 was introduced in 2009 following the great success of the 

. Since that time, the Platinum sensor and the DEXIS digital X-ray system as a whole, have gained many awards from well-respected dental publications, dental researchers, dental technology experts, and very importantly, peer-elected programs. 

 remains the most highly awarded intra-oral digital X-ray system.

The secret to the award-winning success of the DEXIS Platinum is its physical attributes that lead to patient comfort, remarkable image quality with lowered radiation, and overall efficient use. While every digital X-ray system saves time over traditional film, a single-sensor solution saves the most time. 

DEXIS offers the PerfectSize™ Platinum sensor

-an ergonomically designed universal sensor.
	 

When using DEXIS Platinum sensors during the study*, patients found it easier to close completely on the DEXIS biteblocks including bitewing (seen here) and in periapical positions.

 design of DEXIS Platinum provides beveled corners and a smoothly rounded casing that allows the clinician to more efficiently move about the mouth with the sensor, even in tough areas such as upper molars and lower premolars, partly because it is more comfortable than square-cornered sensors. Additionally, the way the 

 cable exits from the back of the sensor lends comfort, especially when taking vertical bitewings.   

In a limited, double-blind, randomized, controlled study*, a head-to-head comparison was made involving the DEXIS Platinum sensor and competitive sensors. Study distribution included patient populations with varying anatomy including small to large mouths, shallow palate, tori, narrow arches, and patients with a strong gag reflex. Of those tested, 88% found DEXIS to be the most comfortable sensor.   

compares to competitive sensors at different exposure times.


	“When I can make my patients comfortable, it creates a better experience for them and less stress for me. Using the DEXIS sensor provides me with a way to capture images while maintaining a high level of comfort which, in turn, lets me finish a radiographic procedure quickly.” Shelly Rice, RDH, Lake Elmo, Minn.

Click here to read about how this sensor can provide optimal diagnostics.

When it comes to any radiograph-the better the image, the better the diagnosis. The ability to see subtleties in X-ray images is crucial to diagnosis, collaboration, and even patient communication.

, during capture, the sensor and the software work in harmony to compensate for radiation variances thus guarding against under and over exposure and giving the best results at the lowest dose. This flexibility in exposure means that you gain more clinically useable, more consistent images at a higher or a wider range of exposure settings, including lower dose settings. You benefit from a reduction in the number of exposure-related retakes, and your patients benefit from the reduction in radiation.

Beveled corners and a smoothly rounded casing, plus the patented cable exit, create patient comfort and aid in efficient placement. 

In a laboratory setting*, image quality was recently analyzed with respect to dose. The results were that the image quality obtained using the 

 demonstrated more consistency across both low and high radiation dose, when compared with other competitive sensors. In addition, the DEXIS Platinum sensor provided higher diagnostic image quality results at lower radiation doses when compared to these competitive sensors.

Post-capture, images can be displayed at ultra-large sizes and even enlarged without pixilation or loss of quality. In addition to the notable image quality of initially captured images obtained using the DEXIS Platinum sensor, DEXIS imaging software has another effective tool, 

. Apply this acclaimed image enhancement tool that utilizes advanced algorithms to provide further definition, detail, and depth for acquired images.

“The greatest benefit to using DEXIS in our practice is improved patient care, and that starts with better diagnostics made possible by great image quality. We use 45-inch monitors in our operatories, and even this enlarged, our DEXIS Platinum images are still so clear, you can see dental conditions that you never even thought existed.” Brad Durham, DMD, Savannah, Ga.

When it comes to helping dentists control dose, DEXIS didn’t stop with the sensor. The company has now taken dose reduction a step further with the all-new 

.
	DEXshield is a unique dental X-ray position indicating device and a patented patient-protective shield.

In a laboratory setting*, DEXshield plus the DEXIS Platinum sensor was determined to reduce dose by at least 30% as compared to the Universal Ring plus the DEXIS Platinum sensor. DEXIS is the only company to provide its owners with both an intra-oral sensor (DEXIS Platinum) and a shielded ring, (DEXshield) with this added benefit of dose reduction. This is a real win for your patients.

“When I started using the DEXIS Classic sensor 12 years ago in private practice, we were able to reduce our settings by at least 60%. When we switched to Platinum, we lowered the settings even more. I was very happy to relay this information to patients. I was excited to be involved with DEXshield development, and I am pleased that we’ve given DEXIS owners another way to further lower exposure to patients.” Christine Hart, CDA, Clinical Affairs Manager for DEXIS.

The DEXshield is a Platinum companion to sensors by DEXIS.

Time is a prized commodity in the dental office. Not only does the sensor’s ergonomic design let the dental professional efficiently move throughout the mouth, the direct-USB connectivity of the Platinum sensor lets them efficiently move throughout the office-just “plug-and-play”.

Articles

The DEXIS Platinum sensor was introduced in 2009 following the great success of the DEXIS Classic sensor. Since that time, the Platinum sensor and the DEXIS digital X-ray system as a whole, have gained many awards from well-respected dental publications, dental researchers, dental technology experts, and very importantly, peer-elected programs. 

Inside Look: Diagnostics, efficiency, patient care at its best

I’ve been working as office director for 16 years and have seen many changes in the dental administrative process from paper appointment books and photocopy billing to digital everything! 

, runs a very busy general and restorative practice, and we all strive to make the best use of our time.

Part of the digital conversion for us has included moving to digital x-ray, specifically to 

. While I hear the clinical staff rave about DEXIS, the software’s benefits don’t stop when our team crosses the threshold to the front office. As I go through my work day of administrative tasks, there are lots of areas that have been improved by DEXIS.

Let’s face it, we’re all human, and we make mistakes. In the “days of film,” occasionally, these film x-rays were misfiled. Then, when a patient arrived for an appointment, and his or her x-rays were not in the chart, panic would ensue as all team members would scramble looking through the appointment lists for days surrounding the patient’s last visit, digging into charts of folks seen during that time or with similar names-all in an effort to find these “lost” x-rays.

After what seemed like hours, the radiographs might not even surface at all, and the team would need to retake them. With digital radiography, since there’s no hard copies to deal with, all the x-rays (and other images) are right where they should be, ready for us to use them.

When we had film, our assistant would need to find time during the busy day to duplicate x-rays. Often, it might take a day or two before I or the assistants would get to it. We would start by taking all the film x-rays out of their mounts since you can’t get a really good copy if you don’t. Then you have to lay them out on the duplicator and expose the dupe film. We would have to process the film and remount the individual films.

There are definitely costs associated with this entire duplicating process, including labor. And we all know that these copies do not have the best quality no matter how detailed you are. With DEXIS, the image does not degrade. It’s the same as when it was taken, crisp and clear.

: With digital radiography, x-rays are right where they should be. Additionally, they can be easily shared and stored.

Having a digital imaging system certainly helps us with sharing images with other offices. Before we had DEXIS, we snail-mailed copies of film x-rays. I wonder just how much time we spent getting these ready to send out, and just how much we are currently saving on postage. Now we can simply email x-rays through a secure server.

Our referring specialists can send us images via email, too, and we can have reports from them before our patients ever leave their offices.

 practice management that integrates very nicely with DEXIS. I spend a lot of time within our practice management software and really appreciate this integration. When it comes time to send an insurance claim, we can attach images right to the claim that comes out of Easy Dental.

If I need to attach an x-ray, I can spot what I need quickly on the Overview screen. And best yet, there’s no waiting for duplication. Claims can go out immediately after treatment through our secure service.

Since I occasionally take radiographs, there’s something that I and the rest of the clinical team agree on: One of the absolute best things about our digital x-ray system is the comfort of the sensor. For years we had patient complaints about the sharp edges of the film we used. We tried several different film brands and holders, but still had issues with patient discomfort. The comfort of the sensor and the absolute speed of acquiring images using DEXIS are far and away so much better than traditional film. 

We all really appreciate just having our DEXIS images at our fingertips….and I would never go back to film!

I’ve been working as office director for 16 years and have seen many changes in the dental administrative process from paper appointment books and photocopy billing to digital everything!  My employer, Dr. Edward Chipps, runs a very busy general and restorative practice, and we all strive to make the best use of our time.

Dental practice efficiency starts at your front desk

While the results of orthodontic treatment usually bring big smiles and straighter teeth, there are some side effects that can go along with treatment as well. 

Such was the case with a recent patient. She was a college student who was about to begin nursing school and had finished her orthodontic regimen. However, she was not pleased with the results.

When she looked in the mirror, she saw discolored teeth, white spots and yellowed composites, a prominent upper left canine, inconsistent shapes and papilla, and worn edges of teeth.

She also complained of muscle tenderness and a sense of not having a consistent bite. It was determined that the prominent canine, slight fremitus of Nos. 6-11, and general tooth wear were indicative of occlusal dysfunction, while the discolored cervical composites and generalized “white spots” were indicative of a history of decalcification.

Noting the decalcification, one of the biggest questions at her exam was whether this was still an active problem. A “bioluminescence” test demonstrated a lower than optimum pH in the oral environment. The patient was put on an aggressive remineralization program using 

 was used due to its durability, natural selection of colors, and its ability to allow underlying tooth structure to enhance the composite’s appearance.

Some of the qualities that I appreciate about the Aura system are: 

•  It’s non-sticky. Less uncured resin is used, resulting in creamy handling. 

•  It’s easy to polish to a mirror finish 

•  It has large particles (60 microns). This means high filler loading and strength. 

•  A big bonus is its low flexural modulus. This means better fracture resistance as less stress at the composite interface means less debonding.

•  It has lower polymerization shrinkage.

•  It is a prepolymerized microfilled composite, making it stronger than a standard microfill.

•  It’s easy to polish to high gloss.

•  It has high fluorescence in the dentin and slight in the enamel and contains opalescence (bluish glow in natural light) to match natural enamels. I think this gives life to the restoration.

•  It has superb gloss retention without the “plucking effect” of large particles. 

The patient wanted a shade that was bright but also looked natural. The Aura E1 shade was selected because it was the most whitish/lightest. It has high opalescence with some degree of translucency and was designed to emulate young enamel for those who are 20 or younger.

Surface discolorations and previous composites were conservatively removed with a flame-shaped diamond, maintaining the outer enamel and creating room for the forthcoming layer of Aura.

Treatment sequence of bonding is begun with tooth Nos. 8 and 10. After outline form and gross contouring, No. 7 and No. 9 were treated in the same fashion. Tooth Nos. 5 and 6 were bonded, followed by Nos. 11 and 12. Aura’s handling properties allowed this be performed very efficiently and effectively.

 37% phosphoric acid was placed over the entire labial surface with a 30-second exposure time (since no dentin was involved) and thoroughly rinsed with water for 15 seconds each.

A universal bonding resin was placed carefully placed using a microbrush and thinned with a warm air dryer.

Each tooth being treated was cured for 20 seconds using 

light with its wide tip. Aura Enamel (Shade E1) was thinly applied and sculpted using 

 placing the gingival half first blending the interproximal. After a 40-second cure, the incisal portion is adapted to the tooth using the anatomy of the incisal edge and adjacent anatomy to guide initial contouring.

Gross finishing is achieved with a thin 16 bladed ET 9 bur to clean the gingival margins and establish labial anatomy. Interproximal surfaces were smoothed with plastic finishing strips.

Overall, she was very happy with the results and could finally flash the confident smile of completed orthodontic treatment.

How to use SDI's Aura universal composite to correct esthetics [VIDEO]

Clear aligner therapy has been a growing option for patients who simply cannot tolerate or who deny fixed appliances. 

The following case study was selected to demonstrate how with proper diagnosis, patient selection and treatment planning, clear aligner therapy such as 

 can acceptably resolve moderate to severe crowding with improvements in facial balance, dental function, smile esthetics and overall oral health.

A 40-year-old female presented with the chief complaint that she didn’t like her smile and was seeking improvement in smile esthetics. The patient was symmetrical on frontal view and had a fat lip balance on profile view. The patient presented with normal gingival display on her smile as well as normal incisor display at rest for her age.

A panoramic radiograph showed all permanent third molars were missing and a fair degree of restorations were present.

Root lengths were within normal limits. No clinical or radiographic pathologies were noted. The patient’s anterior dentition was shown to have moderate root tipping off of the axial plane. Cephalometric analysis all appeared to be within normal limits.

The patient presented with Class I malocclusion, moderate to severe crowding: three-four millimeters of crowding in the upper arch and seven-10 millimeters of crowding in her lower arch. Her upper dental midline coincided with the mid-sagittal plane, and her lower dental midline was approximately four millimeters to her right.

This was to be expected, as the crowding was progressively more severe to the patient’s right with a lower right canine blocked out. The patient presented with thin anterior tissue, and with recession on her upper anteriors prior to beginning treatment.

Fixed appliances were presented as a possible treatment option, as was clear aligner therapy. Proceeding with full braces was attempted; however the patient expressed concerns with the fixed appliances so we elected to complete treatment with clear aligner therapy instead.

Prior to proceeding with clear aligner therapy, the high degree of importance of patient compliance, which was necessary for treatment to work, was discussed. Considering the degree of crowding, patient compliance was fundamentally important to achieving the desired results.

Due to significant crowding and the difficulty of having overlapping lower anteriors (which resembled progressive overlap like shingles on a roof) in the lower, the author elected to perform a series of interproximal reduction (IPR) PRIOR to taking PVS impressions to be sent to 

When the PVS impressions were made for the 

, the patient was given a set of clear retainers to hold the position of the dentition after the IPR was performed. IPR was performed from the distal of the lower second premolar to second premolar, and on the upper, IPR was performed from the mesial of the canine to canine. Approximately 0.15 millimeters of IPR was performed per tooth surface.

The patient’s upper arch took approximately 13 months and aligned predictably and uneventfully. The lower arch took slightly longer at 23 months, with one revision required at month 13. The patient was seen every six weeks. When debanded, judicious cosmetic enamelplasty on the incisal edges of the patient’s anterior dentition was performed. Clear retainers were made for the patient and the patient was instructed to wear the retainers only at night.

The patient began with Class I molar and Class I canine malocclusion. The patient finished treatment in Class I molar and canine with acceptably resolved crowding. Midlines were improved, and root tipping was improved both clinically and radiographically.

Radiographic review showed no significant change in root length or shape upon completion of treatment. The anteriors were proclined and positioned in a more esthetically pleasing position both dentally and facially by providing natural lip support. The patient’s profile has shown improvement, going from a fatter lip balance to a more full convex lip balance, which is commonly viewed as a more youthful appearance.

The patient stated she was extremely happy with the treatment and entire process. She was impressed with the results, and noted she never thought the outcome would have been as great as it turned out to be. The patient was very compliant and motivated, and said the care from and time spent with the treating doctor and associated staff was amazing; she felt the doctor did an excellent job of guiding her through the process.

With adult patients presenting with moderate to severe crowding, it is important to diagnose clinically, with considerations of not just tooth alignment but also gnathological function, periodontal concerns and facial balance. With this patient, the treating doctor felt that any tooth extraction would have both facial compromises as well as functional compromises that would have been unacceptable for both the patient and treating doctor.

Non-extraction therapy was elected moving forward, and IPR was utilized to resolve the crowding, which maximized facial balance and improved dental function. As extractions have long been known to collapse the facial profile, and because the patient was in her mid-40s with an already fat profile to begin with, mild upper crowding and thin lips, the treating doctor felt strongly that a lower incisor extraction should only be considered as a last resort.

Additionally, since the patient’s pre-existing malocclusion presented with uneven, worn edges, it was felt that recontouring of the incisal edges would have a positive effect on the patient’s final cosmetic outcome.

This was accomplished by not removing any tooth mass on the deepest part of the worn tooth, and rather by reshaping the tooth as a whole into a more normal and esthetically-balanced dental smile arc. It should be noted that any type of tooth recontouring must be completed with great care.

Although some may argue that fixed appliances may have been able to finalize the desired dentition in more detail, both the patient and treating doctor felt that it was an inappropriate option for the patient, as she would not tolerate the fixed appliances.

The final results demonstrate that marked improvement in esthetics, function and overall patient well-being can be accomplished with clear aligner therapy such as ClearCorrect.

How to use clear aligner therapy to treat severe crowding [VIDEO]

affirm the importance of the teeth and smile to overall facial esthetics.

  As the world’s population ages, it seems that more people are keeping their natural teeth into their later years.

Studies of the aging face confirm that as lip musculature becomes more flaccid and responsive to gravity and fat volume changes, lower front teeth become more important in the smile display.

A recent PubMed search for “mandibular anterior teeth restorations” reveals only 112 listings, and only six of those truly address the topic. By contrast, a similar search for “maxillary anterior teeth restorations” lists thousands of citations.

The esthetic restorative dentist and dental laboratory technologist of today and tomorrow need guidance for preparation and fabrication of predictably esthetically successful dental restorations for mandibular anterior teeth and their dental implant replacements.

Because the rules and examples for maxillary anterior teeth are so abundant, it seems reasonable to bring the same design concepts for individual and collective fabrication of the maxillary anterior teeth to the work for lower anterior teeth.

This practice is unfortunately fraught with error as the anatomic realities of incisal embrasure form, width/length differences, incisal edge display, and bilateral symmetry for the maxillary anterior teeth, are actually quite opposite to those for the mandibular anterior group.

This article is intended to clarify these differences and provide guidelines for the preparation and fabrication of natural appearing restorations for mandibular anterior teeth. The clinical case example will focus on the porcelain veneer restoration.

The author’s premise is that because the availability of sound rules and techniques addressing the restoration of mandibular anterior teeth is so limited, many dentists and technicians consider working with this group of teeth to be more difficult than the maxillary anterior teeth. A careful look at the rules of preparation and restorative fabrication that follow actually demonstrates that these teeth should be far easier to work with than those of the maxilla. 

As Dr. Morton Amsterdam taught, “We all have eyes to look with, but we only see what we know.”

  Or, as Dr. Harold Shavell has recently written, “The eye does not see what the mind has not taught it to recognize; hence, not every closed eye is sleeping, and not every open eye is seeing.”

Once the lessons about to be described have been studied and digested, a straightforward way to esthetically successful mandibular anterior dental restorations should become clear.

The essence of mandibular anterior preparation and restorative fabrication lies in the natural anatomy of these teeth, both individually and in composition; their function against the lingual surfaces of the maxillary anterior teeth, and the way they are seen in smile display. Dr. Leonard Abrams called this latter observer’s perspective “the view.”

  His vigorous study of dental anatomy, the human dentition in biologic perspective, and his extraordinary insight into the essential elements of tooth display are the groundwork for the lessons about to be described.    

Click here to see how this case was solved with step-by-step photos ...

 The six mandibular anterior teeth (some argue that the mandibular first premolars should be included, making eight) are essentially equal in width and length to the normal observer with good vision under good lighting conditions at a 2- to 4-foot viewing distance. This continuous series of similar shapes can fool the observer into thinking that all the teeth are present even when, by nature or by therapeutic choice, one may be missing. This phenomenon of shape monotony would be barely conceivable for the maxillary anterior teeth.

 For the patient with functional anterior incisal guidance, the mamellons quickly wear away and the widest part of the lower incisor becomes the incisal edge. Thus there can be no incisal embrasures on the labial aspect. Any ill-advised attempt for the dentist or dental technologist to place visible incisal embrasures on the labial aspect of these teeth results in the unnatural “picket fence” look. This is the most common fabrication error for these teeth.

The natural labio-lingual emergence angle of the anatomic crown of the mandibular incisor is between 22 and 23 degrees to the horizontal. This labial tilt is enhanced when the patient functions (e.g. speaking, smiling, masticating) such that the incisal edge becomes the key display component presented to the viewer (“the view”). That is, the entire incisal edge from lingual to labial border. Thus the lingual preparation of the mandibular anterior tooth is much more critical to the final esthetic display of the restoration than for the maxillary anterior tooth. 

Many natural occurring and most therapeutic occlusal schemes place the mandibular anterior teeth inside the maxillary anterior teeth for function. This “anterior coupling” arrangement limits the length of the mandibular anterior restoration to the lingual contacting surface of the opposing tooth. The dimension of incisal edge reduction is critical in this regard.

The recommended preparation design follows the studies exemplified by Stappert et al.

, and the observations published by Friedman

Successful, long-term bonding of a porcelain restoration to a tooth surface requires preservation of an enamel substrate on the tooth. At least 50% of the body of the tooth and all of the margins should be in enamel. A relatively uniform 0.5 mm reduction of the labial surface should be measured and performed.

A 1.5 to 2.0 mm reduction of the incisal edge is recommended for strength, longevity and esthetics of this critical display component, with no overlapping onto the lingual surface. The angle of this reduction should be perpendicular to the long axis of the tooth, not to the horizontal. A second plane of reduction should follow the natural crown profile of the tooth as this contour approaches the incisal edge.

The patient presented with Class IV fracture (MILaLi) of her mandibular right central incisor (

). A bonded composite restoration had been previously placed but failed within two years. So, the decision was made to prepare and fabricate a porcelain veneer restoration. The completed preparation is shown in 

) has already been placed. Digital photographs are made with the shade tab chosen prior to any preparation (

), and the Vinyl Polysiloxane impression made utilizing 

A direct fabricated bonded composite temporary veneer is placed (

). This provisional/temporary technique requires no etching of the tooth surface, application of a thin layer of bonding resin to the clean surface, and direct shaping/molding of the composite of choice. Note the markings with 

) and the fired porcelain veneer is made (

). The veneer is etched with hydro-fluoric acid at the laboratory prior to chairside try-in. After try-in and determination of shade of luting resin using water soluble try-in paste, the veneer is cleaned with phosphoric acid (38-40%), painted with freshly mixed silane bonding agent and placed on the etched/bonded surface of the preparation with the chosen shade of luting resin. Details of this protocol have been previously published

. The adjacent teeth are isolated from the bonding/luting procedure using ultrathin mylar matrix material (

. A one-month post-op of the final veneer is shown in 

Mandibular anterior teeth are distinctly different in many aspects of their form and function from their maxillary counterparts. It is important for the restorative dentist and dental technologist to carefully review this information prior to embarking on their work to fabricate esthetic restorations for these teeth. The choice of source material for this review is critical as many published articles do not demonstrate accurate renderings of natural dental anatomy of the lower anterior teeth. Yet, once studied and learned, the rules for fabrication of such restorations seem simple and straightforward.

Product support for this article was provided by 

1. Nobel Biocare consumer survey 55,000 Americans:  “Smile and appearance of teeth scored highest…”  February 26, 2009.

2. ADA National online consumer survey, ADA News June 18, 2012.  “A nice smile outweighed…”

3. Wu B et al.  Edentulism trends among middle-aged and older adults in the United States:  comparison of five racial/ethnic groups.  Community Dent Oral Epidemiol. 2012 Apr; 40(2):145-53.

4. Fitzgerald R et al.  Update on facial aging.  Aesthet Surg J. 2010 Jul-Aug; 30 Suppl:11S-24S.

5. Greenberg J.  Can they really be opposite?  A new look at four critical aspects of anterior dental morphology.  Comp Cont Ed Dent.  Sept 2008; 29(7):378-385.

6. Amsterdam M.  Periodontal Prosthesis:  25 years in retrospect.  Alpha Omegan December 1974; pp 8 – 52.

7. Shavell H.  Mental imagery:  the key to dental artistry.  J. Esth. Rest. Dent.  2013; 25(1):4 – 15.  

8. Abrams L, Presser FD.  “The view” and the canine connection:  an atlas of mandibular anterior tooth esthetics.  J Esthet Dent. 1998; 10(3):104-120.

9. Kraus BS, Jordan RE, Abrams L.  Dental Anatomy and Occlusion.  Philadelphia, PA:  Williams and Wilkins; 1969.

10. Stappert et al.  Longevity and failure load of ceramic veneers with different preparation designs after exposure to masticatory stimulation.  J. Pros. Dent. 2005; 94:132-9.

11. Jacobsen N, Frank C.  The myth of instant orthodontics:  an ethical quandary.  JADA 2008; 139:424-434.

12. Friedman MJ.  A 15 year review of porcelain veneer failure:  a clinician’s observations.  Comp. CE in Dentistry 1998; 19(6):625-632.

13. Christensen GJ. CRA Status Report:  Lower Anterior Veneers.  CRA Foundation Newsletter, June 2006; pp 1-2.

Recent reports and surveys affirm the importance of the teeth and smile to overall facial esthetics.1,2  As the world’s population ages, it seems that more people are keeping their natural teeth into their later years.3  

How to restore mandibular anterior teeth

It’s truly amazing what a difference one person can make. One person with a positive attitude, a vision and a desire to serve others can inspire a whole team of people to do great things. At 

Smile Central Dental P.C. in Paterson, N.J.

, Cecilia Mescain is that person. She is not only the COO, she’s a visionary who inspired one dentist to leave the practice they both worked at to open Smile Central together in 2004. 	 

	They began treating patients between the ages of 1-17 years and because Smile Central accepts all kinds of insurance, including Medicaid, they treat many children and teens who otherwise would not have access to dental care. “We do this from our hearts,” said Mescain. “Our mission is to help people. I think everyone knows that it’s genuine. We are really here for the community and that’s why we have a loyal following.”	 	That loyal following inspired the opening of three additional locations, including an orthodontics office, in order to fulfill the needs of the community. At the four locations, all within a 10-mile radius, Smile Central is providing dental care for underserved kids, educating them about the importance of oral health and providing an experience that shows kids that going to the dentist doesn’t have to be scary. 	 	For the kids whom Smile Central doesn’t reach through one of the four office locations, a dental health education outreach program is delivered from a vintage fire truck retrofitted with a dental operatory. The truck is driven to Head Start programs, schools and daycares in the area, providing treatment, educational puppet shows and a chance for kids to explore the inside of an old-fashioned fire truck.	

Watch the video below to learn more about Smile Central

In addition to running the outreach program, Mescain manages more than 80 staff members between all offices while handling responsibilities including payroll, billing, accounting, training, marketing and compliance issues. While her background in finance and economics has helped her handle the finances at Smile Central, she is currently completing an MBA, which has helped improve her leadership skills, decision making skills and strategies for creating a competitive advantage at the practice.

	For the support she needs specifically for her role as office manager, Mescain has been a member of the American Association of Dental Office Managers (AADOM) since 2008. She describes the organization as a “fellowship” that makes her feel that whatever challenge she might face, she is not alone. “It’s a great resource for all office managers because we can consult with each other. It helps us become better at what we do,” she said.	 	In 2013 Mescain attended the 2013 AADOM conference on a scholarship from Patterson Dental after her Patterson representative took notice of her hard work and wrote a letter nominating her. “I was very humbled and honored by the letter he wrote and that he felt I deserved to receive the scholarship,” said Mescain. “It’s great to get that support − as a Diamond Sponsor of AADOM, Patterson Dental is very much involved in supporting what the office managers do.”  	 	Mescain makes a difference in the lives of children every day and inspires a staff of more than 80 people to do the same. “We have such a wonderful group of people,” said Mescain. “If it wasn’t for them showing up every day and doing their very best we wouldn’t be Smile Central. The team is so valuable, every person that works with Smile Central deserves to be recognized.”	 	When asked about the future, Mescain says she is envisioning two new office locations in areas where they’re needed as they continue on their mission to take care of the community, one cavity at a time.	

 It’s truly amazing what a difference one person can make. One person with a positive attitude, a vision and a desire to serve others can inspire a whole team of people to do great things. At Smile Central Dental P.C. in Paterson, N.J., Cecilia Mescain is that person. She is not only the COO, she’s a visionary who inspired one dentist to leave the practice they both worked at to open Smile Central together in 2004.    

For New Jersey children, Smile Central is an invaluable ally in the fight against caries [VIDEO]

When patients walk into Ritter & Ramsey General and Cosmetic Dentistry in Jupiter, Fla., the friendly staff expects them to be a little wowed with the elegant look and feel, and with the best dental technology around.

But more importantly, business partners Drs. Chris Ramsey and Robert Ritter expect them to be even more wowed when they walk out the door after receiving top-notch oral care designed to keep their mouths healthy and beautiful.

“The practice of Ritter & Ramsey is a unique practice in the way that we’re trying to practice dentistry like we believe it was supposed to be practiced,” said Dr. Ramsey.

“What I mean by that is we are restorative dentists only. So we’re not root canals, we’re not doing removable, we’re not doing perio, not doing ortho. We’re not trying to be a jack of all trades and masters of none.”

What the practice has mastered is great, consistent results. Choosing a number of 

 helps them follow through on this promise.

“What we are is two guys doing restorative dentistry and because we do restorative dentistry only, we’re trying to do it at a very, very high level,” Dr. Ramsey added.

“To a degree that we believe is not seen in a lot of practices; meaning having a complete and thorough understanding of the adhesives and cements we use and why we use them. We know the different ceramic systems and composites that are out there, and try to create the best dentistry we can by using only the best.”

Dr. Ritter explains that product selection is made easier for the practice because of 3M ESPE’s long track record of successful products.

“3M has a great family of products that I really trust and value,” Dr. Ritter said. “One of the great things about 3M-obviously they’re an abrasive, adhesive company- is they take their core or foundational manufacturing skills and processes from other portions of their business and can invest that into the dental side of things. They have an advantage that other companies just don’t have. What’s great about 3M is it’s a trusted, valued company that has been around a very long time.”

One thing that makes 3M ESPE products so desirable is that the company does not bring new products to market until they have been tested and proven to be able to improve both the dentist’s job and the care received by the patients.

Another key is that the company listens to clinicians and is constantly looking to improve on already outstanding products.

One example of this is its newest impression material, 

3M™ ESPE™ Imprint™ 4 VPS Impression Material

. Dr. Ramsey says the new material builds off the greatness of its earlier version and now offers better results and better economics.

 on a daily basis, the practice does still use traditional impressions for certain cases, much like most practices.

“While everybody is moving to the digital age of dentistry, there are still tens of thousands of dentists who are taking a traditional impression. And 3M’s on top of that,” said Dr. Ramsey.

“Imprint 4 built off the success of Imprint 3, but they listened to the voice of the customer. The dentists said we really need a great impression material that offers better precision and faster speed at a competitive price. Taking an impression can be an expensive adventure, especially if you get a void or a bubble and you have to retake it.”

Dr. Ramsey says the new material is economical, but also sets fast, and is really accurate and dependable.

“They added some chemistry to create Imprint 4 and now they’ve got phenomenal working time,” he said. “The material reacts to the heat of the mouth and it gets to a very rapid set time. That’s something dentists wanted. Let’s be honest, patients don’t enjoy impressions so if they’re going to take one you’d like the experience to be over as quickly as possible, but without sacrificing accuracy within the impression.

“It’s just a great material both on the front end for the patient, and for the dentist and the laboratory on the back end. 3M was able to give us something that’s very, very accurate so I don’t find myself having to retake impressions.”

3M™ ESPE™ Scotchbond™ Universal Adhesive

, which also piggy-backed on the great success of its predecessor.

“If you look at their track record, it’s amazing from a quality standpoint and longevity. There’s nothing better than looking at cases and saying, ‘I put this case in a decade ago with Scotchbond and now I can honestly say that case looks great.’ Now they’ve got Scotchbond Universal adhesive and I’m confident to reach for something like that because of the success we had over a decade plus with products previously.”

It’s a long running trust that clinicians have with 3M ESPE that makes it both easy and exciting when reaching for one of the company’s products.

“We use so many 3M products because of their value and predictability and reproducibility in our practice,” said Dr. Ritter. “Ultimately, when you have predictability and reproducibility, then you have patient satisfaction and profitability.”

“We’re trying to serve the good of the patients and do the right things, but at the same time it is a business. You have to make sure they’re products that can produce for you every single day.”

Drs. Ritter and Ramsey treat the adult patients at the practice, while Robert’s wife, Dr. Isabelle Ritter, treats patients ages 3-13. With the help of a wide range of products and technologies from 3M ESPE, they are confident that they offer up consistently great care.

“In our office, we have really made the investment and the commitment to go digital. So from the moment you walk into our practice everything is digital,” Dr. Robert Ritter said.

“We use Dentrix and we have Dentrix kiosks which go into our iPads. Then you fill out the iPad forms which go into the server, and obviously it’s digital X-ray and all the patient charts are digital. So the only thing that’s not digital is the process for preparing a tooth.”

Currently the practice uses the 3M True Definition Scanner and 

 results, working closely with their lab on the indirect restorations.

“At that point everything is scanned with a True Def Scanner, which is a very easy and fast scan,” Dr. Ritter said. “We digitized the whole process both for implants and for restorative work in the mouth, both for crowns, inlays, onlays and bridges. We work with a dedicated laboratory that produces a lot of Lava Plus monolithic zirconia restorations for us.

“The streamlining ability of the True Definition Scanner gives us a lot of functionality. We’ve been using scanners in our office for four and half years and once you make the commitment to going digital, especially scanning, there’s no going back.”

The same can be said for reaching for cements and adhesives with the 3M ESPE name on the label.

“I’ve said this from the podium many times to many dentist s from around the country,” Dr. Ramsey said. “If it turned out that all the other companies disappeared and that 3M was the only company left, and you had a practice that was made up of only 3M products, you’d survive very well throughout the rest of your career and be very successful.

“The truth is, because of 3M’s wonderful R&D, they just don’t put out a bad product. They won’t rush to market and they are very good about listening to the voice of the customer.”

The fastest setting intra-oral impression material on the market – 3M™ ESPE™ Imprint™ 4 VPS Impression Material – sets in just 75 seconds thanks to unique active-self warming technology.

Working time is not compromised, so dentists can observe good impression taking technique and ensure reliable results. The material’s super hydrophilicity also contributes to its reliability, further helping it consistently achieve precise details. The combination of this unique formulation, long working time and short setting time gives Imprint 4 VPS impression material outstanding accuracy.

3M™ ESPE™ RelyX™ Ultimate Adhesive Resin Cement

3M™ ESPE™ RelyX™ Ultimate Adhesive Resin Cement delivers bond strength, ease of use and world-class esthetics. Used in combination with 3M™ ESPE™ Scotchbond™ Universal Adhesive, the two products provide exceptional strength and simplicity. Requiring fewer working steps, the cement’s formulation includes an integrated component that activates the dark cure function of the adhesive and eliminates the need for an additional activator. Approved for a wide range of indications, RelyX Ultimate 

cement is well suited for CAD/CAM and glass ceramic restorations.

3M™ ESPE™ Scotchbond™ Universal Adhesive is an adhesive for both total-etch and self-etch applications. It offers one simple adhesive application technique for both direct and indirect indications and bonds to all surfaces including enamel, dentin, glass ceramic, zirconia, noble and non-precious alloys, as well as composites-without additional primer. The flip-top vial and unit dose delivery make it easy to use.