fried says. “If the assistant isn’t productive, now you have a dentist that isn’t productive.”

A-dec incorporates dental assistants into the design plan to learn where the current layout restricts the flow and causes a bottleneck. Fried says the company also considers how the office delivers patient care, because a side-delivery system needs different dimensions than a rear-delivery one, along with workday details such as the desire to incorporate CEREC chairside or have the option to stand up while providing care.

“Unless you ask these pertinent questions, you might end up with some nice equipment that doesn’t serve the dentist that purchased it, and we hope to prevent that,” Fried says.

Fried also believes dentists should think about the longevity of their tools. Most of the equipment A-dec makes is designed to last for 20 years of service, he says. “That’s important because dental professionals have to think about their health,” Fried explains. “Make sure you’re getting advice on how to get that right solution for you.”

Dental practices should always consider how short-term tactical decisions affect overall vision, according to Greenwood: Every choice regarding office layout, staffing, and equipment purchases should be in harmony with and directly support the practice’s vision.

For example, before taking on same-day restoration capabilities, the office should consider whether the practice has room for the workflow required, trained staff to manage the process, and the equipment and accessories to support that offering.

People can help in that regard, Greenwood says. He recommends getting a combination of input from outside sources, especially seeking advice from peers at a practice the dentist wants to emulate. External consultants and manufacturers can help, too.

“Because Midmark does extensive usability testing and research into customer needs, we as manufacturers can use the knowledge and expertise to help practices choose the technology and design the workflow needed to achieve their vision,” Greenwood says.

Midmark also offers Impact Design courses in which peers and thought leaders get together to share how they look at practice design and visions. “Through these consultations, we can help dentists realize their vision while understanding how decisions that they make along the way all [affect] each other,” Greenwood says. “The more data points the dentist has, [the more it] helps ensure the best decisions.”

Radiology is a bit disjointed in the dental industry, according to Dr Krell. Clinicians have variable levels of training and could miss some findings. Preferences also differ for which x-rays are needed and how often and for types of imaging, such as scanning or 3D imaging.

Then the various systems and software need to interconnect and function together. Finally, the images must end up in the patient record, but many times they don’t or aren’t easily accessible or reviewed, so the chart is incomplete.

To help solve some of these problems, Denti.AI developed and patented a streamlined tooth numbering and automatic charting functionality. Denti.AI can also identify the essential findings radiology usually reveals, including caries, periapical lesions, bone loss, past restorative work, and missing teeth. Three clinical studies, from UNC, the University of Louisville in Kentucky, and Indiana University, validate these capabilities.

Also, the Denti.AI team focused on providing an experience that fits seamlessly into the workflow, which Dr Krell credits to their partnerships. Because using a new technology such as artificial intelligence can provoke fear, Dr Krell believes if the technology didn’t offer an ideal experience, a dental practice wouldn’t use it. He thinks it is essential to emphasize that AI is a tool, and the control remains in the dentists’ hands.

“This technology is going to highlight areas for dentists, and dentists can approve or disapprove,” Dr Krell says. “This is here to help us catch things that we may miss.”

It is also essential that a practice consider the technology available, the people who will use it, and how well it will fit in the practice’s environment, according to Dr Krell; having new technology that people will use is half the battle, he says.

He also advises being guided by evidence-based medicine, not unfounded marketing claims, to find tried-and-true tools reviewed by key opinion leaders and experts globally and not “fall into a marketing trap.”

“The last thing is, you have to try stuff. Approach it with an open mind, and try it out,” Dr Krell says. “What I don’t want people to do is try 1 thing, not like it, and then give up on the whole sector of innovation. I think that is a mistake, and you could miss out on something there.”

Many practices do not have a process for procurement, Traub says, but overspending on supplies leaves opportunities on the table.

Moreover, with the coronavirus disease 2019 pandemic wreaking havoc on many practices’ bottom line, with less production and more infection control costs, it is more essential than ever to manage expenses.

Method Procurement provides a software subscription that supports a complete inventory, purchasing, and spend management process for the needs of dental practices, which often drives value to the bottom line even faster than added production can, Traub says.

Presenters at dental conferences generally emphasize building a standardized and repeatable process, Traub says, adding that it’s even better to create a strategy that team members can run consistently on their own. He says Method facilitates this by providing data and insight into current dental supplies and supplier relationships: “We like to tell people that it is an alternative to growing production and that 2020 is a perfect time to control expenses.”

Traub says most dental practices increasingly require the support of multiple suppliers, creating a more complex situation to manage. Method’s software offers a clearer picture of buying behaviors regardless of supplier.

A practice’s process can be optimized with formularies for preferred products and pricing or software that highlights pricing increases from specific suppliers, which guides exploring opportunities to negotiate a new price. The crucial factor, Traub explains, is having the data available to make these types of decisions.

“There are a thousand different things data can help with,” Traub says. “It’s tough to manage what you can’t measure.” He encourages practices to devise a well-managed path to profitability and be able to compare expenses against a budget.

“If you have a vision of a certain level of profitability, you need to work backward from that,” Traub explains. “Expense control is a key part of making sure you reach those goals.”

Technology is an augmentation of human limbs and capabilities, Tanz says. Telescopes allow seeing farther; hammers enable hitting harder. He thinks the most impactful form of 

vision in 2020 is computer vision, which gives practices the ability to deploy a second set of eyes to peer into data sets and add value.

Pearl has been collecting what Tanz describes as the most extensive collection of dental-labeled radiographs and oral scans in the field. The company uses them for training machine-learning models to identify pathologies with a high degree of precision and categorize the quality of past tooth preps, margins, and scans that dental professionals produce.

Pearl also works with original equipment manufacturers to incorporate the platform into x-ray sensors and into practice management systems. Pearl also has a carrier business that automates claims and reviews and identifies fraud, waste, and abuse.

“We believe that every office in the world should and will, in relatively short order, incorporate these capabilities as part of their standard of care. We intend to make it very accessible and cost-effective so that it can add value to practices of all shapes and sizes,” Tanz says.

Bringing AI into the dental workflow is a low-risk, high-reward proposition for practices, particularly individual practices, according to Tanz. He says that AI capabilities can be seamlessly integrated with a practice’s existing infrastructure stack.

Moreover, he says that Pearl’s Second Opinion product, which provides pathology analysis, and Practice Intelligence, which analyzes historical practice performance and recommends training and education opportunities based on the records it evaluates, deliver value on day 1 without being cost-prohibitive.

“You can push a button, and these capabilities turn on. You don’t have to invest in expensive software or make a long-term commitment,” Tanz explains. “If you are unhappy with the quality of service, you can cancel it.”

Transparency and consistency, alongside a range of tactical features and functionality, create a superior baseline for care moving forward, according to Tanz. “You always have this second set of eyes helping you along,” Tanz says. “It’s like having another dentist by you 24/7 and on-demand.”

Focus on Full Comparison, Usability, and Trends

Connolly notes that in his experience, dentists often receive a limited scope of input when converting a practice from analog to their vision of digital dentistry. Without considering the total offering, practices don’t have enough information to make the best decision for their workflow. Moreover, Connolly says, sometimes dentists regard a new product as “just another one of those new toys” without considering how it may be different and can help provide a clear solution for the patient.

“It also comes back to asking yourself the question ‘If I invest in this tech, will it allow me to have a better dialogue with patients to accept the treatment plan I recommend?’” Connolly says.

In addition to contemplating how a technology can improve the patient interaction and treatment outcomes, dentists should consider usability to spur adoption of the technology into the practice, Connolly says. It is best to implement tools the clinician understands to best enhance daily use, such as comparing enamel wear on an arch, doing an orthodontic simulation, or crafting a smile design. These functions are part of Medit’s new i500 intraoral scanner, which is built on an open system, he says.

“These added apps are useful for dentists to have a conversation with patients,” Connolly says. “Some of the other technologies in the marketplace are more specific, meaning designed only for ortho or crown and bridge. The i500 is a 

product that is a more diversified communication tool.”

Connolly sees a trend toward patient-focused treatment, accelerated by new direct-to-patient services recently launched in large retailers. He sees the potential for clinicians to capitalize on that trend by enticing that part of the patient population to come to the practice rather than going to, say, a Walmart store. Communication tools built into the Medit software allow sending information directly to the patient.

“When a patient feels they are part of the solutions and not just given the answer, there is a higher buy-in to the treatment plan,” Connolly says. “By opening up the opportunity for the patient to be part of designing the solution, which is a trend today, practices can benefit.”

Enable Patient Vision: Seeing Is Believing

When dentists do a better job of diagnosis and presenting treatment plans with options, Gochoel says, patients feel more comfortable moving forward. PreXion’s 3D imaging allows the doctor to see more and see it earlier. Gochoel says one of PreXion’s key opinion leaders always shares the scans and explains the images to patients. Gochoel estimates that the national treatment acceptance rate is 3 or 4 of 10 patients, but this dentist’s rate is closer to 80%.

“It enables the office to not only provide better dentistry but also to engage with the patient,” Gochoel says.

The new PreXion 3D Explorer takes a large field of view, 15 by 16 cm, which Gochoel says provides a much more complete oral cavity analysis. “[Dentists] often see in the CBCT image what the patient is already telling them about their sleep,” Gochoel says about dentists performing sleep consultations using 3D Explorer imaging.

“Do your homework,” Gochoel says. “There is always more out there than you think there is.”

Although that step can be tedious, he says, it is essential because there are many aspects to understanding imaging technology. Also, be aware of any associated fees, such as for software licenses, software upgrades, or additional staff training. “We don’t charge for those, but some of our competitors do,” Gochoel says. “Homework will help you make a side-by-side comparison.”

For dentists who have never had a CBCT and are in the market for this technology, Gochoel advises talking to someone who uses it and asking about the pros and cons. The information can help guide the conversation during meetings with suppliers.

Greenwood has 30 years’ experience in imaging, and a common mistake he sees involves a lack of training for the office staff. According to Greenwood, Midmark has emphasized training with their acquisition of the True Definition scanner last year and the development of their Extraoral Imaging System CBCT scanner, which they will launch in early 2021. Both units have dedicated training teams that educate the dental practice on how to obtain the most precise possible image of the anatomy.

“It’s making sure that the team can fully utilize the unit that they’re purchasing and the staff is completely comfortable using it,” Greenwood says.

Gochoel agrees that training is essential to get the best usage out of a technology investment: Nobody wants to buy a computer for just 1 function—they want to use all the programs and software; it’s no different with dental technology.

PreXion offers free in-office radiology education when a dentist purchases a system. In addition to the initial training, PreXion provides 8 additional hours of CE education from CBCT Readers for the dentist to take at their leisure and scan interpretation education reports from an oral maxillofacial radiologist. The radiologist will also send back their interpretation and diagnosis of the scan and treatment recommendations, typically within 1 or 2 business days.

“One of our visions has always been to grow the market through better education of the profession. This training partnership goes hand in hand with that strategy,” Gochoel says. “It can provide the dentist that peace of mind in terms of the diagnosis, as well as provide that second opinion, which will be so valuable, especially when the dentist starts taking those first images.”

Greenwood recommends researching the training options when looking to buy imaging equipment. Whether that means purchasing an extra service, making an arrangement with the manufacturer’s representative, or taking a CE course, training is imperative.

“Make sure the staff is knowledgeable about the equipment and applications,” Greenwood says. “With dental imaging, there’s the technology that underlays the use of that product, and the more that they understand how it works and why it works, [the more] it helps them use the products as fully as possible.”

Furthermore, dentists should choose equipment the practice can take full advantage of, Greenwood says. It should be intuitive and easy to learn. He compares it to following a weight-loss plan.

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Whether via enhanced digital diagnostic imaging, improved ergonomics, or the help of artificial intelligence, devising a clear plan can lead a practice to success.

Examining A Practice's Vision Can Help Ensure Success

It’s not fair, but it’s true. Dentists and dentistry, in general, have a reputation that is often less than fantastic. But when you dig deeper, you usually find that people love their dentist—they just don’t like going to see him or her.

We spoke to several dentists and dental industry professionals about products and services that could turn things around. Here’s what they had to say.

Mike Cataldo, CEO of Convergent Dental, which makes Solea lasers, says people have a complicated relationship with their dentist.

“Dentists tell me they hear from their patients, ‘Doc, I love you. I hope I don’t see you again for a long time,’” Cataldo says.

He says people hate going because they think the procedures or cleaning will hurt. Cataldo describes this as an “irrational, acquired fear” that gives an unfair reputation to dentists. 

“In my experience, dentists don’t hurt people very often. The fact is, they’re generally very good at not hurting people,” Cataldo says.

Jonathan Bass, content marketing manager for RevenueWell, says patients feel vulnerable when they are lying in the dental chair with their mouths open. This emotion is compounded by the personal nature of having the dental team put their hands in the patients’ mouths. Add in the fact that coronavirus disease 2019 can be transmitted through molecules in human fluids, and feelings of exposure intensify.

Patients have to trust that dentists know what they are doing, Bass says, just as you would trust a car mechanic to work on your car. Sometimes a car mechanic upsells you on repairs you don’t need, and sometimes an unethical dentist will, also. When this happens, Bass says it hurts the whole profession.

“A few bad apples can ruin it,” Bass says.

Eric Pulver, DDS, FRCD, an oral surgeon in Highland, Indiana, and chief dental officer at Denti.ai, says any profession’s reputation, including dentistry, can always improve. While dentists should embrace technology and innovation, they should also bring with them the standards of care, ethics, and trust established in the past. Dentists have a social contract with their communities built on respect and trust, which carries specific responsibilities.

“Because of our training and our position in society, we shouldn’t just provide what’s expected. We should be striving to go beyond what’s expected and create something new,” Pulver says.

Bryan Laskin, DDS, a dentist in Wayzata, Minnesota, and founder of OperaDDS, says people view the dental experience as inconvenient, expensive, and a necessary evil, comparable to a bandage you have to rip off. Some practices have responded by designing a spa atmosphere in the office, which Laskin thinks is a move in the wrong direction. Competence, efficiency, and organization are more useful for improving the patient experience.

“Having an uncluttered front desk sends a better signal than having a paraffin wax bath for patients to dip their hand in,” Laskin says. “The profession has divided the patient’s experience from clinical care, and those two are intertwined. Directionally, we, as a profession, have completely missed the mark as to what constitutes a better patient experience.”

Brian Connolly, vice president of business development in the Americas for Medit, says people may not have updated their impression of the dental market over the years. However, by marketing implants and clear aligners on television, dentists have inspired people to learn more about dentistry and how treatments have changed.

“My feelings are highly optimistic that the dental industry will have one of the biggest expansions for treatment with the digitizing of the patient and the ability to share the needed information for knowledgeable decisions on treatment,” Connolly says.

Bob Brandon, general manager of Keating Dental Arts in Irvine, California, describes dentists as healers of the mouth and oral cavity, and artists of the smile. He says dentists also have a high standard of success with the line between success and failure measured in microns. As a dentist’s son, he knows that dentists put their patients’ care and interests before anything else, that dentistry is a healing profession.

“Nobody goes into the dental profession looking to get rich,” Brandon says. “Sure, most dentists can achieve a comfortable lifestyle, but it requires a lot of education, hard work, and dedication to their craft.”

An assortment of products and services can improve the complicated relationship that patients have with their dentists.

Any relationship starts with a foundation of trust, Bass says. RevenueWell’s software connects with your patients in many ways, from communicating about treatment plans before an appointment, to a customized text checking in after an appointment, to sending postoperative instructional videos.

“You can personalize the messages, connect with patients, reach out to them beyond that time in the chair,” Bass says.

Bass also thinks managing online reviews is critical. Online reviews help people get a feel for the dentist, the team, and even the cleanliness of the practice when gathering information about which practice to select.

“From a consumer’s point of view, you can see a lot about a practice overall in online reviews,” Bass says.

He also recommends using patient satisfaction surveys, particularly in the COVID-19 environment, when many practice procedures are changing. Checking in with patients provides insight into how they feel about how you are doing and what you can do to improve.

“Surveys can show you what your patients are focusing on, so you know what you can coach the team on,” Bass says.

Changing patients’ perceptions requires investing in products that enhance the patient experience, Brandon says. Three of his favorites are The Wand by Milestone Scientific, a computer-assisted system for single tooth local anesthesia; the Apex Dental Materials line of adhesives and cement; and the Isolite line by Zyris for patient comfort and infection control. For rapid and comfortable healing, Brandon recommends AMD’s lasers. He also supports investing in small companies that want to be your partner in success.

“A high-quality dental laboratory based in the United States should also be strongly considered; do not risk your reputation by trying to save a few dollars outsourcing this important aspect of your practice,” Brandon says.

Medit’s recent launch of the i500 intraoral scanner into the clinical market followed 20 years of the company’s experience scanning in the industrial world and also dental laboratories. The company, based in South Korea, has redefined the price point in the space for clinicians, while patients appreciate how scanning improves the dental impression experience.

“Dental impressions are now done with a digital camera scanner,” Connolly says. He says intraoral scanners and digital impressions allow patients to get a glimpse of what’s possible for themselves.

“There are so many simulators today that can show patients their before and after, allowing them to make a better decision on their treatment,” Connolly says. “The iOS scanning tool is an exciting tool to help make treatment acceptance easier.”

Another way to build a relationship with patients is to let patients know you care about what scares them. OperaVR goggles are a virtual reality alternative for reducing patient anxiety. By overwhelming the senses and distracting patients from what is happening while in the chair, patients do not notice the sounds, smells, and sights that make them nervous, according to Laskin.

“It’s similar to nitrous oxide, but without the drug,” he says.

If OperaVR distracts patients, it does the opposite for dentists. These goggles free dentists to do what they need without distraction, helping them deliver a higher quality of care, Laskin says.

“Eighty percent of adults in the U.S. have some type of dental anxiety, and we, as dental professionals, get desensitized. But it’s pervasive,” Laskin explains. “One of the beautiful things about OperaVR is that in addition to addressing this issue directly, it’s a physical manifestation that you care about that anxiety.”

Many times, patient anxiety can be boiled down to two things in the operatory: the drill and the needle. The Solea dental laser takes the drill and needle out of the equation, which Cataldo says will change the dentist’s reputation.

“They still love their dentist. They just love their dentist more when they don’t use the needle and drill,” Cataldo says.

Once patients realize there is no needle or drill, word travels fast. Cataldo says dentists who incorporate the Solea generally quit advertising after 12 months because they max out their ability to take on new patients.

“Once you build enough momentum,” Cataldo explains, “advertising takes care of itself.”

In today’s dental environment, infection control is on everyone’s mind. Solea did some measurements of the laser versus the drill and discovered that the Solea reduced the amount of splatter in the operatory. Cataldo says at 2 cm from the patient’s mouth, there was 98% less splatter with Solea, and at 8 cm, there was 99.9% less splatter.

“The drill is spraying three times as much water when it cuts than Solea, and it is spraying it against a rotation bur circulating at 400,000 rpm, sending that water and goop up to 18 inches out of the patient’s mouth,” Cataldo says. “With the Solea, there’s nothing to project the water, virus, and bacteria out of the patient’s mouth, so it’s much safer.”

Dentists sometimes have anxiety, too, but not about what they did. Instead, dentists feel concerned about what they didn’t do or might have missed. When dentists are confident that someone (or something) has their back, they can focus on patient care, and their confidence puts patients at ease.

Denti.ai uses machine learning algorithms and expertise of leading specialists in oral and maxillofacial pathology and radiology to identify and detect any deviation from the radiology norm. The technology takes a panoramic radiograph, links in bitewings and periapical images and, using computer vision, sees what the human eye can’t. Denti.ai
also has a patent-pending system for automated charting to populate seamlessly into the electronic medical record.

“It points out findings that we may have seen, or maybe we didn’t see,” Pulver says.

Pulver says Denti.ai can provide dentists with standardization of care, calibration, and earlier intervention, which may result in less expensive care.

“It will help us be the best possible practitioners we can be,” he says.

Redeeming the Reputation is About More Than Products

Connolly thinks dentistry should embrace how it can change people’s lives and fix problems with their teeth. People are searching for better smiles, sleep solutions, alignment, and other issues.

“The opportunity to look at their business and listen to their customers will lead them toward the ultimate goal of all dental professionals: the overall health of the patient they serve,” Connolly says.

Pulver thinks the profession should work together to foster a reevaluation of where the dental profession sits in the marketplace and raise the bar for dentistry to affect patients’ overall health. The global pandemic and fighting the virus have presented an opportunity for dentists to become leaders, and, by working together, create significant change.

“We owe it to each other to work on that,” Pulver says. “We have this opportunity to be adaptive leaders and take these changes and create something new.”

Laskin says reducing people’s dental anxiety is essential. By offering patients sedation options, you improve the patient experience. It shows you care about the “brain that is attached to the teeth.”

“By offering options, and VR is the coolest option, let’s be honest, you are telling people, ‘We care about you,’” Laskin says. “That, in and of itself, is going to reduce anxiety.”

The best way for dentists to improve their reputation is to address patients’ irrational fears, Cataldo says.

“Some dentists say they are good at giving injections, but they are still giving the patient what they are afraid of,” Cataldo says. “People are afraid of the needle and the drill. Taking these tools out of the equation is what makes a difference, not whether you’re good with them.”

Bass says dentists need to empathize with patients. When a patient comes in for a cleaning and is handed a $5,000 treatment plan, the patient may be caught off guard. Understanding patient feelings and providing excellent communication will build trust.

“Put yourself in their shoes. A dentist who does that is already getting off on the right foot,” Bass says. “If you have that mindset and your team has that mindset, now you have an overall practice who cares.”

“The most important attribute for a dentist to strive for is to learn and improve their skill set continually,” Brandon says. “Do not settle for an average result when a great result is within your reach. Do not settle on cheap products to help your bottom line. Treat your patients with compassion, respect, and attention to detail, not to their bank account. If you are guided by the principals of healing and treating others as they deserve, you will live a rich life.”

Here are some dental products, services, technologies, and strategies that show the industry in a positive light.

Changing public perception: Redeeming dentistry’s reputation

It’s no secret that dental practices are not perfect. Some practices had issues before the shutdown for coronavirus disease 2019, while other issues are emerging as practices reopen. However, these are not the same problems dentists had 15, 10, or even 5 years ago. These are the modern kind.

Technology brought in to resolve issues is often a source of modern problems. For example, software innovations have revolutionized numerous challenges in a practice. However, as Jeremy Krell, DMD, MBA, head of marketing at Simplifeye and vice president of business development for Supply Clinic, points out, these platforms do not always work together, resulting in fragmented solutions that don’t talk to each other, so the practice must run multiple platforms at any given time.

“It’s very laborious,” Krell says. “It’s not seamless.”

COVID-19 has made streamlining the payment process a priority for practices, according to Krell. A patient might make several stops at the front desk to check in with insurance, confirm coverage, pay bills, and other business.

“It’s a very high-contact situation, which is both a bad consumer experience and, in the world of COVID-19, far from contact-free,” Krell says. Having a synchronized retail payment process could help reduce face-to-face contact.

COVID-19 also affects practices’ cash flow, according to Robert Patrick, president of Vyne, a health care technology company. Optimizing business operations is critical to owning a dental practice, Patrick says. Not being able to consistently identify a patient’s responsibility prevents the patient from paying in advance. This also delivers an uncertain patient experience, which is not in line with patient expectations.

“We are in an Amazon, cost-comparison world. The patient just agreeing to whatever treatment the dentist might say the patient needs is an interaction that is evolving,” Patrick says. “Being as accurate and confident about the patient’s responsibility will help the patient be more comfortable.”

Dentists’ expectations of themselves have evolved, as well. Ken Wright, DDS, and Robert Wertke, DMD, work together in a private practice in Barrington, Illinois. As education platforms and communications improve, it raises the dentists’ expectations of what they feel they’re capable of, Wright says. Doing more also increases dentists’ need for technology and the modern problems that come with it.“

You have less time to not only bring them up to speed on what they need as a patient, but also to gain their trust and help them understand what their oral health picture looks like.”
— Robert Wertke, DMD

One of the problems I’ve had is you pick a particular route, and invariably there’s an upgrade or a software patch or an equipment need, and all these things don’t always coordinate at the same time,” Wright says. “You can see the goal, but then getting to the goal and staying in the groove is becoming exceedingly difficult.”

Patients expect fast results and expect to dedicate less time to the process, Wertke adds. Furthermore, patients may have preconceived notions about what they want from using online searches without understanding dentistry’s nuances.

“So, you have less time to not only bring them up to speed on what they need as a patient but also to gain their trust and help them understand what their oral health picture looks like,” Wertke says.

Looking at the bigger picture, the industry itself can be problematic, according to Scott Drucker, DMD, MS, cofounder and president of Supply Clinic. In the past, practices have relied on sales representatives for new product information, something that may be keeping practices from adapting to an e-commerce model. Now, he says, dissemination of information is faster via the internet.

“There is an inherent, misaligned incentive when the sales representative makes a commission off of the supplies sold. Put simply, a lower cost of supplies translates to a lower sales rep commission,” Drucker says.

The pandemic necessitated reducing the number of people in a practice at any given time. It also brought to light some broken parts of the supply chain, especially the availability of personal protective equipment (PPE). Drucker believes these factors will encourage practices to find new ways to buy supplies.

“We are going to see this huge surge in the direction of online shopping behavior,” Drucker says.

The method used to purchase supplies isn’t the only significant change caused by COVID-19. Working chairside looks different, too, as patients are hypersensitive about hygiene, according to Edward Shellard, DMD, chief dental officer at Carestream Dental. Patients are demanding that practices go above and beyond their usual strict infection control protocols with enhanced PPE. In addition, as practices reopen, dentists have a backlog of patients who put off preventative care.

“We need to be prepared to see patients with issues that may have started small, but grew over the course of the quarantine,” Shellard says.

Patients also expect the same level of comfort and convenience that digital technology affords them in their everyday lives, Shellard says. Carestream Dental’s 2019 Global Digital Dentistry Survey found that 2 out of 3 patients would consider switching to a practice that uses more advanced technology.

COVID-19 also brought to the forefront the challenges many dentists face with the business side of the practice. A number of dentists struggle with maintaining a healthy bottom line, and in many cases may not have the business expertise or the time to optimize it, says Dan Traub, vice president of product at Method Procurement. Additionally, some dentists may not know the opportunities available for savings, as many aren’t leveraging modern technology and best practices when they’re buying goods and services. Traub says it often happens because they have not put suppliers through a competitive process, often favoring a supplier relationship over their own financial interests.

There is an inherent, misaligned incentive when the sales representative makes a commission off of the supplies sold. A lower cost of supplies translates to a lower commission.”
—Scott Drucker, DMD, MS
President, Supply Clinic

“As a business owner, you want to foster good relationships with suppliers. Those are valuable partnerships, which often bring other services to the table,” Traub says. “But the caution is that you must maintain awareness of the pricing they offer you relative to the market. Not surprisingly, prices tend to creep up over time. You have to be aware of what that is doing to your bottom line and hold suppliers accountable.”

The pandemic also revealed the importance of secure access to patient data for dentists working from home. David Gane, DDS, a general dentist in Vancouver, British Columbia, and CEO of Apteryx Imaging, says access to patient image data is crucial. However, recent ransomware and highly publicized malware cyberattacks of dental offices have made patients wary of having their personal health information (PHI) stolen, and practices are concerned about getting locked out of their data and the potential HIPAA violation that follows.

On the clinical side, Gane says missing caries on radiographs is not uncommon, with an error rate as high as 20% in some busy practices. Also, oral cancers and other cancerous lesions are on the rise, not only because of alcohol and tobacco use, but also because of the human papillomavirus, and can be overlooked.

“It’s incumbent on dentists today to screen for dental diseases using adjunctive devices that enhance visualization,” Gane says.

The good news is many products, services, software, technologies, and more are available to fix these challenges.

Krell says Simplifeye wraps four major services together like “a virtual front desk or virtual practice in a box.” It also addresses the fragmentation prevalent in dental practice software.

“It provides a live chat that talks to its scheduling feature and talks to its telehealth feature and talks to its payments feature. Now you have this 4-pronged solution that all ties back to one central place,” Krell says.

Simplifeye also addresses the need for a retail health care experience with Payments. Patients can pay online with payment information stored by the credit card processor Stripe. Payment information is digitized and tokenized with payment plans you can customize. There are no merchant fees for providers.

“It takes away additional stops at the front desk and modernizes the payments system,” Krell says.

Being accurate and confident from a business standpoint requires better tools for revenue cycle management. NEA Powered by Vyne and its HITRUST CSF Certified FastAttach, a dental clearinghouse and dental claims and attachment solution, can decrease the reimbursement cycle significantly and create cash flow for small business owners. With connections to all the major payers in dentistry, Patrick says users can be confident no matter what payer it is, and they will receive improved reimbursement response. The system works with many different practice management solutions.

“It gives our practices centralized, easy workflow to interact with,” Patrick says.

Also, Vyne Connect, a secure email solution, helps practices communicate securely with anyone through encrypted email.

“It gives practices the ability to share PHI with referring doctors and the ability to communicate with patients securely,” Patrick says.

Supply Clinic is Drucker’s answer to the need for a comprehensive and intuitive e-commerce solution for dental practices. It is a marketplace platform in which multiple sellers can list their offerings for the same products. The platform allows for transparent pricing. Buyers can pull up a single product page for the SKU and see who sells it, price, shipping locations, and approximate shipping times. Practices can also purchase products from multiple sellers in a single shopping cart and checkout.

“Our goal is to make available as much information as possible to the customer so that they can make an informed purchase decision,” Drucker says.

Digital technology provides essential data dental professionals need to make better decisions for their patients. Shellard says general practitioners can use a compact, easy-to-use system for 3D imaging, such as the CS 8100 3D extraoral imaging system. 3D imaging allows dentists to offer more procedures, such as implants, in-house.

Shellard also likes the CS 9600 CBCT system, which uses the latest smart technology and artificial intelligence (AI) to reduce the need for retakes and make recall appointments more efficient. Advanced software algorithms called CS MAR decrease the scatter caused by metal artifacts, so dentists make more confident diagnoses, improving patient outcomes. Intraoral scanners such as the CS 3600 or CS 3700 increase comfort for patients and allow dentists to plan implants, restorations, or clear aligners virtually.

“Clinical can also merge with practice management thanks to new teledentistry options that practices can add to their hosted management solutions,” Shellard says.

Wright and Wertke use the Planmeca ProMax 3D Plus, which checks their boxes for support and seamless integration, plus patient education opportunities. It also relieves diagnostic dilemmas they may have had in the past with 2D images.

“With the CBCT, I see things I would never have seen or contemplated,” Wright says. “It’s phenomenal technology.”

Using integrated technology, Wertke says, dentists can establish an information-gathering first appointment. Using imaging technology, dentists can show patients what they see, and educate them on their overall oral health and related treatment plans. To a certain extent, Wertke says, patients can diagnose themselves.

“It is one thing for me to say they have three or four cavities and other things going on in their mouth. It’s another for me to put it on a screen and let them look,” Wertke says.

Method Procurement is a subscription software provider that has built its purchasing system around the comprehensive needs of a dental practice. It features a cost-comparison tool that allows users to shop from different suppliers. Additionally, the tool provides approval and budgeting support, inventory management, and tight tracking of all steps in the buying and paying cycle. Traub, who has worked in procurement for nearly 20 years for all types of industries, says a fundamental core of the platform is the catalog, which has 400,000 dental products from 2,000 suppliers.

“If you want to know who sells a particular bonding agent, we have that in the platform, along with pricing and, in many cases, the stock availability," Traub says.

“The catalog that we’ve assembled also includes a private label product cross-reference, which we believe is the first in the industry.”

Traub says the mission of Method Procurement is to educate the industry about procurement as the key to improved financial results for practices of any size. The techniques embedded in the tool frequently produce remarkable savings, Traub says. Traub wants dentists to recognize that procurement is a process in need of standardization and deserving of their attention.

Make sure what you’re purchasing can integrate into a larger workflow so you can build the solution set that meets your needs.”
—Edward Shellard, DMD
Carestream Dental

“Our solution helps practices finally be proactive about managing non-payroll expenses, a problem we see frequently discussed but rarely addressed,” Traub says. “We’re taking proven techniques from other industries, and we are helping to push the dental industry forward and modernize their approach to these challenges.”

XVWeb, a true cloud subscription imaging service, provides a full imaging application that provides direct capture from most imaging devices and provides 24/7 accessibility to data from any web-enabled device.

“Many practices appreciate how it integrates with most practice management software, reduces hardware footprint and related [information technology] costs, and includes updates and support,” Gane says.

XVWeb also facilitates HIPAA-compliant image sharing and manages backup and security.

Today’s dental practices tackle new issues, such as COVID-19, technology, and more.