TECHNOLOGY AND TRENDS IN THE FIELD OF AESTHETIC DENTISTRY • VOLumE 7 ISSuE 1 • WINTER 2008
the Big City
Same Office, Newer
System, Better Profits
A New Paradigm in Dentistry
AestheticDentistry TECHNOLOGY AND TRENDS
IN THE FIELD OF AESTHETIC DENTISTRY
VOLumE 7 ISSuE 1 • WINTER 2008
About the Cover Contents • Winter 2008
6 EDITOR’S COMMENTARY
Dick Made Me Do It
Martin Stern, D.D.S.
10 IMPLANT EZ
Implant Dentistry Thrives
Outside the Big City
Schuyler VanDyke, D.M.D.
ustin Caldwell had an irra- 14 LAB PERSPECTIVE
tional fear of dental work, so Presenting Value
his number one question was,
Hernán Varas, M.B.A.
“Will it hurt?” He was also afraid
that veneers would appear fake.
The reality was, it really didn’t
hurt and his teeth are incredibly 18 SCIENCE & TECHNOLOGY
natural looking. See Justin’s story Dento-facial Aesthetics:
on page 4.
A New Paradigm in Dentistry
Aesthetic dentistry by Dr. Chris Nimmi Holstein, D.D.S.
Stevens, Sun Prairie, Wisconsin.
Aesthetic restorations by Arrow- 20 INSIGHTS
head Dental Laboratory, Sandy, Same Office, Newer System,
Utah. Cover photo: Dirk Douglass
Photography, Salt Lake City, Utah
(dirkdouglass.com). Terri Bauer, R.D.H.
24 HOT PRODUCTS
Communication and Loyalty
SPONSORSHIP BY THESE COMPANIES HELPED MAKE THIS ISSUE POSSIBLE:
Arrowhead Dental Laboratory • BioResearch • Cadent • Captek • DEKA Dental Lasers
Dentsply Caulk • Dentsply Prosthetics • Dentsply Tulsa • Ivoclar Vivadent • Officite
For advertising and sponsorship opportunities, contact Scott Henkel
[email@example.com] (801) 572-7235
For subscription or address changes, contact Debi Evans
[firstname.lastname@example.org] (801) 572-7244
Published quarterly by Centennial Publishing Inc., Orem, Utah
Aesthetic Dentistry n Winter 2008 3
COVER STORY n JuSTIN CALDWELL
Small Town Boy Gets
Big City Smile
A fear of dentists kept Justin Caldwell away from getting the confident smile he always wanted.
As a small child, Justin Caldwell lived in the metro areas Justin’s dental restoration was performed by Dr. Chris
of Salt Lake City and Philadelphia. But when he was twelve, Stevens. “Dr. Stevens’ knowledge is extremely apparent,”
his life experienced a cultural change: his family moved to said Justin. “He is educated in every aspect of dentistry,
the small town of Mantua, Utah—population 741. During which gave me confidence that he could handle any situa-
that transition, Justin developed his fear of dentists. tion we encountered. The guys at the lab also did a great
“I got braces when I was eleven,” said Justin. “When I job verifying and re-verifying specifications. Everything went
turned twelve my family moved and I switched orthodontists. extremely well the day of the seating.”
The switch did not go smoothly. After five years, my braces Justin is a firm believer that his new smile affects the
were removed, leaving white calcification marks everywhere. way others respond to him. “I know it sounds cliché,” he
I developed a bad attitude toward dental work and pretty said, “but I’ve had people ask what is different about me.
much stayed away from dentists for several years.” The biggest change, at least from my point of view, is that
Over time, however, Justin became increasingly aware I am now confident about my smile.”
Justin’s phobia of dentists has undergone a dramatic
“I had an irrational fear of dental work, so change. “Modern cosmetic dentistry is easy and painless,”
he said. “Don’t put it off because of irrational fears. Looking
my number one question was, ‘Will it hurt?’” back, two appointments in the chair were such a small
price to pay for a perfect smile.” n
of the necessity to have some major dental work done.
“When I was young,” said Justin, “I tended to use my teeth Justin Caldwell has been a systems analyst for Arrowhead Den-
as a multipurpose tool: ‘Can’t get that screw off with your tal Laboratory in Sandy, Utah, since 2005. He is involved with
hands? Here, let me try my teeth.’ This led to quite a few software development, database administration, help desk, and
workstation/server maintenance and repair.
chips and gashes. I became somewhat self-conscious
about my smile, and began to do the ‘closed-mouth smile’
for photographs. When I was dating my wife, she asked
if she could see my teeth. I refused. My less-than-perfect
smile caused me to smile less.”
Following marriage, Justin starting thinking about his
smile. He got a part-time job at Arrowhead Dental Labo-
ratory and became acquainted with the smile makeover
business. But his fear of sitting in a dental chair prevailed,
and he took no action. Following graduation with a degree
in Information Systems, his part-time position at Arrowhead
became a full-time job, and he started asking questions
“I had an irrational fear of dental work,” said Justin,
“so my number one question was, ‘Will it hurt?’ I was also
afraid that veneers would appear fake. I pictured Chicklets
in place of my teeth. The reality was, it really didn’t hurt and
I believe my teeth are incredibly natural looking.” After
4 Aesthetic Dentistry n Winter 2008
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By Martin Stern, D.D.S. and Dr. Dick Barnes
Dick made me Do It
Proper equipment, attitude, and five essential slides are
necessary to provide life-changing care to more patients.
I’ve had a long-standing relationship with a remarkable it. With proper equipment and preparation, an implant is
Israeli dentist by the name of Martin Stern. Late last year, a ten-minute appointment in our office. Full arch extrac-
we had the occasion to meet at the Greater New York tions, implants, posts, and provisionals take under an hour.
Dental Meeting and renew our friendship. We talked about An implant takes three minutes. Because of lasers, there
how our relationship had been one of mutual benefit. Martin are no flaps, no cutting, and no suturing. And with digital
immediately wrote the following letter that he has allowed impressions, the patient can walk out with a permanent
us to publish. crown in under an hour. It is this way that I am able to help
—Dick Barnes so many get the smiles they have always wanted. It’s Dick’s
k fault—he inspired me do it!
I have an implant practice. I do implants—all day, The clincher is the new patient visit: just seven minutes
every day—in Jerusalem, Israel. And if I can keep up this to present full mouth rehabilitation. This, of course, is also
vigorous, daily pace in Israel, then I know you can do a few because of Dr. Dick Barnes’ tutelage.
each week no matter where you are. It all started with the five slides of patient case presen-
In Israel, there are ten times as many doctors per tation I learned from Dr. Dick Barnes. These sequential
capita doing implants as there are in the United States, slides help patients see the value in their treatment plan
and yet my acceptance rate on patient case presentations and eventually turned my general practice into a recon-
is—give or take—100 percent. That’s right, about 100 struction practice with such a great need for implants that
percent. And much of the credit goes to Miriam at the front I had to refer work to 85 outside dentists and six to seven
desk. She is a wizard at working out a viable financial plan in-house!
for most of these patients. But, over time I became distracted by new technology
It hasn’t always been this way. and drifted away from the five magic slides. After several
years, I flew to Chicago for one day of the American
Academy of Implant Dentistry meeting. It was worth every
The five sequential slides help patients minute. I skipped the technical stuff and attended a couple
see the value in their treatment plan and of courses and reacquainted myself with Dick. After 20
years, I realized that his presentation was as rich in content
eventually turned my general practice into a and correct in philosophy as ever. I realized that nothing
worked magic like Dick’s slides, so when I went back to
reconstruction practice. work I put the slides on the plasma screen in the new
patient room and blew them away. They blew me away!
I’ve been around the world and learned dental tech-
I was never disposed to spending money on myself, niques from some of the great dentists—Christensen,
but Dick Barnes is the one who helped me change my Pankey, Miles, Jameson—they all gave me so much. I
attitude about money and see that I couldn’t do all I wanted enjoy what I do and I do it with a passion and love every
to help the world by treating more patients if I didn’t have minute of it. And to whom can I be more indebted than any
it. He and his programs encouraged me to start practicing other, but Dick. His genius is in his simplicity and this genius
cosmetic dentistry to help the thousands of people that became a catalyst for a unique blend called me. Thank
wanted and needed beautiful, functional teeth. you, Dick. I love you for all you’ve given me. I’ve devoted
Because of my experience with Dr. Dick Barnes, I my life to passing it on to others and have great satisfac-
now have an awesome office—digital radiography, half a tion to have been granted the gift of God to do such—with
dozen lasers, phisiodispensers, and so on. The equipment your help.
has quickly paid for itself because of the amount of treat- We were granted the opportunity to provide much
ment time it saves. It’s Dick’s fault—he inspired me to do for so many, changing the lives of others dramatically
6 Aesthetic Dentistry n Winter 2008
and efficiently. We must maximize this opportunity. It’s an Mrs. Jones; Mrs. Schwartz is like Mrs. Mohammed; they
opportunity to stop and smell the roses. Jerusalem—like each seek comfort, function, health, and esthetics. Yanky
Sandy or Provo, Utah, Brooklyn, or Los Angeles—is made and Moishey, Abdul and Feisel, Bob and Jennifer seek to
up of human beings. They are God’s children—whether look good, feel good, and be done with necessary care.
Jewish or Muslim, Christian or Ottoman. They are mothers We were granted the opportunity to provide this care
and children, grandmothers and grandchildren with needs, and change lives dramatically for so many that it behooves
wants, and hearts and souls more alike than not. us to maximize our opportunity. We are fortunate to have
The opportunity to serve man and god is universal and been exposed to a master who has showed us how to do
can really get lost on Eyewitness News. Mrs. Klirn is like it faster, easier, and better than ever before! n
Keeping Focused on Vital Principles
As editor, I had trouble placing a self-serving piece of of the issue. In the Fall 2007 issue Dr. James Downs’ article,
writing in Aesthetic Dentistry, but at the same time it’s a “Increase Your Energy & Improve Your Practice,” under-
good teaching tool for those of you who wonder whether scores the importance of keeping focus on vital principles
or not the principles you’ve been taught work in real to maintain a successful dental practice. This main article
dentistry. received a tremendous amount of positive feedback.
As we begin a new year, we look forward to providing In the future, we would like readers to be able to post
content that offers more than just fluff. It seems appropriate comments online within one or two days of reading articles
to reflect on the journal’s health, review new features insti- and react to what others say about our published articles.
tuted over the past several months, and mention develop- In all, we are committed to providing our readers an excel-
ments on the horizon. lent source of information to the latest in technology and
Like good clinicians, we begin by measuring our vital
signs. Aesthetic Dentistry is in excellent health. Dentists
are reading in record numbers. The publication now circu-
We now send nearly all the submitted
lates annually to 100,000 clinicians throughout the United
States, Canada, and Europe. Readers can electronically
articles for external peer review, increasing
gain access to the full text of the published articles online their educational value.
at www.arrowheaddental.com in a PDF format.
Readers may have noticed several new features that trends in the field of aesthetic dentistry. We thank each of
Aesthetic Dentistry instituted in 2007. We have created an you for your confidence and support.
advisory board that helps maintain a high level of quality As ever,
content. We now send nearly all the submitted articles for
external peer review, increasing their educational value. We
have established a full spread article highlighting the focus
Aesthetic Dentistry n Winter 2008 7
AESTHETIC DENTISTRY EDITORIAL
John Bauer, D.D.S. Tim Freeman, D.D.S. Robert Kneib, D.M.D. Schuyler Van Dyke, D.M.D.
Mansfield, Texas Flagstaff, Arizona Erie, Pennsylvania Great Falls, Montana
Matthew Buckley, B.D.S. Carol Galliano, D.D.S. Blair Losee, D.M.D. Josh Wagner, D.D.S.
Naas, Ireland Baton Rouge, Louisiana Lehi, Utah Jackson, Wyoming
Sam Cress, D.D.S. Frank Hoffmann, D.D.S. Buzz Nabers, D.D.S. Paula Wagner, D.D.S.
Sugar Land, Texas Hamburg, Germany Knoxville, Tennessee Jackson, Wyoming
Tawana Coleman Nimmi Holstein, D.D.S. Martin Stern, D.D.S. Larry Wheeler, D.D.S.
Fort Smith, Arkansas Charlottenlund, Denmark Jerusalem, Israel Tucson, Arizona
James Downs, D.M.D. Joe Hufanda, D.D.S. Chris Stevens, D.D.S. Joe Willardsen, D.D.S.
Denver, Colorado Charlotte, North Carolina Sun Prairie, Wisconsin Las Vegas, Nevada
Phillip Durden, D.M.D. Jon Julian, D.D.S. Patricia Takacs, D.M.D. Christian Yaste, D.D.S.
Winterville, Georgia McPherson, Kansas Lexington, Kentucky Charlotte, North Carolina
Editorial Director Dick Barnes, D.D.S. Publisher Howard Collett
Managing Editor Debi Evans Custom Publishing Centennial Publishing, Inc. OREM, UTAH
S T A F F
Senior Editor Lindsay Hepworth Printing RR Donnelley & Sons CHICAGO, ILLINOIS
Copy Editor Julie Billings For Information Debi Evans SALT LAKE CITY, UTAH
Creative Director Clark Collett 801-572-7244 email@example.com
Marketing Director Scott Henkel, C.D.T.
8 Aesthetic Dentistry n Winter 2008
ImPLANT EZ n SCHuYLER VANDYKE, D.m.D.
Implant Dentistry Thrives
Outside the Big City
As a small town dentist in montana, I never imagined implant dentistry would grow to be such an
important aspect of my practice.
The idea of placing and restoring seemingly complex
implant devices never entered my mind until about five
years ago. It was then that I met an instructor who intro-
duced me to implant dentistry. I had always thought my
patients were different from those in larger communities
and that implants were just too progressive for my rural
area. Wow, was I wrong!
My uninformed attitude toward implant dentistry was,
in hindsight, due to my lack of knowledge on the subject.
People in my small community had the need for implants
and desired them just as much as anyone. I just needed to
be educated on what implants were and why my patients
would want them in their mouths. Fig. 1 - Exposed, failing implant with total facial bone loss.
I started pursuing education that would teach me to
place and restore implants in my own office. I soon found
I had always thought my patients were
different from those in larger communities
and that implants were just too progressive
for my rural area. Wow, was I wrong!
myself exaggeratedly talking to every patient about the
missing teeth in their mouths. My staff became infected Fig. 2 - ANKYLOS A11 implant placement.
by my excitement, and my practice started seeing benefits
immediately. When people understand the advantages of
an implant instead of an empty space or bridge, choosing The first picture in my discovery process shows the
an implant becomes easy. At a minimum, we as practitio- exposed failing implant (fig. 1). Notice the total facial bone
ners should become informed about implants so we can loss over the existing implant. I removed the implant using
offer our patients a complete range of options. a trephine burr kit and then curetted the site and sterilized
Following my training, one of my first implant cases the area with a DEKA CO2 laser. After sterilization, I placed
was for a patient who has been visiting my practice for small particle Puros Bone Grafting Material. I then placed a
years. He presented with a failing implant in the upper left Resolute Adapt barrier membrane over the bone graft and
central position. An oral surgeon had placed the implant six sutured the overlying tissue together with 6.0 PGA suture.
years previously. There was localized gingival swelling and I then left it to heal for six months. (Normally I would have
noticeable color change to the tissue. I exposed the area to
see what was causing the problem. continued on page 12
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VANDYKE - continued from page 10
waited only four months before placing the implant, but the
patient’s schedule was uncooperative.)
Figure 2 shows the implant placement. I selected an
ANKYLOS A11 implant for the number 9 missing tooth site.
I followed the ANKYLOS placement protocol for surgical
preparation of the implant osteotomy. I made an incision
slightly to the lingual of the number 9 site using the CO2
DEKA laser. I then reflected this tissue slightly to the facial
and lingual to not only check the graft healing, but to visual-
ize the ridge, as well.
I used a pilot drill to initiate the implant location and
orientation. I drilled very cautiously so as not to encroach
Fig. 3 - Seated temporary crown in place.
on the facial plate of bone. I then used a Tri-Spade drill to
a depth of approximately 13 mm so that the final implant
placement would be approximately 2 mm below the crestal We placed an anterior flipper in the interim while
height of interproximal bone. I used the A-11 Conical waiting for the lab to complete the temporary crown.
Reamer in the hand wrench to further prepare the site and The final picture (fig. 3) shows the seated temporary
confirm the depth. Subsequently, I placed an ANKYLOS A crown in place. The best part was that the patient was
11mm implant in the prepared site with ensuing excellent thrilled to have this done in my office instead of having to
primary stability and verified the implant level. go back to the oral surgeon, and he was delighted to get
rid of the temporary flipper he had been wearing since
Learning to place implants has truly made me the grafting procedure. There are so many cases just like
this one waiting to be done in every practice. It is such a
a better dentist. rewarding feeling to place and restore them yourself.
My office now averages approximately 100 implants
Next, I removed the cover screw with a helical reverse per year. To provide the best possible treatment for my
threaded removal instrument and placed an ANKYLOS patients, I continue to pursue additional training. I can’t say
impression pin. I took an impression for the lab to fabricate enough about how implants have positively impacted my
a temporary crown. I then placed a Balance Sulcus Former practice. I’m a more confidant practitioner and am certainly
with a gingival height of 3 mm to allow a gingival collar to providing a great service to my patients. Learning to place
form while the lab fabricated the temporary crown. implants has truly made me a better dentist. If you have
Three weeks later, I placed a Radica temporary thought about learning to place implants, but are hesitant,
implant crown from Arrowhead Lab on the abutment. We please remember my story and get started. n
also performed a gingivectomy on tooth number 8 to bring
Schuyler VanDyke, D.M.D., attended Oregon Health Science
symmetry to the gingival margins of number 8 and 9. By
University School of Dentistry. She has been practicing for 18
placing the temporary crown early, the papilla could start
years. She started Sunset Dental Care in Conrad, Montana in
gaining its natural form prior to the permanent crown place- 1993. Her practice provides orthodontics, implants, cosmetic
ment in approximately four months. This temporary was and family dentistry. She is a member of the ADA, MDA, ICOI,
taken out of occlusion for the four month healing period. AAID, AO, and DOC.
12 Aesthetic Dentistry n Winter 2008
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LAB PERSPECTIVE n HERNÁN A. VARAS, m.B.A.
We all make financial sacrifices to get what we want, particularly
when we see value in them. This principle is no different in
dentistry, where there are three levels of value.
or quite some time I have I was warmly greeted by
postponed the painful a salesperson whose enthu-
task of buying a new car. siasm was contagious. He
The experience of purchasing convinced me that Mercedes
such an expensive item is not manufactures the greatest
something most people enjoy; cars ever built.
especially when we know that Within a few minutes, he
our final decision will be influ- knew exactly what I wanted
enced by somebody else’s and presented me with
knowledge and persuasion benefits that far exceeded
ability. I wanted to purchase the sticker price. He sold me
a high quality, dependable car on the value of a Mercedes.
that was at least as nice as I was eager and happy to
the cars my children drive. sign the purchase agreement.
After speaking with several I was even happier when I
friends and coworkers, I found drove my new baby home. I
myself in a Mercedes Benz thought, “I wish I had done
dealership. this a long time ago.”
Much like my car buying experience, patients accept use lab for product selection
treatment and make financial sacrifices when they under- Dentists with practices that emphasize cosmetics and
stand the value that treatment will have in their lives. In his full mouth rehabilitation understand how fundamental it is to
lectures, Dr. Dick Barnes states that patients go to the utilize their lab for product selection prior to and through-
dentist because they trust their dentist’s skill, care, and out treatment. Factors considered include age, skin tone,
judgment to help them with their decisions—much like previous restorations, shade, eye shape/position, lip line,
I relied on the Mercedes dealer’s knowledge to make a dark post/core, etc. There are so many different products,
good decision. Dr. Barnes also emphasizes the importance procedures, and techniques a dentist can use for a resto-
of being technically and clinically prepared so that when ration that the decision can be overwhelming. Arrowhead
the patient accepts treatment, you can confidently deliver provides a resource to help dentists wade through that
Patients go to the dentist because they trust Today, patients are very demanding when it involves
smile makeovers. They don’t care about how their teeth
their dentist’s skill, care, and judgment to are made; they care about how they will look. They see
value in having a beautiful, natural looking smile. Quoting
help them with their decisions. Dr. Barnes, “Patients no longer want nice caps; they want
beautiful teeth.” Nice caps are totally unacceptable today.
a great restoration. Presenting comprehensive dentistry Arrowhead’s three levels of aesthetic techniques give
carries the responsibility of being fully prepared to follow dentists the flexibility to select the perfect restoration for
through with your and the patient’s expectations. each individual patient. The ultimate goal is to deliver value
to the patient so
What patients want when treatment
Patients want what modern dentists can provide. They is completed,
don’t want technical details; they just want to know that they can say,
they will have a beautiful smile. That is where the value lies. “I wish I would
Comparing it to my car experience, I did not care about the have done this a
technical details or how the car was made. I only cared that long time ago.”
it drove beautifully and that I felt great driving it. n
It is our mission at Arrowhead Dental Laboratory to
help dentists increase the value of their practices by provid- Hernán A. Varas,
ing high quality restorations using state-of-the-art materials M.B.A., is the
and techniques, along with superior technical support and Professional and
service. Our technical support team is fully prepared to
ment Executive at
assist dentists in determining the best possible materials,
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16 Aesthetic Dentistry n Winter 2008
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SCIENCE & TECHNOLOGY n NImmI HOLSTEIN, D.D.S.
A New Paradigm
Future dental patients may not be content with just a beautiful smile; they’ll want a beautiful face
to go with it.
European dentists are faced with an ever-increasing acid, a polysaccharide naturally found in skin. Such fillers
demand from patients to make their teeth and face look are marketed both in Europe and the United States under
younger, more vibrant, and more aesthetically beautiful. the brand name Restylane.
Their collective desire is to travel up the ladder of self- A beautiful smile makeover no longer needs to suffer
esteem so they can get better paying jobs and appear the injustice of being framed by thin lips. For genetic reasons
better in social settings. To them, however, beautiful teeth or just time and aging, the face and lips lose collagen and
without a beautiful frame do not make a complete beautiful become thinner and more wrinkled with what are commonly
smile. called “smoker’s lines” or “lipstick bleeder lines.”
To meet this demand, cosmetic dentists in Europe are Either in conjunction with raising a bite and seating a
qualifying themselves in non-surgical facial aesthetics, such full arch case or just an anterior smile case, trained dentists
as the use of Botulinum toxin and dermal fillers. in Europe are augmenting lips, nasolabial folds, and other
rhytides with Restylane to soften wrinkles and define or
A beautiful smile makeover no longer needs to plump up lips to give them more volume, more youth, and
more radiance. This underlines the fact that lips and teeth
suffer the injustice of being framed by thin lips. are an inseparable whole, but also raises the question of
whether dentists are encroaching on the turf of plastic
Botulinum toxin is marketed under brand names like surgeons.
Dysport and Botox. The purified toxin, a polypeptide, It appears, however, that the emerging field of dento-
prevents acytylcholine release in the synapse between the facial and non-surgical aesthetics lies within the domain
nerve ends and the muscle fibers, creating a temporary of modern dentistry. Dentists are trained at the level of
relaxation of the carefully targeted muscle. After three specialists in facial anatomy and the function of mastica-
to four months, the toxin protein molecule is safely and tory muscles. Dentists have become experts in the art of
completely removed from the body by phagocytosis and injecting dermal fillers, earning the right to learn the liquid
excreted by the liver. face lift.
The dental applications of Botox include not only Whether or not you agree, the field has emerged and
the conjunctive treatment of Trismus (lockjaw), Masseter it is here to stay. Increasing numbers of dentists in Europe
hypertrophy, teeth clenching, TMD, muscle spasms, Sialor- are taking courses in the dental uses of Botulinum toxin and
rhea, non-surgical lip lowering on a gummy smile, reducing dermal fillers, perhaps also prompted by the incitement that
Cheilitis on mouth angles, but also the popular treatment the revenues it brings in can supersede what they make on
of headaches, migraines, and neuralgias by reducing dentistry alone. n
muscular trigger-points—often in conjunction with bite
guards. Most patients, however, don’t mind the side effects Dr. Nimmi Holstein is President of the European Society of
of losing their frown lines and facial wrinkles.1 Dento-Facial Aesthetics. He leads courses in botulinum toxin and
Like it has been in Europe, the next step in dentistry in dermal fillers for doctors and dentists.
the United States may well be to begin creating a beautiful 1~ Once a drug has a US FDA approval it can legally be used for other
frame for the actual dental masterpiece. treatments like dental applications. Such use is called off-label use. Several
muscle injection points for headache treatment coincide with the same
In addition to Botox treatments, in Europe we have
points for wrinkle softening.
seen that dermal fillers are also useful in dento-facial
aesthetics, especially non-permanent fillers like hyaloronic
18 Aesthetic Dentistry n Winter 2008
INSIGHTS n TERRI BAuER, R.D.H.
Same Office, Newer
System, Better Profits
Detailed operation and organizational systems can transform an average dental practice into a
Many Aesthetic Dentistry readers are avid followers
of the Dr. Dick Barnes Group and are familiar with the
general structure taught by its highly trained and continually
educated staff of actively practicing professionals. Several
years ago, Dr. Barnes developed a unique set of detailed
operation and organizational systems, which, when imple-
mented properly and continuously, can transform an
average dental practice into a mega-producing superstar.
Dr. Barnes has the uncanny ability to put this process into a
Every time we have seen a dip in production
or case acceptance, we have been able to
right the proverbial ship by simply returning
to the basics of the structure and adhering to
the sequence of the system.
cohesive sequence of events, that when followed, produce could apply. The key difference is the unique implementa-
predictable success and profitability. tion and presentation by which Dr. Barnes relays these
Total team training
Less than three years ago, we met the incredible System sequence
Tawana Coleman at a Total Team Training seminar and Like any other successful program, there is a specific
our lives and practice were forever changed. For the last sequence and wording necessary for each segment of each
twenty-five years, we have operated a one-dentist practice system comprising the structure. To maximize the potential
in a small Texas town, never producing or collecting of the Dr. Barnes structure, implementation must be in strict
anywhere near $100,000 a month. Now, after diligently accordance with the sequence and wording set forth by the
working to properly implement the structure on the way to system. While it may be exacting in nature, every time we
becoming “Barnesified,” our office averages in excess of have seen a dip in production or case acceptance, we have
$250,000 a month. We have the same doctor, the same been able to right the proverbial ship without anxiety, fear,
staff, the same facility, but a new structure. or practice overhaul by simply returning to the basics of the
This structural transition was not easy. But change is structure and adhering to the sequence of the system.
never easy, and early success helps confidence and desire In spite of the proven success of the Dr. Barnes
soar. With his system, Dr. Barnes has the innate ability to system, some dental offices continue to come up with
clear the extraneous and reinforce the positive to ensure excuses of why it will not work for them. Every participant
continual motivation. In addition, the structure is based on in the dental office—doctor, staff, and patients—are all
common sense principles that we already understood and continued on page 22
20 Aesthetic Dentistry n Winter 2008
BAUER - continued from page 20
members of the same group: the human race. Geographic As daunting as this process may sound, the Dr. Dick
location, economy, or insurance dependency does not Barnes Group has created a complete and simple system
make a measurable difference. Attitude, adaptability, and to help dental practices make the transition to success and
desire are all you need to experience true success in your profitability. Dr. Barnes has assembled top clinicians in Total
dental practice. Team Training, cosmetic dentistry, implant dentistry, and
neuromuscular occlusion with the ability to train dentists
Attitude, adaptability, and true desire to and their staffs. Our office took advantage of these oppor-
tunities, made a commitment to the Dr. Barnes structure,
serve people are all you need to experience and has since become proficient in each identified area.
true success in your dental practice. This has resulted in professional satisfaction and profit.
If we can do this in the small community of Mansfield,
Texas, I am confident that it can be done anywhere. n
Success does come with a price: our office worked
very hard in three areas to incorpo-
rate the Dr. Barnes structure into
the culture of our practice.
Build relationships. From the
initial phone call to the new patient
interview to the actual presenta-
tion of treatment, there are many
opportunities to build a special
relationship with the patient. This
is critical in building trust in any
relationship, but is most important
to the doctor-patient relationship.
People only continue a business
relationship with those they like
dentistry. Everyone in the office
must look past insurance benefits,
apparent financial status, and any
other barrier to acceptance and be able to effectively present Terri Bauer, R.D.H., runs all practice management, business
comprehensive dentistry to each and every patient. management, and treatment coordination for Mansfield Family
Become educated. The dentist must be competent Dentistry. She has been in the dental industry for 27 years. As a
and trained to do aesthetic and implant dentistry, as well as member of the Dr. Dick Barnes Group, Terri assists Tawana Cole-
understand the role occlusion plays in these areas. man with Total Team Training.
22 Aesthetic Dentistry n Winter 2008
The world’s most beautiful teeth.
E X C LU S I V E LY F R O M A R R OW H E A D D E N TA L L A B O R ATO RY:
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HOT PRODuCTS n mARK OLSON
The adage “friends do business with friends” is really true.
We most often choose to obtain products and services the phone. We are entering the era of reaching patients
from those with whom we feel some sort of connection. on mobile devices wherever they are. It’s time to start
The stronger the connection, the stronger the loyalty. thinking about how to reach patients where they are—not
So how is it possible to create strong relationships with where they were. The American Board of Physicians says,
hundreds if not thousands of patients? Is it even possible? “85 percent of patients say that electronic communication
Absolutely. Just ask Oprah! would be a good way to communicate with his/her doctor.”
Millions of people—mostly women—feel that Oprah is SMS, or cell phone text messaging, is rapidly becoming the
a best friend, even part of the family. What’s the secret? de facto standard for instant communication.
What makes you feel loyal to someone you are never or How many personal communications, outside your
rarely with? Communication! She talks to them. She talks to office, do your patients receive from you? You certainly are
them every day about something relevant in their lives. not going to be able to speak personally or write to each
I’m not suggesting that to create loyal patients you of them enough times to turn them into advocates without
need to have a top-rated TV show. But the more you speak
to your patients in a personal and relevant way, the more
loyal your relationship grows.
The loyalty ladder
In the book Relationship Marketing, Regis McKenna
describes the loyalty ladder. The loyalty ladder is comprised
of segments ranging from suspects—those who have
heard your name or seen your advertisement—all the way
Start thinking about how to reach patients
where they are—not where they were.
up to advocates. At the top of the ladder, these advocates
are not only fully committed to you as their dentist, but they
will also insist that everyone they know use you as well.
Moving your patients up the loyalty ladder is relatively
simple. First you have to provide a quality service or experi- Fig. 1 - The Smile Reminder system includes automated and
ence. We’ll assume that is the case. Second, you need to personalized appointment reminders.
establish constant and relevant communication with them
in a personal way. help. Technology is the solution. A good patient relationship
management (PRM) system can help you communicate
Communication evolution with your patients in a personal and relevant way, as often
The dental industry is in the middle of a communica- as you like – in a very economical manner.
tion evolution. We are rapidly leaving the time when we can
reach patients through the mail or hope to catch them on continued on page 26
24 Aesthetic Dentistry n Winter 2008
OLSON - continued from page 24
Jim Higgins, CEO of Smile Reminder—the premier
dental PRM system—talks about the success some clients
see when they use his Smile Reminder service. “We have
practices that have created incredibly loyal patient bases,”
he said. “The doctors that really understand the potential
reward constantly communicate with their patients. They
not only remind and market, but they also educate their
patients about conditions, treatment options, products
and services—even local news and events. They stay in
touch with their patients and their patients stay loyal to
According to Higgins, one benchmark of a loyal patient
base is the volume of referrals a doctor receives. “The Smile
Reminder system tracks referrals and referral value,” said
Higgins. “We clearly see a direct correlation between the
level of communication with patients and the volume and
value of referrals back to the doctor.”
Patient surveys Fig. 3 - Patient surveys improve communication and build
Patient surveys are another great way to improve doctor-patient relationships.
communication and build your relationships. You cannot
know what patients want and care about if you don’t ask. birthday. Surveys and newsletters have also been fantastic.
People love to express their opinion and give feed- I use them to understand my patients better and to educate
back—especially if they think their ideas will make a differ- on what matters most to them. When patients come to
ence. In addition to questions about your office, your staff, the office with a prior understanding of conditions such
as caries and oral cancer, they are more accepting of my
Relevant and personal communication can be examinations and treatment planning.”
sent across your entire practice or just to a Appointment reminders
target group of patients. The Smile Reminder system includes automated and
personalized appointment reminders, last minute cancella-
tion notices, premed reminders, birthday messages, and
and your service, ask about what kinds of educational value tracking recall/recare messages. It also includes
information patients find helpful. When their opinions are custom newsletters, personalized marketing messages,
valued and they see response to their suggestions, your and value tracking referral tools. All messages are person-
patients will become more invested in your relationship and alized to each patient and maintain the practice’s brand
your practice because they have played an active part in and identity. Relevant and personal communication can be
improving it. sent across your entire practice or just to a target group
Dr. Ron Kaminer (Long Island, New York) talks about of patients. No upload of patient information is necessary
his experience using the Smile Reminder Service. “I was because the system will seamlessly interface with your
overwhelmed by the reaction of my patients when I started existing PMS and obtain all the appointment and contact
using Smile Reminder,” he said. “My patients love the information needed.
increased communication! I get comments all the time You may never achieve Oprah status with your
about the personal text message they get from me on their patients, but you certainly can improve your relationships
and push them further up the loyalty ladder. The tools and
technology are available; now you need to make yourself
A graduate of the Marriott School of Management at Brigham
Young University, Mark has 20 years marketing experience
ranging from small start-ups to billion dollar companies. With
particular focus on consumer marketing, his experience includes
time with Marriott Corporation, Sundance Resort, Park City
Reservations, Simmons Media Group, Ticketmaster/CitySearch,
Fig. 2 - All messages are personalized to each patient and Iomega Corporation, and Communitect Inc., parent company of
maintain the practice’s brand and identity. Smile Reminder.
26 Aesthetic Dentistry n Winter 2008