Written by Dr Aaron Nicholas, DDS www.MondayMorningDentistry.com As the saying goes “It’s a pretty sorry carpenter that blames his tools for a failed result”. But the opposite is also true. If we have a great result, it’s not because of the “tools” that were used. Sure, great tools make getting that great result easier, but great tools in the hands of an unskilled operator will not turn him or her into a savant. So, since we’re going to be talking about endodontics, let’s stop talking about tools and start talking about instruments. If you read and believe too much of the marketing in the dental literature, you might start to entertain the idea that all you need to be a great endodontist is the latest great file or irrigation system. Or you might talk to a colleague who has discovered THE file system that will solve all of the challenges they have been having with instrumentation. “No, really. Its amazing. I haven’t separated an instrument this year.” Or maybe you were trained on a particular system and are hesitant to switch because it’s what you know and you’re afraid of having even more issues with an unknown. Not an unreasonable fear. Just as we don’t want to blame our instruments for our “failures”, we also don’t want to give them too much credit for our “successes”. I became a doctor in the 80’s before NiTi and rotary instrumentation even existed. Back then the success rates were comparable to the success rates that we are seeing today with endodontic therapy. So, it’s not the instrumentation. What the current generations of instruments has done for us, is make it easier and less fatiguing to perform endodontic therapy. They have made obtaining the desired shaping much more technology driven as opposed to being operator driven. Less “art” more “system” thus allowing doctors with much less experience to create better and more consistent outcomes. All wonderful achievements. But they aren’t magic. Let’s start at the top What Challenges Are We Trying To Overcome? Almost universally, when I talk to doctors during our 1 Hour Molar RCT, Buildup and Crown course (shameless plug) the three issues that have finally convinced them to refer out all their endodontic cases come down to three things: 1.I can’t find all the canals consistently and in a timely manner. 2.When I’m instrumenting everything Is going fine till the last few millimeters and then I get blocked out or ledge. After that, I can’t get through the blockage or past the ledge, so I must refer the case out anyway. Or it takes so long that it wrecks my schedule. 3.I’ve separated enough instruments and had that conversation with enough patients enough times that I don’t ever want to go through that again. So, it’s easier to just send it out and I’ll do the crown when the case comes back. I think we can agree that challenge number one is not one that we expect that a better file system is going to cure. There is some technology and training that can make this easier and more streamlined but we’re not trying to cover that here. Challenges numbers two and three are commonly blamed on or have cures attempted by the selection of our file system. In truth, both challenges are merely symptoms that a greater problem that has already occurred “upstream”. The blockage or file separation is merely the symptom of this. It’s not the real issue. To consistently not have these issues requires a greater degree of knowledge, training, and practice. However, the file system selected with these challenges can give the operator a bit more “grace” and latitude to solve the upstream issues before they become catastrophic. Technology Drives Acceptable Processes Before nickel titanium, there was still root canal therapy. Canals still had to be instrumented. Debris still had to be removed. And healing still had to take place. It was just done a little differently. Typically, the coronal end of the canal was opened with a series of Peeso Reamers or Gates Glidden instruments. It could also be done with a combination of K and H files, but usually some assortment of rotary instruments were used to speed up the process. In using these, the dentin triangles were removed, and this set the operator up to negotiate the canal system to the apex. I remember sitting in lecture and the endodontist talking about the “beautiful wine bottle shapes” that could be seen on the radiograph after successful instrumentation and obturation. This shape was created by orifice opening with Peezo reamers and then hand instrumentation. If we saw an obturation with that shape today, we would all be critical of the undue amount of dentin that had been removed. So truly our technology drives what we deem to be acceptable treatment. So, let’s talk about what you came here for, the files. Hand files There are two major considerations in choosing hand files. Size (diameter) and stiffness (flexibility). Most of us were given a size 10 (purple) file as our smallest file when we were in our initial years of training. While that might be sufficient for anterior teeth or less calcified canals it is not sufficient for the challenges that prompt most GPs to start referring their endodontic cases. In our office, we keep and regularly use both #6 (pink) and #8 (gray) files. If it’s a highly calcified case, I don’t even attempt the #10, I go straight to the #6. Using too large of a file in a canal too soon is one of the surest ways to create ledging. While it might take a couple more minutes to run through the #6 and #8 before introducing the #10, it will take FAR longer to diagnose and correct a ledge or blockage created by an incorrect file sequencing. As far as file stiffness goes, C hand files were a game changer for me. A C file is the same diameter as its counterpart but it’s a stiffer file. Additionally, the #6 C file is end cutting. In my practice we use C files to cut through blockages that have been created by dentinal “sludge” being packed apically during instrumentation. Just like the smaller K files we keep these in sizes 6,8, and 10. When needed, it is not unusual to go through a box of #6 C files to restore patency. Those tiny blades (flutes) get dull quickly. A small price to pay to keep the procedure in house and moving forward to completion. The Four Horsemen As file systems have progressed there have been numerous improvements that are mixed and matched to achieve better results. None can be completely separated from the others. At present there seem to be four major variables. 1.Structural design - The first popular rotary systems were introduced in 1992. Changes in structural design have been ongoing since day one. Structural design refers to all the tapers, variable tapers, flute designs and file cross sections. 2.Manufacturing treatment – Soon thereafter (1999) companies started looking for ways to manufacture stronger more consistent quality files. Variables here would be twisting wire, milling, electropolishing, etc. 3.Metallurgical developments – Still looking improve strength and flexibility (2007), file manufacturers started incorporating heating and cooling the metals to achieve stronger files with increased flexibility and resistance to fatigue. Enter the gold and blue files to which we have become accustomed. 4.Movements – Improvements to the motions that the files make came next and are still ongoing. This includes things like off-center rotation of the file as well as reciprocating and pure rotary filing. Also included are motors that measure torque on the file and unwind to reduce forces before a separation might occur. Hand Piece-Driven File Systems Hand files do a great job, but they take a longer and make fingers sore and tired. Enter handpiece driven filling. This basically breaks down into three types of systems. Sonic and ultrasonic, rotary or reciprocating systems. Sonic or Ultrasonic I remember trying various sonic and ultrasonic filing systems years ago. It seemed like the files always separated at the tip or became embedded in the canal wall. Both situations would necessitate stopping the procedure, correcting the problem, and then starting again. Frequently, only to be challenged by the same issue all over again. As I was doing research for this article, I couldn’t find a single sonic/ultrasonic system that recommended using the instruments for enlarging the canal. Most were recommending using it for agitating the irrigants used during the procedure. So, we’re left with reciprocating and rotary filling. Reciprocating Filing Systems Reciprocation systems are ones in which the file isn’t just going round and round. Sometimes the motion is 180 degrees clockwise and 180 degrees counter-clockwise. Other systems, cut 150 degrees counterclockwise and then 30 degrees clockwise to disengage the file. There are many other systems out there with many different reciprocation patterns. Most claim a proprietary pattern to make their files work effectively. Intuitively, reciprocating filing seems a little safer since the file isn’t moving in an unending circle. This probably played heavily into the decision most dental schools made to provide one of these systems for their students to learn on. The other might be that a lot of these systems are “one file” systems. So cost is presumably less, and the process is less complicated. Some systems even claim that a reciprocating motion reduces apical transportation of the canal terminus compared to full rotary files. This, however, is controversial and at least one study has created doubt in regard to the claim. Using a reciprocating file compared to a rotating file can take longer to instrument the canal (the file is not cutting all the time it’s in the canal space) and it is more likely to push debris into the periapical tissues. But these, for the most part, seem to be minor issues. It is still far superior to hand filing an entire case and yields more consistent results in less experienced hands. Which is not to say it’s a “beginner’s file system”. It just has a much easier learning curve. Final outcomes are stellar. Rotary Filing Systems Now we come to “true” rotary files. Files that rotate in one direction, pretty much continuously. Rotary files have numerous strategies for achieving final canal shape. Some are more “crown down” while others finish different areas of the canal in sequence. Some have a variable taper in the same file while other use a consistent taper within the file but a different taper between files. Almost universally though, manufacturers recommend hand filing to a #10 or #15 before introducing rotary files into a canal system. This usually does not include using the rotary orifice opener that comes with many systems. Rotary systems will tend to push less debris apically and typically allow the operator to finish instrumentation more quickly than with a reciprocating system, even if multiple files are being used in the purely rotary system. To add to our confusion, different handpiece manufacturers claim superiority based on sensing of torque on the file and having automatic settings to stop rotation or to stop and temporarily reverse the motion until stress is relieved. If the motor is paired with an apex locator, most such systems will allow the operator to set a distance from the apex where they would like to stop filing. Sensing this measurement, the handpiece will auto reverse the file at the pre-appointed measurement. And finally, we come to metallurgy of the files, both rotary and reciprocating. Originally, NiTi files were not heat treated and not very flexible by today’s standards. Almost all rotatory files at present are heat treated. Not to go into a lot of manufacturing science but there are basically two types of heat treatments currently. Both achieve a tougher file that is less likely to break under load. Looking at a file that appears gold in color is the original commercially popular heat treatment. It created a file that was tougher, more flexible and had some memory. This treatment dramatically reduced the number of file separations that doctors experienced. It gave them a bit more grace and latitude in over torquing a file and possible separation. While a lot of doctors were working well with the original NiTi files, this extra breathing room greatly reduced the number of separations of files and the stress on the doctors performing treatment. A slightly different heat treatment leaves the file with a bluish or purplish hue. Files with this treatment tend to be even more flexible and with a bit less memory. All while not giving up the toughness that helped reduce the incidence of separations. In the hand, both feel comparable. More experienced operators might be able to feel that the bluish/purplish heat-treated files are a little “softer”, but it doesn’t seem to affect cutting efficiency or reduce strength. Additionally, a more flexible file in a more tortuous canal seems like it would be a big advantage. If you are looking for a definitive answer to “What is the best file” or “Which system should I buy” I don’t think it’s a straight-forward evaluation and decision. A lot depends on your previous experience and what challenges you are encountering. I encourage you to ask around, look at the claims and research regarding different systems and see what seems to make sense. Insist that the rep allow a reasonable demo period so that you can try it out on some extracted teeth. (Acrylic blocks don’t give any insight on how the file will perform under clinical conditions). Use what seems right and feels good when you are actually performing the procedure. Don’t be impressed by “proprietary” anything. We all think our stuff is best. As they say “The proof is in the pudding” And remember, it’s not the files doc. You’re the magic in your treatment.
Amanda’s Background Amanda is the facility and supply manager at Bubon Orthodontics, where she also handles treatment coordination remotely. She began her journey in the dental field after participating in a high school co-op program, which led to a job as a sterilization technician in a dental office. Amanda initially pursued massage therapy after graduation but returned to dentistry as a dental assistant to pay her bills. She later landed a job at Bubon Orthodontics as an assistant in the clinic, where she has worked for over 15 years. Amanda's role has evolved over time, and she now manages the facility and supplies while taking consultations remotely. Her experience in various roles within the dental field has provided her with an understanding of how practices operate and the skills needed to perform a variety of tasks to be successful in the dental office. Challenges with ordering from multiple vendors Amanda Kaminski had been responsible for ordering supplies for her workplace for over a decade, dealing with multiple vendors and different methods of ordering. It was a task that required time and effort, but she managed to keep up with it. However, when the pandemic hit and her workplace had to adapt to new protocols, Amanda began to feel the strain of her job even more. Around that time, Amanda learned about ZenSupplies, a platform designed to simplify the ordering process by consolidating all vendors in one place. She discussed it with her boss, Dr. Bubon, who initially hesitated but eventually gave in to Amanda's persistent request to try ZenSupplies.Once they implemented the platform, Amanda immediately noticed the efficiency it brought to her job. With ZenSupplies, she no longer had to juggle multiple vendors and different ordering methods. The platform streamlined everything, making it easier and faster to place orders. Moreover, with other members of their team now onboard, it helped improve communication and ensured everyone was on the same page. Now, several months later, Amanda and her team have increased the number of locations they had from twelve to fifteen. Overall, Amanda says ZenSupplies has become an essential tool in their workflow, helping them save time and effort. Watch full interview with Amanda, where she shares her insights and experiences in managing inventory for a dental practice here: https://youtu.be/Z7_V8cDImMg Listen to the podcast: https://share.transistor.fm/s/0a55328c Read the full transcript from the interview with Tiger and Amanda: Tiger: Do you remember the first time you had to negotiate with a vendor? Were you nervous? Amanda: A little bit. Negotiating fees and seeing my grandparents do it every weekend during their rummages helped me grow up with it. However, you don't want to be rude by asking for something as it's the value of a thing. The best approach is to navigate slowly and ask questions, especially if it's a newer relationship. Keep respect in mind and ask if they ever negotiate prices or create a formulary. It's a partnership, and you're both looking out for each other's best interests. Opening a communication and seeing how they respond is often helpful. Tiger: Interesting. Why do you think people are intimidated to ask for a discount? Amanda: Financials are sensitive, and money is always a motivating factor in people's way of going about things, especially in business. It's important to approach the topic respectfully. Tiger: Can you share how you manage the relationship with your vendor? Amanda: My Dynaflex rep and I have known each other for at least a decade now. We talk about our private lives and email things, but it's essential to keep in mind that they have something you need, and you have something they need. It's a partnership, and you're both looking out for each other's best interests. I try to be responsible with what I have and ask for some sort of agreement where we can do a flat discounted rate or negotiate part for part. They often have some sort of internal setup, like if you have this many practices, this is the discount you get. It's often already set up, and you just need to open the door. It's always an interesting conversation because it's happened to us a couple of times with Zen. I constantly watch expenses and never let a credit card statement go without looking at it. Occasionally, when I switch services, I look into the rep's eyes and say, "I think I know what you're thinking," and they nod. We work with each office individually, but we've seen how it happens with DSOs since it's that model. When Amanda signed up with 12 offices, I trusted her and made sure with support we were onboarding all 12 at the same time. Amanda, how did you get the team on board with the implementation? I did a big training session with all of them, and I gave them a few months to get their feet wet before using the required and on-hand amounts. It's a really nice software, and I found it simple to say what we need. I did a lot of the initial organization and then showed the staff how to use it, gave them different suggestions, and expected them to meet my standards. Our staff is set up for changes a lot, and we just roll with it and learn. People don't like change, and that's especially true in dentistry, where offices can be behind the times. That's interesting. We try to have relationships with general dentists and referring doctors, but we see offices stuck in the same couple of decades, still doing a good job but a little bit behind the times.I could teach a course on this topic alone. I've noticed that ortho offices are slightly different from GPS offices in that they are accustomed to change and the fast-paced nature of the office. When I speak to dental assistants who have worked in ortho, they tend to have a different mentality. I'm not saying it's better or worse, it's just different. This ability to adapt to change is unique to ortho offices because it doesn't happen often enough. Many people still use Eaglesoft, Dentrix, or GPS simply because they don't see a reason to change. However, I believe in constantly changing and trying new things. Recently, I was pleased when a new team member joined Zen after an interview with one of our oldest staff members. The candidate was told that the only constant at Zen is change, and she was ready for it. We've had employees who have criticized me for changing things and changing my mind during exit interviews. However, looking back over the past seven years, I believe that constant change has kept us alive. I give credit to Dr. Bubon for having the courage to embrace change, as well as a solid team by our side. Amanda: I agree. Dr. Bubon has learned a lot over the years about what to bring to the table for discussion and what to implement regardless of the response. He's usually good about his delivery, and he has a great team. He knows how to pick his battles and get things done. He values employee retention and works to keep staff members around. Tiger: Employee retention is an important topic. If the average time for employees to stay with a team is seven or eight years when the business is ten years old, it's not just luck. It's important to have conversations with each team member about their growth, challenges, and salaries to ensure they feel valued and are encouraged to stay. It's not just luck that they love working at the company, but rather constant conversations and efforts to keep them. Do you agree? Amanda: In my opinion, I believe it's crucial to have a certain level of stimulation and engagement ещ be successful in the dental office. I enjoy being busy and having a diverse range of responsibilities. This is what has worked for me and kept me here. Although, I don't want to speak for everyone because different people may have different needs. However, I think it's important to be willing to adapt and create positions or infrastructure when needed. This is particularly important in smaller companies or teams where it's easier to stay personal. As for larger companies, it's important for leadership to be more engaging with their staff and create an internal organization of support and organization in general. I think it's a balance between taking pride in what you do, having a good fit of responsibility, and being appreciative of your staff's hard work in keeping the practice thriving and growing. It's a challenging position to be in as a boss, but listening to staff and meeting their employment needs as well as salary is crucial. Tiger: I believe that when it comes to the question of how much to pay an employee, it ultimately depends on the problem you're trying to solve and the size of your business. As someone who runs a business myself, I often hear my friends who also run businesses asking this question. However, I think it's important to consider what responsibilities and tasks the employee will be taking on and how they will contribute to the success of the business. In my opinion, the dental assistant is a critical role in the success of any dental office. While you can open an office without an office manager or hygienist, you cannot do so without a doctor and a dental assistant. That's why I'm passionate about creating a growth track for dental assistants so that they can become even more valuable to the business. Ideally, there should be a path for dental assistants to grow, whether that means becoming a highly skilled individual contributor or a people manager. This would allow them to take on more responsibilities, become more efficient, and ultimately help the business succeed. I understand that it takes an open-minded individual to bring in another set of eyes to their job, but I believe the benefits of having a highly skilled dental assistant are undeniable. Amanda: I believe that having a dynamic where another mini provider is brought in to help with efficiency and productivity requires an open-minded individual. In my opinion, there is a huge value in this approach as it allows for more productivity, helping more people, and increasing production. From my perspective, I can only see positives, but I also acknowledge that it takes a person who is relational and willing to collaborate with another set of eyes to their job. It's something that I think is right and good, but it requires a specific mindset. Tiger: I think it's important to recognize the different strengths and skill sets of your team members, and not just promote someone based on their current job title or position. As you mentioned, someone may be an amazing dental assistant but may not necessarily excel at managing people. And that's okay. It's important to identify those individuals who have the potential to be great people managers and provide them with the necessary training and support to develop those skills. In terms of compensation, I believe that it's important to pay your top performers what they're worth. If you have a true leader assistant who is instrumental in running the office and managing the team, then it's worth investing in that person and compensating them accordingly. However, I can see how having a single office can pose challenges in terms of career growth and advancement opportunities for your team members. One possible solution could be to provide additional training and development opportunities, such as attending conferences or workshops, or taking on additional responsibilities within the office to help them continue to grow and develop their skills. Additionally, cross-training your team members in different areas can also be beneficial for both the individual and the office as a whole. Amanda: I think it's really valid to consider how to keep staff engaged and growing in their roles. In my experience, hiring a consultant to do personality training and identify each staff member's strengths was really helpful in finding the right fit for each position. It's important to remember that people can improve their mindset and way of relating with others if they have the right support and tools. However, if someone isn't suited for a certain role, it's important to recognize that and find a position that better aligns with their strengths. When it comes to staff retention, it's important to be proactive and ask them what they need to stay happy and engaged in their job. Life changes happen, and sometimes a job may need to change with it. It's interesting to see how different doctors in our practice have different ways of relating with staff, but ultimately, it's about finding what works for each individual. While I haven't been in a position where a veteran staff member has left due to life changes, I think it's important to approach each situation with empathy and a willingness to adapt. Tiger: People have kids. Amanda: I've noticed a significant shift in mindset with the younger generation staff that are joining the team. They've been exposed to different experiences and have a different perception compared to the previous generations. The world has changed dramatically in the last five to ten years, and this has influenced their perspectives. As a result, there seems to be a breakdown in perception between the younger staff and the doctors, practice owners, and managers who have been in the industry for longer. I can understand how there may be some conflict when it comes to salary or hourly wage negotiations, as the younger staff may request what some owners perceive as an audacious amount. However, I believe that if an employee is bringing value to the practice and is an asset, they deserve fair compensation. To ensure we get the best candidates, we have implemented an intensive vetting process that includes a thorough background check and a rigorous interview process. We aim to attract employees who take pride in their work and are willing to work collaboratively as part of a team. I think the onboarding process is changing rapidly, and we need to adapt to stay current. While it's challenging to determine what you're getting before seeing someone in action, we believe that our hiring process is the best way to ensure we hire the right candidates. Ultimately, it's a complicated issue, but we are constantly working to improve our process and find the best staff to join our team. Tiger: I agree with your point about the importance of having a diverse mix of generations in the workplace. In my opinion, a work environment where everyone is about to retire is not ideal and may be challenging to sell. Instead, having a representation of different generations can create a melting pot of ideas that can benefit the upcoming and retiring employees. I believe that as long as everyone gets along and works together as a team to reach the common goal, it can lead to a successful work environment. However, I do think it's crucial to maintain a professional relationship with team members and avoid calling them "family." Although some people may use this term to express their appreciation for their team, it can lead to a sense of entitlement and can make it challenging to make difficult decisions like firing an employee. In my opinion, it's better to show respect for team members and express appreciation for their hard work without blurring the lines between professional and personal relationships. Amanda: I agree that different people may have different understandings of what "family" means, and it could be related to their level of vulnerability. In my view, being part of a family is about having a mindset of caring for each other, being loyal, and working together as a close-knit team. However, I can see how some people may see their family and a work or team environment as two different things. I think the difference in our perspectives on this topic may be related to our generational differences. For example, I know someone in dentistry who considers his son to be his best friend, but personally, I value having other friends as well. I believe that being a parent is about being responsible for my child and providing guidance, rather than relying on them as my main source of emotional support. However, I acknowledge that my perspective may not be the only valid one, and I am open to exploring different viewpoints on the matter. Amanda: Personally, I agree that a business and a family are two vastly different things, even though they may share some similarities in terms of dynamics. From my perspective, having a warm and caring dynamic within a work team is important, but it's important to acknowledge the complexities that come with a family dynamic. I can understand why some people may prioritize accuracy and precision in their language, while others may use language more loosely. However, I have noticed a trend towards using the term "family atmosphere" in the workplace, and while it may work for some, I personally find it cringey and uncomfortable. Ultimately, there are different perspectives on how to view this topic, but I believe it's important to recognize the differences between a business and a family. Tiger: Did Zen affect your relationship with vendors in any way, good or bad? Amanda: I understand that there has been a change in the level of personal interaction with the one representative from Dynaflex, Lori. However, I have found that our business relationship has improved as we have been able to maintain regular check-ins and address any specific situations that arise. While we don't interact as frequently as before, I appreciate that Lori is always available when needed and that ordering is now more streamlined. Overall, our business relationship is where it needs to be. Tiger: What would you recommend to offices that are on board with Zen? Amanda: In my experience, it's a relief to have specific products that we know we like and can get every time, rather than constantly trying new things. However, it's important to be patient when getting your inventory set up, as it can take some time to organize and keep track of everything. In my situation, with multiple providers using different materials, it can be more challenging, but I'm always open to learning and improving. I personally have experience with searching for items, but I understand that not everyone on my staff may have that experience. It's important to train and support your staff, and vendors can also be helpful in recommending products. I must say, your staff, particularly Lana, Anastasia, and Delaney, have been amazing in managing my account and providing excellent customer service. It's clear that Zen staff and customer service are top priorities, and it shows in the quality of support I receive.
An efficient dental inventory system is a key for managing any dental practice, but it is especially important for orthodontic clinics. These types of offices have a higher volume of specialized equipment and dental supplies and require a more effective inventory tracking process due to the multiple appointments and longer treatment time of orthodontic treatment. Recently, we had the pleasure of speaking with amazing ortho dental assistants about their experience, how they manage dental supplies to ensure enough product levels are on hand, and some key takeaways of adopting ZenSupplies as an efficient dental inventory system in less than 30 days to continue to thrive and keep the inventory up to date. Delaney Barber, a former dental assistant at Kanning Orthodontics: “In my office, we had an efficient dental inventory system in place for keeping things organized. There was one major storage space, a few smaller storage areas, and working products in the operatory. However, there was one area that needed improvement - ordering. We had multiple people responsible for ordering different items and it was difficult to keep track of what had been ordered and when it was expected to arrive. Additionally, we were not always getting the best prices because we were not consolidating our orders and taking advantage of bulk discounts. In addition, having to track and manage multiple invoices can be a frustrating and time-consuming task, especially for a clinic with limited resources. Overall, it took from 4-5 hours weekly to do the ordering, and that is why the management decided to sign up with ZenSupplies. One of the main challenges I faced with implementing Zen was making the time to enter required and on hand quantities. To make the on boarding experience more efficient and less stressful, I would advise new offices to lean on their team to help with data entry. This way, it can be done faster and more accurately. In terms of inventory optimization, my advice would be to give software solutions a try. Using software can save a lot of time and frustration, as well as make it easier to track orders and received items. This eliminates the need for writing down information on paper, which can easily be lost or overlooked.” Lori Clendenen, Controller at Llon H. Clendenen DDS, MS: Ortho offices have unique needs when it comes to inventory and ordering due to the specific supplies we use. To maximize efficiency in our physical space at the office, we utilize lots of labels and make sure everything has a specific place. Before using ZenSupplies, we organized our inventory using an excel spreadsheet and a tag system. However, we faced numerous challenges with the spreadsheets not being updated and assistants ignoring the tag system. The most frustrating thing for us was running out of supplies. We spent 2-3 hours daily on our inventory and ordering before Zen. When implementing ZenSupplies, we encountered challenges too such as various items not being in the Zen inventory and items being named differently. Our advice to new offices would be to make sure you have all your items in the Zen inventory and that they are named correctly to avoid confusion. Our inventory organization process still includes some struggles with consistency when items are taken out of inventory. But now we place orders 3-4 times a month and do a full inventory check up once a month which helps us stay ahead of the curve with our supplies.” Courtney Heller, Lead Assistant at Bubon Orthodontics: “What makes Bubon Ortho offices unique when it comes to inventory and ordering is that we have multiple offices we need to order for and not just one. Each office has different ordering needs depending on the size or the practice, and demographics of the office we are located in. For example, some of our patients have a higher interest in gold brackets vs. silver or we see more patients want Invisalign vs traditional brackets. This requires us to have a more complex ordering system in place to ensure that each office has the necessary inventory to meet the needs of their patients. Before using ZenSupplies, we organized our inventory have now an an efficient dental inventory system using a paper binder where we handwrote the inventory and wrote a list of items that needed to be ordered. The challenges we faced with this system were that not everyone filled out the inventory/ordering binder and people would verbally state what we needed to have ordered and it would get forgotten about when ordering. The benefits of this system were that we didn't need to login to a website to see what was ordered and it was readily available to all staff. However, the thing that frustrated us the most was that it seemed like we were always running out of or running low on products we used regularly. The first challenge with implementing Zen was finding a responsible teammate to oversee each office we work in. Since it was a new system introduced to us and ordering does take a good amount of time from our day, I feel few people were interested. The next step was setting aside time in our busy schedule to get inventory on every product we have in the office. It took awhile to get the right quantity of items in. After all inventory and products, we in Zen it was just a matter of breaking old ordering habits and using Zen properly with the restock options. Advice I would have for other offices is to make sure there is enough time set aside each week for your ordering team to get ordering done. Ordering is super important to keep the office running efficiently and even though it is a behind the scenes task, it should not be looked over! Our inventory organization process now looks like we have split it into easy to find categories in Zen which helped us find a new way to physically organize our supplies as well, instead of having everything wherever we could fit it. We place orders at least once a week or every other week for two offices and maybe once a month or every other month for one office. We do a full inventory check once a month in each office as some products we don’t use daily, and some products don’t have expiration dates either, so we don’t need to check those products as often. If you're a dental practice that struggles with inventory optimization, my best advice would be to take advantage of all the tools you have access to. We implemented Zen at our practice and it has made our ordering to be an efficient dental inventory system. We no longer have to spend hours on the phone with reps trying to track down items that are on backorder or searching for new products. Everything is just a click away. Don't be afraid to try new technology - it may seem daunting at first, but it will save you so much time and effort in the long run. Give it a chance and you'll realize it is a time saver in the office!”
Welcome to our blog post featuring an interview of Jillian Gomez, Vendor Manager & Customer Success Representative at ZenSupplies, with Diana Arnaldo, Clinical Manager at Irving Park Family Dentistry. In this interview, we will explore Diana's background and her decision to work in the dental field. We will also discuss her current role as a clinical manager and how she streamlines inventory and orders supplies for multiple locations. Still, the main focus of our conversation will be on the career path of dental assistants, and the question on many people's minds - can a dental assistant make $45 an hour? Diana will share her insights on the role of a dental assistant, the necessary qualifications, and how one can grow in their career. Also, she will shed light on industry trends, fair compensation, and budget management for dental offices. You can watch full interview here: Another conversation about dental career growth - https://www.zensupplies.com/blog/41-elizabeth-bueno-clinical-director-of-river-run-dental-exciting-story-of-growth-focus-and-team-work/ Read on to discover what Diana had to say about this important topic. All right, Diana, thank you so much for meeting with me today and agreeing to do this interview. I just wanted to start out with a little bit of background. Can you tell us what your role currently is in your dental office and what was your the career path of a dental assistant? I am the clinical manager for Irving Park Family Dentist. We are a corporation of 10 plus offices, including here in Illinois and in Wisconsin. I got into the dental field when I was really young. Actually. I have been studying since I was in eighth grade. Wow. Yeah. I know I got a lot. Then I accidentally chipped a front tooth and I was really uncomfortable. I was 16 where appearances are pretty much everything and pathetic. It was a really tiny chip, but I just didn't feel comfortable. So when I went and he put a filling, it completely changed me. I got my confidence back and it was that assertion that's what I wanted to do. I wanted to give people that confidence with their smiles as well. That's amazing. Thank you You didn't really have a fear of the dentist, like most kids at a young age. I actually enjoyed it. The only thing I did not like was the fluoride but I did not fear going in at all. When you first went into the dental field, how did you start? What was your first position or job? It was just dental assisting. I did go to school prior so I kind of got annoyed a little bit. So it was just, you know, the basic dental assisting, assisting the doctor sterilizing and then I moved my way up throughout the years. So you are proof you can grow within a dental? Of course. Yes. Yes! Awesome. So what does your day typically look like now? And like how do you help your office stay organized with inventory of products and everything? It varies but it usually starts with checking my texts. I do manage about 10 assistants. If anybody calls off, I have to see how my day is gonna go now because I have a pretty busy schedule. I do have to make sure that we're still able to work throughout the day depending on how many assistants call off. Once I have managed that, I do answer my work email, which includes talking to a couple labs. We work with around five labs. So I have to make sure I have answered all their emails or their questions regarding our cases and follow up on our cases as well. I enter cases once they come in and we have around 10 to 20 cases come in every single day. I check my schedule for the next day, make sure everything is how it's supposed to be. Then I have everything prepared for the patients coming in. And if by any chance we are short staffed back there, I do get to assist sometimes back there as well. Do you enjoy going back to that a little bit? Yeah, I do. There are days I miss it. I'm sitting in the chair and I'm like I need to go back there at least just to feel like I'm on the floor. And you get that I'm sure. And it is also like you get that patient interaction. Kind of that inspired you in the beginning to get into dentistry. Yeah. I was on the floor a little bit more in the beginning here and I did establish a lot of really nice relationships with a lot of patients where they still see me walk by and they come say hi, or even I'm in the office and I see them on the schedule, I'll go say hi to them and we're like, catching up and ask me about my family. And it's just really nice to have those kinds of relationships with your patients. Of course. And it makes their experience so much better. I still have patients that still ask my provider that they want me to assist them and I'll put it on and I'll go back there and help 'em out if they feel comfortable with me. I, you know, I wanna give them that comfort cuz I know it could be a scary chair. Yeah. I will admit, I worked in a dental office for a while and I still get nervous. Even now going to the dentist, it's something I think you just can't really help but you put things into place like knowing a familiar face. Yeah. Makes the difference. Yeah, exactly. That's so cool. So, your offices obviously have ZenSupplies. Most of them have it, yeah. If not all of them. Do you help manage that at all or for the most part are your assistants like taking the lead? No, I do all the ordering. I actually have a master list that was created actually on your website. I was able to share with all of our other offices that master list. So everybody has the same material cuz we do have providers that do travel to other locations. So they do like some materials that we use here. That's what's really helpful about your website. So has it helped you keep track of inventory? Right. So that's really helpful. I do use it and it is nice to have a little warning like, hey, you're kind of running low but I also do have a list as well that I take with me around the office when I'm doing inventory just to double check. And we do have the system, like if we see we're running low, we'll go ahead and put it on a board and then I compare it to what Zen says. So it is a very helpful system. Do you have any advice for other offices? I know some offices struggle with getting some compliance as far as like zening an item out or marking that they took something from their inventory. Do you have any advice on that aspect? I think you just have to be aware of how much your office is using at all times. And there's not every month it's gonna be the same. I mean, I've had months where I'm doing more root canals and I know if I'm doing more root canals, that means in a couple weeks I'm gonna be doing more crowns. So I know I have to stick up a little bit extra on that as like, on that procedure, like impression materials, impression trays. That way I think, this has helped me to never really run out of stuff. I do order just a tiny bit more extra just because I know when I'm ordered, depending on the company I'm ordering from, it might take a little bit while for us to get it in the office. So I do have my assistants as well who let me know when I'm about to hit that. Hey, we're down to three. They know that once we're down to three we have to write it on the board and they have to inform me so I can keep a closer eye on it. Yes. Just to make sure we're gonna make it to the rest of the schedule without having to order before our actual orders do. It's awesome that you're able to analyze and look down the road and know you're gonna need more of a product because like you said, you just did a ton of root canal so you know that crown is coming. So make sure you have those supplies for those patients and there's no delay. That's part of why your office is so … Great:) Thank you! Yeah, of course. Okay. So I wanna get back to a little bit of your role when you first got into dentistry and assisting. So we've kind of been thinking of this idea like how can dental assistants move forward and really grow within the dental office and is it possible for assistants to make, like $45 an hour? What skills do they need to get that pay? Like how can they show their, I don't wanna say worth, but show like, hey, like, I deserve this money because like, I'm doing X, Y, and Z within your office. I'm a real asset. Right. Getting a dental assisting certificate or going to school, do you feel like this really helps push you a little bit further in the career path of a dental assistant? It does. I feel like it, I went through an intensive course where I was certified. It did help me in the fact that when I went into an actual job, I already knew how to take x-rays. I already knew how to take impressions. I knew at least some of the material, but I knew the steps. Because everybody uses different things. Every office is gonna use different materials from different brands, but at least I knew the steps for every procedure. So that's what helped me. And then you never know when every office is different. You might go in where you might be the only dental assistant and if you're not prepared to at least note the basics, it's gonna put you back a little bit. So, it just depends on the person as well, on how fast they learn. I've had assistants here that we've had to train from scratch. Like literally explaining to them the tooth anatomy, the tooth surfaces and I've had assistants that picked up really fast and about three months they're good to go. And then there are assistants that I, they're like, you know what? I can't work like this. I prefer to be in a classroom where somebody's showing me and you know, I'm taking my time and it, and it just depends. I feel like certifications do help you out. There's a certification for sealants and prophylaxis that, you know, gives you an extra step to be, Hey, I'm certified in this. I can do this extra for the office where the doctor can go do something else to produce something else. And you're helping 'em make that production with just the assistant being there? Yeah. So the more they, they, you know, the assistant prepares themselves . The more certifications they have, the more knowledge they have in their field, the more valuable they are and the more they can produce by themselves and have the doctor go on and do something else to work on a different procedure. On average, do you know how long was that dental assistant certificate program? How long were you in? Mine was eight weeks. It was an intense course of eight weeks. It was a Saturday. I remember from 8:00 AM to 4:00 PM. It was all day. It was an all day course. But that was years ago. Yeah. Do you think that offices should invest in their dental assistants career paths and maybe like, do certain certificate programs? Maybe using technology, like sending an assistant to learn the CAD/CAM, how to scan a tooth so that you guys can make crowns within the office? Do you think there's value in dental offices putting that time and like money into their dental assistance? Of course. Because if, you know, if you invest in your assistant, you're also investing in your office because they'll be doing that for you. Yeah. Okay. And do you think dental assistants can get maybe not like that $45 an hour or at least more to be more sustainable and more again, like I don't like saying the word value or like worth, but you know, being seen as a producer, kind of like hygienists are. Right? Like, do you think that dental assistants can make that 45 an hour? I feel like if a dental assistant, just as a dental assistant, you can't. Just because you know, we have to take our minimum wage to $17. But I feel just as a dental assistant, we can, especially in Illinois, we're very restricted in what we can do to help out in our office. I know we just had a couple of certifications that were passed but I still feel that we can't reach where a hygienist is still gonna be able to make that amount of money. As a dental assistant, you can definitely work your way up in the ladder and learn as much as you can. Not only about dental assisting, maybe be cross trained with the front and you know, you can let your provider know like, I'm doing the job of two people. I'm helping you with two people and you are only paying one, so they might be able to pump up your salary a little bit more. But I don't think we'll be as dental assistants at $45 . I think it's a little high. Do you think there are different levels to dental assisting? So like, I know some offices, like you mentioned, most private practices maybe have one dental assistant, right? Maybe two depending on how many doctors there are. But then you look at like corporate dentistry who maybe have like five dental assistants because they have more doctors there, whatever it might be. Do you think there are different levels to dental assisting where maybe you could argue like the higher pay because you are now managing assistants lower than you or you're teaching them the skills? Yeah, there are different levels. Like I said, when I first started I was a dental assistant, which all I did was pretty much what I was taught in school. Take x-rays, bring the patients in, set up charts, sterilize sterilized instruments, and that was my whole day in the beginning of my career path of a dental assistant. Every single day. I moved up to the main dental assistance where you have a little bit more responsibilities, you're responsible for ordering, you're responsible for maintenance for the whole office. And then I became a clinical manager where now I'm in charge of other assistants. I'm still in charge of the whole office, making sure it's running properly. If something breaks down, I'm responsible for calling the company, making sure I schedule something for them to come in. So there, there are levels to that. And with more responsibilities you have, you do have that argument and you deserve more. I mean it comes to, I think, like your drive and your work ethic, like that gets you there. Of course. But did you also have a mentor in the office that kind of took you under the wing to teach you more? Or was it maybe the doctor? I did have great doctors that taught me a lot of things. You do need those providers with you because they're the ones that are gonna show you and teach you as you know, you start moving up for clinical manager when it comes to ordering and try to maintain everything. I had some great assistants help me out. You know, as they were moving on they would show me, this is what you need to do. And I also learned on my own sometimes if I'm making mistakes or you know, trying out things you have to, you learn as you go sometimes. And then there's always people if you're lucky enough, like I was to have people help you out as well. I think it takes a combination, obviously like you're driving your work ethic but also those people who are there to help you learn and grow. Definitely key. How does the hourly rate wage of a dental assistant do you think compare to other positions within the dental office? I think it's definitely changed from when I started. At least the minimum wage has gone double from when I started. You mind sharing where it was when you started? It was $8. I started at $8. Yeah, that was a minimum wage back I think in 2006 I think. Wow. So it has grown It has grown. Went, you know, we had a couple interviews and you know, we were looking at the minimum wage and yeah, it's, and I mean I'm happy because it's a very demanding job to be a dental assistant. We're always on our feet, we're always running around. I'm glad it has gone up but I still feel like we're still not up there compared to the rest of the positions. Like you have said hygienist. I feel like there's still more room for our position to grow and I'm just glad we are giving the opportunity because there's a lot of things now as a dental assistant you can do that. We didn't have that opportunity when I started. Pretty much back then it was just polishing and sealants and now we have, we can do scanning, we can fabricate night guards, we can make retainers and that also helps the career path of a dental assistant get bumped up a little bit as well. Yeah, absolutely. And I wanna say too, like you hit on a great note. Dental assistants are, you are on your feet all day, you are in and out of like dental ops going from one to another, maybe handling two patients almost at once. Yeah. What advice do you have for dental assistance? For one, I guess I wanna start with managing their day, but also two, managing the stress and the toll it might take on their bodies a little bit, right? Yeah. I always try to look at my schedule the day prior just to make sure how it's gonna go and start planning out not only with my staff but also as well with my providers. I think that's a major thing and it also helps with your providers. I was lucky enough here that we have a lot of providers that understand that sometimes we do have to be running around and they're willing to work by themselves and they'll be, okay, I got this. You go get the other patient and come meet me when you're done. Like don't take your time. So I think that's also very important when you do have your providers supporting you and helping you out on that, on that aspect as for stress and you can’t let it get to you, right? It's like I told the rest of my assistants, you guys have to come here. I understand there's a lot of stress going on outside of home and it's best if we don't bring it here because we spend most of the days at work. Yeah. More than we do at our houses. Sometimes I tell 'em I spend more time with you guys than I spend with my family and I don't wanna bring anything. Like it's already stressful enough, sometimes here you have a lot of personalities with your patients, you have a lot of personalities with your providers, with your front desk, with your staff and the back, your assistants and it just makes it easier for us to be happy. We're always trying to joke around back there just to lighten up the day. Yeah. And I think that's what really helps us get through the day and you know, we always try to joke around, try to make somebody smile. We're like goofing around back there as well sometimes. And it just helps our day just go by so much smoother. Right. Because it, it kind of goes back to like you could plan your day but you know, in the dental office, like you never know either. Yeah, exactly. You could try and plan but it might not go as you planned. And you might have a patient cancel last minute or an emergency case and you just, I think having a good office camaraderie and like support system where you can joke and be playful like with your staff makes a huge difference for like those unknowns that come up during your day. Yeah, of course. And I think also what has helped us is we try to get together out of work as well because being in the office is one thing. But going out and actually losing up and getting to know somebody else a little bit more has really helped us come together a little bit more back here. Yeah. I think that's a great point too. You get to know people outside of work, what their lives are actually like, what they maybe go through, what their family dynamics are and getting to know someone can make working with them easier, I guess. Makes sense. Yeah. Yeah. Okay. That's awesome. Let's see. Is there a difference in pay, do you think with dental assistance from like a private practice to corporate or like a government clinic office? I do. Yeah. I've actually worked for both a couple private offices and I work for a couple corporation offices as well. Okay. And I do feel that private offices can offer a little bit more. If not they can kind of balance that out with benefits sometimes, you know, they're able to give a little bit more cuz maybe they don't have as much staff. As a corporate office, like you said here I have 10 girls, just 10 dental assistants cause we still have a front desk and we have providers and we have a call center. So, it's a little bit harder to give everybody the amount they want compared to a private office where maybe it's just one provider and they don't have to distribute that salary as much or stretch it out as much as a corporate office has to. Makes sense. What does downtime look like for them? Or is there like never any downtime? Downtime does happen. It's rare, but it does happen. They already know. We do have a list back there. A reminder when you know there's downtime we have to take advantage because it doesn't happen very often. We have to make sure our rooms are stocked up. We have to make sure we're checking lab cases. We're checking the next day, pulling out lab cases for the next day. So we're not rushing at the last minute trying to find our cases. So they already know that we're supposed to clean the office, reorganize, and make it tidy. They do a great job. I go, I don't have to be behind my staff the whole time. They already know, okay, we're downtime, let's start organizing the composite tray. When we do get busy, we're not running in and out of our rooms cuz we don't have what we need. Right. I like that idea of having that list. So, if there is a patient that cancels and they have an hour, they can look at the list and see what needs to be done. Yes. Great. And then as far as cleaning, because we had talked about this, I think we may have tried to write some type of article or questionnaire for our dental assistants if they clean their office, like what that looks like. Are they cleaning the floors or like, do most offices do you think have a cleaning service for that? Or is it left up to the assistants? No, we do have a cleaning service. She comes three days out of the week. The rest is we have to do it. So we, it does involve, we wipe the whole room down. We broom, we draw garbage. We try to tidy up everything back there. We do try to mop every single day, especially because there's, there's, you know, stuff flying all over us. We do try to mop as much as we can and we have a lot of us, we do have a big office. It's a 10 top office, so we try to maintain everything clean even in between, not even at the end of the day in between patients. If, you know, if we're taking impressions and impression materials, you know, when you take it out there's stuff lying over it. We grab the broom and we clean out and have it as clean as we can for the next patient. That's awesome. With assistants like doing all of that do you have, do you see any industry trends that are changing with dental assistants? I feel like you did touch on this with saying they're able to do a lot more than obviously like when you started when it was more like polishing and like chairside for the doctor, you're able to now help make like retainers or night guards. Do you see the future of dental assistants going up as far as responsibility and the more that they can do within like the app? Yeah, of course. Like I said, I have doctors here and like I said, it just depends on the state you're in. I know here in Illinois we're very restricted still. And hopefully it changes cuz they will open up a field and there're a lot of assistants out there that know how to do a lot of things they wanna learn to do a lot of things and we're very limited. Like I said cad/cam, scanning I know in some states they can let you, they don't let you drill but they let you fill and a lot of states let you cement permanent crowns that we're not allowed here. But I hope that in the future Illinois changes and allows us to do a lot of things and I do feel like this field can grow a lot and we can be a lot more useful than we already are in the office. Yeah. I honestly didn't realize that the laws and rules depend on the state that you're in. Have you worked in a different state besides Illinois? I haven't, no. I do have a lot of providers that come from a lot of states. Okay, so lastly I just wanted to ask if you have any steps that a dental practice can take to ensure they are paying their dental assistance fairly while also obviously managing the budget they have to pay for their dental assistants. Yeah, I mean they just have to make sure you know, look at the minimum wage. They're looking at where their area is located because depending on the area, it also depends on how much an assistanе should be getting paid experience. You have to value the experience that assistants bring into your office. That knowledge that it can also help you out as well. You have to look into the benefits, what you're providing, if it's gonna be maybe you're not able to give that assistant what she wants, but you might be able to help her out with benefits that maybe another office might not be able to offer her. You have to look into your production, see if your production it wants, you've established and separated everything that you know you need to, your office wants to pay. If you're able to give that to assistants, like you said, her worth will be worth it. Yeah. You know, she is gonna be of value to your office at the end. She is gonna help you make money as well if she knows what she's doing. So that's something they have to take into consideration as well. You're just not paying somebody for their job but you're paying them for their knowledge and how they're gonna help you produce as well. And just make sure that the rest of your staff, you have more staff, they're helping you keep that cost down, they're working according to standard procedures established by the practice in order to avoid mis-usage of material as well. Resources and time to maximize the production of your office as well. I think that that's very important. Yeah. Any other last minute advice you wanna give? Dental assistants? Good shoes for them to wear? I wear Converse. Yeah. I feel like and it's changed a lot too cause I remember I used to wear them when I first started and a lot of providers didn't allow that, but now I think it's, oh really? It's changed. It just works. Whatever you're comfortable with, wear it. So just try to wear anything comfortable and my advice to all the dental assistants would be don't stay stuck, you're in there not just assisting, you're in there to learn and help out and always try to be not only one step ahead of your provider, but two. Don't be afraid to ask your provider out the room, why did you do this? Or could have we done something else? I always try to learn something every single day from my provider or from the office, something new all the time just to help me get that step higher. The more you know the better and it's gonna help you out more in the future. Absolutely. Great! Thank you so much for taking this time. I really appreciate it. And I'm sure our dental assistants who listen to this are going to appreciate it too. So thank you. Thank you. Thank you for having me! Links: ZenSupplies Youtube - https://www.youtube.com/channel/UC4I-NnQ8VfQ73hQS80gDB4Q Linkedin Profile of Diana - https://www.linkedin.com/in/diana-arnaldo-7545951a3/ Linkedin profile of ZenSupplies - https://www.linkedin.com/company/zensupplies/mycompany/?viewAsMember=true
Today I seat down with Santosh Patel, President of Complete Specialty Solutions. We talk about early days and how Santosh had to take PTO days to visit dental conferences and meet people at the Starbucks to save money on fancy dinners. With support of his and the family he decided to go all in and pursue the journey against his own doubts of being an entrepreneur. We cover so many things, how AI dental platform, like Overjet and Pearl and true AI applications in dentistry that will revolutionize the industry just like CEREC and digital scanners did back in the days. We discuss leadership traits, biggest cause of specialists burn out, leading by guilt vs fear, and seeing how dentistry will go through next economical challenges as it always does. And we finish our conversation with Santosh’s best advice for life and parenting: “You are never going to be perfect, your kids are never going to be perfect, just accept it and enjoy the life” [embedyt] https://www.youtube.com/watch?v=bYo_rCxf_rc[/embedyt] 3:45 - Starting Complete Specialty Solutions 7:45 - Push back from the Industry 8:00 - a case for building internal software platform 12:00 - Genesis of the idea for the business “Why dental industry didn’t have in house specialty services” 13:50 - Most Specialist coming out of Residency with a tremendous debt 16:35 - “I never had entrepreneurial bone in my body” 17:25 - The concept of changing lanes 19:00 - Dentist take all this debt, get excited about future, build the practice and open the door. And the number of patients is not there. Then they start to question 21:20 - hitting the bottom. It’s always the payroll question 24:26 - Push back and misconceptions early on 30:10 - Constant chicken and the egg problem and to tackle it 37:50 - Larges cause for specialist burn out 46:40 - Employee Retention is a huge issue in dental practices 47:40 - AI in Dentistry - Overjet and Pearl 49:00 - How to apply AI platform to identify hidden revenue with your current patient base 51:45 - AI will change the industry, same scanner and Cerec changed dentistry back in the day 53:00 - Favorite thing about running Complete Speciality Solutions 59:50 - Unique Leadership traits 1:03:45 - Dentistry will always bounce back from any challenge About Pearl: https://www.hellopearl.com/ About Overjet: https://www.overjet.ai/ To learn more about Complete Specialty Solutions: Complete Specialty Solutions provides in-house specialty solutions to general dentist offices through our unique combination of clinical, business and operational support delivered as an integrated and turn-key solution. Our highly experienced team has activated and scaled in-house specialty solutions across all major specialties (oral surgery, orthodontics, periodontics, endodontics, and pedo) in both solo office and large DSO operations during the past eight years. http://www.completespecialty.com/
St. Clair & Massey Orthodontic Partnership is a well-established orthodontic practice that has been serving the community for many years. Recently, the practice has focused on improving its dental inventory organization and implementing ZenSupplies with impressive results. This case study explores the strategies and practices that have been used by this dental practice, and the impact they have had on the overall operation and success of the office. To learn all the details of the dental inventory management process, we have interviewed Carina Sauceda, an experienced dental assistant at St. Clair & Massey Orthodontic Partnership who has a wealth of knowledge of the latest techniques and technologies in the industry. Whether you have an organized inventory management system in place or are just starting out, Carina's insights are sure to provide valuable information and inspiration! Carina says: "Ortho is very Unique when it comes to inventory. We have so many products! The way I organized inventory before using Zen was through a spreadsheet I created in Excel. I had two different spreadsheets. The difference between the two was that one was organized by vendors I had to personally contact by phone, and the other was organized by products I received from one representative, mainly all of our disposables. The spreadsheets contained the item number, the item description, the supplier, and the quantity to order of every item needed for the clinic and our lab. The challenges I faced were that I didn't have a laptop that I could carry around between offices to use digitally. I had to print two sets of the two spreadsheets, which were about seven to nine pages long. What frustrated me the most before starting Zen Supplies was the high volume of representatives calling about sales and having to do price comparisons myself. However, the amount of time spent taking inventory hasn't changed much with or without Zen; it still takes me about two hours per office to do a full inventory check. The order process was faster with Zen, because most products are ordered through it. Some items, like our bands, are easier to order through the website. Placing orders takes about 30 minutes. The challenges I faced while implementing Zen included getting everyone on the same page and understanding my thinking process. I had to move things around and find homes for items that were in multiple locations. Our assistants had a mindset of filling every empty corner with as many items as possible. With the support of the lead assistant, I was able to move items around with different limitations per office due to the amount of storage. This helped me with inventory because I was going to three different areas to count how many of an item we had and then figure out how many to order. I also had to think about how much of an item had to be in the sterilization room for immediate back-up and move as much as possible into the main storage area. For example, how many Caviwipes do you need to keep in the sterilization room to avoid going into the storage for a week with six chairs? We were keeping 15-20 Caviwipes in the sterilization room per office at a time, which was the "fill up every corner as much as possible" concept. With this being said, in our main storage, we would have maybe 5-10 Caviwipes and I would order more because I didn't think we had enough. We realized we only needed 6 Caviwipes for 6 chairs in the sterilization room per week! Having a small amount in the sterilization and everything else in the main storage area cut down the amount I needed to order because we had more than enough and started seeing a decrease in budget because I realized I was ordering way too much. With all this being said, my best advice would be to limit homes for an item to 2 locations. Firstly, things that need to be restocked chairside in the sterilization room can be designated as a quick, one-week stock area. Only items that are restocked weekly should be kept in this area. Secondly, while room limitations may be an issue, proper organization can make it possible to have a main storage area. To make this more efficient, items should be restocked chairside daily and sterilization room items should be restocked weekly with just enough items to get through the week. This will limit the number of times assistants need to enter the main storage area. However, it's important to note that there is no surefire way to completely eliminate stress during onboarding as it is a new and unfamiliar process. But the outcome of a well-organized and efficient inventory system is worth the stress. I was stressed when I started, but I already had all the items and item numbers on a spreadsheet. So, if you don't have that yet, that is where your main stress will be. Some items may be missed and you won't know until you run out, and then realize they were never entered into Zen. But, the Zen team is super helpful and will assist in getting things organized. As for now, my inventory process is as follows: I like working closely with 1-2 people, as too many hands in the pot can get messy. I order once a month and select one date that works for me, ordering on that date every month. I have one assistant who restocks the chairside units and sterilization room in both offices with enough items for a week, a day or two before I do my full inventory. This way, I know she has pulled everything needed from the main storage areas and I'll have an accurate inventory check. If someone is not doing this before going to do the full inventory check, then you are most likely going to have to place orders more often and at random. I do everything with an iPad and carry it between offices. I check everything in and put it away when it arrives and ask for the estimated time of arrival for items that haven't arrived, to see if I need an alternative solution. I do a full inventory check and place orders once a month. I do this to spend less time ordering and inventorying, and I am available to do more things. This also goes for assistants, they are restocking less as well. To wrap it up, a few tips for other ortho offices: - Find a supportive partner/s. - Ask the doctors why you have two of the same concept products and, if they say there is no reason, order just one. - Organize things in a way that even a new person can find the product, not just you. - LABEL EVERYTHING - Explain why you are moving things, as most people don't like change. - Keep products in their original packaging, as this helps visually see how much you have and how much you need to order. Some products can be condensed into a small container, and you may be tempted to over-order this product. - Try new products by ordering a small amount (1 or 2) and trying them out. Sometimes, they work better and are more convenient than what you have been using before."
[embedyt] https://www.youtube.com/watch?v=OeOh9tEiJ8I[/embedyt] This is one of my favorite with one and only Michael Lomoton. His background is in biomedical engineering, but his passion is in dentistry. A few years ago Michael decided to step in and help his wife, Dr. Kathrina Agatep, DDS to run a practice in San Diego. We tour a recently renovated office and talk dental shop, from numbers to what it's like to be a dental spouse. You can check out the practice here: https://dentaldesignsd.com/ Read more about Mike: https://www.linkedin.com/in/michaellomotan/
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