Every year around this time, 5,000 lesson-weary yet fresh-faced dental students emerge from dental school ready to take on the challenge of maintaining and improving the oral health of millions of Americans. When I look across the American landscape at the 125,000 general dentists currently in practice it blows my mind that those 5,000 grads haven’t been snatched up by their junior year of dental school because of how valuable they are.

Don’t think the same way? Indulge me a little while I prove that no matter what you currently think, there is, without a doubt, room for you to hire an associate immediately.

Phones

Your current phone system is just awful. You’re probably using the same copper cable technology invented by Thomas Edison, you have someone manning the phones only during business hours and when you’re closed all calls go to your little answering machine that still uses the little cassette tape. Hey, doc, wake up! The turn of the century happened 13 years ago already! You need to move to a digital phone system – a voice over Internet protocol (VoIP) – run it through the Internet and your network. My practice, Today’s Dental, in Phoenix, Arizona, uses Avaya (formerly Nortel) and it is awesome! When my practice is closed and we get 12 phone calls from people who didn’t leave a message, we can track the missed phone calls and someone on my team can call those numbers back first thing when they get in.

Humans are extremely complex. They’ve got a three-and-a-half pound brain powered by a trillion circuits. The brain is influenced by a person’s nutrition, genetics, whether or not they’re hopped up on caffeine, chocolate or sugar, etc. Humans are very imperfect decision-making machines. When a human brushes her teeth at 6 a.m. and feels something missing in the back of her mouth, she will pick up her iPhone and call her dental office. When an answering machine picks up instead of a live person, she shrugs her shoulders, says, “Eh, whatever,” and just hangs up to either A. just live with it or B. call another dental practice later on that will pick up the phone so they can fix her up. If you can track when your calls are coming in, not only can you call those numbers back right away, but you can adjust your staff ‘s schedule to best cover when the majority of your phone calls are coming in. That way when patients call, you can assure they’re being answered by an actual person.

What I find most ridiculous about your phone system isn’t the technology itself – it’s that you only have someone living and breathing answering the phone 8 a.m. – 5 p.m., Monday through Thursday, with an hour break for lunch each day. There are 168 hours in a week and the average dental practice is open for 32 of them. A practice’s primary concern is, “How the heck can we get more new patients?” Easy answer, make sure a living, breathing person is answering your phones during high-call-volume hours.

Almost every dental practice I visit has two dental assistants and a dentist doing all of the dentistry, and there’s only one person out front filling the schedule. I always say, “Here’s what we’re going to do. We’re going to change your phone system to a digital VoIP, and instead of having two assistants helping do the dentistry, we’re going to move one of those assistants up front. Also, instead of having one person answer the phone from 8 a.m. to 5 p.m., one receptionist is going to come in at 6 a.m. with the owner doctor and she’s going to take a lunch from 11 a.m. to Noon, and then she will leave at 3 p.m. The other receptionist is going to come in at 9 a.m. with the associate dentist and she’s going to work from 9 a.m. until 6 p.m. That way the phones are going to be 100 percent answered when the majority of people are calling. We’re going to stagger the staffing of your front desk because 50 percent of the incoming calls to your practice are made when you are closed early in the morning and later in the evening. Also, of the calls that do come in while you’re open, 50 percent of those go to voicemail while your one-person front desk is taking care of other business. And if both front-desk staffers have their hands full, you need to make sure that any staff member in your practice is comfortable picking up the phone. This way you have much better coverage at the front desk and you’ll be able to fill more holes in your schedule so you can do more dentistry!” If you answer twice the number of calls coming into your office with a live, highly trained receptionist, you will increase the number of appointments. When you increase the number of appointments, most dental offices today can actually absorb almost all of that capacity. Dentists don’t have a problem if you double book them, triple book them, have to work them through lunch, or make them work past 5 p.m.

Don’t want to be open more, or keep someone in the office longer to cover the phones and make appointments after hours? Fine, but I challenge you to track the phone calls you’re missing and then tell me you’re OK with the status quo.

If you have an antiquated phone system, your little answering machine isn’t going to tell you about the missed call at 6 a.m., and unless your patient is fiercely loyal to your practice, you might not hear back from her at all. But if you use the digital VoIP system, your front desk comes in at 8 a.m., notices the list of missed calls and starts calling the numbers back immediately. When you call your 6 a.m. patient back, it clicks with her and she says, “Oh, yeah, I did call you this morning. Thank you so much for calling me back so soon. I have a problem. I think I’m missing part of my tooth.”

Expand Your Hours

Your front-desk staffer is still on the phone with your 6 a.m. caller, and your staffer should know her job so well that no matter the patient’s protests, she goes right for the close and says, “Let’s get you in. Can you come in today? What’s the best time for you to come in?” That’s at least what she should say, but is your practice able to accommodate emergency patients? When it comes time to schedule a patient, almost 140 million Americans will tell you from 8 a.m. to 5 p.m. they can’t leave their business because they’re working! Oh and you’re open Monday through Thursday from 8 a.m. to 4 p.m. – the same block of time your patient can’t come in. So what should you do? How about you hire an associate and expand your practice hours! You have the land, the building, and the equipment. Would you rather it just sit there costing you money, or would you rather use it and make money?! Bring in an associate and cover 50 hours a week instead of only 32.

Don’t think you can land an associate in your neck of the woods? The largest employer of dentists on planet Earth is the United States military. It employs around 5,000 dentists, and it can get these kids to sit on an aircraft carrier in the middle of the Pacific Ocean for half a year at a time, leaving their spouses and children on shore. You think you can’t land a quality associate because you live in Hays, Kansas? Are you kidding me? In Hays, Kansas, at least your associate can have breakfast and dinner with his family! Think about that!

Beef up your front desk so your practice can sell more dentistry, and stay open longer so you can accommodate your patients’ schedules and you can perform more dentistry. Pretty soon you’re going to have more dentistry to do than you have dentists to accommodate it. When that happens – hire an associate!

What are your thoughts? Once you’ve finished reading this, please log onto Dentaltown.com and post your comments under my column. See you online! – See more at: http://www.dentaltown.com/Dentaltown/Article.aspx?i=325&aid=4435#sthash.umefwXW1.dpuf

This year I celebrated my 25th year of practicing dentistry and looking back over the last quarter century, sometimes I wonder if dentistry is just getting too darn easy.

The first five years I practiced, I had a 24-hour-a-day, 7-day a week, callous on my thumb and index finger from carefully moving stainless steel endofiles up and down all the time. When I graduated from dental school, it literally took me two hour-and-a-half appointments to manually clean out a tooth. Dentists today are so lucky! Now we have 300RPM nickel-titanium files that takes care of business in less than half the time – and in a single appointment, no less.

Radiology is also undergoing a complete revolution right now, and endodontics has become so much easier because of it. There is a high percentage of American dentists who use two-dimensional X-rays and it’s so surprising to me how few have moved over to the new 3D technologies. I have still not met a single dentist who’s gone from 2D to 3D and will ever go back. So many skeptics who still use 2D ask: “Well does insurance cover it? Will I have to charge extra?”Yet every single dentist I know who uses 3D says they don’t even care. It’s just amazing what you can see with the new technology. I mean, look at endo again. For years, every time a root canal failed we just assumed we did something wrong. Like, maybe we were just short of the apex and we didn’t get it all cleaned out. When you use 3D imaging, you can plainly see the root is fractured. If you can see that, just imagine how much more dentistry you can diagnose and treatment plan!

I predict, within a few years, general dentists will not refer to endodontists who don’t have 3D X-rays – how would the endodontist even know if the tooth had a vertical fracture if she can’t even see it? Root canal failure is why so many endodontists warranty their work. If it fails in the first year, the patient will get 3/4 of their money back; if it fails in two years, the patient will get half of their money back and so on. If the root canal lasts four years, it’s good enough. The best endodontists, on the other hand, outright refuse to warranty their work. They’re good at what they do, and if they’re using 3D imaging, they can see everything! You’re telling me you’re OK with taking $1,500 of someone’s hard-earned money to perform a root canal that’s not going to last a year and you don’t feel any shame or guilt about it? That ruins endo and root canals for everyone! What sort of connotation does it carry when someone tells you: “I don’t want a root canal. Just pull the tooth. My cousin got a root canal and they had to pull the tooth a year later anyhow. What a waste of money.”

The American Dental Association was way ahead of the curve when they granted specialty status to oral radiologists. In the future, the dentist isn’t going to be the person reading X-rays. Oral radiology is going to explode – not just in the United States but internationally. That’s all thanks to the Internet! I see practices taking 3D X-rays and e-mailing them to an oral radiologist somewhere else on the planet, and within a few minutes, the oral radiologist reads the X-ray and tells you what you’ve got.

The best endodontists in the profession use 3D cone beam computed tomography (CBCT), and they have the ability to place implants. I want my retreats to go to an endodontist who can take an accurate 3D X-ray and if she decides that the tooth isn’t salvageable, the money isn’t an issue because she can either make $1,500 doing the retreat or she can make $1,500 pulling the tooth and placing the implant right then and there. That is outstanding customer service to the patient!

You’d have to agree with me; dentistry is getting so much easier! Look at CAD/CAM. Since I’ve been a dentist all the best labs that I know will tell you that all the best dentists have about a six percent remake rate (couple that with the dentists who say they have never had a remake in 25 years, you know the truth is somewhere in the middle). Now with impressions going digital with optical scanning, those same labs say remakes drop from six to one percent. One percent! When you digitally scan the teeth, if you’ve got a huge monitor that’s two feet by a foot, you just can’t see a prep better than that. You can’t even see a prep that well with loupes on. Taking it further, if you have a milling machine right there in your office you don’t even have to send the impression out to the lab, and you can take care of your patient in the same day. I mean, CAD/CAM technology is something we only dreamed about and wished for 25 years ago. Now it’s a reality, and there are still some of you who won’t give it a shot. You can’t afford to sit on the sidelines with CAD/CAM. If you’ve been thinking about it, take the next step!

Look at implants! I got my fellowship from the Misch Insitute, I got my diplomat from the International Congress of Oral Implantology and I’m telling you, just thinking about placing implants in the 1980s makes my stomach turn. Placing implants has come such a long way since then. When you placed an implant back then, you were talking about long incisions, and when you thought you had an inch of bone to work with, you really didn’t know until you got in there, and you’d receive such a shock that you really only had half as much bone. You had to stay so far away from the mental foramen for fear that an anterior loop could ruin your day. It was such a difficult procedure! Today, you don’t even need to extract the teeth before you get started on placing an implant. You take a 3D X-ray, send it to a lab, the lab makes a snap on retainer with a pilot hole, you get it back, numb the patient up, snap on the retainer, drill right through the pilot hole and the tissue and place the implant. There are dentists who come up to me at seminars to tell me they don’t pull wisdom teeth and that they can’t stand the sight of blood, but they purchased a 3D CBCT machine and are placing seven to 10 implants a month. They’ve gone from zero to 60 in about three seconds in the implant world. I mean, tell me dentistry hasn’t gotten too easy!

And then there’s orthodontics! I remember doing ortho in my practice from 1987 to about 1992, bending stainless steel with these three prongs, trying to figure out the best way to improve someone’s smile. You could literally get a migraine headache trying to figure out what you had to do with the wire. Some things are extremely difficult to wrap your head around and orthodontics in the 80s and early 90s was one of them. There’s a reason orthodontists take so much more school! Then nickel-titanium wires came out, where they could pre-cast the archwire so everything was at the right angle, and all you have to do is bend it into the bracket. The wire straightens all by itself and drags the teeth with it! It’s just gotten so much easier!

What’s even more amazing is thinking how much easier dentistry is going to be in another 25 years! Think about it!

What ways has dentistry become easier for you? When you’ve finished reading my column, I wish you would jump onto Dentaltown.com and post your thoughts under my column this month. See you online! – See more at: http://www.dentaltown.com/Dentaltown/Article.aspx?i=322&aid=4386#sthash.kFjkk5GV.dpuf