When it comes to the ROI of Indirect Restorations, consider both the tangible and intangible costs.
We dentists have to start understanding that our time is the most valuable and expensive asset we have. We tend to believe that personnel, materials, and supplies are expensive—but when you boil it down, it’s really a matter of time itself being the best return on investment (ROI) in terms of our productivity. This concept should be applied to patients as well; ultimately, we have to value their time more than anything. The average patient takes about 3 hours off work for a dental appointment, so the more times they have to do that, the less productive they are, too.
So many of the intangible things that we just accept as the traditional way of doing dentistry are eliminated with chairside digital dentistry. For example, in the traditional model, patients must return to have indirect restorations placed. The cost of the time involved— from the assistant to the front-office person, setting up an appointment and then rescheduling if the patient cancels—adds up fast. These are unrealizable costs. When comparing direct costs of single-visit dentistry vs. two-visit restorations, materials come to mind—impression material, provisional material, temporary cement, all with their guns and tips. These things add up. And don’t forget the cost of ordering and maintaining the inventory.
It’s easier to focus on the tangible ROI when a restoration is fabricated in-house. Using Dentsply Sirona’s CEREC system, the average time for an appointment with me is between 60 and 90 minutes for a single tooth restoration. Typically, my assistant takes our preliminary digital impression, which includes the bite and the opposing. Prepping the tooth varies in time, depending on the case. After isolation, I take a final digital impression. Depending on state law, the dentist can then walk away and move on to other things, such as another patient. A well-trained assistant can do the design and start the milling process, which usually takes 8-14 minutes. It takes 5-8 minutes to design the restoration, including processing. While the machine is milling the crown, the assistant is free to do other things. When the milling is finished, the assistant makes sure it fits and polishes it or puts it into an oven, which takes 5-16 minutes. At that point, the dentist comes back to deliver it, which can take 5-10 minutes when you’re bonding it in. Much of the process can be delegated to an assistant, saving the dentist time.
A good example of understanding the value of time is when something needs a remake or adjustments, we don’t have to start the process over again—we can immediately correct it right in the office. For example, if the color is not right, I can literally just click “mill” again and have a different color restoration ready to go, which is a tremendous advantage.
I like knowing that I’m saving myself and all parties involved time and money, while having the satisfaction of creating indirect restorations myself.
As originally published in Dental Learning, later published in Sidekick Magazine.
About The Author: Dr. Agarwal is a full-time practicing general dentist who deals with the same issues we all face—overhead, difficult patients, ups and downs of private practice, and team management. Despite being contracted with insurance, he’s managed to build a successful practice that is focused on clinical excellence, customer service, and allowing patients to choose optimal dentistry. Dedicated to continuing education, he has studied with many leaders in the field of dentistry but readily admits his best learning has come from the “school of hard knocks.”