Terri Lively

	Excellent office design is more than making everything look nice and new. Dental professionals can use office design to increase productivity and profitability. With a focus on functionality and workflow, dental office design can translate into more revenue for your bottom line. 

	“Getting it right has so many benefits,” says Matthew McLaughlin, territory manager for 

. “Your ‘brand’ value goes up. Your office will be more efficient. You’ll be able to produce more dollars in the same amount of time with less stress.”

	An efficient workflow frees you up to produce more

, says her team’s focus is on building a foundation of function and efficiency first and then fulfilling the practice’s wants and needs. 

	“Before we build out all the little niches and details, we want to make sure we have the core function of the space that it is efficient for patient traffic and also staff flow,” she says. 

	Ciarán Hynes, director of dental furniture product management at 

, and his team focus on patient throughput and workflow to minimize turnover time between patients. They design their equipment to facilitate intentional movement within the operatory, eliminating the need to go to different areas of the operatory that ultimately make room turnover more time-consuming. Once the patient leaves, staff can dispose of soiled materials on one side and then retrieve new barriers and supplies from a different part of the room with minimal back-and-forth movement.

	“When the team is efficient with turnover time between patients, by the end of the day the time gained may add up to allow for an additional patient to be seen, which can represent gains in productivity and revenue for the practice,” Hynes explains.

	Similarly, Hynes believes having designated consumable storage and instrument reprocessing areas centrally located in the practice affords long-term gains over the life of the practice. It improves the staff’s productivity by minimizing walking distances for those repetitive trips back and forth between operatories and supply areas of the practice.  

	“Instead of retrieving instruments and consumables at opposite ends of the building to operatories, in a centrally-located design individual replenishment trips are shorter, quicker and more efficient” he says.

Related reading: 5 ways your office design can help (or hurt) your bottom line

	For practices with a small budget, our experts have suggestions to help their money go far. McLaughlin says that practice owners shouldn’t assume they can’t afford to do something. Instead, he encourages dentists to get a dental office design professional and an equipment expert to consult. Together they can explore the possibilities for expanding the building or operatories in your practice.

	“There are lots of partners out there that know that dental is different and know what’s possible,” he explains. 

	Other areas to examine include small investments like carpet and paint, improving efficiency in the instrument processing center, or replacing equipment that’s more ergonomic than what’s on site currently. 

	“If your body breaks down, then the game is over. A lot of dentists out there have had an injury and can’t practice and now all that training is just for naught,” McLaughlin says. 

	Rhode says practices with small budgets should invest in their reception areas to make the best possible first impression. One significant improvement can be replacing the “wall of files” that used to be the backdrop of every practice reception area with a clean, modern look. 

	“There are a few things we can do to that area to update their desks and give a modern feel to it, like putting a logo on the focal wall or keeping the business space tucked behind so that you don’t have a direct line of vision into it,” Rhode says.

	Rhode also suggests bringing in the latest technology and preparing for the future. She recommends using forward thinking to plan, even if practice owners are considering selling the practice. “Make sure if you are selling that the next dentist coming in has the ability to expand their technology,” she says.  

Trending article: Four things to expect in your office redesign

	Hynes recommends making the most of your budget by choosing the most durable materials that can endure the demands of a dental practice over the long term. 

	“In dentistry, furniture surfaces are subject to a significantly higher rigor of housekeeping, much more aggressive cleaners and much higher frequency of surface disinfection. It’s important to understand the difference between residential furniture and commercial/industrial materials to ensure the lifespan of the furniture matches that of your other equipment,” he says. 

	For example, some furniture makers use melamine panels on the outer surfaces of their cabinets, which, while highly decorative, are very thin and may not withstand aggressive cleaners over time. High-pressure decorative laminate, by comparison, is comprised of multiple layers of phenolic resin sheets fused together into thick, durable sheets that withstand chemical exposure, abrasion, and repeated impact of objects like carts and stools bumping into it. 

	Hynes also advises avoiding natural stone in dental offices because it’s porous and it can absorb fluids. It can also be subject to cracking along natural fissures that may be present. He prefers non-porous surfaces, like quartz, acrylic or stainless steel.

Trending article: 8 reasons operatory esthetics matter to your patients

	One change both McLaughlin and Rhode agree on is increasing the number of operatories that you have. They prefer four to six for one dental practice. 

	“One of the difficult spots they get in is to buy a practice that has three operatories,” McLaughlin says. “Right out of the gate, there is a limit to what you can do. If you have a hygienist running out of one of them, now you are down to two. It’s a vicious cycle because you never get to a point where you are earning enough to invest in the practice.”

	Rhode and her team want to ensure the treatment room is adequately sized. As long as there’s ample space, they design the equipment to fit into the space and make sure its placement promotes proper ergonomics. 

	“Our team comes in at all different phases. Ideally, we want to come in early in the process to help them evaluate the space and create a foundation for function and efficiency,” Rhode explains.  

	As a small business owner, McLaughlin feels that office design can help you present a practice that shows who you are and what your practice is trying to accomplish. When you build a brand well, it results in word-of-mouth advertising that brings patients in from all over, which is intrinsically and financially rewarding.

	“There is something from a personal return standpoint of having a beautiful, well-run practice,” McLaughlin says. “Getting the financial returns that come with that is icing on the cake.”  

Trending article: How better dental office design can prolong your career

Articles

How good office design ­- even office design on a budget - can lead to more revenue.

Why your dental office design matters

	Dr. Jeffrey Delson had his doubts as to whether Dentsply Sirona’s digit Power

 Dispenser was necessary. He wondered why a clinician would need an electronic device that does something a syringe has handled fine for decades. But after he tried it, he decided that the digit Power Dispenser was so handy, simple and fun to use that he began pulling it out all the time when taking traditional impressions.

	“It’s a simple little device that works well,” Dr. Delsen says. “It dispenses consistently, you don’t have to play around with it much and the learning curve is almost instantaneous. It’s a clever little device that you like having.”

	The digit Power Dispenser is a pen-grip style wash material delivery device that’s made to work with

 Impression Material. The design allows dental professionals to get within three inches of teeth when dispensing the material, which Dentsply Sirona says helps with accuracy. Other significant features are the lightweight design and proposed ergonomic benefits for dental professionals.

 is a tool that he “enjoys thoroughly.” He appreciates how it dispenses consistently, as well as how the mixing properties in the slim design mixing tip are designed to help with access and visibility while reducing waste. He says he also enjoys the built-in timer, which has both work and set times, along with the fact that the battery-operated device is rechargeable.

Trending article: The 10 golden rules for taking impressions

	Dr. Delson takes care of people the way he would want to be taken care of, and he prides himself on his lifelong relationships with his patients. He says that his private practice in Brigantine, New Jersey, is about patient care, not finance.

“I try to fix teeth. I am not a high-pressure type of guy,” Dr. Delson says. “I present people with options and they pick what they want to do. Whatever is best for them sometimes is driven by their needs and sometimes it’s driven by their pocketbook.”

	So when a crown doesn’t fit because of a poor impression or the impression material tastes bad, his materials aren’t allowing him to provide the patient experience he wants.

	Dr. Delson uses digital scans in his practice as well, but says he prefers traditional impressions for preparations that are subgingival or difficult to see. For years he used 

 for conventional impressions because it produced accurate impressions even though he - and his patients - thought it tasted terrible. When he started using the digit Power Dispenser, he was able to switch to Aquasil Ultra+, which he says holds up to the standard set by Impregum.

	“The impressions are coming back and the crowns are fitting just as well as with Impregum. Also, Aquasil tastes better,” he says.

	Dr. Delson understands that doctors have many opportunities to invest in when it comes to equipment for the office. He also says that some products are just gimmicks and don’t answer a problem in the practice. However, the digit Power Dispenser isn’t one of those products. Dr. Delson says it’s an evolutionary product rather than a revolutionary one.

	“There wasn’t a problem with a manual syringe; this product just does a great job,” he says.

	For doctors who are reluctant to invest in another gadget for the office, Dr. Delson encourages them to give the digit Power Dispenser a chance.

	“This is the easiest thing to learn in the world. It takes 30 seconds to learn and you are as good at it as you’ll ever be. It’s very straightforward. It’s rechargeable. There is nothing about it that isn’t easy to use and it does make life a little bit easier, so why not?”

Why one dentist prefers using the digit Power Dispenser when taking impressions. 

How to simplify traditional impressions

	Common dental prescriptions like antibiotics and opioids can have severe harmful consequences for your patients. The American Dental Association’s (ADA) recommendations for both types of drugs have changed based on the latest scientific evidence. While both have their time and place in your practice to maintain a proper standard for patient care, overprescribing in either category can lead to serious conditions for some patients.

	Dr. Jennifer Sanders, DMD, has a succinct summary of the dental industry’s stance on prescription medication: “Honestly, most things, like antibiotics and opioids, are overprescribed.” This sentiment is echoed by the literature, the Centers for Disease Control and Prevention (CDC) and the ADA.

	Christopher Cook, DMD, is a private practice endodontist in Louisville, Kentucky, who has been practicing since 1995. Earlier in his career, when the literature showed that they were safe, Dr. Cook prescribed opioids, but usually no more than three days’ worth. Today, he estimates that in the last 18 months he has written two prescriptions for opioids. He also explains to his patients why they’re no longer the answer.

Read more: What dentists NEED to know about the opioid epidemic

	“Education, for me, is critical. You have to tell them, ‘Here’s what I am going to ask you to take to make the pain or discomfort go away if you have any pain or discomfort.’ For me, it’s the nonsteroidal anti-inflammatories (Motrin, ibuprofen, Advil). If it’s still hurting, add one over-the-counter Tylenol in between and that should work, and if not I expect a call,” Dr. Cook says.

	The dental industry is contributing to the antibiotic overprescribing problem in the U.S. 

, dentistry as a whole prescribed 24.9 million prescriptions of oral antibiotic prescriptions in 2014.

 Most, if not all, of these antibiotic prescriptions were for prophylaxis before certain patients’ dental procedures and to treat dental infections.
	Dentistry prescribed only 6.4 percent (16.3 million) of the overall opioid prescriptions in 2012, which 

 However, since dentists tend to write opioid prescriptions for adolescent patients having their wisdom teeth removed, dentists are usually the first healthcare provider to introduce patients to opioids.

	Overprescribing antibiotics contributes to antibiotic resistance, where the drugs are no longer effective against the bacteria the drug seeks to eliminate. 

, antibiotic resistance is an urgent threat to public health.

 The bacteria resistant to antibiotics are difficult and expensive to treat. In extreme cases, antibiotic-resistant infections can have serious consequences, such as physical disability and even death. As part of their 

 campaign, the CDC reports that 2 million people suffer infections caused by antibiotic-resistant bacteria and these infections lead to at least 23,000 deaths.

	However, antibiotic resistance is only part of the risk of overprescribing antibiotics. Another significant problem is an allergic reaction. 

, there were 145,000 emergency hospital visits between 2011 and 2015 for adverse events associated with antibiotics and 75 percent involved allergic reactions.

 Allergic reactions range from minor skin irritation and digestive tract issues to more severe symptoms, like wheezing, trouble breathing and anaphylaxis.

Another serious concern associated with antibiotics is the increasing cases of Clostridium difficile (C. diff), a serious and sometimes fatal condition. When antibiotics eliminate the protective bacteria that live in the gastrointestinal tract, the C. diff bacteria multiply, causing severe diarrhea. 

, the Minnesota Department of Health (MDH) reported that 15 percent of the cases they kept track of over six years were from antibiotics prescribed by the patients’ dentists.

 The lead author of the study, Dr. Stacy Holzbauer, says that reducing outpatient antibiotic prescriptions would lower C. diff rates that don’t occur at hospitals by 17 percent.

Trending article: Achieving optimal oral health with preventive care products

	Antibiotic overprescribing is an issue that’s personal for Dr. Cook. His mother died of a perforated bowel resulting from a C. diff infection following antibiotic therapy. She died within 24 hours. “She got an antibiotic every time she turned around,” he says of his mother’s case.

	Dr. Cook believes that antibiotic resistance is a crucial issue for prescribers today. His patients often come in and demand antibiotics for a toothache. That’s when he educates his patients about antibiotic use. “It’s the whole premise of if you have a splinter in your arm, are you going to take an antibiotic to make it feel better or take the splinter out?” he says.

	The opioid crisis has been increasing in the U.S. at an alarming rate. Opioids interfere with pain signals in a patient’s brain and provide pain relief. There are several different types, from natural opioids like morphine and codeine to semi-synthetic opioids such as hydrocodone (Vicodin) and oxycodone (Percoset) and even fully synthetic opioids like fentanyl and methadone.

	Last October, U.S. President Donald Trump declared the opioid epidemic a public health emergency and urged the country to be the generation that ends the overdose crisis. Per the 

American Society of Addiction Medicine (ASAM)

, 2 million people in the U.S. were addicted to prescription pain relievers in 2015.  Those numbers are expected to rise since 2015.

 reports that as many as 115 people in the U.S. die of overdosing on opioids every day.

	Up next: What dentists can do to protect patients

	What can dentists do to protect patients?

	Maintaining the highest standards of patient care while managing patient expectations can be challenging for any doctor. With so much on the line for the patient, however, it’s crucial that dentists do just that when prescribing medication.

	When it comes to overprescribing, Dr. Sanders believes that staying up to date on the guidelines is vital as they change every few years, particularly with antibiotic prophylaxis.

	“Sometimes the dentist or the orthopedic surgeon isn’t up to date on the latest guidelines. As a result, patients get a prophylaxis per the guidelines of five years ago,” Dr. Sanders explains.

 on premedication for antibiotic prophylaxis for patients with prosthetic joints and orthopedic implants and continued to discourage the practice in 2015.

 Research showed that dental procedures were not causing prosthetic joint implant infections and that the prophylactic antibiotics were not preventing those infections. The latest guidelines have relatively few cases where antibiotic prophylaxis is indicated.

Related reading: Are dentists contributing to antibiotic overuse?

	However, as a guideline, it means that while most people don’t need a prescription, there are cases where a patient might need one. Dr. Sanders says you have to consider that, too. However, in most cases, a prescription isn’t necessary.

	The CDC is working to reduce unnecessary antibiotic use by 50 percent by the year 2020.

	The CDC encourages prescribers to follow the framework presented in its Outpatient Antibiotics Stewardship Program.

 The program seeks to measure antibiotic prescribing, to improve prescribing practices to only necessary cases, to minimize underuse of antibiotics, and to ensure the proper drugs and durations are used. It also enhances any existing guidelines for antibiotic prescribing and ties the standards to evidence-based recommendations about diagnosis and management. There are four core elements to the CDCs proposed 

Outpatient Antibiotic Stewardship program

	1. Commitment: Prescribers should dedicate themselves to the program.
	2. Action for policy and practice: They should implement, assess and modify their prescribing behavior as needed.
	3. Tracking and reporting: They should monitor and evaluate their prescribing practices.
	4. Education and expertise: Education should be an essential element of their prescribing behavior, both for other providers and patients.

	The dental industry and professional associations have responded to the opioid crisis. In April 2018, the J

ournal of the American Dental Association (JADA)

 published additional evidence that supports that nonsteroidal medications are best for short-term pain management.

 The latest findings further support many previous articles supporting the use of over-the-counter pain medication for short-term pain management for patients. 

	However, for many doctors, the decision not to prescribe opioids happened years ago. Dr. Cook abandoned opioids back in the early 2000s.

	“I made a decision a long time ago that opioids shouldn’t be my first choice in pain management for endodontic therapy,” he says. “If I look at my opioid prescription writing for the past 15 years, I have written less than 10 prescriptions a year for post endodontic therapy pain management. When I look at the cases where I did write a prescription, it was for no more than 10-12 tablets.”

Trending research: Are dentists prescribing too many opioids?

 on prescription limits and continuing education for dentists regarding opioids earlier this year. The policy supports mandatory continuing education regarding opioid and other controlled substance prescriptions. Also, the ADA recommends statutory limits for opioid dosage and a prescription that lasts no more than seven days. These recommendations are consistent with the CDC’s evidence-based guidelines.

	Finally, the policy encourages prescribers to register and use Prescription Drug Monitoring Programs (PDMPs). A PDMP gathers and analyzes data submitted by pharmacies and prescribers. PDMPs alert practitioners when a patient has been flagged for inappropriate use of opioids; likewise, it alerts officials if practitioners are prescribing opioids inappropriately.

	PDMPs helped Dr. Cook avoid a situation with one of his patients last month. A 19-year-old man asked him for an opioid prescription for his pain. Dr. Cook ran a CASPER report that showed the patient had been flagged 10 times in the last year. Dr. Cook took the information back to his patient.

	“I said, ‘Listen, you are not getting any narcotics. It’s not going to happen. You can take ibuprofen if you are having some pain and that’s all,’” Dr. Cook recalls.

	“As soon as we show them that report, they immediately go, ‘Boy, whatever you did, I feel so much better.’ Then, they are trying to get out of the office as soon as they possibly can,” Dr. Cook says. 

	When Dr. Sanders, who maintains a private practice in rural Frenchtown, Montana, explains to her patients that over-the-counter medication is as good or better than prescription medication for pain management, her patients often tell her they don’t like taking pills anyway. However, Dr. Sanders recognizes that other dentists don’t receives the same attitude from their patients.

	“It’s tough, especially in some areas and cultures, because some people just want a prescription,” Dr. Sanders says. “It’s about patient education and letting them know that giving them the prescriptions maybe isn’t the best thing for them.”

	1. “Antibiotic Use in the United States, 2017: Progress and Opportunities.” 

https://www.cdc.gov/antibiotic-use/stewardship-report/outpatient.html

https://www.cdc.gov/drugoverdose/maps/rxrate-maps.html

	3. “Antibiotic Resistance Questions and Answers.” 

https://www.cdc.gov/antibiotic-use/community/about/antibiotic-resistance-faqs.html

	4. “Be Antibiotics Aware: Smart Use, Best Care.” 

https://www.cdc.gov/features/antibioticuse/index.html

	5. Geller AI, Lovegrove MC, Shehab N, et al. National Estimates of Emergency Department Visits for Antibiotic Adverse Events Among Adults-United States, 2011-2015. J Gen Intern Med 2018. From: “Antibiotic Stewardship” 

https://www.ada.org/en/member-center/oral-health-topics/antibiotic-stewardship

	6. “Antibiotics for dental procedures linked to superbug infection.” 

. 6 October 2017. Web. 16 August 2018. < 

https://www.sciencedaily.com/releases/2017/10/171006164847.htm

	8. “Opioid Addiction: 2016 Facts & Figures.” 

https://www.asam.org/docs/default-source/advocacy/opioid-addiction-disease-facts-figures.pdf

	10. “Antibiotic Prophylaxis: Prosthetic Joints and Orthopedic Implants.” 

https://www.mouthhealthy.org/en/az-topics/a/joint-replacement

	11. “Antibiotic Prophylaxis Prior to Dental Procedures.” 

https://www.ada.org/en/member-center/oral-health-topics/antibiotic-prophylaxis

	12. “The Core Elements of Outpatient Antibiotic Stewardship.” 

https://www.cdc.gov/antibiotic-use/community/pdfs/16_268900-A_CoreElementsOutpatient_508.pdf

	13. Benefits and harms associated with analgesic medications used in the management of acute dental pain. Moore, Paul A. et al. The Journal of the American Dental Association, Volume 149, Issue 4, 256 - 265.e3.

Are your prescribing habits leading to harmful consequences for your patients? 

The dental prescriptions that are killing your patients

	Scanner technology has changed a lot in the past three years. Sigrid Smitt Goldman, CEO and chairman of 3DISC, says dentists who feel resistant to adding or replacing intraoral scanners to their practice should take another look with the Heron IOS. From changes in functionality to speed to comprehensive capability, Smitt Goldman says Heron IOS isn’t the same technology intraoral scanners used to be.

	“Market research tells us dental professionals are looking for improvement in ergonomics. They are looking for increased training and reduced costs. That’s where we are sitting,” she says of the Heron IOS, which started shipping in the third quarter of 2018. 

 undertook market research. Their analysis revealed one of the barriers to buying an intraoral scanner was that scanners on the market weren’t comfortable; they were often too heavy and clunky.

Trending article: Are digital impressions REALLY the better option?

 is an optical impression system. It produces three-dimensional models for dental restorations. Designed to rest in a dental professional’s hand, the scanner weighs 145 grams, lightweight when compared to other intraoral scanners on the market. It also has a built-in heater designed to prevent fogging. The rotatable tip twists 360 degrees and allows dental professionals to scan areas of the mouth that can feel awkward when scanning with heavier intraoral units.

	“When you need to scan an upper, instead of turning the whole unit 180 degrees to where it’s no longer comfortable, we made it so you can rotate the tip instead. So, you can maintain your comfortable grip on a very lightweight scanner to get everything done,” Smitt Goldman says.

	Another area of concern 3DISC addresses for dental professionals was cost, particularly ongoing expenses not part of the purchase price. Some agreements have fees for every time you use the scanner, for software upgrades or cloud storage.

“First, you have product acquisition, but then it’s ongoing with licensing costs, software update costs and things like that, which make the overall cost of ownership very high,” Smitt Goldman explains of other intraoral scanner purchase agreements. “We wanted to create a model where you buy the scanner at a reasonable price and then you don’t have to pay anything additional.”

	3DISC also addressed the size of scanners on the market with the Heron IOS. Smitt Goldman says many scanners currently available look formidable.

	“They don’t look it in pictures, but when you see them up close, they are large and a little scary for patients. We wanted to create something that could sit chairside and not be obtrusive that the patient is going to be comfortable with,” she explains.

More from the author: 10 ways to simplify pediatric dentistry

 and flexibility don’t come at the cost of performance, Smitt Goldman says. The Heron IOS delivers a fast, precise and accurate scan. 3DISC is proud of their accuracy and precision numbers (25/18 microns, respectively). The team wanted a balance between getting the most precision and accuracy and a scanner that’s fast and robust.

	“You don’t have to reach far and it doesn’t take 15 minutes to complete a scan. It’s a five-minute operation to do a full mouth,” Smitt Goldman says. 

	Smitt Goldman realizes that not all doctors are fans of intraoral scanners, but there are excellent arguments for 

 as a whole. First and foremost, you improve the patient experience by reducing the number of times you need to make traditional impressions.

	“Whenever people ask me what I do, I say, ‘You know how when you go to the dentist, they give you a mass of goop to bite down and you kind of gag on it, and it’s kind of awful? Then they pull it off your teeth and then you wait three weeks for a crown? That’s what we are solving,’” Smitt Goldman says.

	From a practical perspective, there are significant time savings with intraoral scanners, which can translate into more revenue for the practice. Dentists don’t have to make a plaster cast and then ship it to the lab when they scan. In addition, dental professionals can email intraoral scans, reducing the time it takes to get a crown back from the lab. Many times, the fit of the restoration improves as well, so a dentist doesn’t have to send a crown back and wait for another one to come.

Related article: 5 questions you need to ask before buying an intraoral scanner

	The Heron IOS is combined with 3DISC’s QuantorClinic software package and built on exocad’s OEM software platform. The platform provides features for the initiation of dental restoration 

, including order management, scanning, validation, commenting and order submission. Dental professionals can also send data to third-party dental CAD systems.

	“Those things for a dentist should be compelling,” Smitt Goldman says. “If you combine this technology with milling, you can do a one-day turnaround on certain restorations. It can be a practice builder to be able to offer that.”
	Smitt Goldman says Heron IOS is easy to use with a little training.

	“You can have assistants do these scans,” she says. “As a dentist, you do some preparations and rescan the active area and then you are on your way. Your chairside time has reduced significantly on a procedure that you are still able to charge the same or more for than you were before. So from a dentist’s perspective, the economics of this are good.”

	Ten years ago, the medical imaging market was high-cost and hospital-focused.  There wasn’t much effort to bring it down to smaller practices. 3DISC responded with its FireCR Flash Reader, cutting 30-40 percent out of the price and providing a compact product that still had all the features of a hospital-level system. The FireCR Dental PSP System followed the same business model, and 3DISC did well with that also, providing a smaller unit for chairside use that maintained the performance larger units provided.

More from the author: Using silver diamine fluoride as a new caries management solution

	Now with Heron IOS, Smitt Goldman and the team at 3DISC are looking at a market on the uptake three to five years in. She estimates a 13 percent market penetration exists in that space. However, if 3DISC tweaks the ergonomics and trims down the cost to a price point appealing for the single-dentist operation, she says they could take intraoral scanners from 13 percent to mainstream adoption.

	“That has been our approach always. We look for the problems to solve within a particular space, a particular niche,” Smitt Goldman explains. “Then, we try to solve the problems and make products available at a cost that people can be in the market with us.”

Improvements in ergonomics and flexibility have made this scanner a great chairside option.

Making digital impressions affordable with Heron IOS

	Dr. Jeff Briney, DDS, has been using lasers in his private practice in Dana Point, California, for the past 10 years. He also does his own surgical, periodontic, orthodontic and endodontic procedures. He sees BIOLASE’s Waterlase Express™ as an indispensable tool for his efforts to cover the spectrum of dental specialties for his patients.

	“It is my duty to be as advanced in every one of those specialties in dentistry so that I can provide the best service for my patients,” Dr. Briney says.

as baby steps. Originally, he bought an “off-brand” diode laser and incorporated it into the hygiene side of his practice. He switched to BIOLASE’s diode laser eight years ago and moved promptly into the Waterlase line of all-tissue dental lasers over the following year. He now uses both the Waterlase Express and the Waterlase iPlus

Read more: How to choose a dental laser for your practice

	Laser dentistry allows him to offer comprehensive dental care to his patients, many of whom he considers friends. He no longer refers his patients to specialists, preferring to treat his patients himself from periodontic and endodontic treatments to preparations for minimally-invasive dentistry. Dr. Briney also uses the lasers for many of his surgical procedures, like crown lengthening or non-surgical osseous periodontal surgery.

Dr. Briney says he did research before his purchase that shows the Waterlase all-tissue 

 use the ideal wavelength for the most precise, effective and efficient way to cut hard and soft tissue.

	“A lot of other lasers on the market are close to that wavelength but are not idealized for that target tissue,” he explains. “Alternative wavelengths decrease the efficiency and accuracy of the cut. There is also a lot more healing and recovery time when those other wavelengths are used, compared to the wavelength that Waterlase uses.”

	Dr. Briney used the Waterlase iPlus for five years before adding the Waterlase Express to his practice. He says he appreciates how easy the Waterlase Express is to use. The simple interface with the touchpad not only helps him handle the laser for treatment but also helps with patient education. He uses the training and education videos in the tablet to show patients what he’s going to do before he does it.

Trending article: 10 ways lasers can make your practice money right now

	“It easily transfers into the actual procedure,” he says. “There is no downtime. It’s almost a plug-and-play and touch-and-go interface with the Waterlase Express. It’s a very quick interchange between education of the patient and then right into the procedure.”

	Watching the procedures via the tablet animations often solidifies his diagnosis and treatment plan for patients. For example, if patients don’t understand why he recommends a crown lengthening procedure, Dr. Briney shows them how it increases the surface area of the tooth to create a healthier environment for the crown. When patients see the step-by-step 4K HD animation of the treatment available on the tablet, it relieves their anxiety about having the procedure.

	Dr. Briney thinks patients looking for a new dentist will gravitate toward laser dentists. Patients view lasers as a sign of a technologically advanced office.

	“Patients think they are having a higher quality of treatment with a laser versus cutting the bone with a handpiece and drill,” he says. “When they think of the handpiece and drill, they think of Black & Decker from Home Depot. They have a sense of comfort with the laser.”

	Dr. Briney performs many laser treatments with only topical 

, including gingivectomies, frenectomies and lingual frenectomies.

Related reading: 5 reasons to revisit lasers for your dental practice

, would like to see more dental professionals embrace laser dentistry the way medical professionals have.

	“Lasers have been in play for quite some time. In the medical field, 90 percent of doctors have them in use, but dentistry is only 10-15 percent at best. The trends are that lasers have a better response for tissue healing and are less invasive. They are the epitome of minimally-invasive-style dentistry,” he says.

	Dr. Briney thinks most doctors have concerns about the financials and the learning curve involved with laser dentistry. However, he feels if doctors who are wary of it gave the 

	“Any doctor who is reluctant is going to do what I did. They want to take baby steps,” he says.  “I jumped into laser dentistry with diodes. But as the technology has evolved, the diodes are a hygienist’s laser whereas the Waterlase is a doctor’s laser.”

	The Waterlase Express incorporates into many treatments, which translates into a high return on investment for doctors. Also, Dr. Briney says it changes the thought process and treatment planning when you include laser dentistry, which translates into 20-30 percent more revenue on top of what the doctors are doing themselves already.

Trending article: 6 ways to help patients overcome fear of the dentist

	“They are adding so many procedures, which is not only better for doctors and the practice but also for the patients’ well-being,” he says.

	Dr. Briney also says that when doctors see that a Waterlase Express is $800-$900 per month and they’re going to increase their revenue of that expense five-fold every month, the laser easily pays for itself.

	“The Waterlase Express is one of the most affordable all-tissue cutting lasers for a third of the price of other lasers out there, and the Waterlase is doing more procedures compared to those lasers,” he says. “When you see how easy it is to incorporate lasers into the practice and use it for patients, it will be a tipping point of using these lasers as the standard of quality for their practice.”

How BIOLASE’s Waterlase Express is transforming treatment planning and patient care. 

Offering comprehensive dental care with laser dentistry

	Convergent Dental CEO Michael Cataldo has two simple philosophies at his company. First, to make a great product and second, to keep the promises he makes about the product.   Because of that, no other laser company has the money-back guarantee that Convergent does for its Solea

	“The return policy is important for dentists who have been burned by companies that oversold lasers in the past,” Cataldo says. “Every once in a while people will ask, ‘What about the dentists who returned your lasers?’ I tell them I am proud of those returns because not every dentist is comfortable working without anesthesia, or they just change their mind but they don’t get stuck with a $100,000 coat hook.”

 9.3μm laser cleared by the FDA for hard, soft and osseous tissue treatments That unique 9.3μm wavelength is what enables Solea dentists to perform more than 80 different procedures from cavity preps of any size to soft tissue surgeries that would otherwise be referred out to specialists.

Related article: Improving pediatric laser dentistry with Solea

	Cataldo attributes Solea’s success in part to its 

 and a user interface that can make any dentist a laser expert. Regular software updates delivered via Wi-Fi keep Solea dentists current with the latest features.

	“Any dentist can pick this laser up and be anesthesia-free with 90 percent of their fillings within a month,” Cataldo says.

	Cataldo knows that some dentists are reluctant to embrace the technology. Part of this reluctance stems from the general attitude among dental professionals that laser dentistry, as a whole, hasn’t delivered on its promises. However, Cataldo says he created a company culture to combat that reputation. At Convergent Dental, he says, the customer’s success comes first and money comes second.

	“One of my sayings is, ‘Today’s customer satisfaction is the best leading indicator of tomorrow’s sales.’ We really mean customers first, especially in the laser industry,” Cataldo says.

	He also believes in creating an environment in which employees feel the impact they have on the business. A clear definition of corporate and individual objectives combined with regular feedback helps everyone feel the effect they’re having and their importance on the team.

Cataldo says Convergent Dental designed Solea to improve the procedures that dentists do every day. Solea allows them to do the things they already do faster and with a much better patient experience. From there, they can easily work their way into new procedures like soft tissue surgeries that pay more because the laser makes them simple to do. Solea imitates equipment that dentists already use, with a handpiece like that of the drill and a variable-speed foot pedal to control the cutting speed.

	“With one day of training, any dentist can treat virtually all of the fillings that they do without anesthesia or pain and perform dozens of soft tissue surgeries without anesthesia, bleeding, sutures, or discomfort,” Cataldo explains. “You pretty much do everything faster and with a dramatically better patient experience.”

How this all-tissue laser enables anesthesia-free, blood-free cutting.