DT U.S. 1309

A new test for gum disease / GWU researchers crack the mystery of resilient teeth / Leadership essentials for the ‘rookie’ / Informatics and IT in dentistry: a look forward / Cosmetic periodontal surgery: pre-prosthetic soft-tissue ridge augmentation (Part 1) / Events & Industry / Industry News / Cosmetic Tribune 4/2009 / Hygiene Tribune 4/2009

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DENTAL TRIBUNE
The World’s Dental Newspaper · U.S. Edition

MAY/JUNE 2009

www.dental-tribune.com

VOL. 4, NOS. 13 & 14

Cosmetic perio surgery

New smile, new life

Instrumentation strategies

A healthy periodontia is
essential to achieving and
maintaining restorative
esthetics.

Modiﬁying a straight abutment
with porcelain to create a custom
abutment for minimal cost and
improved esthetics.

Today, scaling is about calculus
removal and protection from
injuries that can ruin a career.

XPage

XCosmetic Tribune

A new test for gum disease
Ahmed Khocht, DDS, an associate
professor of periodontology at Temple University’s Maurice H. Kornberg
School of Dentistry, led a team that
studied the efﬁcacy of a colored strip
to detect gum disease by changing
color in response to the levels of
microbial sulfur compounds found in
saliva. The strip changes from white
to yellow, and the darker the shade
of yellow the more severe the gum
disease.
Khocht and his team looked at 73
patients divided into three groups —
those with gingivitis, those with periodontitis and those that were healthy.
A color chart formed the basis of
scoring for the changes in the color
strip, and were compared to scores
for traditional assessments such as
attachment levels, bleeding on probing, gingival index and plaque index.
Using a color strip would be quicker
and easier than using those traditional assessment methods, and would
cause no pain to the patient.
Given that 80 percent of adults
have some form of periodontal or

OSAP offers resources for dentists
to help prevent spread of swine ﬂu
The Organization for Safety and
Asepsis Procedures (OSAP) is providing special online resources to help
dental professionals protect themselves and their patients from swine
ﬂu. The Swine Flu Resources section
of the OSAP Web site, www.osap.org,
includes an overview of the disease,
up-to-the-minute reports on the cur-

Associate Professor Dr. Ahmed
Khocht of Temple University
gum disease, a quick and painless method to identify the diseases would save the dental practice
time and money as well. A growing
body of research supports the links
between gum disease to blood infection, cancer, diabetes, heart disease,
low birth-weight babies and obesity.
Thus, early detection of periodontal
or gum disease is paramount to a
patient’s overall health. DT
(Source: Temple University,
www.temple.edu)

director in the ADA’s 150-year history. The announcement marked the
end of an 11-month search for a new
executive director.
“Dr. O’Loughlin’s background
represents the right mix of experiences we sought in an executive
director,” said ADA President John
S. Findley, DDS. “She has 20 years
in private dental practice and public health dentistry plus 10 years
experience in dental education and
a decade of key leadership roles in

rent outbreak and tips for prevention. The site is a one-stop shop for
current information on the swine ﬂu
epidemic.
According to OSAP, dental professionals should be vigilant as this
potential pandemic emerges. The
site is being updated as new information is received. DT (Source: OSAP)

White wine can increase tooth staining
Researchers from New York University presented their ﬁndings about
white wine and tooth staining during
the recent International Association
for Dental Research annual meeting in Miami, which took place April
1–4.
Using two sets of cow teeth, study
results showed that soaking the
teeth in white wine for one hour
before exposure to black tea produced signiﬁcantly darker stains
than when the teeth were soaked
in water for one hour prior to expo-

ADA names Dr. Kathleen O’Loughlin executive director
Kathleen T.
O’Loughlin,
DMD, MPH, has
been selected
by the Board
of Trustees of
the American
Dental Association to serve as
the next ADA
executive director/chief operating
ofﬁcer, effective June 1. O’Loughlin
becomes the ﬁrst female executive

XHygiene Tribune

management, strategic planning and
business operations.”
“I am incredibly honored to accept
this position,” O’Loughlin said. “It
represents the pinnacle of my professional career. What a great opportunity to serve the profession I have
loved for 30 years and what a tribute
to my deceased father, who as a

sure to black tea.
The one-hour soak in white wine,
which is the equivalent of sipping
the wine during dinner, allows wine
acids to create grooves and rough
spots on the teeth that grant toothstaining beverages deeper tooth penetration. However, red wine causes
signiﬁcantly greater tooth staining
due to the chromogen it contains, a
highly-pigmented substance that is
not found in white wine. DT
(Source: New York University,
www.nyu.edu)

socially conscious practicing dentist
was my role model and inspiration.”
From 2002–2007, O’Loughlin
served as president and CEO of Dental Services of Massachusetts (d.b.a.
Delta Dental of Massachusetts)
where, through her leadership, the
company doubled its reserves,
increased membership by 400 percent and executed a successful ﬁveyear growth plan. DT
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News

DENTAL TRIBUNE | JUNE 2009

GWU researchers crack the
mystery of resilient teeth
After years of biting and chewing,
how are human teeth able to remain
intact and functional? A team of
researchers from the George Washington University and other international scholars have discovered several features in enamel that contribute to the resiliency of human teeth.
Human enamel is brittle. Like
glass, it cracks easily; but unlike
glass, enamel is able to contain
cracks and remain intact for most
individuals’ lifetimes. The research
team discovered that the major reason why teeth do not break apart
is due to the presence of tufts —
small, crack-like defects found deep
in the enamel. Tufts arise during
tooth development, and all human
teeth contain multiple tufts before
the tooth has even erupted into
the mouth. Many cracks in teeth
do not start at the outer surface
of the tooth, as has always been
assumed. Instead, cracks arise from
tufts located deep inside the enamel.
From here, cracks can grow toward
the outer tooth surface. Once reaching the surface, these cracks can
potentially act as sites for dental
decay. Acting together like a forest
of small ﬂaws, tufts suppress the
growth of these cracks by distributing the stress amongst them.
“This is the ﬁrst time that enigmatic developmental features, such
as enamel tufts, have been shown
to have any signiﬁcance in tooth
function,” said GW researcher Paul
Constantino. “Crack growth is also
hampered by the ‘basket weave’
microstructure of enamel, and by
a ‘self-healing’ process whereby organic material ﬁlls cracks
extended from the tufts, which
themselves also become closed by
organic matter. This type of inﬁlling bonds the opposing crack walls,
which increases the amount of force

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(Source: George Washington
University, www.gwu.edu)

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required to extend the
crack later on.”
This research evolved
as part of an interdisciplinary collaboration
between anthropologists
from the George Washington University and
physical scientists from
the National Institute of
Standards and Technology in Gaithersburg, Md.
The team studied tooth
enamel in humans and
sea otters, mammals with
teeth showing remarkable resemblances to
those of humans.
The article, “Remarkable resilience of teeth”
appears in the April 2009
edition of Proceedings of
the National Academy of
Sciences.
Located four blocks
from the White House, the
George Washington University was created by an
Act of Congress in 1821.
Today, GWU is the largest
institution of higher education in the nation’s capital. The university offers
comprehensive
programs of undergraduate
and graduate liberal arts
study, as well as degree
programs in medicine,
public health, law, engineering, education, business and international
affairs. Each year, GWU
enrolls a diverse population of undergraduate,
graduate and professional students from all
50 states, the District of
Columbia and more than
130 countries. DT

DENTAL TRIBUNE

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you ﬁnd a factual error or content that requires clariﬁcation, please contact Group Editor Robin Goodman, r.goodman@dtamerica.
com. Dental Tribune cannot assume responsibility for the validity of product claims or for
typographical errors. The publisher also does
not assume responsibility for product names
or statements made by advertisers. Opinions
expressed by authors are their own and may
not reﬂect those of Dental Tribune America.

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2009

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Dr. Joel Berg
Dr. L. Stephen Buchanan
Dr. Arnaldo Castellucci
Dr. Gorden Christensen
Dr. Rella Christensen
Dr. William Dickerson
Hugh Doherty
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Dr. Roger Levin
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Dr. Dan Nathanson
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Dr. Irwin Smigel
Dr. Jon Suzuki
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Dr. Dan Ward

www.dental-tribune.com

[3] => DTUS131409.pdf

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[4] => DTUS131409.pdf

Practice Management

DENTAL TRIBUNE | JUNE 2009

Leadership essentials for the ‘rookie’
By Sally McKenzie, CMC

Upon entering your ﬁrst “real”
dental practice either as an associate or as an owner, with the dental
degree in hand and requisite experience on your resume, it’s likely
that one thing became abundantly
clear very early on: The learning
process had only just begun. There
is a whole lot more to a career in
dentistry than most young dentists
ever imagine.
Almost without warning, many
are tossed into leadership roles
seemingly overnight. And it’s that
part of the job requirement that
often leaves new dentists shaking
their heads in bewilderment. Certainly, there is a lot to learn as a
leader, but here are a few essentials
to follow from day one as “The
Boss.”

No. 1: Never assume
This is the most common pitfall in leading employees: assuming that your staff knows what you
want. Spell out your expectations

‘your success is dependent upon your
ability to lead your team’

Know the numbers
and the employees’ responsibilities in black and white for every
member of your team from the
beginning. Do not convince yourself that because they’ve worked in
this dental practice for X number of
years that they know how you want
things done. They don’t, and they
will simply keep performing their
responsibilities according to what
they think you want unless they are
directed otherwise.
For example, your scheduling
coordinator may be very experienced in scheduling according to
how other dentists want their days
structured, which may, in fact, be
very different from how you want
your days scheduled. Most good
employees want clear direction,
and it’s tremendously frustrating
for everyone when staff are forced

to guess at what you want. So speak
up.

No. 2: Staff success = your success
Recognize the strengths and
weaknesses among your team members because all employees bring
both to their positions. The fact is
that some people are much better
suited for certain responsibilities
and not others. Just because Brittany has been handling insurance and
collections for the practice doesn’t
mean she’s effective in those areas.
Look at results. Brittany may be
much more successful at scheduling and recall and would be better
suited for those duties. Don’t be
afraid to restructure responsibilities
to make the most of team strengths.
Invest in training early and often
to build loyalty and ensure excellence.

No. 3: Give feedback often

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that is essential in your efforts to
make major decisions regarding
patients, ﬁnancial concerns, management systems, productivity and
staff in your new practice.

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Along with clear expectations,
direction and guidance, employees
crave feedback. Don’t be stingy.
Give praise often and appraise performance regularly. Employees
want to know where they stand and
how they can improve. Verbal feedback can be given at any time, but
it is most effective the moment the
employee is engaging in the behavior that you either want to praise or
correct.
If the assistant emphasizes to
Mrs. Patient just how much she is
going to absolutely love her new
veneers and steers the patient clear
of second guessing this investment she is about to make, tell her!
Express your sincere appreciation
and emphasize the value of the
assistant’s contribution to the practice. Similarly, if employees need
constructive feedback, don’t be shy
with that either. If the front desk
helper is talking about how gross
she/he thinks that whole implant
thing is, she/he needs education
and constructive direction.
Nip problems in the bud or you’ll
suffer numerous thorns in your
side. If an employee is not fulﬁlling her/his responsibilities, address
the issue privately and directly. Be
prepared to discuss the key points
of the problem as you see it, as well
as possible resolutions.
Use performance reviews to
motivate and encourage your team
to thrive in their positions. Base
your performance measurements
on individual jobs. Focus on speciﬁc
job-related goals and how those
relate to improving the total practice. Used effectively, employee
performance measurements and
reviews offer critical information

Certainly, it doesn’t take long for
every new dentist to realize that just
as important as your role as dentist is your role as CEO. It is critical that you understand completely
the business side of your practice.
There are 22 practice systems, and
you should be well versed in each
of them. If not, seek out training
for new dentists. The effectiveness
of the practice systems will directly
and profoundly impact your own
success today and throughout your
entire career.
Overhead. For starters, routinely
monitor practice overhead. It should
break down according to the following benchmarks to ensure that it is
within the industry standard of 55
percent of collections.
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Salaries. Keep a particularly
close eye on staff salaries. These
can mushroom out of control and
send overhead into the 70–80 percent range in record time. Payroll
should be between 20–22 percent of
gross income. Tack on an additional
3–5 percent for payroll taxes and
beneﬁts. If your payroll costs are
higher than that, here’s what may
be happening:
UÊÊ9ÕÊ >ÛiÊ ÌÊ >ÞÊ i«ÞiiÃ°Ê
More staff does not guarantee
an improvement in efﬁciency
or production. It does, however, guarantee an increase in
overhead, unless you are hiring
a patient coordinator who is
going to make sure the schedule is full and production goals
can be met.
UÊÊ9ÕÊ >ÀiÊ }Û}Ê À>ÃiÃÊ L>Ãi`Ê
on longevity rather than productivity/performance. If production is going down and
overhead is going up, payroll
cannot be increased. Establish
a compensation policy stating
that raises will be given based
upon employee performance
and only if the practice is making a proﬁt.
UÊÊ/ iÊ Þ}iiÊ `i«>ÀÌiÌÊ ÃÊ ÌÊ
meeting the industry standard
for production, which is 33
percent of total practice production. If the dentist steps
back and takes a closer look
at what is happening, he/she
will ﬁnd that the hygienists
have far more down time than

[5] => DTUS131409.pdf

Practice Management

DENTAL TRIBUNE | JUNE 2009

they should, patient retention is
seriously lacking and periodontal treatment is minimal at best.
The recall system, if there even
is one, needs immediate attention to ensure that the hygiene
schedule is full, the hygienist
is scheduled to produce three
times his/her salary and cancellations are ﬁlled.
Production. Hand-in-hand with
practice overhead is production, and
one area that directly affects your
production is your schedule. Oftentimes, new dentists simply want to
be busy. Sure you want to be busy,
but more important than being busy
is being productive. Take the following measures to get your schedule on the path to productivity.
Start by using your schedule to
meet production objectives. First,
establish a goal. Let’s say yours is
to break the million dollar mark.
Taking 33 percent out for hygiene
leaves the dentist with $670. This
calculates to about $13,958 per
week (taking four weeks out for
vacation). Working 32 hours per
week means the dentist will need to
produce about $436 per hour.
A crown charged out at $950,
which takes two appointments for

‘determine the rate of hourly production’
a total of two hours, exceeds the
per hour production goal by $39.
This excess could be applied to any
shortfall caused by smaller ticket
procedures. Unfortunately, you are
probably not doing crowns every
hour on the hour.
Use the formula below to determine the rate of hourly production
and whether you’re meeting your
own personal production objectives.
1) The assistant logs the amount
of time it takes to perform
speciﬁc procedures. If the
procedure takes the dentist
three appointments, she/he
should record the time needed for all three appointments.
2) Record the total fee for the
procedure.
3) Determine the procedure
value per hourly goal. Take
the cost of the procedure
— for example $215 — and
divide it by the total time
to perform the procedure, 50
minutes. The production per
minute value is $4.30. Mul-

your ability to lead your team effectively and manage your systems
efﬁciently. DT

About the author

tiply that by 60 minutes to
arrive at $258/hour.
4) The amount must equal or
exceed the identiﬁed goal.
Now you can identify tasks that
can be delegated and opportunities for training that will maximize
the assistant’s functions. You also
should be able to see more clearly
how setup and tasks can be made
more efﬁcient. Thus, you’ll be well
on your way to achieving your own
production goals, whatever those
may be.
In your practice, every system
directly affects your success, as does
every member of your team. Each is
an extension of you. Your systems
and your team will affect whether
you have enough money to pay your
bills. They will keep your schedule
on track or off. They will tell you
what you don’t want to hear when
you don’t want to hear it. They will
be a source of great joy and satisfaction, as well as anger and frustration. But no matter what, your success as a dentist is dependent upon

Sally McKenzie is CEO of
McKenzie Management, which
provides success-proven management solutions to dentistry
nationwide. She is also editor
of The Dentist’s Network Newsletter, www.thedentistsnetwork.
net; e-Management Newsletter
from www.mckenziemgmt.com;
and The New Dentist™ magazine,
www.thenewdentist.net. She can
be reached at (877) 777.6151 or
sallymck@mckenziemgmt.com.

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[6] => DTUS131409.pdf

Dental Informatics

DENTAL TRIBUNE | JUNE 2009

Informatics and IT in
dentistry: a look forward

19
MAY

Increase Net Revenue, Foster
(PSOR\HH&RQÀGHQFH
Michael Moore

Tuesday, May 19, 2009
7:00–8:30 p.m. EST
The Five Keys to Effective Employment
5HODWLRQVIRUWKH'HQWDO2IÀFH

Video – Today’s Most Powerful
Patient Magnet (Part 4 of 6)
Kay Miller
09 Mary
Tuesday, June 09, 2009
JUNE

27
JUNE

7:00–8:30 p.m. EST
Video not only entertains, it fully engages
your target audience when educating patients
and delivering your marketing message both
LQWHUQDOO\LQWKHRIÀFHDQGRQOLQHWRWKH
community.

DTSC Online Masters,
featuring the Roots Summit
and the Implants Summit
Various speakers

Saturday, June 27, 2009
10:00 a.m.–5:30 p.m. EST
A full day of successive webinars covering
various topics in Endodontics and Implantology,
taught by opinion leaders in the industry.

Web 2.0 Marketing (Part 5 of 6)

02 Mary Kay Miller
JULY

Thursday, July 02, 2009
7:00–8:30 p.m. EST
What Is It… and Is Social Networking The Right
Marketing Tool For You?

Ortho Tribune Study Club Launch Online C.E. Festival

11 Various speakers
JULY

Saturday, July 11, 2009, 10:00 a.m.–5:30 p.m. EST
The OTSC will be launched with a full day of
successive webinars covering various current
topics in Orthodontics, taught by opinion
leaders in the industry.

Getting Started in Implantology
Various speakers

July 25, 2009, 10:00 a.m.–5:30 p.m. EST
25 Saturday,
Through a succession of focused webinars,
JULY

leading specialists provide a general overview
of Implantology for those who are interested
LQ´JHWWLQJVWDUWHGLQµWKHÀHOG(DFKOHFWXUH
will provide a thorough introduction to the
techniques, products and practice management
impact in implantology.

Recently, Dr. John O’Keefe, the
editor of the Journal of the Canadian
Dental Association, interviewed Dr.
Titus Schleyer, associate professor
and director of the Center for Dental Informatics, University of Pittsburgh, about the development of
health information technology in the
context of the dental profession.
Dr. O’Keefe: What are the main
developments you see in the areas
of informatics and information
technology (IT) as applied to dental practice?
Dr. Schleyer: We have gone
through a tumultuous period of
change and development in informatics and information technology
over the last 15 to 20 years, so I think
many of these trends will continue
to roll on. For instance, the way
the Internet has inﬂuenced dental
practice and life in general. I think
we have seen changes that we could
barely imagine 20 years ago.
The trends in how we use electronic technology in our lives and
in managing information have
emerged with the stark reality, and
I guess they will continue to mature
and generate new surprises. In
terms of concrete examples, we see
that data and information are much
more accessible and available than
previously, and they are much better connected. We see patients having access to their medical records,
looking at what physicians write
about them and what they diagnose,
and sometimes arguing about it, and
thus taking a much more active role
in their care. I think that is a development that will deﬁnitely inﬂuence
dentistry.
We have almost ubiquitous information access. There are dentists
who access their practice schedules through their Blackberrys, cell
phones and other devices. Some
physicians write prescriptions from
their hand-held computers. So I
think ubiquitous information access
will be a strong trend in the future.
Another big development I see
accelerating is the move toward
paperless practices, paperless being
somewhat of a euphemism for
“mostly computerized practices.”
Paper never really goes away, even
in the most highly computerized
settings. Our research has shown
that we seem to be standing at the
beginning of a rapid acceleration
of computerization of dental practice with respect to pretty much
everything: patient records, supply
ordering, electronic communication with patients, and so on. Based
on historical trends, we expect that
there’ll be a rapid acceleration of
dentists who will adopt these technologies in the future. You can
either sit on the fence or jump off. I
think times are right for more peo-

ple to take the leap and jump into
the fray of computer-based patient
records in their practice.
What do you think are the main
implications of the electronic
patient record, and is there a difference between that and the electronic health record?
Typically, people consider the
electronic health record as something global that has everything
related to a patient’s health in it.
An electronic patient record is often
used in speciﬁc reference to a health
care area, for instance, as in an
“electronic medical record” and an
“electronic dental record.” I prefer
the term, “electronic dental record,”
for us because that identiﬁes the
dental component of the patient’s
health. In general, the impact of
electronic health records will be
very signiﬁcant.
As you know, the United States
is targeting 2014 as the year when
most Americans are supposed to
have access to electronic health
records. This now has been the stated goal of two successive presidents
from different political parties, no
less. Through this national goal and
mandate, so to speak, we will come
to a much more transparent way of
managing patient information.
As I mentioned earlier, patients
now do take a look at their own
health records and sometimes argue
with the physicians about what’s in
them. They detect errors that are in
pretty much every patient record,
and I think that will have a big
impact. I think we will move away
from patient records as incidental
documents that we mainly create
in order to protect ourselves from
lawsuits. In the future, they will be a
central tool that informs and guides
how we care for patients.
When you look at how the United States conceptualizes electronic
patient records, we’re not pursuing
that concept as a goal in of itself. The
idea is to fundamentally improve

www.dental-tribune.com

patient care, as several reports from
the Ofﬁce of the National Coordinator for Health Information Technology have described. How do we do
this? Number one, you give caregivers who need access to patient information the ability to access it. Number two, you connect personal health
information with evidence-based
resources in order to make sure
that patients get the most appropriate care. And third, as I mentioned,
you get the patients involved in their
own health care through electronic
access to their data.
So I think dentistry is a little bit
behind here, but that is not necessarily a bad thing. However, we shouldn’t
wait until a wave of patients washes
over us when people march into our
ofﬁces and demand the same kind
of access to dental records that they
have to their medical records.
Do you think that the patients having access to an electronic health
record would have any impact on
the relationship of a particular
patient with a particular provider? Would it make patients more
mobile?
In theory, patients’ mobility will
be enhanced by easy access to their
health information. But of course,
we have to temper that view by asking whether, and to what degree,
the difﬁculty and effort in obtaining
records inﬂuences a patient’s decision to move to another dentist right
now. Typically, if people are unhappy with their dentist, they’ll “pack
up and go” to a new dentist. Maybe
that will be slightly easier for them if
they do not have to worry about getting their radiographs or particular
pieces of their patient record to their
new dentist. But I’ve never really
felt that patients I talked to who
switched dentists were particularly
inhibited by the fact that they had to
get a copy of the latest radiographs,
for instance. So in the grand scheme
J DT page 8

[7] => DTUS131409.pdf

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[8] => DTUS131409.pdf

Financial

DENTAL TRIBUNE | JUNE 2009

Five of the top 10 reasons why associateships fail
Reason No. 2: the details
By Eugene W. Heller, DDS

The “American Dream” is still to
own a home. The “Dentist’s Dream”
continues to be the ownership of a
practice. Thirty years ago, the dream
was to graduate from dental school,
buy equipment, hang out a shingle
and start practicing. Today the road
to ownership is a little different.
Due to extensive debt, most new
graduates enter practice as associates to improve their clinical skills,
increase their speed and proﬁciency,
and learn more about the business
aspects of dentistry. Most hope the
newfound associateship will lead
to an eventual ownership position.
Instead, many ﬁnd themselves building up the value of their host dentist’s practice, only to be forced to
leave. This forced departure is the
result of a non-compete agreement
when the promised buy-in/buy-out
doesn’t occur.
The following reveal the ﬁrst ﬁve
of the top 10 reasons many associateships fail to result in ownership or
partnership.

Reason No. 1: purchase price
If the purchase price has not been
determined before the commencement of employment, the parties ﬁnd
themselves on different ends of the
spectrum as to what the practice
is worth and what the buy-in price
should be.
When purchase price is established before the commencement of
employment, three out of four associateships lead to the intended equity
position. Conversely, if the purchase
price has not been determined, nine
out of 10 associateships lead to termination without achieving the ownership intended or promised.

I DT page 6
of things, I think there will be only a
minor effect.
You might think this is a leading question but, could it make
it easier for a patient to be seen
independently by a dentist and an
independent hygienist?
I guess it could if the independent hygienist had access to the full
record and would have less work in
doing the work-up and all the data
collection. It would probably make
that easier, but I think one thing to
think about is that this capability
could enhance overall efﬁciency of
our dental care system. Right now,
we spend a lot of time duplicating information that’s already somewhere else in the system. Also, I
think with this more transparent
access, we’ll focus on hopefully more
important things and we’ll start from
information that’s already there. We
might update it, we might verify it,
but we don’t have to spend 25 min-

The more items discussed and
agreed to in writing beforehand,
the better the chance of a successful equity ownership occurring as
planned.
The written instruments should
be two speciﬁc documents — an
Employment Agreement detailing
the responsibilities of each party for
employment and a Letter of Intent
detailing the proposed equity acquisition.

Reason No. 3: insufﬁcient patient
base
Approximately 1,000–1,200 active
patients are required per dentist in
a dental practice. If the senior dentist does not intend to restrict or cut
back on his/her number of available clinical treatment hours, then
the conversion from a one-dentist
to a two-dentist practice requires
an active patient base of approximately 1,400–1,800 patients and a
new patient ﬂow of 25 or more new
patients per month.
Many senior dentists count their
number of active patients by counting the number of patient charts on
a wall. However, the best way to estimate the active number of patients
involves utilizing the hygiene recall
count.
Insufﬁcient numbers of patients
and/or an insufﬁcient new patient
ﬂow signals that all expenses relating to the new dentist are coming
directly out of the bottom line. The
practice then begins to experience
ﬁnancial pressure.
Creation and maintenance of a
sufﬁcient patient base is an extremely important aspect of the business.
If the senior dentist is nearing retirement with the intent that, within
one to two years, the senior dentist

utes going through the whole health
history again from scratch.
When you look out ﬁve to 10 years,
what are practical applications
of the trends you see now for the
dental ofﬁce of the future?
Well, we’ve discussed the impact
of informatics and IT a little bit in
terms of what it means for patients
and practitioners already. I’m hoping
to see the day when computers can
contribute to helping practitioners
keep up-to-date more than that is
currently the case. Currently, computers don’t help much, in my opinion, because you as the practitioner
have to do all the work. In order to
update yourself on a topic or look
up a clinical question, you have to
sit down at a computer, you have to
search Medline or Google, or you ﬁre
off a message to an Internet discussion list. I’m looking for computers to
do more of this for us. For instance,
you could tell the computer the topic
you are interested in, and it would
retrieve and sift information for you.

will turn over total ownership of
the practice and intends to cut back
shortly after the beginning of the
second dentist’s employment, this
problem is not as critical.
Often the senior dentist brings in
an associate dentist as the answer
to increasing business. A practice
with insufﬁcient new patient ﬂow
that experiences the addition of a
new practitioner may result in termination of employment for the
associate.

Reason No. 4: incompatible skills
The incompatibility in clinical
skills between practitioners may
include the possibility of one practitioner’s skill level being below
standard, but it may also include
different practice philosophies. On
the surface, it would appear that
having different skill levels and
philosophies might be desirable. In
reality, the patient base available
to the younger practitioner may
not lend itself to various types of
dentistry.

Reason No. 5: timeframe
The failure to identify when the
buy-in or buy-out is to occur and
when to execute it can result in failure to achieve an ownership status.
The Letter of Intent may have stated
that the buy-in was to occur in one
to two years, but certain behaviors and signs during the continuing employment relationship might
give an indication that the senior
doctor is having difﬁculty honoring
the intended buy-out or that the
associate does not feel ready to consummate the transaction within the
original outlined timeframe. Either
position might result in the demise
of the buy-in as involved parties
lose patience over such delays.

This form of information retrieval is
not that hard computationally.
What is hard is that we have to
separate the chaff from the wheat.
We have to separate valid from
invalid information. And, that’s a job
that humans and dentists are very
well qualiﬁed for, but I think a lot
of the grunt work should be done
by computers and there’s no reason
why we can’t make them do that.
Also, for dental ofﬁces, it means that
the sophistication with which people
look at the computer infrastructure
has to rise signiﬁcantly. One thing
that we have to acknowledge is that
dentists are the “chief information
ofﬁcers” for their businesses. They
are in charge of managing all information technology, whether they do
it themselves or outsource it. But
most dentists don’t have that much
training in that and the number
of dental schools who provide that
training is relatively small.
Look for part two of this interview in the next edition of Dental
Tribune. DT

www.dental-tribune.com

Summary
This article has been aimed primarily at a one-dentist practice
evolving to a two-dentist practice;
however, the issues apply equally to
larger group practices. One-to-twoyear associateships with the senior
dentist retiring at the end of the
associateship and a three-to-ﬁveyear partnership ending with the
new dentist purchasing the remaining equity position of the senior dentist at the end of ﬁve years can also
beneﬁt from the insights provided in
this article.
Unfortunately, nothing can guarantee a successful outcome will
occur. However, by identifying the
potential pitfalls at the beginning of
the relationship, chances of success
can be greatly improved.
Look for the remaining ﬁve reasons in the next edition of Dental
Tribune. DT

About the author
Dr. Eugene W. Heller is a
1976 graduate of the Marquette
University School of Dentistry. He
has been involved in transition
consulting since 1985 and left
private practice in 1990 to pursue
practice management and practice
transition consulting on a full-time
basis. He has lectured extensively
to both state dental associations
and numerous dental schools.
Heller is presently the national
director of Transition Services
for Henry Schein Professional
Practice Transitions. For further
information, please call (800) 7308883 or send an e-mail to hsfs@
henryschein.com

Contact info

Titus Schleyer, DMD, PhD
Associate Professor & Director
Center for Dental Informatics
School of Dental Medicine
University of Pittsburgh
3501 Terrace Street
Pittsburgh, Pa. 15261
Tel.: (412) 648-8886
Fax: (412) 648-9960
E-mail: titus@pitt.edu
Web site: www.di.dental.pitt.edu

[9] => DTUS131409.pdf

09YS9681

When It’s Time to Buy, Sell, or Merge Your Practice

You Need A Partner On Your Side
ALABAMA
Birmingham- 4 Ops, 2 Hygiene Rms, GR $675K #10108
Birmingham Suburb- 3 Ops, 3 Hygiene Rooms #10106
CONTACT: Dr. Jim Cole @ 404-513-1573

ARIZONA
Shaw Low- 2 Ops, 2 Hygiene Rms, GR in 2007 $645,995
CONTACT: Tom Kimbel @ 602-516-3219

CALIFORNIA
Alturas- 3 Ops, GR $551K, 3 1/2 day work week #14279
Bakersfield- 7 Ops, 2,200 sq ft, GR $1,916,000 #14290
Central Valley- 4 Ops, 2,000 sq ft, 2007 GR $500K. #14266
Dixon- 4 Ops - 2 Equipped, 1,100 sq ft, GR $132K #14265
Fresno- 5 Ops, 1,500 sq ft, GR $1,445,181 #14250
Fresno- In professional park. Take over lease. #14292
Lindsay/Tulare- 2 practices, Combined GR $1.4 Mill #14240
Madera- 1,650 sq ft, 3 Ops, GR $449K #14269
Madera- 7 Ops, GR $1,921,467 #14283
Modesto- 12 Ops, GR $1,097,000, Same loc for 10 years
#14289
Oroville-3 ops 3 days of hygiene 2005 GR $338K #14178
Porterville- 6 Ops, 2,000 sq ft, GR $2,289000 #14291
Red Bluff- 8 ops, GR over $1Mill, Hygiene 10 days a wk.
#14252
Redding- 5 Ops, 1950 sq. ft. #14229
San Francisco - 4 Ops, GR 875K, 1500 sq. ft. #14288
San Marino- 6 Ops, 2,200 sq ft, 2008 GR $762K #14294
South Lake Tahoe- 3 Ops, 647 sq ft, 2007 GR $534K #14277
Thousand Oaks- General Prac, New Equip, Digital #14275
CONTACT: Dr. Dennis Hoover @ 800-519-3458

Chicago- 14 Ops, $2 Mill specility office, On site lab #22121
Chicago- Established Practice Looking for Dentist #22122
1 Hr SW of Chicago- 5 Ops, 2007 GR $440K, 28 years old
#22123
CONTACT: Al Brown @ 800-668-0629
Kane County- 4 Ops, building also available for purchase
#22115
Rockford Area-5 ops solid practice. Very good net #22118
CONTACT: Deanna Wright @ 800-730-8883

Eastern Kentucky-3 Ops, Good Hyg. Program, Growth
Potent.#26101
CONTACT: George Lane @ 865-414-1527

MAINE

OHIO

INDIANA
St. Joseph County- GR $270K on a 3 1/2 work week. #23108
CONTACT: Deanna Wright @ 800-730-8883

KENTUCKY

Auburn- Looking for Assoc.GR $2 Million #28111
Lewiston- GP Plus real estate, state of the art office #28107
CONTACT: Dr. Peter Goldberg @ 617-680-2930

MARYLAND
Southern- 11 Ops, 3,500 sq ft, GR $1,840,628 #29101
CONTACT: Sharon Mascetti @ 484-788-4071

MASSACHUSETTS

Grass Valley- 3 Ops, 1,500 sq ft, GR $714K #14272
Redding- 5 Ops, 2,200 sq ft, GR $1 Million #14293
Santa Rosa- Patient records sale - Appox 245 patients. #14286
Yuba City- 5 ops, 4 days hyg, 1,800 sq ft, GR $500K #14273
CONTACT: Dr. Thomas Wagner @ 916-812-3255
Sunnyvale- 3 Ops - Potential for 4th, GR $271K #14285
CONTACT: Kelly McDonald @ 831-588-6029

New Bedford Area- 8 Ops, $650K #30119
CONTACT: Alex Litvak @ 617-240-2582

CONNECTICUT

MICHIGAN

FLORIDA
Miami- 5 Ops, Full Lab, GR $835K #18117
Ocala- Associate buy-in #18113
Pensacola- 4 Ops, GR approx $550K, large lot #18116
Port Charlotte- General practice for sale #18109
Port Charlotte- 3 Ops, 1 Hygiene Room, GR $295K #18115
Southern- General practice for sale #18102
CONTACT: Jim Puckett @ 863-287-8300

GEORGIA
Atlanta Area- 2 Ops, 2 Hygiene Rms, GR $480K #19114
Atlanta Suburb- 3 Ops, 2 Hygiene Rms, GR $861K #19125
Atlanta Suburb- 2 Ops, 2 Hygiene Rms, GR $633K #19128
Atlanta Suburb- 3 Ops, 1,270 sq ft, GR $438,563 #19131
Dublin- Busy Pediatric practice seeking associate #19107
Mabelton- 6 Ops, GR $460K, Office shared with Ortho
#19111
Macon- 3 Ops, 1,625K sq ft, State of the art equipment
#19103
Near Atlanta- 2 Ops, 2 Hygiene Rms, GR $700K #19109
North Atlanta - Spacious Oral Surg. Office, GR 518K #19123
Northeast Atlanta- 4 Ops, GR $750K #19129
Northern Georgia- 4 Ops, 1 Hygiene, Est. for 43 years #19110
NW Atlanta Suburb- GR $780K, Upgraded Equip #19113
Savannah (Skidaway Island)- 4 Ops, GR $500K #19116
Savannah- Group practice seeking associate. #19108
South Georgia- 4 Ops, 1 1/4 acres #19121
South Georgia- 1,800 sq ft, GR 400K #19124
CONTACT: Dr. Jim Cole @ 404-513-1573

IDAHO
Boise- Dr looking to purchase a general dental practice #21102
CONTACT: Dr. Doug Gulbrandsen @ 208-938-8305

ILLINOIS
Chicago-3 Ops, Condo available for purchase #22108
Chicago-3 Op practice for sale #22108

NORTH CAROLINA
Charlotte- 7 Ops - 5 Equipped #42142
Foothills- 5 Ops #42122
Foothills- 30 minutes from Mtn. resorts #42117
Near Pinehurst- Dental emerg clinic, 3 Ops, GR in 2007
$373K #42134
New Hanover Cty- A practice on the coast, Growing Area
#42145
Raleigh, Cary, Durham- Doctor looking to purchase #42127
Wake County- 7 Ops, High end office #42123
Wake County- Beautiful Cutting Edge Digital Office #42139
Wake County- 4 Ops #42144
CONTACT: Barbara Hardee Parker @ 919-848-1555

Boston- 2 Ops, 2 Hygiene, GR $650K. #30113
Boston- 2 Ops, GR $252K, Sale $197K #30122
Lowell- GR $400K #30106
Middlesex County- 7 Ops, GR Mid $500K #30120
Somerville- GR $700K
Sturbridge- 5 Ops, GR $1,187,926 #30105
Western Massachusetts- 5 Ops, GR $1 Mill, Sale $512K
#30116
CONTACT: Dr. Peter Goldberg @ 617-680-2930

East Hartford- 2 Ops, GR $450K #16109
Fairfield Area- General practice doing $800K #16106
New Haven- Perio practice-associate to partner #16107
New Haven Area- Associateship general practice #16102
Southburg- 2 Ops, GR $250K #16111
CONTACT: Dr. Peter Goldberg @ 617-680-2930

Syracuse- 4 Ops, 1,800 sq ft, GR in 2007 over $700K #41107
CONTACT: Richard Zalkin @ 631-831-6924
New York City - Specialty Practice, 3 Ops, GR $400K #41109
CONTACT: Marty Hare @ 315-263-1313

Suburban Detroit- 2 Ops, 1 Hygiene, GR $325K #31105
Grand Rapids Kentwood Area- 3 Ops, Building available.
#31102
CONTACT: Dr. Jim David @ 586-530-0800

MINNESOTA
Crow Wing County- 4 Ops #32104
Hastings- Nice suburban practice with 3 Ops #32103
Minneapolis- Looking for associate #32105
Rochester Area- Looking for associate #32106
CONTACT: Mike Minor @ 612-961-2132

MISSISSIPPI
Eastern Central Mississippi- 10 Ops, 4,685 sq ft, GR $1.9 Mill
#33101
CONTACT: Deanna Wright @ 800-730-8883

NEVADA
Carson City- 5 Ops, 2 Hygiene, 2,200 sq ft, GR $1 Mill
#37105
CONTACT: Dr. Dennis Hoover @ 800-519-3458

NEW HAMPSHIRE
Rockingham County- 2 Ops, Home/Office #38102
CONTACT: Dr. Thomas Kelleher @ 603-661-7325

NEW JERSEY
Jersey City- 2 Ops, GR $216K, 2 days a week #39107
CONTACT: Dr. Don Cohen @ 845-460-3034
Marlboro- Associate positions available #39102
CONTACT: Sharon Mascetti @ 484-788-4071

NEW YORK
Bronx- GR $1 Million, Net over $500K #41105
Brooklyn- 4 Ops, 2 Hygiene rooms, GR $1 Million, NR
$600K #41108
Dutchess County- 80% Insurance, GR $200K #41106
CONTACT: Dr. Don Cohen @ 845-460-3034
Oneonta- 3 Ops, Approx 1200sq ft. #41101
CONTACT: Deanna Wright @ 800-730-8883
Putnam County-6 Ops, GR $1.7 Million #41102
CONTACT: Dr. Peter Goldberg @ 617-680-2930
Syracuse Area- 6 Ops all computerized, Dentrix and Dexis
#41104
CONTACT: Donna Bambrick @ 315-430-0643

Akron- Excellent Opportunity, 2,300 Active Pts, 6 days of
Hyg. #44141
Columbus- 4 Ops, FFS practice for sale #44125
Darke County- 35 yrs, 1200 Act. Pts, GR $330K #44139
Dayton- 10 Ops, Associateship with buy-in option #44121
North Eastern- 2 Yr. Old Facility, State of Art Tech. GR
$830K #44143
North of Dayton- 6 Ops, 15 days of hygiene/wk #44124
South of Dayton- 6 Ops, 4,000 sq ft, GR $3 Million Plus
#44145
Toledo- 2 Ops, GR $225K, Est in 1988 #44147
CONTACT: John Jonson @ 937-657-0657
Medina- Associate to buy 1/3, rest of practice in future.
#44150
CONTACT: Dr. Don Moorhead @ 440-823-8037

PENNSYLVANIA
Beaver County- Ortho practice for sale. #47118
Mon Valley Area- Practice and building for sale #47112
Pittsburgh Area - High-Tech, GR $425K #47135
Pittsburgh- 4 Ops, GR over $900K #47114
70 Miles Outside Pittsburgh- 4 Ops, GR $1 Million #47137
Northeast of Pittsburgh- 3 Ops, Victorian Mansion GR $1.2+
Mill #47140
Robinson Township Area- GR $300K #47108
Somerset County- 3 Ops, 2006 GR $275K+ #47122
Southside & Downtown Pittsburgh- 2 practices for sale.
#47110
CONTACT: Dan Slain @ 412-855-0337
Dauphin County- 6 Ops, GR over $1,100K, Sale price $718K
#47133
Harrisburg- 3 Ops, GR $383K, Listed at $230K #47120
Lackawanna County- 4 Ops, 1 Hygiene, GR $515K #47138
Lancaster County- Associate positions available #47116
West Chester- 3 Ops, 10 years old, asking $225K. #47134
CONTACT: Sharon Mascetti @ 484-788-4071

RHODE ISLAND
Southern Rhode Island- 4 Ops, GR $750K, Sale $456K
#48102
CONTACT: Dr. Peter Goldberg @ 617-680-2930
SOUTH CAROLINA
Charleston Area- 8 Ops fully equipped #49101
Columbia- 7 Ops, 2200 sq ft, GR $678K #49102
CONTACT: Dr. Jim Cole @ 404-513-1573

TENNESSEE
Chattanooga- For sale #51106
Elizabethon- GR $400K #51107
Loudon- GR $600K #51108
Spring Hill- 4 Ops, Good Hyg. Program, Fast Growing Town
#51103
Suburban Knoxville- 5 Ops #51101
CONTACT: George Lane @ 865-414-1527

VIRGINIA
Burgess- General practice #55101
Danville Area- 3 Ops #55105
Newport News- 2 Ops, GR $804,433, Est 1980 #55109
CONTACT: Bob Anderson @ 804-640-2373

For a complete listing, visit www.henryschein.com/ppt or call 1-800-730-8883
© 2009 Henry Schein, Inc. No copying without permission. Not responsible for typographical errors.

[10] => DTUS131409.pdf

10 Clinical

DENTAL TRIBUNE | JUNE 2009

Cosmetic periodontal surgery: pre-prosthetic
soft-tissue ridge augmentation (Part 1)
By David L. Hoexter, BA, DMD, FACD,
FICD

Dentists understand that patients
demand outstanding esthetic, as
well as physiological, results in all
phases of dentistry today. This places an onus on dentists, who must
therefore be able to apply the latest technologies and techniques to
successfully achieve each patient’s
unique esthetic desires. A successful esthetic means knowing how to
create the right illusion, which is
subjective for each individual. Yet,
it can be measured in objective and
subjective standards. How then can
practitioners evaluate and achieve
these goals?
To begin, there are certain basic
and objective characteristics of a
healthy periodontia that must ﬁrst,
before anything else, be observed,
respected and maintained. A healthy
periodontia is essential to achieving
and maintaining restorative esthetics.
Reddish inﬂamed periodontia
immediately attract negative attention to the area. In contrast, a healthy
zone of pink attached gingiva acts as
a subtle background, providing dentists with signiﬁcantly more restorative options for teeth.
Similarly, exposed gold crowns,
gingival margins, exposed gingival
porcelain jackets or laminate margins will draw negative attention.
Also, crowns placed subgingivally in
an inﬂamed area will probably lead
to recession and an irregular gingival pattern resulting in dissatisﬁed
patients.
After healthy periodontia has
been achieved, color, hue, shape,
form, symmetrical appearance and
individual choice must then be discussed. At this point, the challenge
of esthetic dentistry is at its zenith.
Part 1 of this series is about the
role of pre-prosthetic, cosmetic
periodontal surgery to achieve and
maintain healthy periodontia and to
esthetically improve shape, color,
form and appearance.
Clinicians should strive to achieve
the appearance of a healthy symmetrical ﬂow. For example, patients
will not be satisﬁed very long with
an oversized pontic placed in a large
irregular edentulous area with a
ﬁxed bridge. It is unesthetic and
retains food and plaque, which will
lead to inﬂammation and periodontal disease. Often, a phonetic problem will also result. These patients
will be thwarted in and frustrated
by their hygiene efforts, and dissatisﬁed with the illusion of health
and esthetics that they sought to
achieve. Therefore, the relationship
of a pontic and the abutment teeth
to the gingival must be critically
observed before the prosthetics are
fabricated.
By esthetically and physiologically
correcting the edentulous area with
cosmetic periodontal surgery, restor-

Fig. 1: Initial labial view of maxillary #9 edentulous
area with a ﬂipper.

Fig. 2: Labial view of maxillary #9 edentulous area.

Fig. 3: Lateral view showing labial concavity
depression.

Fig. 4: Occlusal incisal edge view showing concave
labial ridge.

Fig. 5: Occlusal view of ﬂap outline.

Fig. 6: Reﬂected mucogingival ﬂap exposing
osseous labial defect.

Fig. 7: Gingival graft sutured in proper position.

Fig. 8a: Initial lateral view of depressed area.

Fig. 8b: Healed ridge augmentation, lateral view.

Fig. 8c: Lateral view of ﬁnal prosthesis on augmented
healed area.

ative dentists are able to fabricate
a correctly shaped prosthesis that
enhances esthetics and function.
It is important to make an assessment before fabricating the prosthetics. In the past, large pontics

were made to ﬁll voids created by
irregularly shaped, depressed edentulous ridges between abutments.
The opportunity to build out and
create a symmetrically harmonious bridge that blends in with the

www.dental-tribune.com

abutment’s periodontia is currently
available.
The following illustrates an
example of how one such patient
J DT page 12

[11] => DTUS131409.pdf

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[12] => DTUS131409.pdf

12 Clinical

DENTAL TRIBUNE | JUNE 2009

I DT page 10
was assisted to an eventual harmonious and esthetically pleasing
appearance.

Case 1
A 25-year-old woman presented to the ofﬁce very interested in
achieving a proper cosmetic look
with a non-removable appliance.
For years, she had been wearing a
ﬂipper removable replacement for
her maxillary left central incisor
(Fig. 1), which was traumatically
lost during an accident (Fig. 2) when
she was 15 years old. Following the
accident, it was suggested by her
restorative dentist (because of her
young age) that she avoid a permanent splint and wait for the pulps of
the adjacent teeth to mature. Years
later, she was referred to me for
pre-prosthetic cosmetic surgery that
would allow for a non-removable,
esthetically pleasing and physiologically maintainable appliance.
Without the surgery, the permanent replacement would have been
a large bulky pontic or physiologically sized pontic, which would have
retained food and plaque because of
a void between the gingival space
of the pontic and the crest of the
edentulous ridge. This void would
then have created a dark and unesthetic contrast. If the pontic had
been made smaller, there would
have been a space between the
pontic and the edentulous ridge in
which food and plaque would also
be retained.
If a removable appliance had
been fabricated, the practitioner
might have achieved an acrylic
color that somewhat resembled the
pinkish gingival area, but it would
have been discernible. If a clasppartial was used for the removable
prosthetics, the clasp would have
been unsightly. An attachmenttype partial would require crowns
to be prepared on the remaining
abutments, and the contrast of the
replacement tooth would have been
detected next to the adjacent abutments. Either partial would have

Fig. 9: Buccal view of a posterior maxillary area
with an extreme depression defect.

Fig. 10: Occlusal view of the same posterior defect
without provisional prosthesis.

Fig. 11: Anterior-buccal view of same defect.

Fig. 12: Tissue ridge augmentation completed in posterior
with new provisional. Notice physiological and esthetic
enhancement.

been an obvious replacement that
contrasted with the adjacent teeth.
After consultation, it was determined that by using a combination
of periodontal surgery techniques,
the shape, height and form of the
ridge could be corrected, enabling
the restorative dentist to place a
physiological crown. The edentulous
ridge had a labial depression and an
incisal edge that appeared concave
(Figs. 3, 4). The tissue had to be
built up incisally and labially, and
a harmonious ﬂow of pink attached
gingivally had to be maintained.
Following a thorough evaluation, an autogenous connective tissue graft was placed subepitheli-

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ally to achieve
a symmetrical
look in one surgical procedure.
After anesthetizing the patient,
the ﬂap outline
and its reﬂection
toward the labial
were completed
(Figs. 5, 6). The
connective tissue donor site
could have been
selected
from
various areas.
In this particular
case, the tuberosity area was Fig. 13: With ﬁnal prothesis in place.
used. The donor
After an uneventful postoperatissue was de-epithelialized, and
the deformed edentulous area was tive period, the patient healed and
sculpted to the desired shape. The continued with good oral hygiene.
original ﬂap outline was designed The referring dentist had a choice
to prevent recession on the adja- of several restorative techniques.
cent teeth and to provide a covering In this case, a ﬁxed splint was fabfor the graft to avoid a keloid on ricated with an acceptable pontic
the crest. During healing, a keloid (Figs. 8a–c).
In a one-stage procedure, we
would have been a different color,
which would have detracted from avoided creating a dark area of
the goal of harmonious color inte- labial depression and/or an irregugration. The ﬂap outline was then lar concave gingival crestal marextended palatally to include more gin. A lengthy, unsightly pontic
attached gingival, which avoided a was replaced by a physiological,
keloid and retained the graft. When cosmetically acceptable, naturalthe autogenous free connective tis- looking pontic, and the patient was
sue graft was in the desired location delighted.
(Fig. 7), the ﬂap was repositioned
Case 2
and sutured for stability.
In this case, the patient had
A second case demonstrates the
worn a ﬂipper for years to replace a use of the same technique in the
missing tooth. Following surgery, I posterior segment of a patient’s
reduced the existing ﬂipper to allow maxilla. An extreme buccal-incisal
space for the graft to heal.
defect (Figs. 9, 10) where an extracwww.dental-tribune.com

[13] => DTUS131409.pdf

Clinical 13

DENTAL TRIBUNE | JUNE 2009
tion was done is shown in a maxillary posterior area (Fig. 11). The
soft-tissue ridge augmentation technique was done. A temporary provisional bridge shows the restored
ridge enhancing the cleanliness
and cosmetic appearance. The ﬁnal
prosthesis displays a prosthetic
appliance that has been in her oral
cavity for 20 years. This shows the
longevity as well as the esthetic
enhancement of the technique and
its ability to enhance the prosthesis.
The ﬁnished prosthesis, which is
easily maintained by the patient,
shows that the unesthetic, unphysiologic defects were successfully corrected (Figs. 12, 13).

www.dental-tribune.com
Missed the last edition of Dental Tribune?
You can now read some of its content online!
Esthetics and the brain
By Editor in Chief David L. Hoexter, BA, DMD,
FACD, FICD

Here’s some other online content that might be of
interest to you …
Interview with Dr Jolán Bánóczy, Hungary, about the
basics of dentine hypersensitivity
By Claudia Salwiczek, DTI

Discover Chile, a Growing Dental Market
By Javier Martinez de Pison, DT Latin America

The 60-second conversion: emergencies to
comprehensive exams
By Sally McKenzie, CMC

The ‘All-on-4’ implant concept for edentulous jaws
By Paulo Maló & Miguel de Araújo Nobre

Summary
In these presentations, depressed
concave ridges — one example in
the anterior and the other in the posterior — were corrected using softtissue grafts. The results eliminated
dark, depressed food gathering,
unesthetic areas. This technique
provides a pre-prosthetic treatment,
thus avoiding large pontics, which
as illustrated, make the area diff
ﬁcult to keep plaque free or cosmetically pleasing. The restorative
dentist will then have a positive
background to create the esthetic
and physiologic prosthesis.
There must be constant communication between the periodontist,
restorative dentist and the patient.
Detailed techniques must be combined with artistic ideas and tempered with patience. DT

About the author

“You couldn’t
PAY ME to go
to the dentist”
24 CREDIT HOURS

Certiﬁed for
24 AGD/PACE-Approved
hours of CE

A
Approved
PACE Program Provider
FFAGD/MAGD Credit
1/1/2009 to 12/31/2012
1

O
T
T
C
E
J
B
U
S
E
G
N
CHA
ati
Relaxed P

Dr. David L. Hoexter is director of the International Academy
for Dental Facial Esthetics, and a
clinical professor in periodontics
at Temple University, Philadelphia. He is a diplomate of implantology in the International Congress of Oral Implantologists as
well as the American Society of
Osseointegration, and a diplomate
of the American Board of Aesthetic
Dentistry.
Hoexter lectures throughout
the world and has published
nationally and internationally. He
has been awarded 11 fellowships,
including FACD, FICD and Pierre
Fauchard. He maintains a practice
at 654 Madison Ave., New York
City, limited to periodontics,
implantology and esthetic surgery.
He can be reached at (212) 3550004 or drdavidlh@aol.com.

re Profit.
o
M
.
e
r
a
C
r
ents. Bette

Most patients would rather do…well, just about anything besides sit in your dental chair. They
associate going to the dentist with pain, anxiety, and discomfort. And who wants to volunteer for that?
Take the “dread” out of “dentist.” DOCS Education’s 3-day Oral Sedation Dentistry
course will teach you 14 proven protocols to relax your patients, ease their fears, and make dentistry easy
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AD-2056

[14] => DTUS131409.pdf

14 Events & Industry

DENTAL TRIBUNE | JUNE 2009

The Greater New York Dental Meeting has
heart, helps educate New York City’s children
As the holiday season is a time for
giving and helping others, the organizers of the Greater New York Dental Meeting (GNYDM) decided the
2008 meeting was the perfect opportunity to commence a new program
focused on improving children’s oral
health. The program, “Greater New
York Smiles,” was made possible
by joining efforts with the United
Federation of Teachers and Doral
Dental of New York.
“We must teach our children
the importance of oral health early
in their childhood,” said General
Chairman of the Greater New York
Dental Meeting, Dr. Clifford Salm.
In order to introduce “Greater New
York Smiles” and other educational
programs, the meeting expanded its
exhibit ﬂoor by adding approximately 120,000 square feet.
Children from local schools in all
ﬁve New York City boroughs traveled
by bus for an educational ﬁeld trip
to last year’s 84th annual GNYDM at
the Jacob K. Javits Convention Center. There they received oral hygiene
instruction in a child-friendly atmosphere. The program emphasized

the importance of oral care in a way
that the children could understand
and showcased step-by-step tooth
care utilizing proper brushing techniques.
Their visit began with the children
viewing a ﬁlm focused on increasing
their knowledge about the signiﬁcance of proper nutrition. One segment highlighted the effects of how
eating various foods can impact oral
health and why it is crucial to eat
healthy foods. After the ﬁlm, they
watched a live demonstration that
taught them about dental ﬂoss and
showed them how to ﬂoss properly.
Finally, the children had the opportunity to practice their newly learned
brushing and ﬂossing techniques at
sinks on the exhibit ﬂoor under the
supervision of program volunteers.
Upon departure, each child went
home with a “goody bag” of dental
treats that included a toothbrush,
toothpaste, dental ﬂoss, pencils with
erasers in the shape of teeth and
a dental coloring book with crayons. To maximize attendance, the
program ran for three school days
— Monday, Tuesday and Wednes-

day. Twenty-four classes of third and
fourth grade students were able to
participate with a total of more than
950 children during the program’s
three days. Local television station
Fox News 5 ﬁlmed and broadcasted
the event on its evening news segment and made it available to afﬁliates throughout the country.
Hygiene students from the New
York University College of Dentistry
Dental Hygiene Program, the New
York City College of Technology
Department of Dental Hygiene, Hostos Community College Department
of Dental Hygiene and members of
the Dental Hygienists’ Association
of the City of New York and the New
Jersey Dental Hygienists’ Association
volunteered their time and skills to
be a part of this new children’s program. The volunteers said they were
touched by the signiﬁcant impact
that they were able to make on the
children.
“We are delighted that through
this program we were able to have
a positive impact on such a large
number of children by teaching them
skills that will beneﬁt them for the

rest of their lives. We look forward
to reaching many more students this
year,” said Executive Director of the
Greater New York Dental Meeting,
Dr. Robert Edwab.
Be sure to watch the Web site,
www.gnydm.com, for information
and updates on this year’s expanded
“Greater New York Smiles” program
and all the other new programs
offered at the 2009 GNYDM. Remember, there is never a pre-registration
fee. Mark your calendar for Nov.
27–Dec. 2 and come be a part of
the excitement of the 2009 Greater
New York Dental Meeting, as well
as experience all that New York has
to offer!
For additional information, please
contact the Greater New York Dental
Meeting at 570 Seventh Ave., Suite
800, New York, N.Y., 10018-1806; Tel.
(212) 398-6922; Fax (212) 398-6934;
e-mail info@gnydm.com. DT

‘Spring forward’ into annual sedation dentistry safety reviews
First Sedation Dentistry Safety Week held March 9–13
It was time to spring forward in
more ways than one in March. While
many people reset their clocks that
month, DOCS Education initiated its
ﬁrst Sedation Dentistry Safety Week
as an annual reminder for some
10,000 sedation dentistry dentists
and their staffs to review the procedures, equipment and supplies used
with every patient.
Each day of the week focused on
a speciﬁc aspect of sedation dentistry such as important checklists for
dentists and patients, and the vital
role of dental assistants and staffs in
sedation dentistry procedures, and
also offered the opportunity for prac-

titioners and consumers to speak to
sedation dentistry experts. In addition, one dentist was recognized as
the Safe Sedation Dentist of the Year.
“No matter where a dentist
received sedation dentistry training, Sedation Dentistry Safety Week
is a reminder to all dentists and
their staffs that they must constantly
review every protocol, every piece
of equipment and their supplies,”
said Dr. Michael Silverman, national
chair of Sedation Dentistry Safety
Week. Silverman, who co-founded
DOCS Education in 1999, is one of
the world’s top sedation dentistry
educators.

New leadership at Milestone Scientiﬁc
Effective April 12, 2009, Leonard
Osser, the founder of Milestone Scientiﬁc, took over the CEO position
with the company. Osser is back in
familiar territory as he held the CEO
position with Milestone Scientiﬁc
from 1997 to 2007.
“It was not something that I expected, but I certainly welcome the opportunity,” said Osser. “The company is
coming off a record year in 2008, and
ﬁrst quarter sales are up $2.2 million
vs. $1.4 million in ’08, so it’s an exciting time to be spreading the word
about C-CLAD (computer-controlled
local anesthesia delivery) and it’s an

exciting time for Milestone.”
Milestone Scientiﬁcs STA System is
rapidly becoming the standard of care
for administering anesthesia. Dentists have been seeking a more effective solution to the traditional dental
syringe, which has not changed since
its inception in 1860.
“We live in a computer-driven
world; that’s one of the reasons dentists and patients are embracing
STA. The STA System is a computercontrolled, local anesthetic delivery
system using DPS technology.” The
DPS technology allows the dentist to
deliver anesthetic below the patient’s

On March 11, DOCS Education honored Tennessee dentist
Dr. Anthony Carrocci with the title
of 2009 Safe Sedation Dentist of
the Year, an award that recognizes
excellence in patient safety and comfort. Carroccia, who owns St. Bethlehem Dental Care in Clarksville, and
his staff have treated nearly 1,000
patients using sedation dentistry. He
has taken oral and I.V. sedation
courses at a number of organizations, and is a diplomate of DOCS
Education as well as a master of the
Academy of General Dentistry.
In addition, March 13 was designated as Talk to a Sedation Dentist Day where sedation dentistry
experts answered 64 calls from

dental practitioners and patients
between the hours of 9:30 a.m. and
5:30 p.m. EST.
Please call DOCS Education at
(877) 325-3627 to speak to a sedation
dentistry expert or to get connected with a dentist practicing sedation dentistry in your area because
there are sedation dentists in every
U.S. state. You can also visit DOCS
online at www.DOCSeducation.com.
In addition, consumers with questions can call (888) 858-7972 or
visit www.sedationcare.com to ﬁnd
a sedation dentist in their area and
to listen to patient testimonials.
Next year’s Sedation Dentistry
Safety Week will take place from
March 15–19. DT

pain threshold, all monitored by the
computer and relayed back to the
dentist through a series of lights and
tones.
STA gives the dentist the ability to consistently and scientiﬁcally
deliver an injection that will achieve
profound anesthesia in one minute
per root. The ability to anesthetize
a single tooth predictably allows the
dentist to administer fewer block
injections — an injection practitioners miss 25 percent of the time and
an injection that requires they wait
eight to 10 minutes after injecting
just to gain onset. With STA, you
start the procedure immediately and
your patient experiences no collateral
numbness to the lip and cheek.

“We expect 2009 to be our greatest year ever. The testimonials we’re
receiving from STA dentists on a daily
basis are proof that dentists are eager
to put down their syringes.
“The feedback we hear from
patients is simply outstanding. There’s
a huge patient base that simply ﬁnds
the dental syringe to be a threatening
instrument,” Osser said. DT

www.dental-tribune.com

Milestone Scientiﬁc
220 South Orange Ave.
Livingston, N.J. 07039
Toll Free: (800)862-1125
Phone: (973) 535-2717
Fax: (973) 535-2829
www.milestonescientiﬁc.com

[15] => DTUS131409.pdf

Industry News 15

DENTAL TRIBUNE | JUNE 2009

The fusion of composite
and adhesive technology
Fusio™ Liquid Dentin represents
the next generation in ﬂowable
composite technology. By effectively
fusing together self-adhesive and
restorative technology into one product, clinicians can now restore teeth
faster than ever, saving both time
and money. Fusio Liquid Dentin’s
ability to tenaciously bond to both
dentin and enamel without a separate adhesive opens up new possibilities for this segment of restorative
materials.
Pentron Clinical Technologies
Product Manager Jeremy Grondzik
states: “While it shares many of the
same indications as a traditional
ﬂowable composite, its use as a dentin replacement material or a selfadhesive base liner shatters previous
perceptions of where and how ﬂowable composites can be used.” This
new generation of ﬂowable composite is priced similar to traditional
premium ﬂowable composites and is
available in the popular Vita* shades:
A1, A2, A3 and B1.

Fusio Liquid Dentin is one of
the latest innovations from Pentron
Clinical Technologies, an established leader in the dental industry,
offering a wide variety of products
to suit your restorative needs. As
one of the pioneers of ﬁber post and
nano-hybrid composite technologies, Pentron Clinical has successfully demonstrated its commitment
to the technological advancement of
dentistry.
The Pentron portfolio of innovative and award-winning dental products includes: Flow-It® ALC™ Flow-

able Composite, Breeze® Self-Adhesive Resin Cement, Build-It® FR™
Core Build-Up Material, FibreKleer®
Posts, Correct Plus® Impression
Materials and Artiste® Nano Composite. For more information, call
(800) 551-0283 or visit www.pentron.
com. DT

* Vita is a trademark of Vita Zahnfabrik

Pentron Clinical Technologies, LLC
53 North Plains Industrial Road
Wallingford, Conn. 06492

Introducing
™

PhotoMed
Universal
Mirror Handle

Enamel Bonding Surface

Dentin Bonding Surface
D

™

CR) Composite
C
Co
Resin
D) Dentin
Den Surface
™
B) BeautiBond
Be
E) Enamel
En
Ena
Surface

One Adhesive: Two Powerful Monomers!
mers deliver
QUnique dual adhesive monomers
equal bond strength to enamel
el and dentin
g time
QSingle coat for shorter working
QOnly 5µm ﬁlm thickness

Bond Strength After Thermocycling2
100

(Mpa)

80
60
40
20
0

Providing convenience and efﬁcacy in a single adhesive,
dhesive,
BeautiBond has a distinct advantage over other seventh-generation
g sixth-generation
adhesives. With bond strengths similar to leading
ch adhesive
alternatives, BeautiBond is the one-step, self-etch

5000 cycle

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(MICROTENSILE TEST METHOD)

Bonding Durability Test
120
100

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ual adhesive mon
onomer
erss
for a wide range of clinical indications. Its dual
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amel AND den
entin..
enable predictable long-term bonding to both enamel
dentin.

80
60
40
20
0

Visit www.shofu.com or call 800.827.4638

0 cycle
BeautiBond (BB)

(%)

The Universal Mirror Handle is
designed to work with most intraoral mirrors that have been made
in the last few decades. You can
position the mirror inline with the
handle or the mirror can be angled.
There is approximately 35 degrees
of rotation to allow comfortable
positioning for buccal and occlusal
views. Unlike other handles on the
market, the Universal Mirror Handle can be locked to hold the mirror
at the angle you choose.
The Universal Mirror Handle is
available individually to work with
existing mirrors, or in a kit that
includes: one mirror handle, one
adult occlusal chromium mirror,
one buccal T1 chromium mirror
and one “O” utility mirror.
Information and pricing can be
found at: www.photomed.net/mir
ror_handle.htm, or call (800) 9987765. DT

The Science
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[16] => DTUS131409.pdf

[17] => DTUS131409.pdf

Industry News 17

DENTAL TRIBUNE | JUNE 2009

DMG America launches new Web site
Consistent with its recent rebranding campaign, DMG America (formerly Zenith Dental), has
launched a new, user-friendly Web
site, dmg-america.com. The new site
features detailed product information, company news, a convention
calendar with booth information,
end user specials and a representative locator for North America.
The dmg-america.com tool bar
provides easy access to the product
catalog, MSDS information, product
literature and a Web site search
engine. The product catalog is divided into logical categories including:
provisional, core and bite registration material sections, and all of the

other quality products. Clicking on
any product brings a full description to the screen, including a list of
features and beneﬁts, as well as any
special offers available. The About
Us tool details DMG America’s history, mission, quality standards and
contact information.
“We’ve designed dmg-america.
com to showcase the products that
have made DMG America such a
strong leader in dental restorative
products,” says Marketing Director Tim Haberstumpf. “dmg-amer
ica.com is a great resource tool for
detailed information on our entire
product line.”
Perhaps the best feature is how

simple it is to navigate between the
Web site sections. Users can jump
from a product description to a more
detailed product brochure or the
MSDS page or a physical properties
page that lists information such as
working time, setting time, ﬂexural
modulus and compression strength
without losing track of where they
were or planned to go next.
“DMG restorative products are
among the most widely used in
the dental industry,” Haberstumpf
said. “Offering efﬁcient access to
product and company information,
dmgamerica.com reinforces our
commitment to quality customer
service and our tradition of innova-

tion.”
In keeping with its commitment
to quality and excellence, dmg-amer
ica.com will continue to expand in
concert with the company’s growth.
DMG America is in the process of
developing a ﬁrst-of-its-kind product, which ofﬁcials believe represents a true leap forward in dental
technology. Keep an eye on dmgamerica.com for further news.
For more information and a complete list of DMG America’s product
offerings, please visit dmg-america.
com or call (800) 662-6383. DT
AD

Cetacaine Topical
Anesthetic Liquid Kit

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Cetylite’s new Cetacaine® Topical Anesthetic Liquid Kit is ideal for
scaling and root planing, providing
patients with effective, non-injectable, cost-effective anesthesia.
Only $2 for a full-mouth application, the included 14-gram bottle
yields up to 34 full-mouth applications. The new, unique dispenser
cap for Luer-lock syringes allows
the clinician to use only what he
or she needs, not exceeding 0.4 ml
maximum dose. Cetacaine’s tripleactive formula (benzocaine 14 percent, butamben 2 percent, tetracaine
hydrochloride 2 percent) has onset
within 30 seconds and duration typically lasts 30 to 60 minutes.
The kit contains a 14-gram bottle
of Cetacaine Topical Anesthetic Liquid with dispenser cap, 20 Vista™ 1.2
mL Luer-lock syringes and 20 VistaProbe™ 27 ga tips. Cetylite now offers
a 14-gram or 30-gram replacement
bottle of Cetacaine Liquid with the
Luer-lock dispenser cap. The cap ﬁts
all Luer-lock syringes. This unique
design also allows for the single dip of
a microbrush, which is ideal for preinjection or other procedures requiring site-speciﬁc topical anesthesia.
Cetylite will demonstrate its new
Cetacaine Topical Anesthetic Liquid
Kit at the ADHA, booth No. 409. The
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Liquid to anyone who purchases three
14-gram bottles or one Cetacaine Liquid Kit as well as a free 30-gram bottle
with purchase of three 30-gram bottles.
For more information, visit www.
cetylite.com, or stop by the Cetylite
booth, No. 409, during the ADHA. DT

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[18] => DTUS131409.pdf

[19] => DTUS131409.pdf

COSMETIC TRIBUNE
The World’s Cosmetic Dentistry Newspaper · U.S. Edition
JUNE 2009

www.dental-tribune.com

VOL. 2, NO. 4

New smile, new life — innovative technologies
and techniques can transform a smile
By Lorin Berland, DDS, FAACD &
Sarah Kong, DDS

An actor-turned-director came to
our practice from www.denturewear
ers.com. He was seeking a solution to

enhance and reconstruct his smile.
Over the past several years, he had
noticed his face slowly “sagging”,
despite an upper denture made by a
cosmetic dentist in Las Vegas (Fig.
1). Since then, he had seen numerous dentists, including several prominent prosthodontists, to resolve his
smile, and more importantly, his
facial concerns. However, the patient
was not prepared to commit to extensive treatment plans, neither in time
nor in ﬁnances; not to mention the
pain and recovery period associated
with the multiple surgeries he would
have to undergo for a permanent
solution.
Among the numerous treatment
options we discussed for his dental
requirements were implants, a new
denture, a precision partial, veneers
and crowns. He was then presented

Fig. 1: Pre-op full-face view.

Fig. 4: Smile Style Guide for smile
design.

Fig. 2: Cosmetic image of upper arch.

Fig. 5: Smile Design P-4: pointed
canines, square-round incisors.

Fig. 3: Cosmetic image of upper
and lower arches.

Fig. 6: Length code L-2: laterals
slightly shorter than centrals and
cuspids.

with an entirely innovative option
he had not heard of before: a new
full denture for the upper arch and
a Snap-On Smile for the lower arch,
to create the beautiful smile and
natural facial dimensions for which
he longed.

Case presentation
A full diagnostic workup was performed, which included a thorough
examination, a full series of digital
radiographs and photographs, and
cosmetic imaging with smilepix.com
(Figs. 2, 3). We had transformed
another gentleman’s smile the previous week by opening his vertical
dimension with a set of Snap-On
Smiles. The latest technology from
DEXIS Digital Diagnostic Imaging

allowed us to access the before-andafter photographs in a matter of seconds, and show an actual case illustration of how opening a person’s
bite through dentistry can change
the appearance of the face to make it
look younger and, naturally, better.
We then went through the Smile
Style Guide developed with Dr. David
Traub (www.digident.com) to select
the shape, P-4 (pointed canines with
square-round centrals and laterals),
and length combination, L-2 (laterals slightly shorter than the centrals
and the cuspids), he preferred for the
cosmetic image, and ultimately, for
his new smile (Figs. 4–6). The digital
photographs stored in the DEXIS
J CT page 2
AD

[20] => DTUS131409.pdf

Clinical

COSMETIC TRIBUNE | JUNE 2009

COSMETIC TRIBUNE

I CT page 1

The World’s Dental Newspaper · US Edition

hub, in combination with his cosmetic images and the idea of a SnapOn Smile, encouraged the patient to
immediately accept the treatment for
his smile transformation.
We began by duplicating his existing upper denture for the wax tryin, using a kit made by Altadontics
to impress the denture. Then we
poured in a bisacryl temporary material, such as Luxatemp Automix Plus
(Foremost), Fill-In (Kerr), and Integrity (DENTSPLY Caulk). After about
40 minutes, we had a duplicate of his
old denture to use as a custom tray
with excellent borders.
Once the duplicate denture had
been trimmed, smoothed and tried
in, we applied PVS adhesive and took
a wash impression with a light body
PVS, such as Splash! (Discus Dental)
and Virtual (Ivoclar Vivadent). With
this time-saving denture duplication
technique, we were able to take a
very accurate ﬁnal impression during the patient’s ﬁrst appointment.
An impression of the lower arch
was taken using System 2 Alginate
(ACCU-DENT), to create a lower
custom tray. To address one of the
patient’s main concerns, his “sagging
face”, we explained that his vertical
dimension had decreased over time
as he lost posterior teeth and ground
down teeth 22 to 27 (Figs. 7, 8). Only
teeth 21 and 31 had close to the
original occlusal height (Fig. 9). The
patient had no desire to treat tooth 31
as he really wanted a painless solution for the time being, especially
with the holiday season approaching.
We took a neuromuscular bite registration with a slow-setting material
(SuperDent bite registration), after a
45-minute TENS treatment with the
Myomonitor, to record his ideal jaw
relations.
At the wax try-in appointment, we
conﬁrmed the look and feel of the
upper teeth. We then took an alginate
impression of the wax try-in to oppose
the Snap-On Smile. For the wax try-in
and eventually the ﬁnal denture, we
selected esthetic denture teeth, such
as Portrait IPN (DENTSPLY Caulk),
Physiodens (VITA) or BlueLine (Ivoclar Vivadent), to create a more natural appearance. At this appointment,
a PVS impression of the lower arch
was also taken in a custom tray with
a regular-set material like Splash!
(Discus Dental) or Virtual (Ivoclar
Vivadent) for the fabrication of his
Snap-On Smile.
About three weeks later, the
patient returned for his quick, painless smile transformation (Figs.
10–16). The patient was delighted
with his new smile, but was even
more excited about the way his new
smile was created. He knew that he
looked older than he should, and did
not wish to go the plastic surgery
route. Rather, he needed to restore
his face with a smile lift, which was
accomplished quickly and painlessly
through high-tech dentistry!
By using the Snap-On Smile to
restore his lower dentition, the
patient now has a beautiful smile

Fig. 7: Pre-op close-up smile.

Fig. 8: Pre-op retracted view.

Publisher
Torsten Oemus
t.oemus@dtamerica.com
President
Peter Witteczek
p.witteczek@dtamerica.com

Fig. 9: Pre-op occlusal view.

Fig. 10: Final close-up smile.

Chief Operating Ofﬁcer
Eric Seid
e.seid@dtamerica.com
Group Editor
Robin Goodman
r.goodman@dtamerica.com
Editor in Chief Cosmetic Tribune
Dr. Lorin Berland
d.berland@dtamerica.com

Fig. 11: Final retracted view.

Fig. 12: Final right lateral view.

Managing Editor Implant
& Endo Tribune
Sierra Rendon
s.rendon@dtamerica.com
Managing Editor Ortho Tribune
Kristine Colker
k.colker@dtamerica.com
Online Editor
Fred Michmershuizen
f.michmershuizen@dtamerica.com

Fig. 13: Final left lateral view.
Fig. 14: Final occlusal view.

Product & Account Manager
Mark Eisen
m.eisen@dtamerica.com
Marketing Manager
Anna Wlodarczyk
a.wlodarczyk@dtamerica.com
Sales & Marketing Assistant
Lorrie Young
l.young@dtamerica.com

Fig. 15
and, more importantly, is able to
experience the look, feel and function of a more permanent solution.
When he came to us, the patient was
not willing to undergo total mouth
rehabilitation in the near future.
Now he is seriously considering a
more permanent solution when time
and conditions allow. Also, his SnapOn Smile can be used as a surgical
guide for implants. In the meantime,
he is reaping the beneﬁts of the
smile transformation that modern
dental technologies and techniques
have helped to create. CT

C.E. Manager
Julia E. Wehkamp
E-mail: j.wehkamp@dtamerica.com
Art Director
Yodit Tesfaye Walker
y.tesfaye@dtamerica.com

Dental Tribune America, LLC
213 West 35th Street, Suite 801
New York, NY 10001
Tel.: (212) 244-7181
Fax: (212) 244-7185

Figs. 15 & 16: Final full-face view
and ﬁnal close-up smile.

About the authors
Dr. Lorin Berland, a fellow of the AACD, pioneered the
Dental Spa concept in his multi-doctor practice in the
Dallas Arts District. His unique approach to dentistry
has been featured on television (20/20) and in national
publications and major dental journals, including Time
magazine. In 2008, he was honored by the AACD for his
contributions to the art and science of cosmetic dentistry. For more information on The Lorin Library Smile
Style Guide, www.denturewearers.com, and Biomimetic
Same Day Inlay/Onlay 8 AGD Credits CD/ROM, call
(214) 999-0110 or visit www.berlanddentalarts.com.
Dr. Sarah Kong graduated from Baylor College of Dentistry where she served as a professor in restorative
dentistry. She focuses on preventive and restorative
dentistry, transitionals, anaesthesia and periodontal
care. She is an active member of numerous professional organizations, which include The American
Dental Association, The Academy of General Dentistry,
The American Academy of Cosmetic Dentistry, The
Texas Dental Association and The Dallas County Dental Society.

Cosmetic Tribune strives to maintain utmost
accuracy in its news and clinical reports.
If you ﬁnd a factual error or content that
requires clariﬁcation, please contact Group
Editor Robin Goodman, at r.goodman@
dtamerica.com. Cosmetic Tribune cannot
assume responsibility for the validity of product claims or for typographical errors. The
publisher also does not assume responsibility
for product names or statements made by
advertisers. Opinions expressed by authors
are their own and may not reﬂect those of
Dental Tribune America.

Tell us what
you think!
Do you have general comments or criticism you would like to share? Is there
a particular topic you would like to see
articles about in Cosmetic Tribune?
Let us know by e-mailing feedback@
dtamerica.com. We look forward to
hearing from you!

[21] => DTUS131409.pdf

[22] => DTUS131409.pdf

[23] => DTUS131409.pdf

HYGIENE TRIBUNE
The World’s Dental Hygiene Newspaper · U.S. Edition
JUNE 2009

VOL. 2, NO. 4

www.dental-tribune.com

Protective extraoral and reinforced
instrumentation strategies
By Diane Millar, RDH, MA

Imagine working in your profession as a dental hygienist without
ever experiencing work-related
pain. Dental hygienists expect to
have long careers once they enter
their profession after graduation.
Unfortunately, having a long career
in dental hygiene can be problematic if protective reinforced instrumentation and ergonomics are not
implemented. Numerous hygienists
experience pain, fatigue and injuries that lead to a shorter career.
Scaling is no longer exclusively
about calculus removal. It is about
calculus removal and protecting
oneself from injury.

Learning extraoral fulcrums
to prevent injury
Utilizing protective extraoral
reinforced instrumentation techniques requires scaling teeth with
two hands, instead of one, to ensure
optimum performance and to promote occupational health and career
longevity. These techniques allow
the non-dominant hand to assist
and reinforce the dominant hand
while primarily using extraoral fulcrums. Reinforced instrumentation
techniques can extend career longevity in the ﬁeld of dental hygiene,
which has documented evidence of
ergonomic disorders.
There are several ways to learn
protective instrumentation strategies to help prevent injury if a
hygienist isn’t sure how to utilize
extraoral reinforced techniques.
There are “hands-on” courses
offered at seminars for dental hygienists who want to practice on typodonts, as well as a new book that
was written for dental hygienists in
private practice titled, “Reinforced
Periodontal Instrumentation and
Ergonomics for the Dental Care
Provider,” published by Lippincott,

Williams and Wilkins in 2007. This
book shows extraoral, reinforced
fulcrums in every area of the oral
cavity, ergonomic positioning techniques that guide the practitioner
to utilize the 8 o’clock position to
the 2 o’clock position around the
dental chair for improved access,
and stretches that can be done
in the operatory for wellness and
career longevity.
Unlike years ago, many dental
hygiene schools are now introducing extraoral fulcrums during the
ﬁrst semester in pre-clinic. The
primary reason for this is extraoral
fulcrums need to be utilized in
order to use an ultrasonic scaler
correctly. There is also more of
an awareness of the importance
of proper hand ergonomics to prevent injury by keeping the hand,
wrist and arm in a neutral position. With this awareness, dental
hygiene schools utilize ultrasonic
scalers, magniﬁcation loupes and
protective extraoral fulcrums.
In the early 1980s and earlier,
the ultrasonic scaler could only be
used for heavy calculus removal in

many dental hygiene programs. It
was important to ﬁrst and foremost
learn how to scale by hand and not
depend on an ultrasonic scaler. Also,
scaling by hand in those days primarily was done by utilizing intraoral
scaling techniques, not extraoral
techniques. Extraoral fulcrums and
reinforced scaling “tips” were often
introduced during the second year of
the dental hygiene program.
Thankfully, with the awareness
of documented injury in the dental
hygiene profession, proper hand
ergonomics that incorporate a neutral position of the hand, wrist and
arm while using extraoral techniques are being taught in many
dental hygiene schools the ﬁrst
semester of the program.

Incorporate hand and arm
exercises
Hand strength is important to
successfully implement extraoral
fulcrums. In fact, fulcrum pressure determines whether an instrument stroke will be appropriately
controlled. Other important factors include an extended grasp and

adequate pressure exerted against
the patient’s cheek and jaw for support. The amount of pressure that
needs to be exerted throughout the
appointment and throughout the
day with each patient is signiﬁcant.
If a dental hygienist’s hands and
arms are weak and are lacking
muscle tone and strength, injury
can occur.
Ideally, dental hygiene schools
should be implementing hand and
arm exercises to increase muscle
endurance, which can help prevent
injury while in the hygiene program as well as in private practice.
This would also set a standard of
awareness to exercise one’s hands
and arms on a regular basis. Using
squeeze balls and light weights daily
will increase strength, improve
muscle tone and provide increased
endurance. Hygienists who do this
and graduate from dental hygiene
school and enter into private practice will have the muscular strength
and endurance to treat eight to nine
patients per day, and will be less
prone to injury.
If a dental hygienist has had a
problem with carpal tunnel syndrome, tendonitis or any other
upper body musculoskeletal injury,
incorporating protective reinforced
techniques will help reduce additional injury by utilizing both hands
to scale. Coupled with that, the
larger muscle groups in the arms
versus the smaller muscle groups in
the hands will be used.

Advantages
Scaling with both hands while
utilizing protective extraoral techniques will enhance scaling technique efﬁcacy and reduce the incident for injury, especially when
treating patients with heavy calculus, by providing the following
beneﬁts:
J HT page 2

Tennessee State’s hygiene clinic expands
By Fred Michmershuizen, Online Editor

Tennessee State University’s
Dental Hygiene clinic is getting bigger. The groundbreaking for a $1
million addition to the clinic was
held May 5. The expansion will

increase the clinic’s size by 3,900
square feet, adding 20 new teaching areas and space for faculty and
staff ofﬁces.
“This upgrade will signiﬁcantly
boost the clinic’s capacity for training hygienists,” Dr. Marian Patton, dental hygiene department

head, said in a statement. “Most
importantly, the renovations will
provide students with a learning
environment in a state-of-the-art
facility, which builds upon the team
approach to dentistry in the working world.”
The Dental Hygiene Clinic has

been in Clement Hall on TSU’s
Nashville campus since moving
from Meharry Medical College in
1974. The program has a placement
rate of more than 90 percent, offering a two-year associate of applied
science degree and a bachelor of
science in dental hygiene.

[24] => DTUS131409.pdf

Editor’s Letter

HYGIENE TRIBUNE | JUNE 2009

HYGIENE TRIBUNE
The World’s Dental Hygiene Newspaper · U. S. Edition

Dear Reader,
We have been blessed with the
ability to work in a profession with
endless potential, but where do
hygienists ﬁnd out about opportunities available beyond the walls of
an operatory? In the 25 plus years
I have spent in the dental world, I
have heard colleagues ask, “What
more can I do with my hygiene
degree?” While there are many
possibilities, none will be realized
if we don’t put forth the time and
energy necessary to discover new
endeavors.
As with our hygiene career, all
new roads begin with education.
Learning about alternative prospects in dental hygiene is easy in
today’s world. The Internet abounds
with educational resources. A great
place to begin learning is visiting
online dental hygiene communities. These groups are composed of
hygienists who are utilizing their
degrees in numerous ways. While
several groups exist, those that
come to mind are DTStudyClub.
com, AmyRDH.com and Hygiene
town.com. Look at the sites available, see what others are doing and

I HT page 1
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dominant hand.
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hands for instrument placement.
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arm fatigue.
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strength.
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U i«ÃÊ ÌÊ `iVÀi>ÃiÊ >`]Ê ÜÀÃÌÊ
and arm pain.

Publisher
Torsten Oemus
t.oemus@dtamerica.com
President
Peter Witteczek
p.witeczek@dtamerica.com
Chief Operating Ofﬁcer
Eric Seid
e.seid@dtamerica.com

learn about opportunities.
Continuing education regarding non-clinical hygiene topics is
another source of learning. Look
for courses that discuss writing,
speaking, consulting, etc. Again,
networking with the people who
attend these conferences is a wonderful way to gain insight on what
is available. Many conferences provide these opportunities. Two that
are especially memorable to me
are RDH magazine’s Under One
Roof (rdhunderoneroof.com) and
CareerFusion (careerfusion.net).
These gatherings have the ability
to change the professional world of
dental hygienists.
Explore the world of continuing education and plan to attend
at least one session this year to get

U *ÀiÛiÌÃÊ ÕÀÞÊ >`Ê ÜÀÀi>Ìed disability.
The beneﬁts of using extraoral
fulcrums in comparison to intraoral
fulcrums are many. Most importantly, these protective scaling fulcrums stabilize the clinician’s hand
while instrumenting. In turn, this
helps the hands, wrists and arm
remain in a neutral position. These
added beneﬁts help guard against
injury that can occur while scaling
and root planning. Our profession
requires good ergonomic techniques for career longevity as well
as career satisfaction. Thus, it’s
important to try new innovative
scaling techniques not learned in
school. The results are well worth
the effort to ensure a long career as
a dental hygienist. HT

About the author
dental hygiene has embraced working in private
practice coupled with leadership roles such
as faculty positions as an associate professor,
public speaker and, in 2007, a published author
of a dental hygiene instrumentation manual
titled, “Reinforced Periodontal Instrumentation
and Ergonomics for the Dental Care Provider”.
r obtained her dental hygiene degree from
t Los Angeles College in 1981, a bachelor’s
science degree in health science: health
e at the California State University of Long
ach and a master’s degree in education
om Pepperdine University in 1999. Visit
her online at www.dianemillar.com. If you
are interested in purchasing Millar’s book,
please visit www.LWW.com.

Group Editor
Robin Goodman
r.goodman@dtamerica.com
Editor in Chief Hygiene Tribune
Angie Stone RDH, BS
a.stone@dtamerica.com
Managing Editor Implant
& Endo Tribune
Sierra Rendon
s.rendon@dtamerica.com
Managing Editor Ortho Tribune
Kristine Colker
k.colker@dtamerica.com

career enhancement on the move!
Best Regards,

Angie Stone, RDH, BS
Editor in Chief

A-Rod’s
brushing habits
detailed in
new book
By Fred Michmershuizen, Online Editor

The book “A-Rod: The Many
Lives of Alex Rodriguez” by Sports
Illustrated writer Selena Roberts
contains more than just allegations
of steroid use by the New York Yankees third baseman. According to
the book, which was released May
4, A-Rod brushes his teeth after
every game.
But in a bizarre revelation, the
book also reports that A-Rod gets a
clubhouse attendant in the locker
room to load the toothpaste onto his
toothbrush and hand it to him. Talk
about being pampered!
The book describes A-Rod as an
insecure prima donna who used
steroids. The book also alleges that
he spent wild nights with strippers
and had an obsession with Yankees
shortstop Derek Jeter.
At least dental hygienists can take
comfort knowing that the baseball
all-star — who makes $28 million a
year playing for the Yankees — has
clean teeth!
The preloading of the toothbrush,
which the book claims took place
after every game A-Rod played in
his three seasons with the Texas
Rangers, was described as a “timesaving measure.”

Online Editor
Fred Michmershuizen
f.michmershuizen@dtamerica.com
Product & Account Manager
Mark Eisen
m.eisen@dtamerica.com
Marketing Manager
Anna Wlodarczyk
a.wlodarczyk@dtamerica.com
Sales & Marketing Assistant
Lorrie Young
l.young@dtamerica.com
C.E. Manager
Julia E. Wehkamp
E-mail: j.wehkamp@dtamerica.com
Art Director
Yodit Tesfaye Walker
y.tesfaye@dtamerica.com

Dental Tribune America, LLC
213 West 35th Street, Suite 801
New York, NY 10001
Tel.: (212) 244-7181
Fax: (212) 244-7185

Hygiene Tribune strives to maintain
utmost accuracy in its news and clinical
reports. If you ﬁnd a factual error
or content that requires clariﬁcation,
please contact Group Editor Robin
Goodman, at r.goodman@dtamerica.
com. Hygiene Tribune cannot assume
responsibility for the validity of product
claims or for typographical errors.
The publisher also does not assume
responsibility for product names
or statements made by advertisers.
Opinions expressed by authors are
their own and may not reﬂect those of
Dental Tribune America.

Tell us what you think!
Do you have general comments or criticism you would like to share? Is there
a particular topic you would like to see
articles about in Hygiene Tribune? Let us
know by e-mailing feedback@dtamerica.
com. We look forward to hearing from
you!

[25] => DTUS131409.pdf

[26] => DTUS131409.pdf

4

ADHA 86th Annual Session

HYGIENE TRIBUNE | JUNE 2009

ADHA Annual Session schedule at a glance …
Wednesday, June 17

Saturday, June 20

7–4 p.m., Lobby Day
3–5 p.m., Green & Growing: Meeting the Oral Care Needs of Health
Conscious Consumers

8–9:45 a.m., Saturday Plenary Session, ADHA Awards & Keynote
Presentation by The Healthy Humorist, Dr. Brad Nelder
10 a.m.–12 p.m., Seeking the Right Fit: Finding the “Perfect” Job
10 a.m.–12 p.m., Student Advisor Development Workshop
10 a.m.–1 p.m., Antibiotics in Dentistry
10 a.m.–1 p.m., Revive, Refresh, Renew: Creating Balance for the
Dental Hygienist
10:30 a.m.–12:30 p.m., Faculty Solutions for Dealing with Challenging
Students
10 a.m.–4 p.m., Exhibits XXVIII
1–3 p.m., Colgate’s “Stars and Stripes Dessert Extravaganza”
1–4 p.m., Marketplace
2–5 p.m., Women’s Health: Fit and Fabulous!
2–5 p.m., America’s Next Top Hygienist: How to Maximize Your
Communication Style to Get Positive Results
3–5 p.m., EBD: Managing Information So It Doesn’t Manage Us
3–5 p.m., Dental Hygiene Education 2020
5–6:30 p.m., CODA Hearing
7–11 p.m., IOH Beneﬁt Reception, combined event with IOH Silent/Live
Auction and entertainment (free!)

Thursday, June 18
8–9:15 a.m., Plenary Session, Zap the Gap: Solving the Multi-generational Puzzle, featuring Meagan Johnson
8–10:30 a.m., Student Table Clinic/Poster Judging
9:30 a.m.–12:30 p.m., What’s New in Local Anesthesia
9:30 a.m.–12:30 p.m., Diabetes Mellitus: Strategies for Providing Comprehensive Care
9:30 a.m.–12:30 p.m., Destination: Calibration of Calculus Detection
9:30 a.m.–12:30 p.m., Pre-BOT Meeting
10–11:30 a.m., Stop Me Before I Strangle Someone!
10:45 a.m.–12 p.m., Student Table Clinics and Poster Sessions
12:30–2 p.m., Student Awards Luncheon
1–2:30 p.m., Lunch & Learn
1–2:30 p.m., 1st Timers/Mentor Luncheon ($20 fee includes lunch)
2:30–5:30 p.m., CDC Guidelines for Infection Prevention and Control:
Developing Best Practices in Dental Practice Settings 2008
2:30–5:30 p.m., Fun Pediatric Dentistry: Inspire, Educate and Lead
2:30–5:30 p.m., Destination: Calibration of Clinical Attachment Loss
2:30–5:30 p.m., Posture, Pain and Productivity in Dentistry
3–5 p.m., Student Welcome
7–11 p.m., Sunstar Student Bash

Sun., June 21

Friday, June 19
7–8:30 a.m., Procter & Gamble/Crest Breakfast
9 a.m.–3 p.m., Exhibits XXVII
10 a.m.–1 p.m., Anti-infective Periodontal Therapy
10 a.m.–1 p.m., New Product Presentation
10 a.m.–12 p.m., Byte Me! Dental Anatomy and Occlusion Like You’ve
Never Seen It Before!
10 a.m.–1 p.m., Posture, Pain and Productivity in Dentistry
10 a.m.–1 p.m., Student Assembly: Your Association, Your Voice
12–2 p.m., Exhibits XXVIII, Free lunch on exhibit ﬂoor
12–2 p.m., Research Poster Sessions; DENTSPLY/ADHA Student Clinician Program
2–5 p.m., Are You Smarter than Dr. Esther Wilkins?
2:30–5:30 p.m., Recent Advances in Caries Detection and Diagnosis
2:30–5:30 p.m., The Good, The Bad and The Ugly
2:30–5:30 p.m., Be Part of the Solution: RDH Role in Emergency
Response and Forensic Dentistry
2:30–5:30 p.m., “Cha-Cha-Changing!” Understanding Perimenopause in
Ourselves and Our Patients
6–7:30 p.m., Philips Sonicare RDH Mentor of the Year Reception
7–9 p.m., DENTSPLY/ADHA Student Clinician Program Awards Banquet

7:30–9:30 a.m., District Discussions (free and open to all)
10–11:30 a.m., House of Delegates (free and open to all)
11:30 a.m.–1:30 p.m., Johnson & Johnson Healthcare Products/
ADHA Awards Program for Excellence in Dental Hygiene/President’s
Luncheon ($60 fee)
2–4 p.m., Town Hall Forums (free and open to all)
5–6:30 p.m., Candidates Forum (free and open to all)

Monday, June 22
8–11 a.m., Mega Issues Forum (free and open to all)
11:30 a.m.–2:30 p.m., District Discussions, (free and open to all)
11 a.m.–12 p.m., Student Discussion (free, geared toward students)
2:30–5 p.m., House of Delegates (free and open to all)
5:30–6:30 p.m., Balloting (delegates only)
6:30–7:30 p.m., Leadership Mentoring Session (free and open to all)

Tuesday, June 23
7–8:30 a.m., ADHA Legislative Chairs Workshop (free, geared toward
State Presidents/Legislative Chairs)
8–10 a.m., Growing Your Membership Online: MySpace, Facebook and
YouTube for Newbies (free and open to all)
8:30–10 a.m., Organizing and Integrating Effective Public Health Efforts
(free and open to all)
10 a.m.–1 p.m., House of Delegates (free and open to all)
1–2:30 p.m., Installation Luncheon, (free and open to all)

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[27] => DTUS131409.pdf

HYGIENE TRIBUNE | JUNE 2009

ADHA 86th Annual Session

How to make the most of your
convention experience
By Amy Morgan

Meeting checklist

We at the Pride Institute have all
heard the horror stories from the
dental community on what can go
wrong, based on prior convention
experiences. The worst stories can
include:

. Hygienist disappearing from
the ﬂoor or lecture.
. Alcohol related/party experiences that result in a “lost
weekend” for all.
. Purchasing everything on the
ﬂoor and then regretting it …
deeply.
. Purchasing nothing you were
supposed to (with or without
regret).
. Taking C.E. courses that teach
you to macramé or “what not
to wear” with no return on
investment (ROI) for you, your
continuing care program or the
practice.
. Taking C.E. courses that could
enhance continuing care, but
three weeks later, many Tyle-

Convention pre-meeting checklist
1) Assess the situation
a. What are your primary goals (on
the ﬂoor and in lectures)? What
are the “problems” to be solved?
What are the opportunities to
fully explore?
b. What resources/constraints do
you have?
i. Time
ii. Money
iii. People

2) Deﬁne the outcomes you want
(Hint: this should tie to the vision
and strategy you have for your
department’s and practice’s success, as well as opportunities to
enhance your existing skills)
a. Be as speciﬁc as possible (“I want
to relax and party like a rock
star;” “I want to attend a class
on oral cancer screening and as
many laser-learning sessions as
I can to enhance my skills;” “I
want to take time to explore new
clinical opportunities;” “I want
to research — on behalf of the
dentist and team — a state-ofthe-art patient education system
to enhance value and commitment.”).
b. What future trends in dental
hygiene care should be the primary focus in future planning for
the practice?

3) Examine how you might
achieve this/these goal(s)
a. If you have X amount of time to
maximize your hygiene experience, what are the possible ways
to get the information you want

nol are ingested … all is forgotten.
. General chaos and mayhem
that results in team breaking,
not team building.
This can be quite frustrating to
a hygienist that has taken personal time and money to create an
opportunity for continuous growth.
There’s got to be a better way and
we can help!
To truly maximize the potential
of your convention experience, it
requires focused planning before,
during and after the meeting. Once
you have made the commitment
to attend, there must be pre-work
done both informally and formally
through staff meetings that cover
the steps below.

or need?
i. Attend in person.
ii. Purchase lecture notes, CDs,
DVDs, books.
iii. Send a proxy (team member, family member, colleague
with whom you’d share notes)
iv. Take time to meet with peers
and educators to get feedback
and support about trends, purchases, successes and challenges.
b. Review the course offerings and
set priorities for lecture attendance.
c. Is there a budget for the hygienist to purchase items/products
for the hygiene department? The
practice?

4) Set expectations for you and
your team’s participation
a. Clarify logistics: i.e., compensation, meals, budgets for ﬂoor
purchases, mandatory vs. volunteer attendance, expectations for
activities not during convention
hours.
b. How will information gathered
from courses be “reported back”
to the rest of the team and new
information integrated?

5) Plan for fun (for Pete’s sake!)
a. Don’t forget this is an excellent
time to blow off some steam, see
each other in a different light and
truly bond with one another.
b. Don’t assume; plan events with
your team or colleagues if you
truly want this to be a motivating
moment.

Once you arrive at the convention,
let’s pretend you and your team are
visiting a special town on a “vacation.” You have two areas that you’d
like to visit: lectures land and exhibit
land. Let’s create a checklist that
maximizes the visits to both lands!

content?
h. How will this address the problems and opportunities back at the
practice?
i. When will an action plan for implementation be developed to implement this information?

Exhibit land
Lectures land
a. What do you want to learn? What
do you want your team to learn?
What do you want the dentist to
learn?
b. What is the purpose of the lecture: clinical, certiﬁcation requirements, practice management, customer service?
c. Which courses would expand
hygienists’ skill sets, i.e., local
anesthesia, placement of antimicrobials, new products, etc.?
d. What activities are available to
explore networking opportunities?
e. What are the expectations for participation and note taking at the
lecture?
f. To what can you send a proxy
(team member)?
g. How and when will you debrief the

Post convention checklist
Now that you have arrived safely and securely home, it’s time to
implement!
1) Schedule a staff meeting to review
key learning from the lectures
attended. Each team member
who attended a session or who
saw something on the demo ﬂoor
will be allocated some time to
present key concepts learned.
2) Brainstorm priorities and action
steps for implementation.
3) Assign accountability for action
step completion and timeline the
process.
4) Schedule any training that needs

a. Review a map of the meeting ﬂoor
and determine which booths will
be sought out and why.
b. Pre-block ﬂoor time versus lecture
time to ensure no double booking.
c. Do you want free toothpaste or do
you need a new hand piece? Stick
to your plan.
d. Keep your budget and strategy
in mind. Convention-only pricing
can always be negotiated once you
return home.
e. Preserve some time to see new
stuff. This is such a renaissance
period of new models and new
methods in dentistry, it is vital that
you and your team keep your eyes
and ears open to the next innovation that matches your vision for
care and service.

to be done to implement new
technology purchases.
5) Reconcile your purchases to your
original budget.
6) Schedule any follow-up calls with
you, the dentist and vendors for
incomplete purchases.
7) Recognize and acknowledge the
team for what made the meeting
successful and plan what’s next.
Congratulations, you are now
armed and dangerous! You and
your team just might get the most
out of this meeting. Just follow the
checklists!

About the author
Amy Morgan is a dental consultant
and CEO of Pride Institute, a nationally acclaimed results-oriented practice
management consulting company. Morgan has revitalized thousands of dental
practices using Pride’s time-proven management systems so they become more
secure, efﬁcient and proﬁtable. Additionally, Pride offers continuing education, marketing, on-site training and telephone consultation support. Founded in
1976 by James Pride, DDS, Pride Institute
is dedicated to substantially improving
the professional, ﬁnancial and personal
lives of dentists and their staff. For more
information, call (800) 925-2600 or visit
www.prideinstitute.com.

[28] => DTUS131409.pdf

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