	Throughout a workday, dentists see patients for many different treatments, from simple hygiene appointments to more complicated restorative procedures. One of the most common procedures is a direct composite restoration. 

The ultimate goal in a direct composite restoration is to provide the patient with a pain-free and esthetically pleasing result. Although this procedure is common and often relatively simple, the patient may feel discomfort if the correct products are not used together. 

One problem often associated with direct composite restorations is post-operative sensitivity. Several factors can cause this sensitivity, including the etching mode and amount of residual moisture in the tooth when applying an adhesive. 

In the past, the chosen etching mode often relied on the brand of adhesive, with some requiring one specific etching mode. Now, dentists can choose between self-, selective- or total-etch techniques, all from the same 

. One such universal adhesive, 3M™ ESPE™ Scotchbond™ Universal Adhesive, gives dentists the ability to use several different etching modes. With Scotchbond, dentists don’t need to be concerned with post-operative sensitivity because of the unique chemical makeup of the product. 

Another advantage of a universal adhesive is that dentists don’t need to worry as much about the residual moisture left in the dentin after rinsing off the etchant, thanks to the adhesive’s high moisture or dehydration tolerance. Dentists are given a larger window to place the adhesive and no longer need to risk overdrying of the restoration, which can contribute to post-operative sensitivity. 

The following case demonstrates how using a universal adhesive in a direct restorative procedure provides the efficiency to complete the procedure in less than 30 minutes.

A 35-year-old male presented with pain in tooth No. 20 and was diagnosed with recurrent decay beneath an existing conservative occlusal composite restoration. A direct composite restoration was chosen due to the size and location of the decay.

Check out the following video to see how the case was handled:

The existing decay on tooth No. 20 is removed. A Garrison FenderWedge® protects surrounding soft tissue and enamel from the high-speed drill.

 The restoration is etched in total-etch mode using 

 A total-etch mode is selected due to a majority of the restoration being in the enamel portion of the tooth and to ensure high bond strength with the existing enamel. The etchant sits for 15 seconds and is rinsed off, leaving the restoration slightly moist.

 Scotchbond™ Universal Adhesive is applied to the restoration and scrubbed for 20 seconds. The adhesive is dried using oil- and moisture-free air for five seconds and light cured using the 3M™ ESPE™ 

 A thin layer of flowable liner, 3M™ ESPE™ Filtek™ Supreme Ultra Flowable Restorative in shade A1B, is placed to decrease the likelihood of voids when additional composite is layered and is light cured for 10 seconds.

 The restoration is filled using a two-stage incremental technique, with a dual-shade technique chosen to offer a higher level of esthetics. To recreate the dentin layer, 3M™ ESPE™ Filtek™ Supreme Ultra Universal Restorative in shade A1B is first applied. The composite material is placed in a vertical incremental layering technique to combat polymerization shrinkage and shaped using a Hu-Friedy® Mini 4 Composite Instrument.

 The composite material is light cured for 10 seconds.

 A second layer of restorative is placed using Filtek Supreme Ultra in shade A2E, chosen to mimic the esthetic of the existing enamel and to provide a more seamless integration. The restorative is shaped and then light cured for 10 seconds.

Using a finishing bur, the restoration is adjusted for proper occlusion.

To complete the restoration, 3M™ ESPE™ Sof-Lex™ Spiral Finishing and Polishing Wheels are used to provide a natural luster and shine to the restoration.

When completing a direct composite restoration, it’s important to use materials that provide the longest-lasting and most comfortable results. Two years of personal clinical experience using a universal adhesive have resulted in zero adhesive-related post-operative sensitivity complaints. Universal adhesives give dentists the flexibility to choose their preferred etch mode, while providing confidence that the likelihood of post-operative sensitivity is greatly diminished.

Dr. Jeff Blank graduated from the Medical University of South Carolina College of Dental Medicine in 1989 and maintains a full-time private practice in Fort Mill, S.C., where he emphasizes complex restorative reconstruction and cosmetic enhancement procedures. He holds an adjunct instructor post in the Department of General Dentistry at the Medical University of South Carolina College of Dental Medicine and has authored dozens of clinical manuscripts on a variety of clinical techniques and materials. He is a fellow in the Academy of Comprehensive Esthetics and the International Academy of Dental Facial Esthetics and an active member of the International Association for Dental Research, the Academy of Operative Dentistry, the American Academy of Cosmetic Dentistry, the Pierre Fauchard Academy, the American Dental Association and the Academy of General Dentistry. 

Articles

How to achieve clinical confidence with universal adhesives

Looking for the latest dental fee information for your state or region? Look no further than this exclusive report from 

In late 2014, we provided you with a look at the 

20 often-used codes and the fees associated with them

 … from a nationwide perspective using data compiled from more than 12,000 dental practices. In this article, we are taking a look at the fees broken down by geographic region.

“Data and information is the first step towards knowledge and wisdom for running a more profitable practice,” said Vijay Sikka, founder and president of 

. “Knowing data is key to knowing and managing the score. If you can measure it, you can manage it.” 

Which states perform the most dental procedures? Find out here.

 region, you’ll find dental fees and associated codes for Alabama, Arkansas, Florida, Georgia, Louisiana, Mississippi, South Carolina and Tennessee. Click on the Southeast region link below.

 region, you’ll find dental fees and associated codes for Kentucky, Maryland, New Jersey, North Carolina, Pennsylvania, Virginia and West Virginia. Click on the Mid-Atlantic region link below.

 region, you’ll find dental fees and associated codes for Connecticut, Maine, Massachusetts, New Hampshire, New York, Rhode Island and Vermont. Click on the Northeast region link below.

region, you’ll find dental fees and associated codes for Illinois, Indiana, Michigan, Minnesota, Missouri, Ohio and Wisconsin. Click on the North Central region link below.

Interested in the free Practice Monitor from Sikka Software?	Click here to learn more.

 region, you’ll find dental fees and associated codes for Iowa, Montana, Nebraska, North Dakota, South Dakota and Wyoming. Click on the Midwest region tab below.

region, you’ll find dental fees and associated codes for Colorado, Kansas, New Mexico, Oklahoma and Texas. Click on the South Central rRegion tab below.

 region, you’ll find dental fees and associated codes for Arizona, California, Nevada and Utah. Click on the Southwest region tab below.

 region, you’ll find dental fees and associated codes for Idaho, Oregon and Washington. Click on the Northwest region tab below.

Editor's Note: If your state is not listed, not enough data was available from that state to accurately gauge the average fees.

RELATED: Is your practice declining? Here's why and how you can stop it.

“2015 is going to be a mixed bag of macro and micro economic fluctuations,” Sikka said. “As a big data company, we are noticing that there is a downward trend emerging in some of the key dental indicators. So, it becomes extremely important that fees are carefully evaluated and aligned for every dental practice with the profitability of that practice. Every dental practice is unique and how you practice is what determines your profitability even more than where you practice.” 

Want to know more about your fees?	Download Sikka Software's free fee analyzer

As a note about the figures, the data is broken into the 50

 percentile, meaning the 50th percentile is the fee below which 50 percent of the observations may be found, etc.

SOUTHEAST (FL, GA, AL, SC, MS, LA, AR, TN)

MID-ATLANTIC (NC, VA, MD, NJ, PA, WV, KY)

NORTH CENTRAL (OH, IN, MI, IL, WI, MN, MO)

	SOUTHEAST (FL, GA, AL, SC, MS, LA, AR, TN)

	MID-ATLANTIC (NC, VA, MD, NJ, PA, WV, KY)

	NORTH CENTRAL (OH, IN, MI, IL, WI, MN, MO)

Looking for the latest dental fee information for your state or region? Look no further than this exclusive report from Sikka Software and Dental Products Report.

Dental fees broken down by geographic region

	This February, National Children’s Dental Health Month, join caring dental professionals across the country for the America’s ToothFairySmile Drive, a national campaign to raise oral health awareness and collect oral care products for at-risk children.

America’s ToothFairy: National Children’s Oral Health Foundation

 launched its first Smile Drive in February 2014 in 

, an America’s ToothFairy Underwriter, and the Kid’s Crest

 products at Walmart. More than 430,000 oral care products were collected and distributed to vulnerable children, many of whom had been sharing a toothbrush with siblings, using the same toothbrush for years, or didn’t have one at all.

Seven-year-old David was thrilled when he received his very own toothbrush from last year's drive. "I didn’t have a toothbrush,” he said. “I had been wishing for one, and my dream came true!”

The America’s ToothFairy Smile Drive is made possible by Align Technology, the makers of Invisalign

 clear aligners. This year, Smile Drive locations will expand beyond select Walmart stores to include dental practices, schools, businesses and pharmacies. Dental practices that collect and donate 100 or more oral care products will receive a certificate, be recognized on the National Smile Drive Directory with a link to their practice website, and receive a promotional toolkit that includes donation box labels, event flyers, content for patient newsletters and more. The dental practice that collects the most oral care products will receive a plaque for in-office display, be eligible for recognition in local and national media and win prizes from leading dental companies.

Learn more about the Smile Drive campaign!

Oral care products collected through the 2015 Smile Drive can be personally delivered by practice staff to a preferred local charity-a great opportunity for media coverage from a local television station or newspaper. 

Join the movement to save the smiles of children in need! Register your dental practice for the America’s ToothFairy Smile Drive.

 This February, National Children’s Dental Health Month, join caring dental professionals across the country for the America’s ToothFairy Smile Drive, a national campaign to raise oral health awareness and collect oral care products for at-risk children.

Join the America's ToothFairy Smile Drive to help kids get access to dental care [VIDEO]

 in Newport Beach, Calif., she advised him to go electronic with his health records. She knew it was essential to embrace the future of dental practice management.

“Futuristically, everyone is going to electronic,” she said. “So do it now or do it later.”

 in Umatilla, Ore., agrees that incorporating electronic records is important to do now, particularly if you have patients who are on Medicaid or Medicare. Dr. Carr’s practice has a large percentage of these patients.

“The requirement at the end of next year is that anyone who sees Medicaid and Medicare patients must implement the meaningful-use standard with certified software to avoid payment reductions from Medicare. If you implement it early, the government offsets the costs,” she explained.

Getting reimbursement money requires certain qualifications and percentages to benefit from the program. If 30 percent of your patients are Medicaid-eligible, you can get up to $63,750 per licensed dentist. Carr explained it wasn’t as difficult to get the reimbursement as she thought.

“I was really surprised because a lot of people said it was going to be hard. The hard part for me was getting the reports right,” she said. “Once I had the data, it only took me 30 minutes to have it filled out and approved.”

Many clinicians are making the transition to practice management software for their practice. 

 has a fully integrated and certified* electronic health records software built into its system. Burkholder chose DentiMax for its great charting capabilities and the medical records integration.

“When I looked at DentiMax, I saw it had not only great practice management utility, but, also, the clinical side was really good, too. There was incentive for me to choose them over the competition because I believe the two go hand-in-hand,” she explained.

Related reading: EHR software from DentiMax helps dentists get the most from government incentives

Both Carr and Dr. Burkholder like how it improves efficiency for their practices, each of which has a holistic approach to patient care. From patient treatment and health history to preferences for hygiene techniques and medications, the clinician can decide what information to include in the entry. Then, the software has tabs built in so you can access the information you need to know quickly.

“There is nothing worse than flipping through paper in front of the patient. It’s inefficient. It’s bad to be inefficient because in this day and age with the reimbursement being lower from insurance companies, people are trying to treat more patients. To do that without diminishing the quality of care, you have to be more efficient with your time. With electronic charts, you have tabs, and you aren’t looking for things,” she explained. “You can find things so much more quickly.”

Carr agrees. “The records are so much better. Anytime you have better records, you are going to have better care,” she said.

	Dr. Carr’s practice has always embraced the move toward electronic health records. Adopting computer technology as early as 1982, he was one of the first to go chartless and electronic in the country and has been with 

Burkholder recognizes some practices might be reluctant to adopt an electronic health records system because they fear the adoption process could be slow or painful. She says it doesn’t have to be. Her practice had a staff member who knew the program that would add the data and convert it. The staff member would look at the next week’s appointments and enter them the week before, so the information would be converted over time.

Trending article: Is your dental practice completely HIPAA compliant? 

“It’s a process, but it’s not as bad as you think. Once you get a system down and do it over and over again, it doesn’t take as much time,” she said.

Carr likes how training occurs in the office at minimal expense. Other systems, she said, want to come in and train the whole staff for two to three days. She estimates trainings like that can cost a practice $20,000 to $30,000 in overhead and lost productivity. When you consider the turnover in staff most practices have, it isn’t practical. She described the DentiMax system as logical with questions to get the proper information.

“It’s easy to go from Point A to Point B. I can have somebody running a program in five minutes,” Carr explained. “Not that they can do everything the system has to offer in five minutes but at least enough to put in patient information and schedule appointments.”

DentiMax practice management software improves the patient care for the Burkholder practice as well. Burkholder explained that along with giving them easier access to the pertinent data, it also presents the treatment plan in the same file. This results in shorter appointment time.

Free E-Book: Simple ways to boost your practice image

“People have a hard time making time to go to the dentist. This system results in less time in the chair. Everyone likes that,” Burkholder said.

The Burkholders opted for a cloud-based system, mainly because she wanted to avoid housing a server and the related maintenance. She also likes that the upgrades are seamless and effortless. She also didn’t need to buy the software. In addition, she likes that the cloud gives her accessibility from any location.

Burkholder also advises practices to consider how the practice management system integrates with X-rays, digital imaging and intra-oral imaging. She chose the DentiMax system because it does these things, all from one company.

“In the end. if you want to run a successful practice, you want minimal costs, minimum vendors and all components of your electronic records-practice management, clinical and intra-oral-to integrate well,” Burkholder said. “The more you can put under one umbrella, the better for your practice. When things go wrong, you want it fixed quickly and all the brains under one roof.”

“This software is just amazing. It does everything but pick up the phone and call for you,” Carr agreed. “And they’re working on that!”

Trending article: 6 must-read articles for personal and professional success in 2015

*Certified software per ONC-ACB requirements to help providers meet Stage 1 and Stage 2 requirements for meaningful use.

 When Dr. Anita Burkholder, MD, helped her husband, Dr. Rich Burkholder, DDS, set up his new dental practice in Newport Beach, Calif., she advised him to go electronic with his health records. She knew it was essential to embrace the future of dental practice management.

How DentiMax practice management software improves efficiency for today’s clinician

	As technology continues to provide unparalleled advances and innovation, dental practices continue to change their methods for performing treatments, maintaining patient records and communication. 

With the integration of computers and the Internet into daily practice, patient data and dental records have been transferred to electronic platforms, allowing quicker access to information and easier communication between dental professionals. Additional digitization within the dental practice has also occurred, incorporating digital photographs, digital radiographs, emailing, texting, websites and social media. 

As our society has become more mobile and demanding of its 

 and information resources, the more personal on-demand devices have also started infiltrating dental practice. Smartphones, tablets, digital cameras, laptops and other 

 now enable a variety of functions within dental operatories almost instantaneously. 

They provide immediate access to and capturing of information, improving efficiency and practice management. However, although these so-called smart devices make it easier than ever to maximize the information within a dental practice that can lead to enhanced and more efficient care, sometimes their use might not be so smart.

Photographic and information sharing with mobile devices

Smartphones and tablets have permeated our society and our workplace. A survey completed by the 

in 2013 determined that 91% of American adults own a cell phone and 56% own a smartphone.

In addition to at least half of dental team members owning smartphones, many dental offices have integrated the use of mobile devices into their practices. Mobile devices (i.e., iPads, iPhones, Androids, etc.) are now used for capturing images, chart documentation and interoffice communication. 

 This can be very beneficial for practices to improve efficiency and communication, as mobile devices are portable, easy-to-use, and convenient. Unlike mobile devices of the past, cell phones and tablets can now take quality images acceptable for diagnostic and treatment planning.

 Information can be stored on the device or in “the cloud” for network access. These devices also have email and message capabilities to easily share information. Because of the prevalence of popular brands of mobile phones, limited training is required for using this equipment. 

In addition to the use of dedicated “practice-owned” portable electronic devices, the use of personal mobile devices for practice-related functions has also increased. Clinicians may use their devices to share information and photographs about cases with colleagues, talk with patients or communicate with office staff. With access to the dental office network remotely, some team members can work from home charting or accessing billing information, while using their personal devices to check in and ask questions of staff members in the office. Additionally, some social media marketing encourages staff members to take photographs on their personal devices around the office and post them on the Internet. The convenience of this technology may be too good to pass up, but the seriousness of patient privacy, along with new regulations and guidelines that have been developed, may give you reason to pause to ensure proper patient information protection. 

 Health Insurance Portability and Accountability Act 

(HIPAA) in 1996, dental practices became a covered entity responsible for creating and implementing policies to protect personal health information (PHI).

 By establishing national standards, these policies required dental practices and team members examine the way they treated PHI within their practice. The HIPAA guidelines include two major components: The privacy rule and the security rule. 

Under the privacy rule, the law requires that HIPAA-covered entities must implement safeguards to protect PHI. Another component to HIPAA, the security rule, is far more comprehensive, and sets standards for access, management and storage of 

electronic patient health information (ePHI).

 This rule requires that ePHI be maintained with confidentiality, integrity and accessibility, and that practices utilize security risk assessment to demonstrate their ability to protect ePHI.

 Health Information Technology for Economic and Clinical Health

 (HITECH) Act widens the scope of the privacy and security protections of HIPAA and provides more enforcement.5 This law further expands upon the principles of protecting ePHI and places liability on the practice to prove compliance on all HIPAA/HITECH rules. This spans threat monitoring to documentation of ongoing security measures, even if third-party applications are used for encryption. It also requires that the sender and receiver of an ePHI file or email utilize secure locations, as well as a secure pathway through which the material is sent. 

In addition to HIPPA and HITECH, systems are required to be 

Digital Imaging and Communications in Medicine

 (DICOM) conformant, with all images taken in the practice meeting these standards.

 DICOM images include not only digital images, but also any pertinent patient data or notes regarding the images.

Thus, any ePHI images stored on personal mobile devices or even mobile devices within the practice must be secured and shared over a secured network. With the increased scope of requirements for maintaining the privacy and security of ePHI, dental practices must assess the risks present in their current policies and equipment. 

Although mobile devices provide a convenient and easy-to-use option for taking photographs and sharing information, according to the 

, theft and loss of unencrypted devices and media storage have been the leading culprits of major HIPAA health data breaches.

Another study of health care workers determined that theft accounted for 66% of the reported breaches over the past two years.

 These data beaches occur generally because the mobile device did not have users enter a password or provide biometric identification to access the information stored on the device.

Additionally, these devices were typically not encrypted, meaning ePHI could be shared with anyone with access to the mobile device, and the devices used public Wi-Fi connections or unsecure cellular networks to send and receive ePHI.

To avoid some risk while continuing the use of mobile devices in the dental practice, a variety of safeguards are available. These include setting strong passwords, encryption, automatic log off, requiring a user ID, enabling remote wipe, locking the device, registering the mobile device, installing a firewall and using a secure Wi-Fi connection.

However, when using personal mobile devices, these safeguards may not be enough to be categorized as HIPAA and HITECH compliant.

Dental-specific equipment may be the best approach to ensure full HIPAA, HITECH and DICOM compliancy. Dedicated dental digital cameras provide dental practices with the ability to take a variety of photographs, ideal for diagnostic purposes and treatment planning. These devices can be securely locked away, and can either utilize a secure Wi-Fi network for transfers or connect directly to the practice computer. Once on the computer, these images can then be shared through secured access to other necessary parties. Although some convenience may be sacrificed, these cameras are typically lightweight, intuitive and ideal for dentistry, capturing precise and accurate photographs of the face and intraoral cavity. 

For practices that choose to utilize mobile devices for patient care, especially Apple products (e.g., iPhones and iPads), there are several ways to make your devices more HIPAA and HITECH compliant.

1. Set longer passcodes. The automatic 4-digit pin does not provide adequate security, and users of Apple devices are recommended to create a longer passcode of between 7-10 characters. 

2. Activate remote features. Apple products include three options for lost or stolen iPhones and iPads. The erase data feature erases all data on the device if the wrong passcode is entered 10 times. Remote tracking utilizes the iCloud to locate the device as long as the device is connected to Wi-Fi or has a cellular signal. Remote wipe can be initiated as long as the device is connected to Wi-Fi or has a cellular signal, but once wiped it can no longer be tracked. By activating these features, the data can still be removed from the device and protected in the event of a lost or stolen device.

3. Disable Siri. By disabling Siri when the phone is locked, the voice-activated feature is unable to access information when the phone or tablet is locked. 

4. Avoid auto-login apps. Although most dental professionals utilize mobile devices for convenience, auto-login apps are a major threat to ePHI confidentiality and security. This includes the native Mail application on Apple devices. In order to remain HIPAA-complaint while using mobile devices, users should access mail by using the Internet browser that requires a username and password, and users should always logout after each session.

In addition to the native apps found on Apple devices, additional application development has led to a variety of dental specific apps. The purposes of these apps are mixed, as some focus on providing convenience and instant access to information, while others claim to provide better security and HIPAA-compliancy. Before utilizing any applications on your mobile device, users must determine whether the app will have access to ePHI, and if it does, if the information will remain HIPAA compliant. This includes requiring a username and passcode upon opening the app, ensuring that the material on the app is encrypted, and safeguarding that the information is stored in a secure cloud network, not on the mobile device itself. 

Some applications (e.g., Dropbox and Google Drive) are not secure and can put your data at risk because they have not signed HIPAA-compliant Business Associate Agreements, and they allow, in some cases, unauthorized users to access your information without your knowledge.11 Users must research any applications they download to their phone that could potentially be a threat to ePHI data, in order to remain HIPAA and HITECH compliant, and to avoid any breeches of patient information. 

Due to the high demands and technological advances within dental practices, many offices have found that utilizing personal and office specific mobile devices improves efficiency and convenience. However, with strict regulations for storing and sharing patient information by HIPAA and HITECH, dental practices must consider the risks in utilizing mobile devices in every day practice. The law comprehensively protects any type of patient information stored by a dental practice, and with more enforcement, dental practices must implement strict policies regarding personal mobile devices and secured sharing. By utilizing equipment designed for dentistry (i.e, dental digital cameras), dental practices reduce their risk for HIPAA and HITECH violations and yet continue to capture and share essential information compliantly.   

Shannon Pace Brinker, CDA, CDD is a national and international speaker and published author. Shannon serves as the editor in chief of Contemporary Product Solutions, which she owns with her husband Erik. Contemporary Product Solutions provides product reviews for the complete dental team, and is the only dental editorial that combines product reviews for the whole team. Shannon is a past faculty member at the Dawson Academy and Spear Education. She is an active member of the AACD and the first auxiliary to sit on its board of firectors. Shannon was selected as one of Dental Product Report’s 25 most influential women in dentistry, and Dr. Bicuspid’s dental assistant educator of the year in 2012. For more information, Shannon can be contacted at shannon@cpsmagazine.com.

1. Smith A. Pew Smartphone Ownership-2013 Update. 5 June 2013. Pew Internet. Retrieved from www.pewinternet.org/Reports/2013/Smartphone-Ownership-2013/Findings.aspx.

2. Helvey GA, Culp L, McLaren EA. Developing a digital dental team. Compend Contin Educ Dent. 2012;33(12):654-5. 

3. Summary of the HIPAA Privacy Rule. 1996. United States Department of Health and Human Services. Retrieved from http://www.hhs.gov/ocr/privacy/hipaa/understanding/summary/privacysummary.pdf. 

4. DiMatteo A, Latanyshyn KA. The case for digital radiography. Inside Dent. 2014;10(10):110-9. 

5. HITECH Act Enforcement Interim Final Rule. 2009. United States Department of Health and Human Services. Retrieved from http://www.hhs.gov/ocr/privacy/hipaa/administrative/enforcementrule/hitechenforcementifr.html. 

6. Farman A. DICOM for digital imaging and communication in dentistry. Inside Dent. 2009;5(8):80-3. 

7. McLaughlin J. The great BYOD challenge: 5 tips for implementing a HIPAA-compliant “Bring Your Own Device” policy. The Profitable Dentist. 2014;249:10-1. 

8. HIPAA Security Rule Compliance When Communicating with Patients Using Mobile Devices. Jan 2011. Center for Democracy and Technology. Retrieved from http://www.projecthealthdesign.org/media/file/Mobile-Device-Privacy-and-Security-Webinar-Slides-012511.pdf. 

9. Lewis Dolan P. Doctors driving IT development with their mobile technology choices. 23 May 2011. American Medical News. Retrieved from http://www.ama-assn.org/amednews/2011/05/23/bisb0523.htm. 

10. Your Mobile Device and Health Information Privacy and Security. 21 March 2014. HealthIT.gov. Retrieved from http://www.healthit.gov/providers-professionals/your-mobile-device-and-health-information-privacy-and-security.

11. Rios J. HIPAA Security for iPhones. 10 Oct. 2013. HITECH Answers. Retrieved from http://www.hitechanswers.net/hipaa-security-iphones/. 

 As technology continues to provide unparalleled advances and innovation, dental practices continue to change their methods for performing treatments, maintaining patient records and communication. 

HIPAA compliance and digital photography with personal mobile devices

have made in his practice, and why making a good first impression doesn't have to cost more.

Dr. Chad Wagener has been practicing in Ankeny, Iowa, for 24 years. He has a solo practice with six employees and is a member of the ADA, Iowa Dental Association, ALD, AACD, and is currently President of the Iowa Academy of General Dentistry, Associate Adjunct Professor at the University of Iowa College of Dentistry, and member of the Catapult Group.

While always on the lookout for products and technology that make their jobs easier, Dr. Wagener and his staff recently made a switch in the dental scrubs they wear. Here they share their story of TiScrubs dental scrubs.  

Get DPR's latest e-book: How floss alternatives can help patients with preventative care

“Patients have several first impressions when they come to our office, from the initial phone call, to the office décor and the professionalism of the team,” he said. “I have a very busy general dentistry office that is modern and high tech. When it came to finding new scrubs for my team and I, we really did not want the traditional cotton or blended lab coats or smocks. I was looking for something more modern looking.  

, TiScrubs caught my eye.  These scrubs were different from anything else I had seen. They were lightweight, breathable and antimicrobial. My team was excited about them, and our patients constantly comment on how professional we look. These scrubs are very comfortable to wear, keep me cool even during my toughest procedures and are holding up great!”

They also are cutting costs for the practice.

“Previously we were sending our scrubs out to a local dry cleaner to have them laundered and pressed.  Now we have installed a washer and dryer and do our own laundry.  This has saved us hundreds of dollars every month with minimal additional time from the team. The scrubs come out of the dryer looking great, and we have not noticed any fading like we used to with our cotton blended scrubs. And if the scrubs were not enough, some of the profits go towards helping TeamSmile, a non-profit organization using professional sports to draw disadvantaged kids into their first dentistry experience. TiScrubs are a win-win, and they make any team look and feel their best and make a great first impression!”

Related reading: DEXIS and TeamSmile bring dental care to underserved children

“After 19 years working in the dental field, it has been refreshing to find scrubs that are functional, fashionable, comfortable and easy to maintain all in one product,” said Victoria Carr, Expanded Function Dental Assistant at the practice.

“Because our attire is consistent day in and day out, it is important to our team to feel good about what we wear. Our new TiScrubs do just that!  From a very busy vendor floor at the Chicago Midwinter Meeting, our first impression of the TiScrubs product and representatives stood out among all the rest and has proven itself over the last year. They have been wonderful to work with!”   

, Kansas City dentist and creator of TiScrubs, was so inspired by a case featured on NBC’s Nightly News with Brian Williams where a Maryland boy died as the result of an untreated abscessed tooth that he decided to reach out to members of the dental community to find a way to make a difference.

Understanding the universal appeal of professional sports, Dr. Busch’s vision was to facilitate partnerships between dental professionals, pro sports teams and dental organizations with the goal of providing life-changing dental care and instruction to children who otherwise would not have access to it. He thought: What better way to get kids excited about taking care of their teeth than to tie dental health care in with professional sports?

 outreach program was hosted by Dr. Busch’s hometown NFL football team, the Kansas City Chiefs. The Chiefs organization promoted a fun, one-day event where dental volunteers provided outreach services to Kansas City area children.

TeamSmile quickly expanded around the U.S. with the help of other NFL, MLB, NBA, NHL and Pro Golf teams but Dr. Busch needed to find a way to sustain TeamSmile and keep his philanthropic dream alive.

In 2010, he came up with an idea. He had always provided the dentists, hygienists and other healthcare professionals volunteering at TeamSmile events with standard, cotton medical scrubs embroidered with the sponsoring pro sports team’s logo; however, he never thought the traditional scrubs fit the image of the high-tech dental events and the pro-athletes that were a part of them. So Dr. Busch decided to create a line of athletic-looking, performance scrubs for the volunteers to wear. These scrubs, which he called TiScrubs, were so popular with TeamSmile volunteers that Dr. Busch decided to offer them to everyone in the healthcare community and use the proceeds to help fund TeamSmile.

Today, TiScrubs and TeamSmile help improve the smiles of thousands of kids around the U.S. each year

 Dental Products Report talked to Dr. Chad Wagener, DDS,  about the differences TiScrubs have made in his practice, and why making a good first impression doesn't have to cost more.

Dental scrubs that can help cut costs, work more efficiently

	Opening a practice can be a daunting task full of many unknowns. One practitioner shares her top tips for making the process easier.

, has learned a lot from her mentor, Dr. James Saycich, her dentist since she was a child. Dr. Saycich inspired her to go into dentistry while she worked as his assistant in high school. After graduating from the University of Las Vegas, Nevada, dental school in 2007, Dr. Dee Dee worked with Saycich at his dental office for five years. “He taught me how to run a practice,” Dr. Dee Dee said. “Everything from managing my assistant to doing payroll.” 

As Dr. Dee Dee’s patient load grew, and she became anxious to work with updated technology, she decided it was time to open her own practice. She and her husband, Mike, opened 

 in 2011. As the office manager, Mike handles many of the details so Dr. Dee Dee can focus on patient care. They learned these five important lessons along the way: 

Get DPR's latest e-book: How floss alternatives can help patients with preventative care

A solid business plan is the foundation of a new practice. Dr. Dee Dee developed a basic business plan and recruited a friend who works as a financial planner to help with the hard numbers. “At first, try to keep everything you do in-house,” Dr. Dee Dee said. “If you have a family member or a friend who can help out, by all means, ask for it.” Dr. Dee Dee revisits her business plan annually to compare financials with the prior year. 

Dr. Dee Dee said it’s important not to overestimate the amount of 

 you’ll get right away. She said to keep your business plan simple and straight-to-the-point. If anything, underestimate the amount of money you and the business are going to make right away. 

Related reading: 8 steps to turn phone calls into patients

“The hardest thing is building the team,” Dr. Dee Dee said. “A great team will have the same vision as you, and it’s hard to find good people that are on the same page.” To do this, Dr. Dee Dee suggests interviewing lots of candidates and involving the team in the selection. “You want to find people who see this not just as a job,” she explained. That’s why each candidate is asked: “Which matters to you most: Job satisfaction or pay?” If the candidate responds with “pay,” it’s a red flag.

 good people, give them a reason to stick around. 

At Dee for Dentist, this means profit sharing, team lunches, holiday parties, scavenger hunts, 5K races and volunteer events. “If employees get along and are friends with one another, they are going to enjoy being at work, and they’re going to stick around,” Dr. Dee Dee said. 

“Technology is expensive,” Dr. Dee Dee said. “But if you’re investing in it to make yourself a better clinician, the investment will be worth it because it will set you apart from other offices. Your patients will know you care about their treatment. It’s a steep investment, but if it’s part of your business plan, it’s always doable.” 

Dee for Dentist was opened when the economy was down, but, despite that, business has grown tremendously. Dr. Dee Dee and Mike have hired more staff members, continue to add new technology and are enjoying great success. “I’m very proud and surprised,” Dr. Dee Dee said. “I didn’t realize we would get to this point this fast.”

 Opening a practice can be a daunting task full of many unknowns. One practitioner shares her top tips for making the process easier.

The top 5 tips for starting your own practice

	Each year, Dr. John Flucke shares his predictions for emerging and continuing dental industry trends in the coming year. Here are his predictions for 2015.

Well, here we are again ... another year under our collective belts and more growth and development in our beloved profession. I got some great advice and mentoring in dental school (Brett, I’m talking about you!) but I also got a few tidbits of “ less-than-stellar advice.” The worst advice I got was from an older instructor who told me, “Flucke, you are getting such a great education here, you could graduate and never learn another thing and you’ll be just fine.” Uh, that hasn’t held up.

We have seen some changes come down the pipe in 2014, and 2015 promises to be even better. Predicting the future is always dicey and more than a little stressful for me. It was easier for my toupee-wearing Uncle Louie to walk down the street on a windy day than it is for me to put my Technology Evangelist reputation on the line with predictions. However, my bosses here at DPR (and all of you amazing readers) really like predictions … so here we go!

I’ve written about Internet-connected equipment before, but now we are starting to see equipment that is Internet-connected and “Internet smart.” By that I mean that they have a connection and update themselves over the Internet whenever improvements are developed. My 

 autoclave sends e-mails to me on every cycle and notifies my service folks at Goetze Dental if it needs repairs. My 

 handpiece systems connect to an iPad and an iPod, respectively. They are run by apps that are updated by the Apple devices and have the ability to be truly “intelligent devices.”

 continues to become a bigger part of what we do, this year I’m looking at ways “the cloud” can work in every office. We use 

to stream in custom-made entertainment and dental information that is unique to our office. This affordable service provides custom cloud-based videos and other information that is created just for us and stored in the cloud. 

Patient education is also something that is better in the cloud. With no updates to run and no server to buy and maintain, services like 

 make patient education easy to use and simple.

Then we get to patient communication services such as 

. Being able to text, e-mail and confirm patients through the cloud with no staff time involved is amazing!

Related reading: Cloudy with a chance of computing 

At some point, there is going to be a merge between dentistry and medicine from a records standpoint. The federal government wants to have a single record because doing so will allow for more comprehensive diagnostic data to be available which will allow anyone treating a patient to be able to provide more comprehensive care. Having all of a patient’s healthcare data in a single storage spot that doesn’t treat medicine and dentistry as separate will also create efficiency … and that should save money. Hopefully the merging of the health record will do just that.