Where There's a Mill, There's a Way!

By Shannon Pace, CDA, CDD

We’re all faced with tough decisions: What to buy, what to put off, what to forgo? Wants suddenly give way to necessities. The pinch can also be felt across many industries and professions nationwide—and dentistry is no exception. The dental procedure that might have at one time been a priority, has taken a back seat to more pressing issues. Money that might have been saved for a more esthetic smile, restoring a fractured tooth, or eliminating tooth pain, might now be used to pay the utilities or phone bill.

As part of a progressive practice offering comprehensive care, we are seeing more and more that the current patient focus has shifted from what was once cosmetic and elective to now what is basic and essential. But despite a continuing dismal economic forecast, we are using innovation and technology, particularly with the E4D Dentist System, to overcome many of our patients’ economic concerns and continue to provide the oral healthcare that they not only need but also want. As both an empathetic practitioner and a small business owner, my clinician has made the conscious decision to evolve his practice into the digital age because, especially in today’s economy, each patient’s experience becomes critical for continued success. In dentistry, time is money—for the patient, for the team, and for the clinician.

The E4D Dentist system is a comprehensive scan, design, and mill restorative system. It can scan in the mouth, from an impression or from any stone model—all without the application of a contrast agent (aka “powder”). It takes just minutes to gather the necessary scans of the preparation and the bite registration material and then virtually design the restoration chairside using DentaLogic™ Software. Once the form and function have been confirmed, the data is sent wirelessly to a mill, where out of a block of IPS Empress ceramic (IPS e.max CAD) a beautiful restoration is fabricated before your eyes. Exposing and educating your patients to what modern technology can offer in all phases of dentistry— from digital X-rays (DEXIS) and cone beam (i-CAT) technology to the E4D Dentist System—will only elevate your skills, patient treatment, and patient respect.

When a clinician can provide treatment options that can save on both materials and time without compromise, the benefit is not only to the practice, but also to the patients. I see patients and hear their concerns about treatment plans, insurance, and finances on a daily basis. In our practice, we consistently express two main desires about every patient; we aim to perform the most conservative amount of work required to achieve the patient’s level of satisfaction, and we try to do it in the shortest amount of time possible without compromising the quality of work.

The E4D Dentist, which was designed with a team concept and optimized treatment workflow in mind, helps our practice reduce costs, increase productivity, and improve efficiency. The dental assistant plays a notably large role in this restorative solution. Assistants are encouraged to attend the included 2-day E4D Elements training session at E4D University in Dallas, where they learn to scan, design, mill, and finish the restoration by staining and glazing or polishing. Assistants can also enroll in the take-home office-study Chairside Dental Designer (CDD) program. This unique program provides motivated dental assistants and technicians the opportunity to gain professional recognition and establish credibility and proficiency in many skills required in the modern dental office with CAD/CAM dentistry. Certification requires competency in CAD/CAM design, digital intraoral photography, finishing restorations, and exchange of ideas and information on E4D’s online ECOforum. Having the assistant take on such a large role frees the dentist to do more productive and clinically intense procedures, such as treating a patient, consulting, or a hygiene check, without sacrificing precious time during the day. As the doctors and assistants become more confident and proficient with the system, patient chair is reduced. In most cases, procedures are just a single appointment; however, even reducing the turnaround time and temporary time from the typical 2–3 weeks to 2–3 days is greatly appreciated by all. The next time you put on a temporary, ask the patient if he/she would rather get the final in an hour, the next day, or 2–3 weeks, and you can easily gauge the patient’s true desire if given the choice. There is also a reduction in production time per procedure, which equates to less overhead, improved efficiency, and greater savings. We have the ability to treat those who want a single-visit procedure and also come up with a plan that fits the patient’s budget and ours.

Most times patients have never been given the option of getting an indirect procedure done in one appointment. It is safe to say that all patients would be interested and delighted to have choices, there are some patients who, if offered same-day dentistry with the E4D Dentist system, would search out and stay in your practice. Consider these unique, “but everyone has them” situations:

Dental Phobic

Patient #1

has a debilitating dental phobia that she attempts to control by premedicating with Valium before all dental procedures. She, like many of our other patients, was especially relieved to learn of a single-visit option available to her since our office acquired the E4D Dentist system. The patient recently fractured tooth number 19 and insisted on a same-day solution. Spending less than two hours in the dental chair, the patient walked away with a functionally esthetic final crown without having to anticipate a second or third visit. Whenever you have the opportunity to educate patients like this that they only have to get one shot, see the dentist one time, take one-half the medication (only one visit), and not risk a loss of a temporary, they are excited and feel you understand and care.

Busy Schedule

Patient #2

has a similar fear of dental procedures. As a flight attendant, she is always on the go, making it hard for her to schedule regular dental appointments. Upon a recent visit to our office, she learned of three teeth that needed attention. We treatment planned to do a direct composite occlusal filling on #15, an onlay on #14, and an inlay on #13. We started the procedure by preparing all tooth surfaces. Once all of the teeth had been prepared, the assistant began scanning #13 and #14 then started the design, using E4D’s Dentalogic design software. Meanwhile, a second assistant stepped in to assist with the filling on #15. As the filling was completed, the E4D restorations were taken out of the mill and the assistant then glazed and fired the restorations and, after a short time for cooling, the restorations were ready to be seated. The patient left the office that day with a smile, knowing she wouldn’t have to worry about a temporary falling out mid-flight, forcing her to see an unfamiliar dentist far away from home.

Overly Sensitive

 Patient #3 is a police officer with a “bite that feels everything.” With a chief emphasis on occlusion, we applied bite registration material over the prepared tooth to accurately map the opposing dentition. Since the E4D Dentist’s acquisition unit employs laser technology, bite registration material may be applied without using a contrast agent, regardless of brand or composition. The bite registration was then scanned, and the proposed crown was evaluated for high occlusal spots on the software. These spots can be virtually reduced in strength with the click of a button, thus eliminating the need for manual reduction in the mouth. As expected, the patient’s crown dropped into place without the need for any further adjustments—all in just one appointment.

High Risk

Patient #4

is an elderly patient, who is on several medications and has many aging restorations. Recently, she presented as an emergency patient, missing a crown with the remainder of the tooth broken off at the gum line. The patient is on a fixed income, recently widowed, and could not afford a $1,300 lab-fabricated restoration at this time. After conferring with the doctor, patient coordinator, and patient, the office adopted a sliding scale fee approach and used the E4D Dentist system for her case. The savings in lab fees allowed our office to work within her budget, providing the quality of dentistry that our office consistently delivers and minimizing the risk of any dental treatment in a compromised patient by eliminating one—if not two—additional appointments.

The effective marketing, communication, and utilization of this type of technology—offering patients something they’ve never been offered before—sets you and your office apart. We maximize the involvement of the team, providing services that less than 6% of the practices in North America can offer—without compromising our ideals of form, function, and esthetics. We can better adapt to the economic and social needs of our patients—all with the E4D Dentist System. Where there is a mill there is a way, and we have the mill and the way.

Tooth numbers and costs are based on U.S. information