The Dawson Academy Blog

Here's to the New Year: Resolutions to Improve Your Practice in 2009

As the turbulent times of 2008 now fade into a distant memory in our rear-view mirrors, it's time to look toward the promise that 2009 can bring to both our personal and professional lives. Although vows to stop smoking or lose weight are always terrific ideas, why not make a new promise to yourself this year? Use this opportunity to enter the new year with a renewed outlook for both you and your practice. By making—and sticking to—the following New Year's resolutions, you can help get your dental practice in tip-top condition. Here's how:

First, set goals for yourself. Consider where you are professionally and set a goal for where you'd like to be next year. Would you like to see more patients? Would you like to work only four days a week? Are your objectives realistic? Keep an open mind and document your goals, being sure to refer to them often to check your progress. Whether you hope to work less, work more, or ask for more referrals, you'll never get there if you don't know where you are going.

Second, master a new skill. Most successful dentists are quick to tell you the areas in which they could use a refresher course—a fact that dentists striving to be successful should keep in mind. It's a fact that we aren't bestowed with a mastery of dentistry simply by graduating from dental school. True mastery takes time and practice—and The Dawson Academy can help with both. By signing up for any of our 2009 courses, you will be well on your way to mastering dentistry and changing your future. In addition, you may want to subscribe to our newsletters, blogs, and You Tube page for even more new information about dentistry. The Dawson Academy strives to keep you "in the know" when it comes to the dental community.

Third, delegate, delegate, delegate. Although it's only natural to want to take ownership of everything in the office with your name on the door, you must also remember that you can only do so much. Therefore, remember that your number one goal is to provide your patients with quality dentistry; the rest is just details. Focus on getting tasks that carry minimal reward delegated to your staff. For example, do you manage your office's financial books? Perhaps an accountant may be better suited for the job, freeing you up for more time treatment planning. Look for ways to delegate and your practice will reap the benefits.

Next, assess your practice. Are you satisfied with the direction of your practice? Are you satisfied with the camaraderie of your staff? Are you satisfied with the career paths set forth for both you and your employees? If you need to make some tough decisions, remember to separate the business side of things from the personal side of things as you examine your team and office dynamics. After all, the most important rule of business is to separate yourself completely from the business before making any long-term decisions.

Finally, focus on your patients. Although it can be relatively easy to forget about your patients' satisfaction when your elbow deep in fillings, crowns, and paperwork, take the new year as a renewed opportunity to remember the very people who keep your business in business: your patients. Service is the cornerstone of any dental practice, so, unless your willing to lose a few patients, don't forget that fact as you renew your vows for 2009.

Avoid Subprime Results in Your Practice

Measure What's Really Important and Accomplish What Really Matters

by Larry M. Guzzardo  

 

In his groundbreaking book, Thriving on Chaos, Tom Peters proclaims, “What gets measured gets done.” He further explains, “Develop simple systems that encourage participation and understanding by everyone.” In other words, measure what’s important. Create measures of what is happening in your practice and empower staff to take action to achieve improvement. Keep what you track simple, paring it down to a few essential statistics that can capture the vitality of your practice at a glance. Anything you want to improve should be measured and monitored regularly.

 

Determine What is Important.

Determine what is important to the lifeblood of your practice, but don’t ignore non-financial measures, such as laboratory quality control, adherence to hygiene departmental protocol, or patient satisfaction. Ultimately, the staff will consider what you track as important. By not paying attention, you won’t be able to react until it is too late, keeping you from getting things done, making you appear indecisive, and preventing you from delivering on promises and commitments—which is certainly not the formula for a winning team. However, too many offices operate without any real direction, having a direct impact on employee development and practice progress. As a result, individual staff members may form cliques and resort to uncoordinated efforts to get things done.

 

Avoid Inaction.

So, what causes this inability for dentists to take action? Usually, the failure to put the right people in the right jobs leads to problems in the workforce. Oddly enough, doctors admit to knowing there are performance issues with certain staff members, but they choose to ignore it, hoping the employees can resolve it on their own. To make matters worse, the rest of the staff is aware of problematic employees, but the doctor usually does not seek their advice to address the matter. When a staff member is underperforming, ignoring the problem is bound to make it worse. Strong leaders encourage and stretch the abilities of talented staff.

Once the decision has been made to challenge your staff, you must commit to tracking their progress in detail through regularly scheduled review sessions that conclude with comprehensive constructive Actions Plans that outline the employee’s goals until the next review session (usually six months). Effective leaders begin by focusing on clear and specific goals. With clear goals, effective doctors implement them in a way that appears simple, but produces profound effects. At the end of every staff meeting or employee review, doctors should create an Action Plan. Note exactly what is supposed to be done by whom and by when. Then, discuss the steps that should be taken and how you will assist them. You can then review this agenda before you adjourn and make it the first thing you review the next time you meet. As simple as it may seem, this process is the first step in learning to get things done. It is the doctor who brings these habits into a practice where they did not exist before. Now under your renewed direction, the whole tone of the office changes as staff members prepare for meetings differently.

 

Embrace the Routine.

Sure, keeping track of assignments, following up on them, and evaluating progress seems boring, but it’s a routine you should learn to embrace. In underperforming practices, many dentists find no reward in continually improving systems and procedures. They rant, “Why can’t the staff just do this by themselves?” They’re afraid of being seen as too controlling. However, Dr. Dawson teaches us that where there are no controls, you will find control freaks. Ironic, but true, especially if there is no way to determine progress, meaning dentists must constantly check and recheck. This waste of time keeps the doctor from focusing on the staff and patient care. Time-efficient doctors who are engaged in what is happening in their practice are hungry for information, including information about daily and hourly production, collections, bad accounts, the schedule, incomplete treatment, hygiene therapy, supplies, equipment, and even the facility. They never want to be the last to know. They use meetings as an opportunity to have their staff bring data to them to be evaluated. By incorporating measures and tracking results, staff can self-monitor their progress and offer solutions to problems, facilitating their ability to understand the goals and vision of the practice. Developing measures and monitors saves time and allows the doctor to lead the practice and work toward fulfilling commitments and promises.

 

Larry M. Guzzardo who has co-authored two books, “Powerful Practice” and “Getting Things Done,” conducts in-office practice management consultations exclusively for dentists to enhance trust, create organization, increase profits, and develop patient relationships that last. Larry has presented numerous workshops, including “Winning Patient Acceptance,” “Business Communication Systems,” and “The Leadership Challenge.” Larry can be reached at 800-782-5770 or www.larrymguzzardo.com if you have further questions.

Spotlight: Dr. Upadaya, Dental Practice Flourish Thanks to Teachings of The Dawson Academy

To many patients, dentistry seems so simple: brush, floss, rinse, and visit a dentist every six months for a routine check-up. In fact, many dentists buy into a similar concept. However, as Dr. Rajeev Upadaya of Florham Park, NJ—as well as countless other students of The Dawson Academy—can attest, the requirements for a healthy mouth extend beyond simply healthy teeth. And truth be told, if you master these requirements, you’re bound to grow your practice exponentially, regardless of the economic conditions—and Dr. Upadaya’s success is proof positive.

Dr. Upadaya has long seen dentistry as a labor of love. But shortly after buying his current practice more than four years ago, Dr. Upadaya realized there was something missing, specifically comprehensive, complete dentistry. “When I took over the practice, we were a very routine, general dental office,” Dr. Upadaya explains. “Over the last four years, we’ve become a very comprehensive-based practice and it’s all due to what I’ve learned at The Dawson Academy,” he adds.

While many dentists may spend what seems like a lifetime analyzing a patient’s dentition but not addressing real problems, students of The Dawson Academy can proudly attest to the impact that Dr. Peter Dawson’s founding principles can have on their own dental practices, a fact that Dr. Upadaya became aware of within the first few minutes of Seminar One: Functional Occlusion – From TMJ to Smile Design.

“From the first seminar I went to, it transformed the way I view dentistry and how I practice it,” Dr. Upadaya emphasizes. “It opened my eyes to look at things I thought were normal and realize that there were actual signs of pretty dramatic occlusal disease. It taught me ways to stop that, prevent that, and how to do it predictably,” he continues.

As Dr. Upadaya has expanded his dental focus, he has also come to realize the importance of function when correcting his patients’ esthetics, which has been especially helpful now that the demand for cosmetic dentistry now supersedes most any other procedure conducted in a dental office. In particular, Dr. Upadaya has learned that creating smiles that function properly, feel great, look great, and provide the longevity people desire should now be the cornerstone of his dental practice going forward.

“I’ve always been wowed by the cosmetic results I’ve seen at other seminars, but I’ve always been a little nervous about getting into it because I’ve also seen so many failures,” Dr. Upadaya explains. “But once I got the knowledge I did through The Dawson Academy, I learned that we can do truly functional esthetics. We can achieve the same if not better esthetic outcomes by making sure the function has been addressed to make someone’s mouth healthier before all else,” he adds.

Thanks to the lessons learned from teachings of The Dawson Academy, Dr. Upadaya has positioned his practice for continued growth throughout his local community. He is also convinced that any dentist willing to adopt a similar philosophy can reap the same benefits from The Dawson Academy for their own practices.

“The lessons learned from The Dawson Academy will provide anyone with the confidence and knowledge needed to see, diagnose, and treat any occlusal situation they can and will see in their practice,” Dr. Upadaya explains. “In fact, it will help dentists see that there are a lot more problems in their routine patients than they will ever realize,” he continues, “and they now have the training needed to offer solutions. Finally, these newly diagnosed problems will help make their practice even more profitable.”

Small Business Council of America Honors Dawson Academy Faculty Member

Dr. Andrew C. Cobb, a faculty member for The Dawson Academy, was recently presented with the 2008 Small Business Humanitarian of the Year Award for his efforts with Somos Amigos Medical Missions, a non-profit, public charity corporation that provides medical and dental care to people living in a rural area of the Dominican Republic.

Dr. Cobb of Bethesda, MD, was presented the award along with Dr. Gael M. Delany of Chevy Chase, MD, and Dr. Michael T. Keegan of Rockville, MD for working to create a state-of-the-art clinic that provides medical and dental care to thousands of people who otherwise would have no access to health care. Not only does Dr. Cobb, along with Dr. Delany and Dr. Keegan, donate their time to the effort, they have also worked to assemble a team of dedicated dentists and physicians who will also provide complimentary dental and medical care to the local citizens.

“Initially once a year and then twice a year for the past five years, and beginning in 2008 three times a year, our volunteers travel to Naranjito in the Dominican Republic to staff our clinic,” Dr. Cobb explains. “We have become the physicians and dentists for these simple, but grateful people. What makes Somos Amigos Dental Clinic unique in a third-world country is that we strive to create a state of dental health which can be sustained over a lifetime. Prevention, restorations, prosthetics, and even endodontic treatments are offered. We have seen a great improvement in the dental health of the children in the immediate area because of their visits to our clinics. Most of our patients travel by foot or mule to reach our clinic, and many of our patients travel two to three hours each way for an opportunity to be seen by our professionals,” Dr. Cobb adds.

The Dawson Academy couldn’t be more proud to be affiliated with a dentist like Dr. Cobb who is commited to providing optimal care for each one of his patients, regardless of where they may live.

“The Dawson Academy would like to congratulate Dr. Cobb for receiving an award for such a fantastic cause,” explains Jon Forrest, President and CEO of The Dawson Academy. “We encourage our faculty members to participate in worldwide dental outreach programs that help the less fortunate, and there’s no better example of that type of commitment than Dr. Cobb. We are extremely honored to have him here at The Dawson Academy,” Forrest adds.

Ten Steps to Gear Up in a Down Economy

Ten Steps to Gear Up in a Down Economy

The holiday season is now upon us, so many of us are now taking stock of those things for which we are truly grateful. It is also the time of year when many of us begin to take stock of what the next year of our lives and businesses will look like. And with so many looming questions about the economy, your game plan for the next year is likely clouded with uncertainty—uncertainty that can breed itself into some very unhealthy fear for you, your team, and your patients. You don’t have to look far to see that people are very concerned about the future. That’s why, as dentists and team members, it is absolutely critical to polarize our thinking. When things are down, more than ever, you have to keep your spirits up.

Here are ten steps to help keep your spirits up in a down economy:

1. Understand What Goes Down, Must Come Up.

We’ve seen this happen before. As a matter of fact, we’ve seen it happen several times over the course of our lives, and we will no doubt see its occurrence again in the future. The problem is that Americans have very short memories, and we’ve grown impatient with progress. We get upset and discouraged when the world around us doesn’t support the expedient needs we have in our lives. 

There is no question that the economy will come back up—it’s just a question of when and by how much. We can only speculate as to these answers. One thing is for sure, its not coming back any time soon, so prepare for a little turbulence over the next few months. 

2. Stop Watching Television.

There is very little redeeming value in anything that comes from the flat screen in your living room. If used inappropriately, it can become a monstrosity of negativity and lies. That’s why you should avoid watching political commentary or the market fluctuations for hours on end. Those programs feed on fear and uncertainty, and it’s what keeps viewers engaged and coming back for more. 

If you watch television and listen to the commentary, it will eventually start to permeate your brain, impacting how you think. The brain has a very hard time separating truth from fiction when it is inundated with images. Therefore, we accept things that we see as truth, even if it isn’t. Buying into false statements and negativity is the natural digestive system of the brain, so be careful what you feed it.

Instead of watching television, write your patient newsletter or create content for your Web site. What’s more, work on developing an effective treatment plan for your patients.

3. Put a Massive Filter on Your Written Sources.

Although reading the newspaper, informative Web sites, great dental journals, and wonderful books can be tremendously rewarding and educational, there is a plethora of written materials that can be a detriment to your spirit. When it comes to potentially harmful brain stimuli, be careful not to overindulge in it. Recognize it, look it over, and then move on. Overindulging in negativity, which can be detrimental in the current climate, changes the chemical compounds within your brains. Although we spend an inordinate amount of time protecting our kids’ brains from harmful stimuli, we do nothing of the sort to protect our own, leaving us to wonder why kids live with so much optimism and connectedness with the environment around them, but adults can’t. In reality, the reason is quite simple; you should adopt a similar philosophy.

4. Choose “Not to Participate” in the Recession.

When it comes to the economy, as hard as it may sound, simply choosing not to participate in it can be the easiest way to stay upbeat. Obviously, remaining oblivious to our current conditions is nearly impossible, especially with so much news and television coverage, but you cannot allow the conditions to impact the mission you have established for your practice and patients: comprehensive, complete dental care.

You can choose not to participate in the recession in the following three areas:

• Your thoughts – First, choose not to participate in the recession by thinking positive thoughts. Your thoughts manifest themselves into reality every day. Be careful that the message you send the people around you is not fearful and sympathetic to the economic woes of the world.

• Your team – Second, choose not to participate in the recession with your team. Your team will voice their concerns about the economy to you, and it will be very important for you to assume your leadership role and help them remember the goal of treating patients.

• Your patients – Finally, choose not to participate with patients. Your patients will also express their concerns to you. When they do so, you have two choices: sympathize or empathize. Sympathizing with your patients until the spiral of emotions hits the bottom and now nobody’s excited about doing anything and you both feel miserable will not benefit anyone. What’s more, empathizing with your patients and quickly getting back to the purpose of their visit will allow you to quickly place the emphasis back on their needs by asking “Now, how are YOU doing?”

5. Pre-block a Memorable Childhood for Your Kids.

You kids get one shot at their childhood, which means they will either have a fantastic and memorable childhood or one that is easily forgettable—and you get to decide which.

Make an effort to pre-block some memorable events in your children’s lives now. You get very few summers with your kids, so make them all count.

Don’t let the chaos and the busyness of life spoil your plan. Pre-block a few great trips with your kids this summer, because we all know what happens when you don’t pre-block them: They never happen. 

6. Bring a Better You to Your Practice in 2009.

You are only as young (and as good) as you feel. Whether you are doing one crown or ten crowns, dentistry is inherently stressful. It is important to understand that without proper compensation, this stress can wreak incredible havoc on the body and mind, sending non-verbal messages to everyone around you. Make sure the messages you send are the ones you want to send. These messages will have a great deal to do with how you feel about yourself.

Sign up for something that makes you accountable to finishing it. Make sure that whatever you sign up for makes you a better person by completing it. The greatest gift you could ever give the people around you is a better you.

More than ever, people need positive sources of energy. They need to tap into others that have a great outlook on life and the future. What an opportunity for your patients and team! Does the world see you this way? Keep in mind that how we see ourselves has a great deal to do with how the world sees us.

7. Load the Bus and Plan for a Great Ride.

This upcoming year is very much like a bus ride that starts on Jan. 1 and ends on Dec. 31. Make sure the destination, passengers, fuel, stops, maintenance, and supplies are all taken seriously before you leave. 

All too often, we don’t take the time to really look at this entire inventory, so we just keep driving without a well designed plan. Dentists always wonder, “How do I get my staff motivated?” I have a better question, “What does your staff have to be motivated about?” 

Design a plan that authentically motivates the people around you. If you are a leader, let your staff know that you have a plan for the trip ahead. The plan has to first energize you and then the people with you. Without it, people will most likely want to ride another bus or sit quietly while you determine the destination.

8. Commit to Being a “Chair Tipper” This Year.

One of the most important elements of being exceptional in any craft is continuous study. Continuing Education has become an integral part of every well-minded dentist’s career. How intentional you become about the retention of knowledge can greatly impact your return on investment when it comes to these efforts.

Statistical research has shown for years that students who sit closer to the front have higher grades than students who sit in the back of the classroom. Make a commitment to become a team that “tips the chairs” (to save your seats) of the first few rows in any CE course that you attend. Being a “chair tipper” for your practice makes a statement. In essence, it says to the speaker, the rest of the dental community, and, most important, you and your team, that you are serious about becoming “the best” and getting the most out of today. The Dawson Academy has some incredible new offerings this year. Make a commitment to “tip the chairs” at a few of them.

9. Go Viral and Supercharge Your Marketing.

Now is the time to supercharge your marketing efforts. When the market is down, you have to step up your marketing. Ask yourself, “What opportunities are we missing?” Come up with a marketing plan focusing on at least seven areas of missed opportunities.

People often think that marketing is about spending money to attract new patients to the office—but it’s simply not true. Marketing is everything you do! Every effort you make sends a signal to your community. Make sure you know how to create your signal, send it, and control it.

When dentists tell me that they need to come up with a marketing plan, they are most likely to forget all of the elements that patients most appreciate in a practice. Start working on the very things that patients see the most. Then, when those things are sending great viral messages, work on the media that supports that message. Begin first with the most cost effective media like the internet and e-mail. There is no greater way to connect with an already captive audience than a fantastic Web site and electronic newsletter. In fact, after the initial start-up costs, they’re almost free! Sound like hard work? Staring at an open schedule is much harder.

10. Remind Yourself of What “Stewardship” Means.

“Stewardship” is a great word to create context for any worthwhile accomplishment. Stewardship starts with the fundamental belief that everything that you have in your life is a gift that has to be returned some day. Whether it is your body, your family, your home, your business, your team members, your friends, and even the profession of dentistry … well, they are all gifts that have to be returned someday.

Sometimes we lose the true appreciation for how special these things are. Using the concept of stewardship helps us to be accountable to a cause other than immediate self-interest. What’s more, it screams for a deeper sense of appreciation and care than we could willfully give to each of these gifts. Practice stewardship and you will find that you will soon be gifted with more than you could ever imagine.

The economy may be down for now, but it won’t stay there. Regardless, always remember that you have a choice in how you respond to it. This ride may get a little bumpy, and it may be a bit long. Your team is going to look to you for answers. Your choices, disciplines, and thoughts will greatly impact all of the wonderful people around you, so be sure to choose wisely. There is no greater time for you to be up than when the market is down.

To see more of what the Top 10% of the dental practices are doing in the country today to beat the recession, join us in Orlando, FL on April 3–4. For more details, please contact us at 1-800-952-2178 or info@TheDawsonAcademy.com. 

My very best to you and your family during this great holiday season.

Sincerely,

Kirk Behrendt
Speaker & Coach
ACT Dental Practice Coaching
www.actdental.com
1-800-851-8186

Alumni Membership Privileges

The Dawson Academy's Alumni Association: Membership Has Its Privileges

Although American Express may have coined the phrase “membership has its privileges,” The Dawson Academy has adopted a similar philosophy regarding membership within its Alumni Association. Designed to give our students a special experience that extends beyond the classroom, the Alumni Association is your gateway to information needed to implement the Dawson principles in your own dental practice. From developing the best treatment plan to viewing podcasts conducted by Dawson Academy faculty members, our alumni network is designed to help you grow your practice by providing the knowledge you seek. The following are just a few examples of the resources you will find:

Blogs. Here you can find regular, ongoing articles, press releases, and information about both The Dawson Academy and the dental industry in general. From discussions about growing your practice to the latest dental technology, this blog will provide you with the information your practice needs to thrive. What’s more, we welcome you to comment on the blogs and engage in conversation with your fellow Dawson alumni.

Podcasts. Podcasts have quickly become one of the most integral forms of communication. Realizing this, we provide these video segments to reinforce the lessons learned in our seminar series and hands-on courses, and introduce new ideas that may energize your practice. Generally ten minutes or less, these podcasts provide you with the opportunity to stay on top of your dental game.

Discounts. In our struggling economy, very few people aren’t interested in saving money. That’s why we’re proud to offer all alumni network members a 40 percent tuition savings for all seminar auditing and a 10 percent discount for all bookstore purchases.

Links to You Tube Page. Video is now one of the premier communication options available, and The Dawson Academy is pleased to present our You Tube page, which will provide videos that address current issues, technologies, materials, and even member questions.  And best of all, this information is delivered directly to your desktop computer.

Seminar Dates and Locations. In our continuing effort to meet the demands of our students, The Dawson Academy is pleased to partner with Henry Schein Dental to now offer courses throughout the United States. Founded on our two organizations’ shared belief in continuous learning, the initiative will help combine advances in technology with a sound clinical approach—and here is where you will be the first to know our latest course dates and locations.

Message Boards. Similar to our blog, the message boards provide you with the opportunity to engage in discussion with your fellow alumni members. However, this time you get to choose the topic.

As you can see, there is a wealth of information to be found on our alumni network. We welcome you to log into the site with the account activation code listed on the manual from your latest session and browse the site. You’ll soon see that it’s an invaluable resource for any complete dentist who is looking to grow his practice.

How Do You Overcome Patient Objections to Treatment?

To many patients, a dentist’s job should consist only of checking for cavities and passing along a free toothbrush. In fact, some patients seem bothered by any examination that isn’t “what they’re used to”. That’s why it can often be difficult to explain to a patient that they are suffering from severe occlusal disease and are in need of treatment to correct their problems. Whether the treatment consists of reshaping or surgery, some patients can simply be a hard sell.

What types of objections to treatment do you hear from your patients and, what’s more, how do you convince them otherwise? Please see below to both share your answers and learn how your colleagues are handling similar situations.

December Events and Happenings

Head and Neck Anatomy With Dissection – December 4–6 (Seminole, FL) 

Foundations for Success: Integrating Today's Technologies for Predictable Results – December 5 (San Diego, CA) 

Invisalign Certification Course – December 5 (St. Petersburg, FL)

Defending Your Practice Against the Recent Economic Slump

With the price of fuel, insurance, and food continuing to rise and the stock market and home prices continuing to drop, many consumers are being forced to pinch pennies to make ends meet. In particular, many middle class Americans are being squeezed by a declining workforce and soaring expenses. As a result, many dentists are also feeling the pinch as patients are being forced to choose both where and how often they spend their hard-earned dollars. Purchases that once were included in the monthly budget are now being phased out in favor of the bare essentials, leaving some dentists searching for answers.

Here are some 'Best Practices' as you aim to defend your business against our most recent economic slump:

1. Remain calm: Although we’re not technically in a recession, statistics do show that consumers are being more cautious with their incomes. Realize, however, that this is merely a phase we’re going through. Like all other downturns we’ve experienced, this too shall pass. Remain focused on your priorities to your patients, and you will surely survive.

2. Focus on your patients: As mentioned above, your patients should remain priority number one. Be sure to provide each patient with the same high level of service they have come to expect from your practice. In other words, be sure to give each patient a thorough examination of their entire masticatory systems. What’s more, keep your eyes and ears open for any ways to provide your patients with any additional value. For example, are your patients looking for any new services? Are your patients just looking for you to continue providing them with the same core services? Consider your patients’ needs as you wade through turbulent times.

3. Search for new opportunities: While any slump in business is admittedly difficult, a wise dentist, or businessman for that matter, will scour the horizon for any new opportunities. Specifically, you may be able to gain new patients from nearby competitors by offering new methods of business that were perhaps never considered before. For example, while the need for good dentistry will never go away, perhaps certain services will be more in demand. Consider the needs of the market and adjust accordingly.

4. Manage your cash flow:  During tough financial times, many dentists suffer from the curse of the late payment. As patients struggle to manage their own funds, they may choose to forego making their monthly quota to your office; don’t let that happen! Make sure your front office stays on top of your patients’ financial obligations by implementing and adhering to a strict payment policy.

In addition, you may want to review your business expenses. Are there any areas you can cut back on? Spend some time conducting your due diligence to ensure your vendors’ prices are appropriate. What’s more, review the contributions of your staff to determine the essential members of your team. If push comes to shove, it’s best to know ahead of time who needs to be cut.

5. Re-evaluate your advertising efforts: Although common knowledge tells you to cut costs, now may be a good time to closely examine your advertising dollars. As some dentists are withdrawing from the advertising world due to the tough times, now may be a good time for you to strike, since there are fewer advertisers in the marketplace. The recent slump may provide you with a great opportunity to increase brand awareness and drive additional demand for your services.

6. Pick the brains of your peers: For every dentist who is struggling in current times, there are surely three more who aren’t struggling. Take advantage of The Dawson Academy Alumni Web site to find dentists in your area and pick their brains. Be sure to talk or meet with other dentists in your neck of the woods to find solutions to your issues. In time, perhaps you’ll find your competitor is actually your greatest advisor.

Successfully managing your practice through an economic downturn can be a challenge. However, it’s important for you to take this opportunity to realign your business to meet current economic demands. As the owner of the practice, focusing on your patients’ needs and reducing your costs will be paramount to your efforts. In no time at all, you’ll surely find yourself thriving during these tough financial times.

 

 

Designing a Winning Smile

A winning smile. Many patients believe it’s the first thing people notice about them, helping them to display beauty, self confidence, and even the appearance of overall health. And while none of these points can be argued with, what many patients do not know is the importance of function when designing a winning smile. Instead, patients are only focused on the appearance of their teeth. But as physicians of the entire masticatory system, we must consider function, comfort, and long-term stability when helping a patient achieve a winning smile. The foundation if this understanding can be developed in two of programs, Functional Occlusion – From TMJ to Smile Design and Achieving Predictable Esthetic Results.

The first thing you should be aware of before you begin to design any patient’s smile is that you can leave the trial-and-error guesswork at the door, since you won’t need it. In fact, The Dawson Academy firmly believes that there is a definite process for designing each and every smile. Once you understand this concept and apply it in your esthetic smile designs, you will never end up with anterior teeth that look artificial, or are uncomfortable or unstable.

Next, you should always consider the overall function of a mouth when designing a smile. Whenever a patient comes to visit you for a correction in their esthetics, you must first examine their overall masticatory system, which consists of the temporomandibular joints (TMJs), anterior teeth, posterior teeth, and masticator muscles. All too often, cosmetic corrections are made without any consideration for the natural appearance of the teeth. For example, flip through a tabloid magazine or spend a few minutes watching an entertainment talk show filled with movie stars and musicians. Do you notice anyone who appears to have bigger than natural teeth? Do you notice anyone whose dentist has clearly not focused on their contours? Although bigger, whiter, and faster is what most patients will ask for, you must be certain to focus on giving them a naturally beautiful smile, not a smile that is chock full of artificially contoured anterior teeth that clearly do not provide both optimal form and function.

It’s Up to You

With each new esthetic design case, you must make two critical decisions that will help determine if the smile is in harmony with the function:

1.       The position of each anterior tooth

2.       The contour of each anterior tooth

While there are many different factors that influence the two decisions above, the decision-making process for restoring anterior teeth follows a specific sequence. You must be certain to follow each and every step in the following sequence. And always remember the golden rule that The Dawson Academy preaches: There must be no shortcuts!

Mounted Casts

The single, most overlooked aspect of smile design is ignoring the importance of properly mounted diagnostic casts. Research shows that casts are the only proven method of determining the arc that each lower tooth travels as the jaw opens or closes, which helps determine the correct relationship of the lower incisal edges to the upper anterior teeth. And since anterior guidance must start at centric relation to achieve immediate posterior disclusion, functional smile design cannot be achieved until the posterior teeth provide zero interference to the condyles in centric relation or the anterior guidance. The surest way to make that decision is through mounted casts. Although it may seem time-consuming to take a facebow and centric bite record, the amount of time saved if this procedure is not done surely outweighs the effort.

Finally, once the casts are mounted, be sure to closely examine the condition of the TMJ/occlusion, since turning your attention away from it can only lead to problems. Until the displacement of the condyles is corrected, accurate analysis of the anterior relationship is not possible.

Restoring Anterior Teeth

As mentioned above, the importance of the TMJ to overall smile design should never be overlooked. In fact, it is absolutely critical that the smile-planning process includes a thorough analysis of the temporomandibular joints. Can the TMJs be seated into centric relation? Load test each and every one of your patients to find out. If there is any sign of tension or tenderness, your patient is not ready to proceed to anterior restoration. If you proceed with the restoration despite any tension or tenderness, your patient will soon find himself back in your dental chair, pleading for a speedy repair to his cracked front tooth.

Once the condyles are completely seated, take a moment to examine the relationship of the anterior teeth. Is there any interference or premature contact of the posterior teeth? If so, it will not be possible for you to analyze an ideal relationship. What’s more, posterior interferences that require displacement of the TMJs to achieve anterior contact will lead to the any or all of the following problems:

1.       Overload on posterior teeth
2.       Hyperactive incoordinated muscles
3.       Mandibular slide forward into anterior overload
4.       Excessive wear, hypermobility, and tooth migration

Achieving Anterior Contact

With all of these things in mind, your first key thought process in smile design is simple: Get the back teeth out of the way so the front teeth can contact in centric relation. Examine your mounted casts in centric relation and decide which treatment options you should select for achieving anterior contact in centric relation. Until that decision is made, you are not ready to proceed with anything else about the front teeth. If anterior restorations are planned for any patient at maximal intercuspation instead of centric relation, the end result is sure to be a disaster. That’s why should consider the following options for achieving anterior contact:

1. Reshape: Consider reshaping the posterior teeth to close down the vertical dimension of occlusion (VDO) in order to gain anterior contact.

2. Reposition: Consider repositioning either posterior or anterior teeth.

3. Restore: Consider restoring the anterior teeth to achieve contact, or posterior teeth to achieve more closure.

4. Surgery: Consider surgical reposition of a segment of the dento-alveolar process.

Once the posterior teeth are out of the way and the anterior teeth have been positioned to allow for maximal intercuspation at centric relation, you are free to begin your treatment process. The goal of any smile design is to achieve a fully balanced, symmetrical smile that shows 10–11 millimeter central incisors and no hint of gingival margin. And whether this is achieved through whitening, crowns, or porcelain veneers, a smile that has been designed under such stringent conditions will help ensure that your patients’ teeth not only look good but withstand the tests of time.

The Dawson Academy programs are designed to consider optimal form and function even before esthetics are considered—a fact that your patients will come to love.

The Bite Record Directive: The Need to Properly Record Centric Relation

When it comes to developing a successful treatment plan, few things are as important as the need for accurate, usable bite records. In fact, Dr. Peter Dawson believes that one of the biggest—but yet easily fixable—flaws most dentists make is not verifying that the intended joint position is both achieved and recorded accurately. Not only does this oversight lead to frustration, wasted time, and errors in treatment planning, not properly recording your patients’ centric relations can and will cause unacceptable grinding on new restorations. That’s why it’s imperative for complete dentists to take the time and effort needed to ensure they attain accurate, usable bite records.

First and foremost, it’s important to remember that the preciseness of the determination of centric relation can easily be lost if not matched by the preciseness of the intraocclusal bite record combined with an acceptable facebow record. What’s more, some dentists will argue that it’s nearly impossible to repeatedly find centric relation. However, tests have proven that centric relation can be reproduced on mounted casts to needlepoint accuracy. And best of all, it’s a process that can be learned in just a few hours time. But, you must be certain to stay clear of the following problems that may impact the accuracy of your bite records:

·         Improper manipulation

·         Lack of guidance or verification of centric relation

·         Flimsy bite-recording materials

·         Too-deep indentations in the bite material

·         Use of easily distorted, soft waxes

·         Nonexistent indentations in the bite record

·         Unstable bite-recording materials that may warp or distort

Despite all these possible problems that may impact the accuracy of any bite record, it still remains the best way to accurately verify a patient’s centric relation. That’s why you should keep the following five criteria in mind as you make an intraocclusal bite record:

·         The bite record must not cause any movement of teeth or displacement of soft tissue.

·         It must be possible to verify the accuracy of the interocclusal record in the mouth.

·         The bite record must fit the casts as accurately as it fits the mouth.

·         It must be possible to verify the accuracy of the bite record on the casts.

·         The bite record must not distort during storage or transportation to the laboratory.

When attempting to verify centric relation, all five of the above criteria should be met, especially if you choose to take a wax bite record, easily the most popular method of recording centric relation. The following will illustrate how:

1.       Choose the right type of wax. Although wax is the most popular method for recording CR, it is also the most easily abused. That’s because the quality of the wax can have a profound impact on the quality of the records. For example, the wax must be soft enough so the teeth do not move during recording. What’s more, once the wax is cooled it must remain brittle hard, so no damage can be done to the wax during transport or mounting. The right kind of wax should break with a snap when it is bent.

Although you are certainly free to choose whichever wax you like, Dr. Dawson highly recommends Delar wax, which is a brittle-hard wax that is supplied in wafers that are thicker at the front for more even penetration by the teeth from back to front.

2.       Soften the wax. Since the wax is so hard, it will be necessary for you to soften it through the use of a small torch, being careful not to overheat the wax. Be sure to flame both sides of the wax carefully, striving to attain a slight shine on both sides of the wax. You’ll then want to allow a few seconds just for the heat to penetrate the wax.

3.       Insert in the mouth. Once the wax has been softened to a slight sheen, you’ll want to begin the actual process of recording the bite. Insert the wax into the patient’s mouth and place it against the upper arch, pressing against the arch to ensure you indent the wax with the teeth.

4.       Manipulate the mandible. Now that the wax has been comfortably placed into the patient’s mouth against the upper arch, ask your assistant to hold the wafer in place to free your hands for mandible manipulation into centric relation.

5.       Verify centric relation. Once the wax has been seated against the upper arch and you have had the chance to place your hands on the lower jaw for manual manipulation, you’ll want to make sure the joints are properly seated. Take the time here to load test your patient to ensure the joints are in the appropriate placement.

6.       Have the patient close into the wax. Maintain firm, upward pressure on the condyles as the patient closes into the wax. If not, patients may have a tendency to protrude at the start of closing into anything between the teeth.

7.       Check the premolars. At this point, you want to make sure the first premolars have made a definite indentation in the wax. This step will help make sure that the posterior teeth will recorded with indentations that will hold the casts in a stable relationship with the bite record.

8.       Remove the wax and begin trimming it. While the wax is still warm, you want to remove it from the patient’s mouth and begin trimming it back to the indentations of the buccal cusp tips so the fit of the bite record can be verified in the mouth. You’ll also want to make sure that you have made a perfect tooth-wax-tooth fit by checking for voids or cracks between the teeth and the bite record.

9.       Verify the bite record. Now is the moment of truth. Submerge the wax into a glass of cold water to return it to a brittle-hard state. Then, return the wax to the mouth and seat the condyles and load test the patient for verification of centric relation. Hold the condyles firmly in centric relation while the mandible hinges to bring the teeth into maximal contact with the bite record. Make sure that both sides of the arch contact simultaneously with no premature contact or deflection into the hard wax. Finally, make sure that there are no voids between the teeth and the wax at complete closure.

10.   Check for soft tissue impingement. You’ll now want to examine the bite record to that it is not being effected by any soft tissue. If there is any soft tissue contact at gingival margins, take this opportunity to trim these sections back. If you find that the wax is difficult to manipulate, feel free to re-soften the wax with the torch once again. However, be certain to only warm the wax where the indentation of the teeth has been made. You can then re-insert the wax and place it back against the upper teeth and mandible, closing the patient into it to adjust it as necessary. Once inserted, it should extend directly across the arch without touching any palatial tissue.

11.   Store in water. Now that you have verified centric relation and made an accurate bite record, you’ll want to store the wax until you use. The easiest way to do this is to float it in a cup of water in a sealed plastic container, such as a Tupperware jar. One of the more common mounting problems can be attributed to casts that haven’t been carefully handled.

Although some may argue that taking a wax bite record is the most time-consuming process for verifying centric relation, chances are that they’re not doing it properly. In fact, the wax bite technique is the simplest and fastest way to record centric relation. What’s more, it is also the most accurate way to mount casts, because the casts fit neatly into the record with very little movement.