Clinical Mastery https://clinicalmastery.com Clinical Education for Achieving Great Dentistry Fri, 16 Nov 2018 17:44:49 +0000 en-US hourly 1 https://wordpress.org/?v=4.9.8 5 Reasons to Incorporate Sleep Dentistry into Your Practice /incorporate-sleep-dentistry-into-your-practice/ /incorporate-sleep-dentistry-into-your-practice/#respond Fri, 16 Nov 2018 17:22:22 +0000 /?p=4742 One of the big questions on many clinician’s minds lately is whether or not to incorporate sleep dentistry into their treatment modalities. It can be challenging to decide what new ideas or techniques will be most beneficial from a personal and financial perspective.   At CMS, we recently added a Sleep Dentistry and OSA Treatment […]

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]]> One of the big questions on many clinician’s minds lately is whether or not to incorporate sleep dentistry into their treatment modalities. It can be challenging to decide what new ideas or techniques will be most beneficial from a personal and financial perspective.

 
At CMS, we recently added a Sleep Dentistry and OSA Treatment Course with Dr. Sam Cress. Much of what Dr. Cress teaches regards the transformational power of screening for and treating sleep disorders. It opens up a whole world of possibilities you may never have considered before.

Incorporate Sleep DentistryOf course, the number one reason to take on this new realm of dental care is the benefits to patients. Some estimates claim that 1 in 15 Americans suffer from obstructive sleep apnea (OSA). OSA can cause long-term issues like persistent exhaustion and changes to behavior or cognition.

Here’s our take on why you should incorporate sleep dentistry into your practice:

1. Reinvigorate Your Passion

Let’s be honest, any career can become less exciting over time. With dentistry, it’s easy to get comfortable in a particular way of practicing and realize you’ve lost your passion for the work.

Dr. Cress has experienced this firsthand. After he had been practicing for 15 years, he realized he was burned out and needed a change in his career. That was when he was introduced to sleep dentistry. He believes it has completely changed his life and made him a truly comprehensive dentist.

2. Alleviate OSA Symptoms

OSA goes unnoticed by many medical professionals because the symptoms can be attributed to other concerns. Essentially, what happens is that during sleep the airway closes to an extent that triggers the brain to wakefulness.

This persistent interruption of sleep can lead to many unfortunate health effects, such as an increase in the likelihood of suffering from heart disease or a stroke. Good sleep is so critical to a variety of physical processes. Plus, it simply reduces quality of life to feel drained much of the time.

3. Collaborate More Broadly

A really fun and rewarding aspect of screening patients for sleep disorders is being able to collaborate with MDs on treatment plans. Sleep dentistry is one of the key areas where medicine and dentistry collide.

4. Change Patient Lives

Changing lives is inevitable with sleep dentistry. Therapies you enact will give you the ability to drastically improve the way many of your patients feel daily. They may seem hesitant at first, but they will also likely be very interested in interventions that can impact the way they sleep.

5. Boost Practice Productivity

Finally, you will certainly see a boost to your bottom line with sleep dentistry services. You can use it to market your practice more broadly and also promote specific treatments or devices.

When you love what you do, the work and living are easy. We encourage you to start learning about what it takes to incorporate sleep dentistry into your practice.
 
Sleep Dentistry & OSA Treatment

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/incorporate-sleep-dentistry-into-your-practice/feed/ 0 Setting Yourself Up for Success: Temporary Implant Crown /success-temporary-implant-crown/ /success-temporary-implant-crown/#respond Thu, 18 Oct 2018 17:39:29 +0000 /?p=4627 Implant dentistry provides much opportunity for practice growth, professional satisfaction, and dental team expansion. As digital dentistry continues to grow, it also becomes easier to coordinate with the surgeon and dental lab. Along with this advancement is the need for a temporary implant crown technique that keeps patients happy. Find Success With the Temporary Implant […]

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Implant dentistry provides much opportunity for practice growth, professional satisfaction, and dental team expansion. As digital dentistry continues to grow, it also becomes easier to coordinate with the surgeon and dental lab. Along with this advancement is the need for a temporary implant crown technique that keeps patients happy.

Find Success With the Temporary Implant Crown

temporary implant crownImplant restorations require the careful manipulation of a variety of factors while considering the extent of the dental work to be completed. Before and after the implant is placed, it’s key to organize how the esthetics will be achieved by hiding the abutment and color matching to surrounding teeth. Have your dental assistant take thorough pre-op photographs, either for use with chairside CAD/CAM fabrication or a dental laboratory.

You must also factor in how the temporary can aid in the implant healing process. For example, leaving the gingival embrasures open is much more favorable to the patient. Additionally, immediate temporization is likely a suitable pathway to further protect the implant site.

Provisionals for implants must be durable enough to last at least six months in the mouth. Their creation will begin with models taken from the patient. The missing tooth/teeth should be waxed onto the model and a vacuform stent should be fabricated on the model. The latter will function as a provisional mold.

One of the most important steps to take after affixing temporary abutments to the implant and reducing them is to try in the stent over the abutments. Adjust if necessary. Also, you can increase retention of the provisional material to the metal by utilizing a self-adhesive resin.

Our final tip in the temporary fabrication process for implant crowns is to place a light-activated material into the access of abutments. This will prevent the provisional resin material you later apply from blocking abutment removal.

Want to elevate the quality of your restorations? Check out this post on the Gold Dust Dental Lab blog featuring a technique for incisal edge translucency. We’re also loving a throwback blog from CMS educator Dr. Mike Smith on screw-retained implant crowns. Read it here.

What are your thoughts on fabricating esthetic and functional temporary crowns? Please let us know your take on this topic in the comments! 

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Getting the Yes: Take Initiative With This Dental Case Acceptance Technique /dental-case-acceptance-yes/ /dental-case-acceptance-yes/#respond Tue, 02 Oct 2018 18:26:44 +0000 /?p=4629 How well do you understand what your patients value? And not what you think they should, but what they actually do? Dental case acceptance will be elusive if you aren’t able to get down to a patient’s ‘why’ with efficient and effective questions. 2 Intentional Game-Changer Questions When you sit a patient down to discuss […]

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How well do you understand what your patients value? And not what you think they should, but what they actually do? Dental case acceptance will be elusive if you aren’t able to get down to a patient’s ‘why’ with efficient and effective questions.

2 Intentional Game-Changer Questions

case acceptance strategy and questionsWhen you sit a patient down to discuss the comprehensive care you think they need, don’t start by throwing tons of extraneous information at them. Instead, ask these two game-changer intentional ‘why’ questions:

1. “What’s most important to you about your teeth?”

2. “What has been the nature of your past dental experiences?”

These two questions seem simple, but are invitations to the patient that can drastically improve your patient-doctor relationship. How can you proceed with care if you don’t understand what they value? Pay attention to how they answer these questions, as opposed to the details.

The patient’s level of comfort with proposed treatment and dentistry on the whole is very important. It will help you determine if they are driven by avoiding the consequences that come with delaying treatment or if they are primarily motivated by the benefits of good treatment. Common responses to the first question fall into either the consequences or benefits category.

Consequences:

  • That I keep them
  • That they look nice
  • That they are healthy
  • That I’m comfortable

Benefits:

  • That you don’t hurt me
  • That it doesn’t cost too much
  • That I don’t have any needs
  • That I don’t lose them

Case Acceptance for Comprehensive Treatment

Before a patient even sits in your chair, you can begin enrolling them in comprehensive treatment. Shift your treatment planning from a sense of trying to convince patients to agree to case acceptance and more toward providing them extremely valuable care. It’s powerful to consider the patient’s unique needs, then develop a visual treatment presentation based on the way they see their care.

Focus less on costs and dental jargon. Focus more on the transformation they will undergo after working with you. The nature of the conversations you have with patients will drive success. Engage in co-discovery and leading questions that teach you about their desires and needs. This will guide you and your patient toward great treatment decisions.

Implementation is the key to case acceptance. You must take action, otherwise you will never achieve what you want with patients.

What aspect of patient consultations do you find the most challenging? Let us know in the comments below and we’ll give you a nudge in the right direction!

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The CMS Dental CE Courses: What Order Should You Take Them In? /what-order-should-you-take-the-cms-dental-ce-courses-in/ /what-order-should-you-take-the-cms-dental-ce-courses-in/#respond Tue, 25 Sep 2018 14:34:59 +0000 /?p=4669 As you make your way through the Clinical Mastery Series curriculum dental CE courses, you will inevitably grow and deepen your learning. That part’s a given! But what’s the best order to take courses in and why? Everyone’s path is unique, yet there are good reasons for taking certain dental CE courses in a specific […]

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As you make your way through the Clinical Mastery Series curriculum dental CE courses, you will inevitably grow and deepen your learning. That part’s a given! But what’s the best order to take courses in and why?

Everyone’s path is unique, yet there are good reasons for taking certain dental CE courses in a specific sequence. Keep reading for advice you can use to maximize the value you get out of the CMS courses and your dental continuing education.

We’ve also included some first hand advice from CMS alumni and educators Dr. Lee Gary and Dr. Chris Kerns.

Ultimate Occlusion Series

Ultimate Occlusion 1: Mastering Functional Dentistry

  • Style: Hands-on
  • Pre-reqs: None
  • Length: 2 days

The best place to start if you’ve never taken a CMS course before is our ‘Ultimate Occlusion 1: Mastering Functional Dentistry’ course. It has a lot of group activities where dentists can meet and network.

UO1 provides a great introduction to applying occlusion philosophies practically in the dental practice, and is the basis for moving from single tooth dentistry to full mouth treatment. You’ll meet all of the CMS instructors, and you’ll have plenty of time to work and network with your peers. The relationships created in a UO1 course can last a lifetime, and are extremely valuable as your dentistry career progresses.

Ultimate Occlusion 2: Mastering Complex Cases

  • Style: Hands-on
  • Pre-reqs: UO1
  • Length: 2.5 days

Ultimate Occlusion 3: Mastering Full Mouth Reconstruction

  • Style: Hands-on
  • Pre-reqs: UO1 and UO2
  • Length: 2 days

UO2: Mastering Complex Cases’ and ‘UO3: Mastering Full Mouth Reconstruction’ are scheduled in such a way that dentists can complete the entire series in a convenient time frame. Level 2 teaches essential skills to incorporate aesthetic full mouth treatments. Level 3 is designed for clinicians who want to elevate their prosthetic skills.

Here are Dr. Lee Gary’s thoughts on his experience with UO1 and later courses:

I started with UO1 and after the first day knew that I would be signing up for UO2 as soon as it was available. I took UO2 within approximately 2 months of UO1 and I was really glad I did. From there I branched into the over the shoulder courses and the photography course the following year. I then repeated UO1, UO2, and Photography before proceeding to Treatment Planning and taking my team through the team training course.

What surprised me most was how much value I got out of repeating those courses! Hearing the information for a second time after implementing those ideas in my practice really allowed me to absorb it more deeply.

Advanced Treatment Planning Workshop

  • Style: Hands-on
  • Pre-reqs: None
  • Length: 2 days

Treatment planning is a useful follow-up course to the philosophy introduced in UO1 and UO2. You’ll learn how to get cases off your shelf and into your schedule.

Digital Photography

  • Style: Hands-on
  • Pre-reqs: None
  • Length: 1 day

Dental photography is a solid introduction to intraoral photography. It sets the stage for fantastic comprehensive dentistry and images that better communicate the quality of your work. Once you have your base from the Occlusion courses, you’ll want to learn how to take stellar photography that will help you to communicate better with your patients, prospects, and partners.

Dr. Lee Gary wishes he had taken this course sooner:

If I could go back and do anything differently, I would have taken the photography course sooner. Nothing has had a greater impact on every single facet of my practice than implementing photography. My camera is right up there with my hand piece as far as importance in treating patients.

Team Training

  • Style: Team focus
  • Pre-reqs: None
  • Length: 2 days

Team Training is another course that is best to take after UO1 or UO2. Learn vital communication skills from Dr. Lee Gary, Dr. Chris Kerns, and CMS Executive Director Jenn Janicki.

Below is Dr. Chris Kerns’ perspective on getting the most out of your CMS learning:

First and foremost, I recommend taking the courses as quickly as possible in any order as opposed to planning a sequence. Action always wins over intention for me. However, I believe the most logical foundational sequence would be: UO1, UO2, Photography, then Team Training.

I would then do the following: FMR, Anterior Aesthetics, and U03. I think it is much more beneficial to take Dr. Nosti’s Full Mouth Rehab course prior to Dr. Olitsky’s Anterior Aesthetics, and both prior to UO3. After that, Mike’s TMJ/TMD course can be added for interested clinicians.

Full Mouth Rehabilitation: Live in the Op

  • Style: Side-by-side learning with Dr. John Nosti
  • Pre-reqs: None
  • Length: 4 days (2 weekends)

Full Mouth Rehab is a more advanced course that is often taken later on. Observe Dr. Nosti as together you go through the process of diagnosing, treating, prepping, and seating 20 units of a full-mouth rehab.

Anterior Aesthetics: Live in the Op

  • Style: Live patient with Dr. Olitsky
  • Pre-reqs: None
  • Length: 2 days

Anterior Aesthetics fits in well at multiple points in your CMS journey. You’ll want to make sure you take the Occlusion courses before jumping into smile design, so your patients don’t end up wearing down their beautiful restoration due to occlusion problems.

TMD Workshop

  • Style: Hands-on
  • Pre-reqs: None
  • Length: 2 days

The TMD Workshop is a unique course from Dr. John Nosti and Dr. Mike Smith that demystifies one of the most confusing topics in dentistry. It reviews diagnostic modalities and key treatment rationales.

Let us know what courses you’ve taken and why or any advice you have for clinicians looking to join the CMS family!

UO1 2019 course dates

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3 Ways to Understand Your Dental Team Better /3-ways-understand-dental-team-better/ /3-ways-understand-dental-team-better/#respond Mon, 17 Sep 2018 13:58:35 +0000 /?p=4664 It’s easy to get into a routine at work, especially with the stress of personal and professional responsibilities always building up. As a result, you might develop a comfortable pattern with your assistants, hygiene team and other staff. You assume everything is good because for the most part it is. But what is your dental […]

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It’s easy to get into a routine at work, especially with the stress of personal and professional responsibilities always building up. As a result, you might develop a comfortable pattern with your assistants, hygiene team and other staff. You assume everything is good because for the most part it is.

But what is your dental team really thinking? Just because there are no major issues doesn’t mean team members don’t have concerns, questions, wants, goals, and needs. Different personalities may also have a hard time speaking up when they have nothing they perceive as worth bothering you over.

As the leader in the dental practice, you must seek out opportunities to discover others’ potential, consistently improve their experience, and provide chances for growth.

To understand what your hygiene team wants you to know, you have to see things from their perspective:

3 Ways to Understand Your Dental Team Better

1. Communication is Key

As the head of the business, you are concerned with efficiency and maximizing productivity. Both are good for your bottom line and the practice’s overall financial security.

The problem is that you can’t be everywhere at once. Plus, your role is different from your team’s, so you don’t know how they view many of the patient care procedures. They probably have a lot of ideas about how to do things ‘better,’ opinions they may not voice for a variety of reasons. It’s important to communicate with them, and also to make sure they are comfortable communicating with you.

For example, most hygienists likely wish you knew that you could come in at any point during an appointment once they’ve gotten x-rays. They would rather take their gloves off and stop then have to wait for you at the very end. That could put them behind schedule, leaving the patients that follow a bit peeved.

It seems counterintuitive: Wouldn’t they prefer not to be interrupted? Of course, everyone is different, but it’s a good idea to check in with them to figure out what they prefer. The simple act of asking can go a long way.

2. Teach Them and Learn Together

Hygienists and dental assistants are a lot like dentists. They all love teeth and oral healthcare! Your team is likely curious about dentistry beyond their expertise. They would love to learn about joints, muscles, occlusion, airway, and all of the other domains that are part of modern comprehensive dentistry.

Are you providing opportunities for professional advancement? Are you educating ongoingly? Your dental practice will suffer if you don’t help your dental team’s reach and exceed their potential.

Imagine how much more value they could add to the business and patient care, as well as how high staff morale could be, if your entire team felt both intellectually challenged and respected.

3. Appreciate Them

It’s always useful to learn how people like to be recognized and make that special effort to do so. No one wants to be ignored or unappreciated. Though you’re busy, don’t be so busy that you can’t take a moment to thank the people who keep the dental practice running smoothly.

Your dental team wants you to know that they are a vitally important part of the dental team, both in their relationships with patients and their ability to help patients move forward with treatment. And they’re right!

You can start by verbally acknowledging your team on a group and individual level. Then, figure out how they can continue to support you in case acceptance endeavors.

Most importantly, don’t take your team members for granted. Open up lines of communication, create comfortable, regular discourse, and see how your relationships become stronger for it.
 

Team Training Workshop

Photo courtesy of Primo Smiles.

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An End of Week Checklist to Maximize Dental Practice Productivity /checklist-maximize-dental-practice-productivity/ /checklist-maximize-dental-practice-productivity/#respond Wed, 05 Sep 2018 17:21:20 +0000 /?p=4658 How long has it been since you made a checklist? There’s something so satisfying about ticking off boxes or crossing out lines of to-do items. In the dental practice, you can increase productivity by using free time to make your work more efficient and more successful with a targeted checklist. Many dentists have adopted a […]

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How long has it been since you made a checklist? There’s something so satisfying about ticking off boxes or crossing out lines of to-do items. In the dental practice, you can increase productivity by using free time to make your work more efficient and more successful with a targeted checklist.

Many dentists have adopted a ‘4 days on – 3 days off’ style of being in the office. Some even do less. It’s all about where you function best, but either way you’ve likely got a brief period in between the ‘on’ days where you can refocus and consider what areas need optimizing.

Here is a simple, easy-to-follow checklist you can use to get your ducks in a row at the end of a work week to maximize dental practice productivity:

1. Check-in with your team

Though your morning huddle allows you to stay connected with how your team members are feeling about the current state of the dental practice, it wouldn’t be a bad idea to have brief personal check-ins with individual members.

Alternately, you could hold mini-meetings separately with individual departments, such as front desk, hygiene, and assistants.

2. Review upcoming patients on the schedule

Make sure you are ready for any treatment planning presentations or large cases that are coming up. You might have to review chart notes for larger cases or finish treatment plans. It’s nice to be able to visualize the week from a technical perspective and prepare for the extent of dentistry you will be completing.

3. Handle your inbox before the weekend

Emails are a pain, yet they keep you connected to a variety of important business contacts. Respond to any queries you’ve been delaying, reach out to mentors you may have been neglecting, and get that inbox as close to zero as possible so you can have a fresh start on Monday.

4. Ensure all items are sent to the lab

You likely delegate sending cases or other information along to the lab so you can focus on more important matters. Still, that’s not an excuse to assume everything is running perfectly. Quickly review what items have recently been sent and which are planned for shipment or electronic transfer.

5. Reach out to specialists

During the work week, it can seem like there is absolutely no time even for a 5 minute phone call. Once your final patient has left the building on Wednesday or Thursday, you can take a deep breath and get specialists on the phone.

It’s imperative to discuss ongoing cases and understand how patients you have referred (or received from a referral source) are faring.

6. Call upcoming new patients

This one might shock a few people, but it’s extremely powerful! Pick up a phone and call new patients scheduled for the next week. Beforehand, check who referred them and any other important information.

Convey how excited you are to meet them and touch base for just 2-3 minutes. Patients are way less likely to cancel and will be amazed at the personal touch from their new dentist.

7. Carve out 30 minutes for education

A stagnant brain is no good for dental professionals. You must stay updated on current trends, technology, materials, and techniques. Spend just 30 minutes reading a blog, article, or other web content in an area that intrigues you.

8. Review practice numbers for the month

Where are you at based on your monthly production? Reviewing practice numbers is a great opportunity to determine financial health.

Checking off these 8 items will keep you engaged, motivated, and committed to providing the best healthcare possible on an ongoing basis.

What tasks do you always complete at the end of the week?

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The Importance of Occlusion in Comprehensive Dentistry /occlusion-comprehensive-dentistry/ /occlusion-comprehensive-dentistry/#respond Sun, 22 Jul 2018 02:31:11 +0000 /?p=4616 Changing up your general approach to diagnostics and patient exams is a real struggle. That’s especially true if you are already providing exceptional service and your patients are quite content with your care. But change is a good thing and that’s why we believe you should understand the importance of occlusion and add it to […]

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Changing up your general approach to diagnostics and patient exams is a real struggle. That’s especially true if you are already providing exceptional service and your patients are quite content with your care. But change is a good thing and that’s why we believe you should understand the importance of occlusion and add it to your oral health toolbox if you haven’t yet.

Here’s why:

Why Occlusion is Key to Comprehensive Dentistry

With all the responsibilities of dentistry combining to make this profession busy and challenging, it’s a headache even to consider adding a new element like occlusion to your process. But the reality is that it may be more detrimental to ignore than it is time consuming to implement.

Patients who have higher functional risk (occlusal risk) can break or wear down their teeth prematurely, can break or cause restorative dentistry like crowns, fillings, or veneers to fail early, and can also be at risk of developing acute or chronic TMD symptoms. This includes muscle pain, headaches, and a restricted opening that could prevent them from eating their favorite foods.

Figuring out a patient’s occlusal risk is equally as important as figuring out caries risk or risk for periodontal disease if you take a comprehensive approach to maintaining oral health. Unmanaged occlusal risk can compromise a patient’s function and long-term esthetics.

There are many good reasons not to pay attention to occlusion, but they can be bypassed with proper training and good advice. Your reasoning may be that you don’t know how to do an occlusal risk assessment. Most of us are skilled at assessing cavity or periodontal risk, but not occlusion.

We also stumble with the barrier of incorporating occlusion into the time we have for a comprehensive exam. And then how do we get compensated for it? That’s exactly the kind of eye-opening learning on assessing and integrating occlusion that can you can get from our CMS courses on functional dentistry.

Check out the first post in a three-part blog series on why occlusion matters here. What are your thoughts on comprehensive dentistry? Please let us know!

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How to Conduct a Successful New Patient Exam /successful-new-patient-exam/ /successful-new-patient-exam/#respond Mon, 16 Jul 2018 18:40:21 +0000 /?p=4586 A successful new patient exam is an opportunity to start developing a long and productive relationship. It may feel like a hassle, especially when you have complex cases already on the schedule, but it’s worth every second. If you think of the exam as laying the groundwork for a mutually beneficial partnership to benefit the […]

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A successful new patient exam is an opportunity to start developing a long and productive relationship. It may feel like a hassle, especially when you have complex cases already on the schedule, but it’s worth every second.

successful new patient examIf you think of the exam as laying the groundwork for a mutually beneficial partnership to benefit the patient’s health, you will come across far more engaged. This might be the most significant aspect of the entire experience. It’s all about first impressions when it comes to how a patient perceives your dentistry.

Likely, the patient will be nervous and apprehensive. That’s why you need to do your best to make them comfortable while gathering the necessary diagnostic information to provide quality care moving forward.

Here’s what you must include to get the patient exam perfect:

4 Qualities of a Successful New Patient Exam

From a broad perspective, new patient exams are composed of two major components: the pre-clinical interview and the diagnostic portion. Of course, you can’t proceed with treatment in the future unless you first clearly understand their goals and desires for their dental health.

The patient might have a hard time communicating these to you at first. You’ll have to listen carefully and give them the space to open up about their hopes and expectations.

Next, make sure to carry out an assessment of functional risk factors, including joint exam, muscle exam, and occlusion exam. These cover all the bases so you understand any interventions that may be essential prior to restorative work.

Third, it isn’t a bad idea at all to review any systemic issues regarding their health, which could involve airway, apnea, and breathing. Finally, make sure you share the possibilities dentistry has to offer them. If they don’t know what’s in store, they can’t develop excitement about the idea of dental care!

What’s your number one tip for a successful new patient exam? Let us know your thoughts!

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Making Sure You Get a Great Impression Every Time /great-impression-every-time/ /great-impression-every-time/#respond Wed, 11 Jul 2018 18:36:08 +0000 /?p=4539 A great impression can facilitate superb dental work or it can present unintended problems down the road. The end result depends on your ability to troubleshoot issues that may occur and communicate your intentions with the dental lab. Tips for a Consistently Great Impression One of the most important steps you must take for an […]

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A great impression can facilitate superb dental work or it can present unintended problems down the road. The end result depends on your ability to troubleshoot issues that may occur and communicate your intentions with the dental lab.

Tips for a Consistently Great Impression

taking great impressions every timeOne of the most important steps you must take for an amazing impression is maintaining a topography difference between the tissue and preparation. Ensure impression material can flow between the surrounding gingival tissues and the prepared tooth’s margin.

This single step will guarantee the stone model is far more successful. A visually gorgeous prep will pour ideally if you use either a cord retraction or prep design that isn’t flush with the tissue.

Additionally, remember that results you believe look great intraorally may be challenging for the lab. You have to find that sweet spot between very precise and too precise. For an all-ceramic restoration, do not assume a ‘cowboy hat’ fragile shoulder can be replicated in the lab.

Another issue relates to pulls and bubbles. These appear when the impression distorts before it can set or a bubble shows up because of improper wash use. In this case, the lab tech can’t tell where the restoration should end. The only way to avoid the latter problem is by examining continuity closely and utilizing a material viscous enough to prevent pulls while it sets.

Finally, though you always want to be as conservative as possible, you shouldn’t attempt to preserve small toothbrush abrasions (abfractions). This is also true of undercuts, because what happens is the lab cannot create a fit tight enough to keep out bacteria. It simply isn’t possible to fill the divet with ceramic in this case.

What tips do you have for perfect impressions the lab will love? Please let us know in the comments! 

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How to Make Your Temporary Bridge Successful /temporary-bridge-successful/ /temporary-bridge-successful/#respond Sun, 08 Jul 2018 13:58:56 +0000 /?p=4554 An esthetic and functional temporary bridge will set you up for success later on when placing the final restoration. In our haste to impress patients with efficiency and a superb outcome, we can easily overlook the nuances and critical techniques involved in the interim step of temporary fabrication. Fabricating a Successful Temporary Bridge It’s arguable […]

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An esthetic and functional temporary bridge will set you up for success later on when placing the final restoration. In our haste to impress patients with efficiency and a superb outcome, we can easily overlook the nuances and critical techniques involved in the interim step of temporary fabrication.

Fabricating a Successful Temporary Bridge

temporary bridge succesIt’s arguable that the temporary bridge is even more important than the final. Why is that? Well, consider how important first impressions are in all aspects of life.

How the temporary bridge feels in the patient’s mouth, how significantly it improves their smile esthetics, and how well it protects them against poor oral hygiene will influence their expectations of later dental work.

An unhappy patient is much harder to win over than one who is already completely satisfied with their temporary bridge. The latter will also be more likely to trust you if any issues occur or challenges present themselves. Clearly, while the lab is fabricating the final bridge, you had better pay close attention to temporary technique!

My advice for a gorgeous and comfortable temporary bridge is four-fold. First, the bridge should touch adjacent teeth. This ensures the prepped and adjacent teeth don’t move. Second, once you’ve secured that first aspect, the temporary should be in proper occlusion but not too heavy. If you make the occlusion light on the pontic, you’ll have a much easier time overall and not have to worry about fracturing.

Third, don’t make the contacts too small and the embrasures too big between the pontic and the abutment. If you do, the pontic might break, leaving you with an unhappy patient. Finally, shape the pontic against the tissue to prevent food impaction and more closely adhere to natural tooth esthetics.

Do you have pearls of wisdom regarding temporaries? We’d love to hear from you in the comments!

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