Book Review: ITI Treatment Guide: Digital Workflows in Implant Dentistry

By Dr. Alan E. Friedel

Digital Workflows in Implant Dentistry is a compilation of material presented in 2018 at the ITI Consensus Conference in Amsterdam that was worked into this book.  This book is extremely thorough in detail and is not intended for dentists seeking a simple “cookbook” approach to digital workflow. If you have an academic interest, or if you are heavily invested into digital dentistry, this book will be of interest. There are 14 chapters to the book, and the first 12 examine different aspects of digital approaches to what were formerly analogue procedures. These concepts include: Digital Scans, CAD/CAM, Implants, Computer Guided Surgery, and Digital Articulators to name a few.

Chapter 13 provides multiple case studies some of which by the nature of digital workflow have areas of overlap. For those readers who find most of the book to be too dense, these presentations are more in the nature of a “nuts and bolts” approach to the topics raised in the preceding chapters. The cases start with single implant restorations and become progressively more complex ending with a case requiring multiple implants and the correction of a large bony defect in a patient’s maxilla.

The final chapter is brief but provides a listing of those technologies which one would have to invest in if a doctor decided to immerse into a digital approach to clinical care. Each chapter ends with concluding remarks where the authors lay out challenges being faced in the area of discussion and provide cautionary notes.

The illustrations are up to the high standard the publisher is renowned for and provide visual understanding of the topics being introduced. These images will be familiar to those doctors used to working in this realm, but will be a revelation to those of us who have not yet experienced high resolution STL files or CBCT radiography.

This book is of an Academic Nature and would be of great value in a teaching environment pointing towards how dentistry will be practiced in the coming generations. It should be part of the library of any institution engaging in digital practice. It is not for the average reader.

Visit floridadental.org/member-center/publications/book-reviews to read the full review.

10 Times your Dental Assistant Has Saved the Day

By Megan Donawa, EFDA, CDA, BA

Being a dental assistant is kind of like being a superhero. We use our abilities beyond those of ordinary people and demolish villains like dental fear, anxiety, and the biggest culprit: tooth decay and periodontal disease. Although these moments of strength are stealth-like, these skills never go unnoticed. Here are 10 times your dental assistant has (flawlessly) saved the day:

  1. Using our mind-reading powers, your treatment room is set up for any and every step within your patient’s appointment…including those unexpected times of treatments that have gone rogue.
  2. We use our accelerated healing powers to talk a patient off the ledge of dental anxiety and fears (because when you’re in our chair, everything is going to be okay).
  3. The best heroes have control over patient documents like health history, radiographs, and past dental history to better prepare you for the battle against oral pathology!
  4. Taking advantage of our super speed, we’re able to maneuver our complete set up from a simple filling to a surgical extraction without breaking a sweat.
  5. Magically projecting our knowledge of insurance basics to dominate the quality of communication between the patient and the team. (Because true champions are cross trained!)
  6. Delicately handing off our patient to the front office to schedule their next treatment to ensure teamwork to serve dental justice.
  7. With organization as our ammunition, we create an effortless workflow to communicate with you.
  8. Hitting back self-doubt with a vengeance and trusting the processes that we’ve put into place for patient care.
  9. Using our supernova voice to bring our best input from the doctor-assistant side to the table during meetings and huddles.
  10. Dental crime never sleeps, so we set back up to save the day again… tomorrow.

Connecting with Hispanic Floridians to Reverse Trends in Oral Health

By The Moore Agency

Every September 15 to October 15 is set aside as Hispanic Heritage Month to recognize Hispanic contributions to our culture and celebrate their achievements in our communities.

Hispanic Floridians are a vital part of our communities and culture. It is even more important for dentists to be aware of the needs, beliefs, and motivating factors of the Hispanic community since they make up almost one in four Floridians, many of which are probably patients of FDA dentists. But there is a disparity among Hispanic populations when it comes to oral healthcare. Only 27.8% of Hispanic adults visited a dentist in 2017-2018, compared to 47.4% of non-Hispanic White adults and 38.9% of non-Hispanic Asian adults.

Lack of knowledge presents a major obstacle to better oral health among Hispanic Floridians. One recent study found that 6 in 10 Hispanics believe that more information on oral care habits in Spanish would benefit them. The issue of lack of knowledge available to this community is an even greater problem since Hispanic individuals often experience more oral health issues compared to the general population.

In response, we have developed a bilingual advertising campaign with the Florida Dental Association. The campaign aims to inform Hispanic Floridians about oral health care and how to find a local dentist in both Spanish and English. Through authentic communication that prioritizes visuals and wording relevant to this audience, the FDA hopes to reverse the oral health trends of Hispanic families in Florida.

Another way you can ensure your dental practice is catering to Hispanic members in your community is to promote if your dentist or dental hygienist is bilingual. Bilingual team members improve a person’s dental visit by removing the fear of miscommunication and providing comfort in a potentially stressful situation. By promoting this on social media or promotional materials, you may be able to help someone in your community treat their oral health issues for the first time in their life.

It is our sincere hope that you see more Hispanic patients in the next few months as a result of this campaign. The Florida Dental Association has made it clear that this audience is a priority, and we will continue to work with them to help Hispanic Floridians attain a healthy smile.

Strategic Planning For Your Dental Practice After Hurricane Ian

By Dr. Richard Huot

In September 2004, the author was experiencing one of two hurricanes to hit his dental practice in a matter of three weeks.  His first article, “Prepared for the Worst,” appeared initially in the October 2004 issue of Dental Practice Report. After Hurricane Katrina hit the Gulf Coast and New Orleans, he wrote “Protecting Your Practice Against Disaster” in the November 2005 issue of Dental Economics.  This article is about what to do after the impossible:  a category 4 near 5 hurricane direct hit on your home and practice such as some dentists have just experienced recently with Ian.

The impact on the individual dental practices will be devastating, and some practices may be slow to recover, quite possibly never opening again due to businesses leaving the area.  Your preventive maintenance schedule will be thrown into disarray, and as “snowbirds” slowly return to Southwest Florida, those appointments may be skipped or postponed, as we have seen in COVID-19 and past hurricanes.  The survival tips below are intended to help my fellow dentists cope step-by-step as they slowly rebuild their lives.  The tips are based on the experiences we relied on, and passed on to our clients, to help us get through those tough times.

Take Care Of Your Family First

Our loved ones need to be reassured that there is hope, despite what appears to be the contrary. I can still remember my then 6-year-old looking at me very seriously and asking me if our home was destroyed.  As dentists, we provide a pretty affluent lifestyle to our children, and they need to be told honestly and gently that life as they know it will change quite drastically for them for at least the foreseeable future.  Initially, while the damage is too extensive to navigate back to your homes and offices, I would recommend that you concentrate on looking for a healthy diversion such as a “change of scenery” in another geographic location.  Some homeowners’ insurance policies cover meals, housing and other expenses while you are not capable of occupying your primary residence. You might even consider attending a continuing education meeting in that time frame!  Regardless of what you choose, I would encourage you to keep all of your receipts for food, travel and lodging until you can determine coverage, and stay away from dramatic news coverages to avoid focusing on events that you have no control over, at least for now.

Another option is to reactivate a license you may have in another state as a “backup” if you are looking at possibly being out of your office for anything more than a few weeks.  It would also be beneficial to look into the process of obtaining a license in another state if that particular state has a recognition program with another.  The process time varies from state to state, but licensure by credentials has been fast tracked since COVID, and many states are looking for practitioners in areas you may like or have visited in the past.  Most practice interruption insurances have deductibles or wait periods and have been hard to obtain since prior hurricane years, so finding employment in that extended time frame is certainly in order.

Take Care Of Your Staff Next

Hopefully, prior to the storm, you have given your staff a copy of all the telephone numbers (cell) and addresses of everyone.  This “phone tree” will be helpful to get an idea of where everyone is and, as owner, you need to reassure your staff members that you will lead them through these tough times.  Until each situation is assessed, I would not make any promises of employment or pay until the local municipalities tell you how they will deal with power and water issues, and you have time to estimate how long your practice will be inactive.  A liberal use of available personal time and vacation time is in order to pay your employees in the meantime, if they have accumulated that time for 2022 and prior years.  Your staff needs to know that you have empathy concerning their plight, but your financial health has to be secure in order for theirs to be.

In our case, my office manager was a volunteer first provider in the area, so I kept her salary going as she helped our community.  She was also able to provide me critical information and advised me when it was safe to come back.  She also kept the staff appraised and slowly had them report as work for them to do become available.  Once electricity is restored, the office manager can assist you in determining when it is appropriate to start scheduling patients and having staff back.  It is critical to instill in your staff that reestablishing a normal work schedule at the soonest time possible is key to the financial health of the practice.

Contact Your Dental Society For Help

The Florida Dental Association and its affiliate dental societies are doing a fantastic job in contacting all dentists affected.  Take a look at the FDAS “Storm Proof” guide for helpful hints after the hurricane hit, and how your practice can recover.  https://issuu.com/todaysfda/docs/hurricane_guide_2022

The American Dental Association has recovery materials that include methods for managing pay and leave issues following a hurricane, tips for accessing patient information during an emergency and links to guidance from the Occupational Safety and Health Administration.

Contact Your Local Bank Or Finance Company For Help

If you haven’t done so prior to the storm, you should have a business line of credit established with the institution where you deposit your earnings.  A good rule of thumb is 1.5 times your monthly overhead expenses.  That should allow you to pay most expenses prior to insurance coverage processing and give you financial piece of mind.

If you don’t have one already, a wireless laptop computer goes a long way in keeping you in touch with your community, and on the laptop, you should have all the vital information that keeps your practice running, along with an alternate power source.  Your accounts payable software should be loaded, to pay invoices from away, and keep track of the situation in Florida via the internet and email.

Make arrangements to retrieve your practice information from the cloud and, if necessary, install a new workstation/server so that information can be accessed by either you or your office manager if equipment was damaged in the office.

Contact Your Colleagues For Help

With the unprecedented number of hurricanes we experience in Florida, it is truly a pleasure to see how dentists “pitch in” and help their fellow colleagues.  We are small businesses and independent as a group, thus may be reluctant to ask for help.  Even after utilities are restored, it may make economic sense for two or more practices to merge, due to economies of scale and the permanent loss of patient base due to businesses relocating and financial hardship.  Even in affluent areas, going to the dentist will be way down the priority list for a good amount of time for all patients.  For any practice agreement of any large length of time, I would advise to get the “space sharing” arrangement in writing to avoid conflicts related to patients, expenses, etc.

For a dentist older than 50, it may make economic sense due to retirement plan rules to sell your practice to a younger practitioner.  Starting from “scratch” is a daunting task, capital intensive and may not necessarily the best financial choice at this stage of your practice life.  My advice would be to seek practice management consultants who have experience in this specialized area, and to identify practitioners in your immediate area who are potential candidates for merger, buyout, etc. 

Maintain A Positive Attitude!

After Hurricanes Frances and Jeanne in 2004, there were some days after we returned where it took everything to assume a normal life, especially since we evacuated once again in a matter of two weeks. Much of the same can be said for what it will feel like once you reach your community.  You can avoid “hurricane shell shock” by striving forward and attacking each hurdle one at a time.  Designate a fellow colleague or business acquaintance as a “wingman” and share your experiences with people who can help you get through this. Sometimes just having someone there with a different outlook or ability to spot a solution is all that is needed in the tough times ahead.

Dr. Richard Huot founded Beachside Dental Consultants, Inc. in 2004 and is a lecturer and author.  He served on the American Dental Association (ADA) ADPAC board from 2008-2012 and was Treasurer in his last year.  He was on the ADA Council of Government Affairs and is currently a member of the ADA Standards Committee for Dental Informatics (SCDI); he also serves as chair of the Council on Insurance and Retirement Plans (CMIRP).  Dr. Huot graduated from the College of Financial Planning in 1996 and is currently enrolled in the Chartered Financial Consultant program at the American College of Financial Services.