Effective systems keep your dental office running smoothly. The better business is, the more efficient your systems need to be. A thriving dental office means a consistently full schedule. Over time, systems may start to break down as steps get skipped and tasks fall to the wayside. Building systems that work for your team means your office can keep running as smoothly as possible so you can focus on giving your patients the best possible care. Areas of the Office First, let’s break down the goal of successful systems in each area of a typical dental office. Front Desk/Concierge Your concierge is a patient’s first point of contact when they enter your practice. Disorganization, paper clutter, even dusty computer screens can give your patients the impression that your entire practice is likewise disorganized and even dirty. Regular routines for dusting, sterilizing high-touch areas, and minimizing clutter will keep your front desk looking spotless. Sterilization Poor organization in sterilization puts your patients and entire staff in danger. Improperly sterilized instruments can spread serious bloodborne illnesses. Failure to comply with strict regulations also puts your practice in danger of running afoul of regulatory entities like OSHA. Establish effective routines for keeping your sterilization equipment in good working order, handling instruments safely, and staying on top of tasks like changing out the ultrasonic bath. Operatories Regardless of whether you choose to assign specific operatories to each clinician or prefer to have them rotate based on the day’s schedule, effective systems for organization in each operatory allow your team to work together to keep each room properly stocked and sterilized. Supply Closet/Inventory A well-organized inventory helps prevent over- or understocking supplies, which can directly impact the profitability of your practice. When carpules of anesthetic get shuffled to the back of a dusty closet and left to expire, it’s money down the drain. Ordering Aside from how you organize your physical supplies, effective systems for ordering likewise keep your practice running smoothly. Ordering for a dental office means coordinating the needs of each department in your practice as well as multiple suppliers and reps. Efficient systems for ordering supplies and instruments will prevent over- and under-stocking, and ensure deliveries arrive when they’re needed. What Makes a Good System? Next, let’s look at a few universal concepts that will help you build effective organizational systems for your dental office. These ideas can apply to every area of your office to help them run more smoothly. Simplicity is the key to systems that work. Every extra step is one more thing that will eventually get skipped and lead the system to break down. Streamline your systems as much as possible; what is the fewest number of steps that will reliably get this job done, and what is the most direct way to achieve each of these steps? Simplicity in your systems also means minimizing the mental burden of keeping track of tasks. The more you can automate reminders for things like spore tests, the less likelihood they’ll get forgotten. Most of us are painfully aware that time is a limited commodity in a thriving dental practice. Your assistants, hygienists, and treatment coordinators need systems that will save them time. Need labels properly filled out for biohazard bags? Why not print out sheets of stickers in advance so your staff can grab and stick in seconds rather than filling them out by hand? Simple adjustments to save a few moments on each step in your system add up to an office that runs efficiently and less chance of important tasks falling to the wayside on busy days. When you combine simplicity and speed, you get convenience. Convenient systems are more likely to be followed. It seems obvious. But when you look closely at the workflow in your office, look for any areas where the system could be easier to maintain. For example, cassettes make instruments easier (and safer) to carry. We all have pedometers on our smart watches, but your staff doesn’t have the time or energy to make their 10,000 steps on unnecessary movement between patients! Once you’ve established systems that are simple, fast, and convenient, make sure the expectations are consistent and predictable. Any new system may take some trial and error as unforeseen problems come up. But constantly changing your systems in the pursuit of better efficiency can be frustrating and confusing for everyone involved. Get your staff’s input from the beginning about what works for them and what needs improvement. Then, give new systems some time to become habits and check back with them for feedback about how things can be tweaked or improved. Maintain Your System for Peak Efficiency Once you find a rhythm and routine that works for your team, maintain it! Keeping a system in good working order over time takes planning, but you can work it into the system from the beginning. Make a plan to periodically check in on your system. While constant changes can lead to disorganization, re-evaluating your system regularly (maybe once per quarter for example) needed can allow you to adapt and eliminate roadblocks. For truly peak efficiency, look for any areas where you can establish systems that maintain themselves. Automating workflow and organization as much as possible frees your staff to focus on providing the best possible experience for your patients while eliminating human error or forgetfulness. Automation in your systems can be as simple as setting a cell phone alert for weekly or monthly equipment maintenance. Specialized software can help you easily track your previous orders, automatically place regular orders, and coordinate lists between multiple suppliers so your staff doesn’t have to waste time do it by hand. Above all, remember that the goal for systems that work is to help your entire team enjoy better flow in your workdays and allow you to give your patients undivided attention at every visit!
Now that COVID-19 isn’t dominating the infection control news stories (although it is still present), we turn our attention to some additional news regarding infectious disease transmissions that may affect us in dentistry. Some of the information is good news and of course, some is not so good. Recently the Food and Drug Administration (FDA) granted approval for two new vaccines for Respiratory Syncytial Virus (RSV)., The vaccines are the first for preventing this serious respiratory virus. According to Gavi The Vaccine Alliance, RSV infects millions of people globally each year with lower respiratory tract infections, with mild symptoms. Young children and older adults are particularly vulnerable, and many are hospitalized for treatment of the infections. RSV infections can also be fatal, especially in patients with underlying medical conditions. These new vaccines, approved for individuals over 60, is reported to reduce the risk of severe RSV-related lower respiratory disease by 94%. RSV is characterized by the Centers for Disease Control and Prevention (CDC) as an infection of the lower respiratory tract that includes symptoms of runny nose, decreased appetite, coughing, sneezing, wheezing and fever. These symptoms are similar to COVID-19 and influenza however, a single nasal swab test (PCR) can detect which of these viruses is occurring in a patient. Some danger signs in children and adults that indicate the need for immediate medical intervention include difficulty breathing, stridor (wheezing, grunting or high-pitched sounds with each breath), coughing or wheezing that does not stop, decreased alertness, bluish skin, tongue or lips, dehydration, and high fever (104°F). According to the CDC, in the 2022-2023, the overall rate of RSV-associated hospitalizations was 51.9% per 100,000 people. The CDC’s National Respiratory and Enteric Virus Surveillance System (NREVSS) is an excellent resource for dental health care providers to monitor RSV, influenza and other respiratory virus trends in the area where their dental practices or clinics are located. This information is updated weekly by states and regions in the U.S. If the pandemic taught us anything in dentistry, it is that the threat of respiratory infections can be serious, and that dental health care personnel are at risk of exposure from patients and from each other. Even though the pandemic is over, endemic COVID-19, influenza and RSV infections continue to spread. Reappointing patients who have respiratory symptoms should be a standard protocol in every dental practice, with the exception of patients needing emergency treatment. The CDC recently reported that cases of malaria were identified in Sarasota County, FL and Cameron County, TX. These four cases, not related, are believed to be locally acquired, which is not as common as cases that are acquired when individuals travel to countries where malaria is common. Malaria is a parasitic infection, transmitted through mosquito bites. If not treated, malaria can be fatal. The CDC, along with state and local health departments are increasing efforts to raise awareness among professionals and the public of the potential risk of malaria and other mosquito-borne infections. Preventive measures include DEET-containing insect repellent, loose-fitting long-sleeved shirts and pants and utilizing screens on doors and windows. Symptoms of malaria infection include: fever, shaking chills, headache, muscle aches and fatigue. Nausea, vomiting and diarrhea can also occur, along with anemia and jaundice. If not treated promptly, malaria infection can cause kidney failure, seizures, mental confusion, coma, and death. Candida Auris According to the CDC and the Association for Professionals in Infection Control and Epidemiology (APIC), Candida Auris (C. auris) is an emerging fungus, discovered in Japan in 2009. It is considered to be an urgent antimicrobial resistance threat. The CDC states that it is spreading at an alarming rate in hospitals and long-term care facilities. Of great concern to health care professionals is that C. auris is difficult to identify, often is mistaken as a bacterial infection, and medical laboratories must have specific technology to correctly identify it, which is beyond standard laboratory methods. The most concerning issue is that C. Auris is resistant to the most commonly used antifungal medications. It is easily spread in health care facilities and is especially harmful to individuals who have weakened immune systems. In these individuals the infection may enter the bloodstream, causing what is described as an invasive infection. Although no cases of C. auris infections have been associated with oral health care, it is possible that an infectious patient may be treated in a dental practice. Patients may be ill from other types of medical conditions, and they may be experiencing fever and chills as the result of a C. auris infection. This reinforces the need to monitor every patient’s vital signs, including temperatures, at the beginning of each visit. During the pandemic, the CDC recommended checking temperatures before patients were admitted to the dental office. While that is no longer necessary, taking a patient’s temperature and blood pressure is considered a good medical practice. And the temperature and blood pressure needs to be recorded in the clinical note. Unless it is an emergency, or the fever is believed to be caused by a dental infection, these patients should be reappointed until they are well enough for oral health care procedures. In addition, if appropriate disinfecting protocols are not followed with all patients, C. auris could be spread to other patients and dental health care professionals. In most cases the tuberculocidal disinfectants that are used in dentistry will be effective against C. auris, but dental professionals can look up their disinfectants on the Environmental Protection Agency (EPA) list for emerging pathogens to determine if the product they use is effective against C. auris. Dental Unit Water Quality Bacterial infections resulting from patient treatment using untreated, contaminated dental unit water continue to be investigated by the CDC. While most of the cases identified have affected pediatric patients who received pulpotomies, adult patients have been infected as well. The CDC states that any dental unit with untreated water is a potential infectious disease threat to patients. It is also a threat to dental health care providers as well, due to the exposure to aerosols created from that water. Much attention has been directed at how to treat the water, and there are many products on the market that are effective in controlling microbial contamination, but the issue still exists. There are several reasons why this is the case, including a lack of consistency in using the waterline cleaner/disinfectants, not following the manufacturer’s instructions for use of the product, lack of shock/cleaning of the dental unit waterlines according to the equipment manufacturer's instructions and product instructions, and a lack of testing to determine if the products or procedures followed are actually working. Every dental practice needs to have a waterline protocol in place that includes training for the team to understand the risks of using contaminated water, selecting the appropriate product that is compatible with the dental units in the practice, a testing protocol, and a protocol to follow if a dental unit fails to meet the CDC recommended <500CFU/ml. The CDC has a great deal of information on its website about dental unit water quality that can help guide a dental practice to establish and follow the necessary protocols. Taking a Broader View of Infection Prevention and Control As dental professionals, we sometimes view issues in a narrow context – only looking at what directly affects the delivery of oral health care. It is important to recognize, however, that comprehensive oral health care includes recognizing what is occurring in the global context of infectious disease. In many cases dental professionals dismiss some issues as irrelevant because very few or no infections have been documented in dentistry or are unlikely to occur in dentistry. Dentistry is a profession of preventing oral disease and should also be a profession of preventing the spread of infectious diseases. U.S. Food and Drug Administration: https://www.fda.gov/vaccines-blood-biologics/abrysvo U.S. Food and Drug Administration: https://www.fda.gov/vaccines-blood-biologics/arexvy Gavi.org https://www.gavi.org/vaccineswork/rsv-vaccines-are-we-close-taming-one-worlds-biggest-killers-children DC RSV-NET: https://www.cdc.gov/rsv/research/rsv-net/dashboard.html#:~:text=In%20the%202022%2D2023%20season,was%2051.0%20per%20100%2C000%20people. CDC NREVSS: https://www.cdc.gov/surveillance/nrevss/rsv/state.html CDC: https://www.cdc.gov/malaria/new_info/2023/malaria_florida.html CDC FAQ’s About Malaria: https://www.cdc.gov/malaria/about/faqs.html CDC Increasing Threat of Spread of Antimicrobial-resistant Fungus in Healthcare Facilities: https://www.cdc.gov/media/releases/2023/p0320-cauris.html CDC Invasive Candidiasis: https://www.cdc.gov/fungal/diseases/candidiasis/invasive/index.html EPA List P: Antimicrobial Products Registered with EPA for Claims Against Candida Auris: https://www.epa.gov/pesticide-registration/list-p-antimicrobial-products-registered-epa-claims-against-candida-auris CDC Dental Unit Water Quality: https://www.cdc.gov/oralhealth/infectioncontrol/summary-infection-prevention-practices/dental-unit-water-quality.html
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.
During the COVID-19 pandemic, both OSHA and the Centers for Disease Control (CDC) recommended that dental treatment rooms have increased ventilation and air purification to remove potentially infectious aerosols. In its updated guidance for COVID-19 from (May 8) and for Ventilation in Buildings (May 11, 2003); the CDC makes specific recommendations about the use of HEPA air filtration systems, the recommended number of air exchanges in the office, and recommendations for operating the heating, ventilation, and air conditioning (HVAC) systems. Why is the CDC still recommending these enhancements? Because COVID-19 is still spreading, although not at a pandemic level currently. There are also numerous other airborne infectious diseases that can be transmitted in a dental setting, including influenza, respiratory syncytial virus (RSV), measles, chicken pox, tuberculosis, and others. Those risks were present pre-COVID-19, but the pandemic brought this concern to the forefront, especially with respect to aerosol generating procedures (AGPs). AGPs include the use of an air/water syringe, high-speed handpiece, ultrasonic scaler, air polishing, and air abrasion., These recommendations are made in addition to that of increased use of high-volume evacuation (HVE), to assist in containing aerosols during treatment. In addition to infectious disease transmission risks, dental team members are also potentially exposed to chemical hazards, such as disinfectants, methyl methacrylate (acrylic), and dust from various materials such as silica. Except for exposure to infectious disease, where the effects typically present with symptoms shortly after exposure, effects of the exposure to chemicals and dusts, symptoms may not manifest for many years. The need for improved ventilation in dental facilities goes beyond COVID-19 and is a positive step in ensuring the health of dental professionals. Let’s look at what the CDC and OSHA recommend, starting with some key terms related to indoor air quality. The CDC guidelines state that ventilation is defined in several with respect to buildings: Indoor air movement and dilution of viral particles through mechanical or non-mechanical means Filtration through central heating, ventilation, and air conditioning (HVAC) systems and/or in-room air cleaners (portable or permanently mounted) Air treatment with Ultraviolet Germicidal Irradiation (UVGI) systems (also called Germicidal Ultraviolet or GUV) Ventilation is important to the health of dental teams and patients since airborne infectious agents spread more easily in indoor settings than outdoors, due to the higher concentrations of the viral particles indoors. Maintenance of HVAC systems is not always top of mind in buildings unless there are issues with regulating the temperature of the buildings. Regular maintenance, including filter changes according to the manufacturer’s instructions, upgrading the types of filters, and making sure that the filters fit properly so that as little air as possible gets around the edges of the filter. The CDC also recommends a “layered” approach to improving air quality, with includes other strategies. More on that later… Air Exchanges Air exchange is defined as the number of times the air gets replaced in each room per hour or ACH. Ideally the indoor air is exchanged with outdoor or “fresh” air, filtered air, or a combination of both. According to the American Society for Refrigerating, Heating and Air Conditioning Engineers (ASHRAE), buildings should have a minimum of 5 ACH, but higher is better. The ACH is controlled by the HVAC system in the facility, and the other types of filtrations that have been implemented in the facility. An HVAC technician can advise a building owner or tenant about the system and its capabilities, and on modifications that can be made to meet this goal. MERV and HEPA: ASHRAE developed a rating system for air filters in HVAC systems using Minimum Efficiency Reporting Values or MERVs, that refer to a filter's ability to capture larger particles between 0.3 and 10 microns (µm). The higher the MERV rating, the better the filter is at trapping certain types of particles. HEPA stands for High Efficiency Particulate Air filter. It is a pleated type of filter used in many HVAC systems and air purifiers, such as those that were installed in treatment rooms in dental facilities during the pandemic. According to the Environmental Protection Agency (EPA) this type of air filter can theoretically remove at least 99.97% of dust, pollen, mold, bacteria, and any airborne particles with a size of 0.3 microns (µm). Using air purifiers with HEPA filtration has been recommended by the CDC for reducing the airborne pathogens in healthcare facilities, such as dental offices, where AGPs are being performed. MERV ratings for HVAC filters and HEPA filtration work together to establish the layered approach to ensuring enhanced indoor air quality in dental offices. There are also ultraviolet light filtration systems that can be installed in dental facilities. These systems, called UVGI or Upper-room Ultraviolet Germicidal Irradiation are very effective at removing air contaminants, including infectious aerosols. Although they are used primarily in hospital settings, they can be effectively used in dental office facilities. To reiterate, just because the pandemic health emergency is over, COVID-19 is still present, as are many other airborne transmissible diseases and chemical hazards that can pose a threat to dental team members and patients. Until COVID-19, which had such an impact on dentistry and the entire population, air quality was not a major area of concern in dentistry. The pandemic has hopefully changed this forever. It’s not just the airborne bacteria or viruses that can affect dental professionals. Dust, chemicals, and other volatile organic compounds contribute to indoor air pollution that can cause health issues for the members of our profession. This is not a new issue in dentistry, just more highly scrutinized by the high level of infectiousness of COVID-19. In 1994, the EPA, American Lung Association, Consumer Product Safety Commission, and the American Medical Association published a booklet called “Indoor Air Pollution: A Guide for Health Professionals” as to aid in diagnosing health issues caused by exposure to airborne particles in indoor air. So, what are the takeaways from these updated CDC guidelines? Follow the CDC and ASHRAE guidelines for enhanced ventilation in your facility. Remember that infection prevention and control isn’t just about surface, instrument, or equipment contamination. Threats are always in the air – pandemic or no pandemic. In addition, safety in the dental office includes the potential for exposure to other harmful substances in the air, such as chemicals. Develop a protocol for indoor air quality, which includes regular maintenance of the HVAC system, utilizing HEPA air purifiers in treatment rooms, opening windows periodically (if possible) to increase fresh air exchanges. Continue to use high-volume evacuation for all AGPs – especially the use of ultrasonic scalers, which create the most aerosol. In addition, the CDC and ASHRAE also recommend setting your HVAC system to “on” instead of “auto” to keep the fan circulating all the time. Creating a healthier work environment is always a good plan of action for dental teams. It helps to ensure career longevity for the team and a safer environment for patients as well. CDC Interim Infection Prevention and Control Recommendations for Healthcare Personnel During the Coronavirus Disease 2019 (COVID-19) Pandemic, May 8, 2023 https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-recommendations.html CDC Improving Ventilation in Buildings, May 11, 2023 https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/improving-ventilation-in-buildings.html CDC Interim Infection Prevention and Control Recommendations for Healthcare Personnel During the Coronavirus Disease 2019 (COVID-19) Pandemic, May 8, 2023 https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-recommendations.html OSHA Subpart U – COVID-19 Emergency Temporary Standard 4 (b) https://www.osha.gov/sites/default/files/covid-19-healthcare-ets-reg-text.pdf ASHRAE – Core Recommendations for Reducing Airborne Infectious Aerosol Exposure https://www.ashrae.org/file%20library/technical%20resources/covid-19/core-recommendations-for-reducing-airborne-infectious-aerosol-exposure.pdf EPA – What is UVGI? https://www.epa.gov/coronavirus/what-upper-room-ultraviolet-germicidal-irradiation-uvgi-what-hvac-uvgi-can-either-be Indoor Air Pollution: A Guide for Health Professionals, EPA, ALA, CPSC, AMA - https://www.epa.gov/sites/default/files/2015-01/documents/indoor_air_pollution.pdf
What is a Dental Technician? A Dental Technician or Certified Dental Technician is a valuable part of the dental team. Dental lab technicians are responsible for creating and repairing implants, dentures, veneers, bridges and crowns, and orthodontic appliances. Most dental technicians work behind the scenes and collaborate with dentists to fabricate dental prostheses and appliances in a laboratory for patients. Some choose to open their own dental laboratory or work at established dental labs, dental offices, and dental schools. Skills Of A Dental Technician Deciding if becoming a dental technician is the right fit for you can be done by looking at the skills required and determining if they align with your strengths. Although they have little to no interaction with patients, they are an integral part of the dental team. Their primary responsibility is creating custom dental prostheses and appliances that help people chew, speak and gain confidence in their smile. Some of the necessary skills of a dental technician are: Dexterity Steady hands Independent worker Detail-oriented and precise Interpersonal and collaborative skills Knowledgeable of dental materials and anatomy of the oral cavity Individuals working as dental assistants possess many of the qualities listed above. Those looking for a change in their career with the capability to work independently with no patient interaction may consider becoming a dental technician. The overlap in job responsibilities and education can allow an easy transition. Dental assistants that have completed college courses may be able to transfer those existing credits to a dental technician program. In addition, they have the advantage of hands-on experience and prior knowledge in a dental setting which can make them stand out among other applicants. Becoming A Certified Dental Technician (CDT) Upon the decision to become a Certified Dental Technician, there are multiple things to consider. Certification is granted to those that have passed all exams administered by the National Board for Certification in Dental Technology. Eligibility to take the exams requires either being employed as a dental technician for five years minimum or completing a dental technician program by an accredited school. Admission into a dental technician program requires a high school diploma or equivalent and prerequisite courses. Including college-level English, science, math, and others based on the application requirements. Only a select number of spots are available, and students are selected based on their grade average. Depending on the location, schools offer a two or four-year program with varying tuition costs. Those attending a two-year program will graduate with an associate degree or certificate, and graduates of a four-year program will be awarded a bachelor's degree. Earning an advanced degree in dental technology is an investment that can expand future job opportunities and income and prepare you for the CDT National Board Exams. CDT National Board Exams The National Board for Certification in Dental Technology administers three separate exams: Comprehensive Exam ($255) Written Specialty Exam ($255) Practical Exam ($595) Each of the exams independently tests the knowledge and skills of the individual. The comprehensive exam is a 160-question multiple-choice exam that covers a broad spectrum of ethical practices, oral cavity anatomy, dental terminology, health and safety standards, etc. The written specialty exam is an 80-question multiple-choice exam related to the individual's chosen specialty. Specialties include implants, orthodontics, crown and bridge, complete dentures, partial dentures, and ceramics. Lastly, the practical exam is given in a dental laboratory setting to test the hands-on skill of the individual in their chosen specialty. Career Outlook Being a Certified Dental Technician proves your knowledge and ability to do the job, and gives you ground to negotiate a higher salary. According to the U.S. Bureau of Labor Statistics, the average yearly salary is $39,090. Dental Technicians are not required to be certified to work. However, most companies are searching for trained and educated individuals. Certified Dental Technicians can select the setting they will work in. Some choose to work at a full-service lab which allows them to diversify their tasks each day. Meanwhile, others may prefer staying within their chosen specialty where their strengths lie in. To maintain certification status, Certified Dental Technicians must complete twelve hours of continuing education (CE) courses per year. This is required to stay up to date with the latest technology, dental practices, and safety standards. The projected growth of the workforce is expected to be 2% from 2021 to 2031, with an average of 9,900 open positions per year. If you are passionate about becoming a Certified Dental Technician and helping the people in your community, now is a great time to take the first steps. The sacrifice and hard work will be worth the reward in the future! Article Content References “Dental and Ophthalmic Laboratory Technicians and Medical Appliance Technicians : Occupational Outlook Handbook.” U.S. Bureau of Labor Statistics, 4 Oct. 2022, www.bls.gov/ooh/production/dental-and-ophthalmic-laboratory-technicians-and-medical-appliance-technicians.htm. “CDT Application & Exam Process - National Board for Certification in Dental Laboratory Technology.” , nbccert.org/certificants/certified-dental-technician/cdt-application.cfm. “Certified Dental Technician (CDT) Continuing Education Requirements - National Board for Certification in Dental Laboratory Technology.” , nbccert.org/education/cdt-requirements.cfm.
What is Dental Smiles Month? — June is nationally recognized as Dental Smiles Month. The mission behind the campaign is to bring awareness to the importance of dental health and promote healthy smiles. A smile matters because often it is the first feature we notice about one another and a way to express confidence. The health of your oral cavity is directly linked to your overall wellness, and many health conditions can arise from bacteria spreading from the mouth to the rest of the body. Dental Smiles Month is dedicated to making dental resources available and educating the community. Serve Your Local Community Serving your community well can be beneficial to yourself and others during the process of establishing your dental office in the local community. Serving others establishes rapport and can give insight into the values of a dental office. Also, it can be rewarding to be able to contribute to the community. Many ways in which that can be done are through volunteering, monetary contributions, and donating dental supplies. 1. In-Office Free Dental Service Day Designating a day once a month to offer free services can benefit those in the community and your office. This is a way to give back to the community and bring in people who may never have stepped into your office otherwise. Getting their foot in the door can lead to a long-lasting relationship in which they continue returning for future treatment and refer others. Free clinic days should still require scheduled appointments ahead of time to ensure the dental team does not feel overwhelmed. These designated days can include services such as: Radiograph Day Dental Hygiene Day Invisalign Consults Day Restorative Treatment Day 2. Host School Dental Assemblies Hosting a school assembly about the importance of dental health is a great way to make dental education fun for children. Did you know in the US, dental caries are the number one most common preventable childhood disease? Providing a space to educate students on how to take care of their teeth equips children with the knowledge to make changes that can improve their dental health. Dental education can influence change which has the opportunity to create a lasting impact that benefits them now and in the future. Providing demonstrations during the assembly can ensure the children are using dental products correctly, and gifting goodie bags containing these products can enhance dental hygiene routines such as: Brushing Timer Tongue Scraper Mouth Rinse Toothbrush Toothpaste Floss 3. Use Your Social Media/Website To Provide Dental Educational Tools Creating a platform on social media sites and a dedicated website is necessary today for any dental office to stand out among the competition. These platforms can be leveraged to educate more people about dental health and provide value to current patients. Providing dental educational tools is also a way to market your office for others to find and become a part of the dental family. Educational tools can be provided in the form of videos, text, and blog posts dedicated to a specific topic. This information can consist of topics such as preparing a child for their first dental appointment, pediatric dental care, braces, Invisalign, adult dental hygiene routines, etc. Trusted information from a reliable resource is invaluable and necessary for those looking to find answers. 4. Team Up With Local Sports Leagues Gaining the attention of those in your local community can be accomplished by sponsoring local sports teams. The teams can vary from little leagues to professional sports leagues in your area. Typically, a donation will be made on your behalf in exchange for advertisements with your office name and logo on team jerseys, banners, and various advertisements. The sporting events can provide an opportunity for your office to set up a booth to talk to attendees, hand out flyers, and raffle dental items and services. In addition, free tickets are provided to games which can be distributed to dental team members for a group outing! 5. Support Non-Profit Dental Clinics Non-profit dental clinics provide dental services to those who are low-income and uninsured. They rely heavily on funding and support given by the community to keep their clinic afloat. Therefore, donations and volunteers are necessary to continue their efforts. Volunteering at a non-profit dental clinic is a great way to have a positive impact on your local community if your budget does not have the capacity for donations otherwise. Donating your time and expertise can be equally as valuable! Spread Awareness Of The Importance Of Dental Health With A Smile! Article Content References Benjamin, Regina M. “Oral Health: The Silent Epidemic.” Public Health Reports (Washington, D.C. : 1974), 2010, www.ncbi.nlm.nih.gov/pmc/articles/PMC2821841/. *Please note that this article has been written by a guest writer, and the opinions expressed therein may not necessarily reflect those of the company.
Most of the time a Dental Assistant will reach a cap on how much they are able to make hourly. This isn’t uncommon for most jobs, but especially Dental Assistants. Many are passionate about what they do and don’t care about the pay. If you are someone who is looking to make extra cash while not leaving your current job, or even having to leave the comfort of your couch, we got you! In this article we will dive into online side hustles you can easily pick up while working as a dental assistant whether it’s full time or part time. Starting your own blog What are your hobbies? What do you like to spend time doing or chatting about? If you like to write, then this may be the side hustle for you. You are able to build a business you love to educate, entertain, or provide opinion based feedback. If this interests you, we have found an easy step by step guide by Scott Chow to get you started! https://www.theblogstarter.com/?gad=1&gclid=CjwKCAjwpayjBhAnEiwA-7ena4vMCSyLM6Bh0kTh5ZzAdJqoW-hjfpzBO64J3P9GGr28j95G7VeiKBoCSvQQAvD_BwE This guide will provide you with everything you’ll need to get started with blogging. If you remain consistent with this, it can become quite the lucrative side hustle. Selling clothes, shoes, home goods, etc If you love fashion, but find yourself only wearing items of clothing one or two times only to never see them again. Reselling is a great side hustle you can do from home! Like many, trends and your tastes in clothing or homewear can change over time. This can be a pretty easy way to earn extra income and profit from what you originally purchased. There are many secure sites out there for this like Poshmark, Depop, Grailed, Amazon store fronts, etc. This side hustle takes very little time to set up and actually get going. Here you will find how to set up a profile with one of these sites and get to selling right away. https://www.themodestman.com/how-to-sell-clothes-online/ Freelance work You may have heard this term a time or two, but in case you haven't, freelance is a type of self employment. You essentially choose when and who you would like to work with. This means that since you have the freedom of choosing your own days and hours, it can be the perfect side hustle job opportunity. An example of one of these jobs could be a virtual assistant. https://www.nerdwallet.com/article/finance/how-to-make-money NerdWallet provides all of the details you need to see if this could be the right fit for you and your lifestyle. Social media manager If you’re someone that likes to spend time on social media platforms, then you can get paid for it too! Being on social media is how most businesses market themselves nowadays because it’s fairly inexpensive to what other marketing methods cost. With how much time we spend on social media daily, this is now turned into a job opportunity for some. For someone that likes to create and post content, the job itself is a great side hustle all from your phone. “Businesses will now hire social media managers to expand their online presence and brand awareness, increase sales and revenue, and attract business opportunities. Primarily, social media managers create content with heavy marketing strategies to attract potential customers and clients.” Says Jason Fell from the 8 best online side hustles. https://www.entrepreneur.com/guide/side-hustles/the-8-best-online-side-hustles-of-2023 Teach a language remotely If you think about it, there are people all over the world that speak a different language than you do (whichever one you may speak primarily) and would like to learn the language you speak as a second language, third, sometimes even fourth. This side hustle can be a great way to make extra cash as you get paid by the hour for your services. A lot of things can be done online now, so teaching a student one on one is no different! You don’t need any teaching experience to join these sites, but most do require you to have a Bachelor’s degree. Once you’ve picked up a few regular clients and made a name for yourself, it will be easier to attain a consistent income for yourself. https://www.websitebuilderexpert.com/building-websites/best-side-hustles/ Start a Youtube channel This option leaves you with a lot of room to completely customize your content to what you want, like, and the audience you are targeting. Although this side hustle can take some time before you see the income, it’s definitely worth it since you are 100% in control. One idea can be a faceless channel. This means you create videos with voice overs, photos, clips of other things besides your face. So no need to worry if you’re camera shy. Be sure to publish your content on a consistent basis with a niche. The goal is to gain a following so you can be paid for views, brand deals, and sponsorships. Turn a hobby into a business. You can easily sell the art you create online for extra income. You can gain a following this way as well and have people customize or request certain orders to fit what they are looking for. This side hustle again, allows you to be 100% creative on your own time and be passionate about a project you are working on. Many people sell handmade items or original artwork online, either through an independent online shop or through different selling sites. https://www.coursera.org/articles/side-hustles-from-home Test Websites Testing websites sounds a lot more technical than it really is. You aren’t required to have any technical background in order to do this job. Essentially, this role will have you testing different sites and seeing if there are any bugs or improvements to be made. You report back any errors or feedback and that’s it. You can work on your time without a strict schedule with certain hours, so you are able to make it work whenever you have free time. https://www.digitalnomadsoul.com/online-side-hustles/ Creating templates/layouts/digital wallpapers As you can see this side hustle all has one thing in common, it’s completely digital and all for online use only. If you are artistic and like to create, this can create a fun side job for extra cash. Focus on the different prints you’d like to create for a specific audience. Are we wanting them to be templates for birthday E-invites? What kind of phone wallpapers can they access if you offer different themes? You can create a large variety of different templates, layouts, and digital wallpapers to sell to larger companies for use. Or you can sell them individually to whomever is looking to purchase them from you. https://yesimadesigner.com/the-best-online-side-hustle-ideas-for-creatives/ Online Surveys That’s right, get paid to take surveys online! It’s pretty simple to do too. These companies will notify you if they have a survey that matches your profile. These are typically online market research polls for influential brands. It may not be as lucrative as the other side hustles mentioned above, but it’s still a good way to earn extra cash aside from being a Dental Assistant. Sometimes the day to day can get busy, and this option provides little effort. https://www.entrepreneurmakeover.com/fast-side-hustles All in all, whether you work part time, looking to make more money, need something remote, etc. We have you covered. Start by assessing your skills, consider the environment in which you would be working in, and find your niche or hobby that interests you. Your side hustle should be fun and not feel like a burden. Hopefully these 10 ideas will help you get started as a Dental Assistant looking for a side hustle.
With this quick video, you'll learn how to use Google Spreadsheets and Typeform to get your dental budget and ordering under control: [embedpress]https://www.loom.com/embed/67e5327e35b949a6969b95a0a9c9f2a0[/embedpress] Step 1: Gather all vendors in one place. Start with gathering all vendors in one place. This is probably the most daunting and the most important step. You need to know everyone you are buying from and have the information at your fingertips. We recommend using this template (download here, or make a copy and add to your google drive). When you add all the information, please check for accuracy, most importantly usernames and passwords, make sure it’s accurate. I also recommend using Keeper for password protection. A lot of offices write down passwords into the spreadsheet and share with their team. Then if you need to let the person go, you are probably not going to reset all passwords which is an opportunity for someone to use your credentials for something not good. Save yourself time and headaches and get a password manager. Using the template you can add all the vendors and skip username/password if you decide to use the Keeper for password management. You will notice the first tab is “Vendors” and we reckoned using the columns to fill out all that you can: 1.“Account Numbers'' - most vendors will have your Customer Number, if not a big deal, as long as you have a username to log in. 2. Shipping Terms - you can find this information in your invoice or call your sales rep. a) Min order amount for free shipping; b) Shipping cost, Fuel Cost, Handling Cost. With some vendors shipping is free, but then there is a fuel charge of $15.99. Please ask and add it all into a spreadsheet. 3. How to Order - online is the best way to order supplies, add to card and be done. However, some vendors do not have a robust or easy-to-use site, so quite often you will need to call the right person. And finding the right person is key. With Top 4 suppliers, it’s easy, you have a sales rep that would love to talk to you. But when it comes to specialty products, ortho, implants, bone graft or membrane, or my favorite, sutures, you need a person to call that can answer even the most difficult question within minutes. So once you get a person like that, please add to the “How to Order section.” Step 2: Enter orders with TypeForm This is where TypeForm becomes very handy, simple to set up, and a tool that gives you access from any phone. You can even send the link to TypeForm to your sales rep to fill out the order information if they place orders on your behalf (even though I don’t recommend doing this). Go to their website, create a account, and click “Create Typeform''. Here are the steps and how to create a form: 1. Start from Scratch 2. Give it a Name “Ordering Form” 3. Fill out the questions: a) Starting with 1st Question “Date Purchased” and the Type select “Date” b) Next Question is to type “Vendor Name” and choose Dropdown. Then enter the list of vendors from your spreadsheet from the tab “Vendors”, just the names. You can literally copy-paste to Typeform to save yourself time. c) Next Question - Order Total - Short Text d) Next Question - Order Sales Tax - Short Text e) Next Question - Order Shipping Charge- Short Text f) Next Question - What did you Order - select Long Text g) Next Question - Expected Delivery - Select Date in the “Type” h) This is my favorite - Create a question “Type of Expense “, choose “Dropdown” in the type and copy-paste the following categories i. Dental Supplies ii. Lab Supplies ( Ex: Stone material, Aligners, Vacuform, Cerec) iii. Office Supplies iv. ReSale v. Marketing vi. Parts & Equipment vii. Service i) Last Question - Who Ordered - also drop-down so it’s easy to track who placed the orders. If you plan to share this with your rep (or multiple reps) please include their name in the drop-down so they can identify themselves when placing orders on your behalf. 4. Publish the Typeform and Download the QR code. Also, send yourself a link to this form so you can access it from your phone. 5. 6. Last step is to connect Typeform with your Ordering spreadsheet. Select the button Connect - all the way at the top and choose “Google Sheet” Option. 7. Follow the steps (most likely you will need to copy the link to your spreadsheet and paste it in the Typeform). Now you have connected Typeform to Google Sheets. Why did we do it this way? I’m sure there are ways of getting information to Google where you do not need to use TypeForm, but I find it very easy to use and reliable. Now with a link or QR code, I can add any order into a main spreadsheet or have my team do it. With the link or QR code, after you scan or click on the link, you can save a webpage to your homepage on the phone so it’s easy to find on an ongoing basis. Step 3 Balancing the Budget Now all of your transactions are in one place with proper labels. Dental supplies are properly tracked and are not mixed together with service/ parts or CEREC blocks. Now we need to add the totals for Supplies expenses into the Monthly Spreadsheet that calculates Monthly Budget and how much is left. I recommended using 3 Month Average for Collections and multiplying by 4% to get your real monthly budget. Then add the date and amount for each vendor each time you place an order, total only. But make sure this total is what reflects on the credit card statement. There are times when you order 50 items and the supplier could ship all 50 items in 2-3 shipments, meaning 2-3 tracking numbers and separate invoices for each shipment. You need to then track it starting the PO Number, please refer to the example below, where one PO contains 3 invoices and 3 separate charges on the credit card. Once you add it all up, the spreadsheet tells you how much is left for the month. We recommend that you always look at how much is left before placing any order. We’ve seen offices get below 5 or even 4% on supplies by simply cutting out of the order items that can be purchased next month and are not urgent at all. This will take 40-60 min at the most and save you at least a couple of thousand dollars. If you need help with any of the above steps, please reach out and I’ll be happy to help. We are exploring other ways to incorporate type form to optimize back-office operations and make things easier. For example, we are testing Spore test automation and the ability to track other Infection Control related issues in one place. Tiger Safarov Book the time with me here Google Sheet Template
With the global economy battling the post-COVID era and a current inflationary wave, the dental industry has faced its own challenges such as increased operating costs and a high employee turnover. During the pandemic, dental offices had to spend more money to ensure the safety of both their staff and patients. This included purchasing personal protective equipment (PPE) at a historical high price and implementing new protocols for cleaning and disinfection. However, it seems that the costs are returning to the pre-covid prices and we hope that this trend continues. In this article, we would like to share some insights on managing costs of dental supplies we've gathered from talking to ZenSupplies key vendors, DC Dental and DDS Dental, about the trends and statistics for 2022 and 2023. They shared some interesting data with us and gave us a sneak peek into the areas of potential savings. Kara Moran, Director of Marketing at DC Dental: In 2022, the dental supply industry saw a resurgence as dental offices reopened and looked for ways to operate efficiently. To achieve this, many practices took advantage of discounts and promotions offered by manufacturers. The top 10 products in the market included: Lidocaine HCl 2% w/EPI 1:100 50/Bx Septocaine (Articaine HCl 4%) w/Epi 1:100K 50/Bx Cook-Waite Lidocaine HCL 2% 1:100M 50/Bx Orabloc Articaine 4% w/EPI 1:100k 50/Bx Saliva Ejector 100/Pk White Saliva Ejector 100/Pk Clear W/Blue Chlorhexidine Gluconate 0.12% Oral Rinse Essentials PF Ultra Nitrile Exam Gloves Blue Small 300/Bx 0.9% Sodium Chloride Irrigation 1000 ml Essentials PF Ultra Nitrile Exam Gloves Blue M 300/Bx These products were in high demand as dental offices sought to return to their normal operations. As the market for gloves returns to pre-COVID prices, we at DC Dental are excited to announce a variety of promotions and discounts on our top-selling products that help managing costs of dental supplies. Our current bestseller is the Essentials PF Ultra Nitrile glove, which is now available at $14.95 per box of 300 - a significant reduction from its previous price of $65 per box. Additionally, we will be offering flash sale promotions throughout the year, including discounts on the Essential PF Ultra Gloves, bringing the net price down to $11.96 per box of 300. We are also thrilled to announce our partnership with Dash Medical Gloves, with the next flash sale, ‘Love Your Glove’, featuring Alasta Shimmer Pink, taking place on February 13th and offering a Buy 7 Get 3 Free promotion. Furthermore, our weekly flash sales will include a wide range of products such as instruments, gloves, masks, wipes, composites, bond, and handpieces. Additionally, we are excited to introduce and recommend Tanigo, a novel product that stands out in the market. Tanigo is a single-use HVE Suction-Mirror head that combines the functions of HVE suction, dental mirror, and retraction dental functions all in one device. Its compatibility with existing HVE valves and tubing eliminates the need for additional adapters or parts, making it a convenient and smart HVE suction system. Furthermore, Tanigo's 8 suction intakes surrounding a 50-degree angled anti-fog mirror enable proper aerosol reduction during dental procedures, ensuring a continuous clear mirror and minimizing liquid accumulation in the patient's mouth. In terms of cost-saving strategies for dental offices for 2023, we highly recommend taking advantage of manufacturer promotions, which can offer discounts of up to 40% off regular prices. Dinesh A. Sakhrani, Co-founder of DDS Dental: As we reflect on the year 2022, it is evident that the fields of cosmetic dentistry and preventatives have undergone a process of normalization. Additionally, we have noticed a stabilization in the pricing of infection control products. Still, the margins for DDS have experienced a significant decline. This is because we have implemented strategies to offer more competitive prices to our members on various platforms as well as DSO members. Also, we have experienced a significant loss in freight, both in terms of incoming deliveries and outbound shipments. In order to address this issue, we are currently in the process of upgrading our shipping criteria, with the goal of ensuring that our clients receive their products in a timely manner. We work closely with manufacturers to ensure timely delivery of backordered items too. We recognize that certain products may be at risk of being out of stock, but by basing our inventory management on usage patterns, we are able to anticipate and mitigate these potential shortages. Our dedicated team is solely focused on expediting products and we maintain frequent communication with manufacturers to secure estimated arrival dates. Additionally, we utilize overnight shipping to receive products as soon as possible and minimize delays in fulfilling orders. Despite incurring significant freight loss fees, we are committed to doing our part in these challenging times to ensure timely delivery of products to our clients. We believe that when offices come to realize that they may be overpaying for products, they will begin to explore options with smaller providers. Clients can start partnering with DDS to identify cost-saving opportunities within the products they currently use. Together, we can work towards lowering prices through Contract pricing, even for clients with a limited number of offices. DDS can negotiate on behalf of our clients by highlighting the value they bring to manufacturers. It is important to plan ahead when managing costs of dental supplies and to keep a one-month inventory on hand to prevent last-minute rush orders. By taking a few extra days to find the best deal, offices can often achieve a savings of 10-12%, which can make a significant impact on overall costs. To further assist new offices, we recommend offering a glove trial to test out a healthier and cost-effective option, providing free freight for orders over $50, and conducting price comparisons to ensure the best deals are being secured.
Mary Govoni, CDA, RDH, MBA, Mary Govoni & Associates So much has happened around current state of infection prevention and other areas of health care over the course of the last 3 years. At times the change has been dizzying, confusing and frustrating. Many dental team members are expressing their sentiments about COVID-19 fatigue. The most common comment I hear is “I’m so tired of COVID”, and I am as well. The reality is, however, that the pandemic still isn’t over. On Jan. 31st President Biden disclosed that he will end the national emergency declaration related to COVID-19 on May 11, 2023. Does this mean that the pandemic is over? What, if anything, will be impacted in dental practices relative to COVID-19 guidance and protocols? It is important to note that although the current state of infection prevention is to end the national medical emergency declaration in May 2023, the CDC, and World Health Organization (WHO) may not end the declaration of a global pandemic of COVID-19 if cases are still spreading. This action does, however, indicate that the crisis era of the pandemic is over – not that COVID-19 is gone from our lives. In fact, what the CDC and other public health agencies have stated is that COVID-19 is beginning to enter the endemic stage of the spread of the disease, meaning that it will likely be always present at some level, like influenza. This means that COVID-19, like influenza, will always present some level of risk of transmission in dentistry during aerosol generating procedures (AGP’s). In some states, under this emergency declaration, some dentists and hygienists have been allowed to administer COVID-19 vaccines to patients, which will most likely end. But our IPAC protocols should continue to be followed, until further updates from the CDC. COVID-19 cases continue to spread across the country. New Omicron subvariants have been identified and now make up most of the COVID-19 cases in the U.S. It is important to note that these variants are vaccine evasive, resulting in both vaccinated and unvaccinated individuals being infected with the virus. The CDC continues to urge health care facilities to follow their guidance for COVID-19, which includes both patient and health care worker protections thanks to current state of infection prevention. These viral outbreaks have been complicated over the last few months by a surge in cases of influenza that is higher than in recent years. In addition, the respiratory syncytial virus (RSV) has also surged, especially in young children. These viruses, and others, such as measles, can be spread through respiratory secretions, which puts dental professionals at risk of infections during AGP’s. As a reminder, AGP’s are defined by OSHA and the CDC as the use of a high-speed handpiece, air/water syringe, ultrasonic scaler, air polisher and air abrasion. Although the number of cases of COVID-19, Flu, and RSV are now decreasing, the risks of exposure for dental professionals performing AGP’s is still present. To minimize the risk of exposure, dental professionals must still follow CDC and OSHA interim guidance, public health regulations and state dental board rules for infection control and especially for utilizing the correct PPE for these procedures. A recent study conducted at the Harvard School of Dental Medicine and published in JAMA Network,, concluded that there was no increased risk for dental practitioners contracting COVID-19 during clinical activities. The article was cited by many groups within dentistry, but the tag line used for the citations did not include one very important conclusion from the study, which was that the study participants were wearing recommended PPE, including N-95 respirators. On the surface, it might appear that the study concluded that the risk to dental professionals was minimal, when in fact it was and is not – for professionals not wearing the correct PPE and for those dental practices that are not continuing to screen patients for respiratory symptoms of COVID-19 and other infectious respiratory viruses. Another issue that has come to light again in dentistry is that of contaminated dental unit water. In 2015 and 2018 outbreaks of bacterial infections in pediatric patients who received pulpotomies in practices in Georgia and California, respectively. These outbreaks drew attention to the need for proper testing and maintenance of dental unit waterlines to prevent infectious disease transmission. In Oct. 2022, the CDC issued a warning through its Health Alert Network (HAN) that another outbreak had been reported. Although it is a common practice in dental facilities to treat the dental unit waterlines with some type of antimicrobial agent, to reduce the formation of biofilm and microbial growth in the waterlines, it is not as common for dental practice to test their water quality for contamination. Testing is the only way for a dental team to know if their dental treatment water meets the CDC guideline of <500CFU/ml. Every practice should have a waterline protocol in place that includes baseline testing of the water that is going into the unit, regular cleaning/maintenance with an antimicrobial agent, shocking the lines to remove residual biofilm and testing. There are readily available resources for dental practices for water testing, both in-office and mail in services. The CDC suggests that testing be performed at least quarterly. Many times, dental team members question the need to follow CDC guidance, since the CDC is not a regulatory agency, such as OSHA. The reality is, however, that most states require compliance with CDC guidelines in their dental rules. And public health departments also require compliance with CDC guidance during current state of infection prevention. Even in our collective state of COVID fatigue, we have the responsibility to protect the health of our patients and of course, ourselves. Viewing CDC guidance as a burden or a nuisance, or simply a recommendation, can distort our thinking, and allow us to forget that responsibility. Patient and health care worker safety is our primary obligation as health care professionals. Having said all that, we must always look at the practical side of compliance with regulations and guidelines. This begins with training of dental team members to understand what is require and why it is so important. According to OSHA and the CDC, new employees must be trained at the start of employment, which is often overlooked, as many dental practices do not have a formal onboarding process for new employees. This is even more critical now due to a shortage of dental health care workers, and especially those with some prior experience in dentistry. If new procedures or products are implemented or introduced into a practice, training must be provided to the team and annual training updates must be provided. Training and retraining of team members, aids in ensuring consistency in how effectively infection prevention protocols are followed, thus increasing both patient and worker safety. Competency evaluations are an excellent tool for assessing the effectiveness of training. This is especially important in the case of new and inexperienced team members, with no dental experience. Can the new employees demonstrate how to appropriately reprocess instruments or turn over treatment rooms, following cleaning and disinfecting protocols? And is there an Infection Control Coordinator appointed in the practice that can monitor that protocols are followed? A discussion of current state of infection prevention and its effect on dental practices would not be complete without addressing the issue of the financial impact on the practice. Additional PPE, which has increased in price during the pandemic, is a key factor. This leads some team members to consider how to cut costs with respect to infection control, such as reusing disposable items and some PPE – like face masks. There are many areas where cost-savings can be implemented in dental practice, but cutting back on, or cutting corners is a slippery and dangers path for dental professionals. Think of your safety, that of your patients and family members and strive to always do the right thing. 1. Centers for Disease Control and Prevention – COVID Data Tracker https://covid.cdc.gov/covid-data-tracker/#datatracker-home (Accessed 1/31/23) 2. Centers for Disease Control and Prevention – COVID-19 Variants https://www.cdc.gov/coronavirus/2019-ncov/variants/index.html?s_cid=11720:covid%2019%20variants%20of%20concern:sem.ga:p:RG:GM:gen:PTN:FY22 (Accessed 1/31/23) 3. Centers for Disease Control and Prevention – Interim Guidance for Healthcare Personnel - Potential Exposure at Work – updated 9/23/22 https://www.google.com/search?q=cdc+guidance+for+healthcare+workers&rlz=1C1CHBF_enUS1016US1016&oq=CDC+guidance&aqs=chrome.2.69i59j69i57j35i39j0i512l4j69i60.4783j0j4&sourceid=chrome&ie=UTF-8 (Accessed 1/31/23) 4. Centers for Disease Control and Prevention – Infection Control Guidance – updated 9/23/22 https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-recommendations.html (Accessed 1/31/23) 5. Centers for Disease Control and Prevention Flu Activity & Surveillance Data https://www.cdc.gov/flu/weekly/fluactivitysurv.htm (Accessed 1/31/23) 6. Centers for Disease Control and Prevention Respiratory Syncytial Virus (RSV) https://www.cdc.gov/rsv/index.html (Accessed 1/31/23) 7. Centers for Disease Control and Prevention - The National Respiratory and Enteric Virus Surveillance System (NREVSS) https://www.cdc.gov/surveillance/nrevss/index.html (Accessed 1/31/23) 8. Centers for Disease Control and Prevention – Infection Control Guidance – updated 9/23/22 https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-recommendations.html (Accessed 1/31/23) 9. Harvard School of Dental Medicine – Study Shows Dental Practitioners Did Not Face and Increased Risk of Contracting COVID-19 During Clinical Activities https://hsdm.harvard.edu/news/study-shows-dental-practitioners-did-not-face-increased-risk-contracting-covid-19-during#:~:text=Study%20Shows%20Dental%20Practitioners%20Did,Harvard%20School%20of%20Dental%20Medicine (Accessed 1/31/23) 10. Jama Network – Evaluation fo Comprehensive COVID-19 Testing Program Outcomes in a US Dental Clinical Care Academic Setting, Dec. 13, 2022 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2799439 (Acessed 1/31/23) 11. Mycobacterium abscessus Infections Among Patients of a Pediatric Dentistry Practice — Georgia, 2015. MMWR Morb Mortal Wkly Rep 2016;65:355–356. DOI: http://dx.doi.org/10.15585/mmwr.mm6513a5 (Accessed 1/31/23) 12. Hatzenbuehler LA, Tobin-D’Angelo M, Drenzek C, et al. Pediatric Dental Clinic-Associated Outbreak of Mycobacterium abscessus Infection. J Pediatric Infect Dis Soc. 2017 Sep 1;6(3):e116-e122. https://pubmed.ncbi.nlm.nih.gov/28903524/ 13. CDC Health Alert Network - Outbreaks of Nontuberculous Mycobacteria Infections Highlight Importance of Maintaining and Monitoring Dental Waterlines https://emergency.cdc.gov/han/2022/han00478.asp (Accessed 1/31/23) 14. CDC Division of Oral Health – Dental Unit Water Quality https://www.cdc.gov/oralhealth/infectioncontrol/faqs/dental-unit-water-quality.html (Accessed 1/31/23)
In this vendor spotlight blog post, Jillian sits down with Dr. David Epstein and Jason Epstein to explore the exciting history behind Wonderful Dental as a successful dental company. From pediatric dentistry to the founding of this family business, this conversation covers a wide range of fascinating topics and highlights the impact of Dr. David's legacy on the dental industry. The journey of Wonderful Dental is truly inspiring and sets the stage for future advancements in the field. You can listen to the conversation on our podcast page: or read the transcript below. : I was reading about the background and history of Wonderful Dental but would like to know more about how it started and turned into a successful dental company. Dr. David Epstein: In 2016, after 50 years of practicing pediatric dentistry and 18 years of teaching at the University of Connecticut, I retired. I looked at the future and one of the things I noticed was the negative reaction most kids had to the prophy paste or fluoride varnish used in dentistry. I wanted to create a better product that was better tasting, hypoallergenic and met my requirements for a good preventive product. I worked with chemists to develop flavors and we found a way to incorporate synthetic flavoring to eliminate allergens and make the product taste good. I tested everything on my six grandsons, who are very critical, and when they gave a thumbs up, those were the flavors we went with. I also realized that the cost of doing business in the dental supply industry was very high. So, we started an e-commerce company to minimize overhead costs and save offices money. Joseph helped with marketing and increased sales by 800% in the first six months. Jason joined the company later to handle the technical aspect and make the company a well-oiled functioning entity. At 81 years old, my role in the company is to provide information and create good relationships with our offices. I have met so many nice dentists and pediatric dentists from all over the country, which has been wonderful. The input from Joseph and Jason has made this company successful. They are the nuts and bolts behind the scenes, making everything happen and growing the company. : Well, when we first started, we were operating from a small warehouse located in Connecticut, close to Dr. Epstein's residence. As the company grew, we realized we needed a more technologically advanced warehouse that could receive orders electronically and provide us with real-time visibility. So, we moved to a warehouse in Brooklyn. Today, we have around 40 to 50 warehouses, with our two main locations being in Pennsylvania and Texas. Our goal for this year is to open a third warehouse in California, but we need to ensure we have enough product in our supply chain to fully stock it before the end of the year. : With supplies being limited due to Covid, I feel like manufacturers are still trying to catch up. Have you guys faced any challenges with getting the supplies needed to make your product? I know your products don't have a lot of additives, but I imagine the flavors that make them taste so good for kids might not be easy to get in stock. : Yeah, we're lucky that most dental supplies use bad flavors, but we use good ones and there's plenty of those available. Flavor hasn't been our challenge, but we've faced challenges with lid stock, forming web, and other things. We work closely with our suppliers to give them visibility to our dental inventory demand and try to get ahead of it as much as possible. But it has impacted us a few times over the year where we've run low in stock on certain flavors. But we hope to continue to get ample supply to service all the offices we've grown significantly over the last few years. We're just trying to get ahead of the forecast. : Did you start off with just prophy paste, or did you always offer both prophy paste and fluoride? How did you expand your product offerings and how it helped you become a successful dental company? Dr. David Epstein: Actually, our successful dental company started with varnish. The original varnishes were terrible tasting and unattractive. I switched to varnish in my office after studies showed that it was more effective. We switched to a fluoride varnish that was dark amber in color and almost unpalatable in taste. After using it, parents would ask why their child's teeth were yellow after just getting them cleaned. We worked to improve the flavor of the varnish by masking the taste of the rosin and alcohol. We also improved the prophy paste by eliminating the titanium dioxide that made the paste super sticky and difficult to rinse off. We also removed the fluoride from the prophy paste as it had no significant reduction in decay. Our focus is on eliminating allergens and making products that are patient and office friendly, even if they are not the most visually appealing. : Also, the key to a successful dental practice is time management, and this is especially important in pediatric practices where children may resist getting fluoride treatments or teeth polishing. Good flavors make these procedures more efficient and save time. Not only do children enjoy these flavors, but they also have other benefits, such as reducing the risk of clogging up the office's plumbing. It is important to advise dental offices to avoid using fluoride varnish, as it can harm the plumbing. Instead, it is recommended that children spit the varnish into a cup and dispose of it in the trash. Over the course of 50 years of practice, the speaker has gained valuable knowledge and ideas that can make things easier for dental offices and help them to be successful. : I was going to ask, what advice do you have for making the dental experience positive for young children, especially in pediatrics? I know some adults are scared of going to the dentist due to negative experiences they had as kids. Dr. David Epstein: This is what inspired me to become a pediatric dentist over 50 years ago. When I was in dental school, I wasn't a fan of going to the dentist and when I walked into the Children's Dental Clinic for the first time, I was scared. I didn't have much experience with children and I was single with no children of my own. But for some reason, kids liked me, and by the end of my senior year, my classmates were sending me difficult kids to treat. It just seemed to click, and I fell in love with pediatric dentistry. I went on to teach at the University of Connecticut for 18 years, but when I retired at 75, I felt it was not appropriate to be in the clinic teaching kids. However, I discovered the internet was a wonderful opportunity to continue teaching and communicating with dentists. : Could you have ever imagined that wonderful would become what it is today when you first started? Dr. David Epstein: Not in my wildest dreams could I have ever imagined the need for these kinds of products and the reach I would have with so many offices. I have to credit Joseph for his marketing efforts, as it has touched so many people and created a warm and friendly feeling toward wonderful. The feedback we have received has been fantastic, and it has all been due to our exceptional marketing program. As the business grew, I saw the logistics were beyond my abilities or Joseph's, and that's where Jason filled the gap, completing the triangle and making the company function well. : Your company has received some amazing reviews and what's great is that you offer samples. I know a lot of companies do this, especially with products like Prophy Paste and Varnish. What samples do you have available?" Dr. David Epstein: We offer a sample packet of all of our products on request. Providing samples is a necessary and effective part of our promotion, but it can be quite costly. We try to do it on a selective basis. When offices request samples, we are happy to send them out. As we have partnered with large groups such as Zen, we offer samples to all members of that group. We rely on Zen to connect us with offices and are always happy to send out samples. : One of the goals when starting the company was to make products at a cost that was affordable for dental offices. How do you analyze pricing and ensure that it is optimal and affordable? Dr. David Epstein: It was a real epiphany for us when we realized we could make all these products and save offices money as a successful dental company. We realized we could eliminate major expenses such as advertising in dental journals and reduce the cost of attending meetings and having booths. Once we found out we could reach offices through an e-commerce company, we could pass those savings on to them. We also reduced our packaging cost, which lowered the price of our prophy paste. Offices were surprised that a dental company actually lowered the price of something. I've been practicing for 50 years and I've never seen that happen before. Some companies would push offices to spend more money by offering promotions, but that never sat right with me. Our prices are fair and reasonable, and I think offices appreciate that. : Is there anything you are particularly excited about for Wonderful, for this year 2023? Are there any forecasts or things you're looking forward to continue being a successful dental company? Dr. David Epstein: I am excited about continuing to build relationships with dental offices. Our goal is not just to be a dental supply vendor, but to create a strong bond with offices so that they feel free to contact us with questions. As for new products, we're considering adding more flavors in the future. Our most popular flavor has been marshmallow, and recently, s'mores flavor varnish has received great feedback. We also have a unique prophy paste product for adults, which has been well received. : Historically, marshmallow has been the most popular flavor for paste and varnish. Our s'mores flavor varnish has been a hit. Our adult line of prophy paste, which is 20% coarser than medium, has also taken off as it is more efficient at removing stains while still polishing the enamel. Dr. David Epstein: I have a background in pediatric dentistry and have seen a lot of changes over the years. I learned that coarse paste damaged the enamel, but medium pace was not strong enough to remove stains. That's why we created the adult line of prophy paste, which is 80% less coarse than coarse paste. I believe in always improving and finding better ways to do things. A lot of what I offer to dental offices is based on my personal experiences and lessons learned over the years. : Is there anything else you would like to add as far as advice you would like to give dental offices in regards to saving on dental supplies? : Zen offers great products that save money for dental offices. We are grateful to be a part of Zen as it reaches a wider audience. My advice to dental offices would be to take advantage of buying directly and not just rely on dental supply house catalogs. Investigate better products at better prices through e-commerce companies like Zen. Dr. David Epstein: My advice for a successful dental company would be to consider the quality of products while looking for cost savings. At Zen, we focus on providing the highest quality products and constantly making improvements. In my practice, I always sought the best products for my patients and when starting the company, this was a top priority. We never wanted to compromise the quality of our products for cost savings. The cost savings turned out to be a secondary benefit. Our philosophy has always been to provide the best products. : Thank you for joining me today and for being partners of Zen. Your company brings more than just great products; it brings a positive experience for patients with your flavors. It may seem small, but it makes a big difference in the dental experience. Thank you!
LEAN methodology in a dental setting involves implementing effective ways to manage the clinic’s operations and increase overall dental office efficiency. This can encompass things such as streamlining scheduling, minimizing waste, and enhancing communication among patients and staff members. One of the main advantages of LEAN methodology is increased dental office productivity. A Lean Dental Office will have shorter appointments and less downtime for patients, as well as more patients seen per day for dental professionals. A few examples of implementing LEAN in a dental clinic can include: - Adopting a digital appointment system that allows patients to schedule appointments online, reducing the need for phone calls and paperwork. - Implementing a dental inventory management system for monitoring inventory and ordering supplies in a timely manner to decrease waste and save money. - Using an electronic system to track patient information and medical history, which can improve communication among staff members and enhance patient safety. - Scheduling regular staff meetings to discuss and resolve any issues or inefficiencies in the clinic’s operations. - Analyzing data and metrics regularly to identify areas for improvement and make changes to the clinic’s processes. The 90% rule in a lean dental office refers to the concept of identifying and eliminating non-value adding activities to focus on the critical 10% of activities that truly add value to the patient experience. This principle is also based on the idea of “lean thinking.” Therefore, the goal of the 90% rule is to streamline operations, reduce costs, and improve the overall quality of care for patients. The first question to start with: what procedures do you perform most frequently? By identifying these procedures, you can begin to implement the 90% rule. By dedicating 90% of your time and resources to these high-value procedures, you can improve efficiency and enhance the patient experience. Where else can the LEAN 90% rule be applied within the dental office? It is worth noting that the LEAN 90% rule is not limited to only one aspect of the clinic, it should be applied to all aspects of the clinic, from patient flow, to communication, inventory, and so on. To apply the LEAN 90% rule for other areas within a dental clinic, the following steps can be taken: 1. Identify and map out the current processes in the clinic: Create a detailed map of each process, including all the steps involved, the time spent on each step, and the people involved. For example, these processes could include but are not limited to scheduling appointments, ordering supplies, or tracking patient information. 2. Identify value-added and non-value added activities: Analyze each step of the process and determine which activities add value to the process and which do not. 3. Measure the performance of these processes: Collect data on how long each process takes, how often it is performed, and how many errors occur. 4. Determine the 90th percentile: Use the data to determine the 90th percentile of the population for each process. For example, if scheduling appointments takes an average of 10 minutes, but the 90th percentile takes 15 minutes, then the process should be designed to handle appointments that take 15 minutes or less. 5. Redesign the process: Once the 90th percentile has been determined, redesign the process to accommodate the majority of cases. This could involve simplifying the process, eliminating unnecessary steps, or automating certain tasks. 6. Monitor the process: After the process has been redesigned, monitor its performance to ensure that it is meeting the needs of the 90th percentile. Regularly collect data and analyze it to identify any areas for improvement. 6. Continuously improve: Continuously look for ways to improve the process and make it more efficient. Empowering Staff Members to Lead LEAN Initiatives Implementing Lean dental practice management system in an organization can be a complex process, and it is crucial to involve staff members in the process. It may take time for Lean to become fully integrated into the company culture, and there may be initial resistance from some employees. To combat this, it is important to keep communication open and gather input and feedback from staff members when identifying and implementing Lean projects. By giving employees a say in the changes that affect them and allowing for a trial period, it can foster greater participation and ownership of the projects. Once the benefits of increased productivity are evident, staff members are likely to become more invested and enthusiastic about Lean principles. Additionally, sharing the benefits with staff members can further incentivize their participation and ideas. The Importance of Establishing a Process It’s important to remember that while achieving great results is important, the methods we use to get there are even more crucial. Leaders who only focus on the numbers without considering the process may end up with manipulated numbers or negative behaviors that harm the customer experience. Some other key things to keep in mind when it comes to process include: - Following the consistently of solving problems on a daily basis; - Making problems visible to everyone; - Encouraging open communication about problems; - Cross-training employees for added flexibility and agility; - Holding daily morning meetings for training, learning, and updates. Continuous Enhancements and Involvement Adopting Lean principles in a dental office can be a never-ending journey of continuous improvement. By constantly examining and evaluating processes, dental clinics can make measurable improvements time and time again. By bringing different teams together and trying new ideas, dental clinics can bring their workflow optimization to a new level. Not only do these changes improve productivity and reduce waste, but they also engage employees and foster creativity, making the process highly rewarding. written by Angie Bachman, Director of Clinical Training at Design Ergonomics
DentalTechup is a popular YouTube channel that focuses on dental technology and product reviews. It was started by Dr. Aaron DeForest, who is a dentist himself and understands the challenges faced by private practices in the dental industry. He noticed the landscape of the dental field changing with the emergence of corporate dentistry and large-scale DSOs, which lowered the cost of supplies and outcompeted private practices on advertising budgets and dental technology. To address this challenge, Dr. DeForest started DentalTechup to help dentists determine what software and products they are interested in purchasing. Dr. Aaron DeForest is a visionary who believes that technology is the key to driving progress in the dental industry. He recognized that many dentists were struggling to keep up with the latest technological advances, and that paying for expensive consultants was not a sustainable solution. As a result, he started DentalTechup, a platform that provides dentists with free resources to help them learn about new technology and how to implement it in their practices. This is important because technology has the potential to improve patient care, increase efficiency, and reduce costs. Overall, Dr. DeForest's vision for DentalTechup and Digital DSO is to create a more connected, innovative, and technologically advanced dental industry. By empowering dentists with the knowledge and tools they need to succeed in a rapidly changing world, he is helping to ensure that patients receive the best possible care, and that the dental profession continues to thrive well into the future. According to Dr. Aaron DeForest, a change in industry dynamics is not likely to be initiated by individuals, but rather by companies and their leadership. One specific company that is driving transformation in the dental industry is ZenOne, which supports over a thousand dental offices with its innovative software. We highly recommend watching Dr. Aaron DeForest's video, where he provides insights into the overall mission of ZenOne and shares his initial thoughts about the platform’s benefits: https://youtu.be/CQDnZyVe2u0 Dr. DeForest will be releasing a video in the future that will provide even deeper insights into ZenOne's features about their budget setup options, varying prices, shipping speeds, and QR code tracking. Here are some important main points throughout the video: - ZenOne supports over a thousand dental offices with their software, connecting dentists to multiple vendors, and sharing resources digitally to save them money and make their work more efficient. - ZenOne allows users to set up a budget on their account to control their monthly spending or savings. The platform offers similar products with different prices and shipping speeds, giving users the flexibility to choose what best suits their needs. - The platform also features QR codes to streamline the order process and make it easy to use. - Tiger, the CEO of ZenOne, cares deeply about the user experience and is known for personally visiting clients for hours and days at a time to ensure their needs are met. He is dedicated to providing dentists with innovative solutions that prioritize their interests. He makes sure their needs are met with the software. - Not only does ZenOne show you your budget, but actually how much you saved during the ordering process as well. - Features of the platform include: Dental Catalogs, your inventory, restock inventory, quick order, office supplies, orders, and reports to make ZenOne simple, and easy to use.
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.
Dr. Daryl Brito has an intriguing story to tell related to dental entrepreneurship. He started his career as a Doctor of Medicine in Dentistry. Completing dental school and eventually opening up his own practice. However, he did not stop there. In a short period of time, he ventured into the distribution of dental products, achieving what many dentists aspire to accomplish over the course of their entire professional careers. Undoubtedly, he has more aspirations in his mind that he hopes to achieve. Watch the full interview with Tiger, owner of Zen Supplies and Dr. Brito here: https://youtu.be/oHo9UAWCHNI Listen to the interview: https://share.transistor.fm/s/71885638 Dr. Daryl Brito's journey to becoming a dentist began when he was still in high school. He had the opportunity to shadow his local dentist and was drawn to the stress-free, easy-going atmosphere in the office. The experience inspired him to pursue a career in dentistry. In 2015, Dr. Brito graduated from Nova Southeastern University and relocated to Florida. He grew up in New Jersey, but was ready for a change in lifestyle. The quality of life in Florida was much better than what he experienced in New Jersey. He was particularly drawn to the beautiful winters and warm climate. He recalls how during his dental school days, he adopted a student-like lifestyle to save as much money as possible. Despite this, he managed to live comfortably, take yearly vacations, and even travel internationally a few times. However, his primary focus was always on aggressively paying off his student loans. One of the ways in which Dr. Brito managed his finances was by conducting a 90-day analysis of his expenses. He wanted to understand exactly how much he was spending and where his money was going. By doing this, he was able to establish a baseline and identify areas where he could cut back. One of the things he found was that eating out was costing him a significant amount of money, so he made a conscious effort to reduce his dining expenses. Dr. Brito's disciplined approach to finance has served him well, and he believes that it is essential for everyone, regardless of their profession, to have a good understanding of their financial situation. By being mindful of his spending and prioritizing his debt payments, he has been able to build a stable financial foundation that has allowed him to focus on growing his career as a dentist. Dr. Brito initially believed that his job as a dentist would be stress-free, but he quickly realized that healthcare in general, especially dentistry, is far from stress-free. He found that opening his own office made a significant difference. He had previously worked in a corporate setting, where he was treated like a robot and saw over 30 patients a day, with little care for patient well-being or staff. In his private office, he now sees 8-10 patients a day, allowing him to go at his own pace and build better relationships with his patients and team. The quality of life has significantly improved, and he no longer experiences burnout. The change has been amazing for Dr. Brito, and he is grateful for the opportunity to provide better care for his patients, but he didn't just stop there. Dr. Brito knew that he needed a second source of income to help pay off his student debt even faster, so he started his own business. Through his business, Dr. Brito also made a connection that many doctors face - the "doctor tax" where companies and reps charge an exorbitant amount simply because they know he is a doctor. Luckily, he found a way to beat this system by getting equipment for other dentists at a fraction of the cost that other companies would charge. When it comes to sourcing the equipment, Dr. Brito prefers to buy used equipment from retiring doctors or those looking to trade in for newer models. He meticulously tests the equipment and gathers information about its history, just like one would when buying a used car. This has proven to be a profitable venture, as many retiring doctors give away expensive equipment for pennies on the dollar. Dr. Brito's friend and fellow dentist, Dr. Lynn, was also able to save a significant amount on equipment by buying from various companies rather than purchasing everything from one large supplier. Dr. Brito believes that one can easily save 50% on the cost of equipment by shopping around and comparing prices before you buy. Basically, right at the onset of the Covid-19 pandemic, he decided to start selling Personal Protective Equipment (PPE) in addition to dental equipment. This proved to be successful and helped to sustain his business during the tough times. Though PPE sales have tapered off since then, it remains a part of his business. When asked about his yearly sales volume, Dr. Brito revealed that it currently stands at around 1.2 million. He recently started his own dental practice with a friend, Dr. Ashley Natty, after a six-month gap where he focused on his dental equipment business. However, when they tried to secure a loan, the banks were hesitant to approve them as they were not currently practicing as dentists. After being advised to find a job, Dr. Brito found a part-time position at a practice, which he worked at for six months until the previous owner sadly passed away. The wife of the deceased owner had to sell the practice, and it just so happened that Dr. Brito and Dr. Natty were in the process of looking for a location to start their own practice. They purchased the practice in January 2022 and renamed it West Tampa Dental. Despite having more bargaining chips, Dr. Brito and Dr. Natty wanted to be fair to the previous owner's wife and kept her on as their office manager while also adding new services such as Invisalign and implants to grow the practice. Asking about the challenges he faces with running two businesses simultaneously, Dr. Brito admits that his work doesn't end at five and often requires him to work on weekends and attend continuing education courses. Although, he sees it as a natural part of being a business owner and enjoys the flexibility that comes with it. The only weakness he identifies with is his difficulty with delegation, which he is actively trying to improve. When asked about expanding his product offerings, Dr. Brito expresses a desire to do so gradually, but acknowledges that he will eventually need a warehouse to accommodate the growing inventory. He prefers to keep it in-house for now, but he knows that he will have to move to a bigger space soon. While he is hesitant to commit to a location too far from his home in South Tampa, he recognizes that it may be more affordable to do so in the suburbs of Lakeland, albeit with a longer commute. Overall, Dr. Brito is focused on steady growth and finding the right balance between work and personal life. Dr. Brito believes that 2023 could be a very interesting year for the economy and the dental industry. While sales have been strong in the first few months of the year, Dr. Brito is concerned about the potential for a recession. With layoffs occurring in various industries, he worries that this could negatively affect dentistry and dental equipment sales. He is interested to see if dentists will turn to purchasing more used equipment if budgets become tighter during a recession. Dr. Brito's strategy for growing his businesses during the recession is to focus on the fundamentals. For his dental practice, the key is to get new patients through the door, and he is using marketing tools such as Bird Eye to help achieve this goal. Dr. Brito also emphasizes the importance of keeping patients in-house during a recession, and recommends having a three to six month emergency fund to weather the storm. Dr. Brito recommends saving money on supplies and equipment in 2023 by opting for smaller third party companies. According to him, these smaller vendors offer miles exempt supplies at a much lower price compared to bigger companies. The price difference can be significant and can quickly add up, making it an effective way to save money on supplies and equipment.