Hosting a Patient Focus Group: Part 2

August 30, 2017 Richard Hunt DDS

Patient focus groups are useful for truly understanding the experience people have at your dental practice. You can go right to the source for questions you have about patient perceptions, instead of speculating based on your own point of view.  

In my last blog, I introduced the why and how of a patient focus group my wife Amy and I hosted to celebrate our practice’s 25th anniversary. The first four questions we asked invited patients to share their thoughts. Our final question was:

If you could design the perfect dental practice, what would it look like? (2 groups)

Read on to learn what the focus group taught us …

Results of the Patient Focus Group at My Dental Practice

The ensuing conversations and comments from our five main questions were uplifting and empowering for everyone on our team. We all found it quite interesting that their comments were rarely about our dentistry but rather about how we make them FEEL when they are with us. We thanked them for their participation and invited each of them to refer others who share similar values.

While the evening was considered a huge success, the impact came in subsequent waves of influence. With their permission, we proudly display the portraits and quotes throughout the office and on our website (www.huntdentistry.com). Each of these patients have become empowered to refer countless other “A” patients to us. The portraits have become a daily source of inspiration for our team and other patients – “How can I get my picture on the wall?”

The “focus group” concept really helped to reaffirm our practice mission of developing trusting relationships with as many of our patients as possible and helping them become healthier and happier through our compassionate care. We’re all looking forward to our 30-year anniversary!

How would you host a patient focus group? Please let us know your thoughts in the comments!

Related Course

Mastering Aesthetic Restorative Dentistry

DATE: November 20 2025 @ 8:00 am - November 23 2025 @ 12:00 pm

Location: The Pankey Institute

CE HOURS: 32

Dentist Tuition: $ 6300

Single Occupancy with Ensuite Private Bath (per night): $ 345

Aesthetic dentistry is where artistic form meets functional restorative dentistry. Where patients, clinicians, specialists and laboratory technicians communicate with each other in an effective way and each provide input contributing…

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Richard Hunt DDS

Dr. Richard Hunt is a native of Rocky Mount, NC and represents the third generation of dentists in the Hunt family. He earned his Doctor of Dental Surgery degree from the UNC School of Dentistry in 1989. Dr. Richard has served his profession as president of the NC Dental Society and the Dental Foundation of N.C. He is also a former chair of the Dental Assisting National Board. Dr. Hunt realizes the importance of life long learning and attends over 100 hours of continuing education every year in order to remain knowledgeable about current topics and techniques in his profession. In turn, he also enjoys teaching other dentists about the joy, happiness and satisfaction that can be achieved through patient care based on a trusting relationship and clinical excellence. Dr. Hunt has served as a member of the Visiting Faculty of the Pankey Institute for Advanced Dental Education in Key Biscayne, FL. since 2002. He returns regularly to teach dentists from around the world about the clinical and behavioral skills necessary to lead a progressive, health centered dental practice.

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Hosting a Patient Focus Group: Part 1

August 29, 2017 Richard Hunt DDS

Hosting a patient focus group can change the way you look at your dental practice. Most of the time, we see our practice not through the eyes of our patients, but through our own. The life of a dentist is hectic, filled with CE, family, and general work hours. At some point, we can benefit from taking the time to learn what commonalities and perceptions our best patients share.

Why I Hosted a Patient Focus Group at My Dental Practice

My wife Amy and I wanted to celebrate our 25th year in practice, so we decided to host a “focus group” of very special patients who represented a wide range of ages and experiences.

With our team’s input, we carefully selected 10 of our “A” patients (engaged, proactive, health oriented, appreciative) and invited them to an after hours reception at our office. The invitation list included some who had been patients for 20+ years, while others were relatively new. Some had completed complex restorative plans, while others had more simple needs. Their ages ranged from 26 to 85.

Questions Asked in the Focus Group Session

We greeted patients with champagne and light hors d’oeuvres. The group mingled while taking turns to have several images created by a professional portrait photographer. These portraits were gifts for the participants.

After a while, we settled in for a session facilitated by one of our “special” patients who prompted the group to think and then share their thoughts about the following questions:

·      What brought you here?

·      What keeps you coming back?

·      What does a nice smile mean to you?

·      What gives you confidence in the Hunts and their staff?

·      Are there any buts?

We rounded out the session with a final question that took a closer look at their ideal dental practice. You can read Part 2 in this series next week, where I’ll reveal the final fascinating question and the results of the focus group.

How do you think a patient focus group would benefit your dental practice? We’d love to hear from you in the comments!

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DATE: November 21 2024 @ 8:00 am - November 24 2024 @ 12:00 pm

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night with private bath: $ 290

This course is sold out Aesthetic dentistry is where artistic form meets functional restorative dentistry. Where patients, clinicians, specialists and laboratory technicians communicate with each other in an effective way…

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Richard Hunt DDS

Dr. Richard Hunt is a native of Rocky Mount, NC and represents the third generation of dentists in the Hunt family. He earned his Doctor of Dental Surgery degree from the UNC School of Dentistry in 1989. Dr. Richard has served his profession as president of the NC Dental Society and the Dental Foundation of N.C. He is also a former chair of the Dental Assisting National Board. Dr. Hunt realizes the importance of life long learning and attends over 100 hours of continuing education every year in order to remain knowledgeable about current topics and techniques in his profession. In turn, he also enjoys teaching other dentists about the joy, happiness and satisfaction that can be achieved through patient care based on a trusting relationship and clinical excellence. Dr. Hunt has served as a member of the Visiting Faculty of the Pankey Institute for Advanced Dental Education in Key Biscayne, FL. since 2002. He returns regularly to teach dentists from around the world about the clinical and behavioral skills necessary to lead a progressive, health centered dental practice.

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Paying Your Mortgage Twice a Month

August 28, 2017 Ricki Braswell CAE

Do you feel daunted when thinking about how to achieve financial freedom?

I admit I don’t know exactly what that looks like, but I’ve had some success with easing my financial burdens thanks to a couple of habits I’ve implemented over the years.

Paying Your Mortgage Twice a Month

One habit is paying my mortgage twice a month. If your first thought is, “holy cats I can’t do that,” I understand, but it may not be as difficult as you assume. I’m not suggesting that you pay double, I’m suggesting that you pay ½ a month ahead.

Instead of paying $2,000 on the 15th, you would pay $1,000 on the 1st and $1,000 on the 15th and then repeat the next month. Why is this a good idea? Because mortgages are calculated over a long span of time and a large portion is comprised of interest. By paying twice a month, a larger percentage goes to the principal.

Habit Development to Reach Financial Freedom

So how do you get into this habit?

It’s pretty easy if you are beginning a new loan because you have about a 45-60 day grace period after closing before the first payment is due. You can make your first ½ payment 15 days before the due date.

If you have an existing mortgage and like most of us don’t have the money on hand to make an additional ½ payment, then you can start by saving toward the ½ payment until you have enough to make it for the first time, which then reduces your next monthly payment. That may take you a few months.

This same idea can be applied to your car payment. For both your mortgage and your car, make sure your loans don’t carry a penalty for early payoff.

Financial freedom is one step closer.

What steps do you take to better manage your finances? We’d love to hear from you in the comments! 

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DATE: August 10 2025 @ 8:00 am - August 14 2025 @ 2:30 pm

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Ricki Braswell CAE

Ricki Braswell, CAE, joined the Pankey Institute as President & CEO in April 2011. A former Executive Director for National Association of Dental Laboratories, National Board for Certification in Dental Laboratory Technology and The Foundation for Dental Laboratory Technology, she has a wealth of experience in nonprofits, corporate communications, human resources, and publishing. Ricki has served on The L. D. Pankey Foundation board of directors. In 2010, Dental Products Report named her one of the Top 25 Women in Dentistry.

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Retention & Orthodontic Treatment

August 28, 2017 Lee Ann Brady DMD

How Understanding Orthodontic Treatment Can Improve Your General Care

The question of what to tell patients when they ask, ‘How long do I need to wear my retainer?’ is a conundrum on many fronts. First of all, we aren’t the orthodontist! But more than that, we have to look at things from the orthodontist’s perspective before we can decide on the best answer.

In my last blog on this topic, I went into more detail about why answering this patient question is so tricky. I also outlined five questions only an orthodontist can answer that lead to a better general understanding of retention after orthodontic treatment. Below, I give the answer to the first:

What is the Orthodontist’s Responsibility With Regard to Retention After Orthodontic Treatment?

Most orthodontists have a protocol for how they manage retention. This is why general dentists should discuss the specific protocol of orthodontists they refer to with those orthodontists. One way of doing this is to ask, “How much is management of retention included in the treatment fee?” and “What about after that?”

Protocols usually have a clearly defined endpoint to treatment. This includes how long they expect to monitor retention. An example of this is an orthodontist who includes 2 years of retainer checks in their treatment fee. Orthodontists might then ensure their patients are aware that the fee includes a defined period of supervised retention after treatment. In this case, monitoring retention after the fact incurs an additional fee.

Because orthodontists usually recommend long-term retention, ideally they would make patients aware of the cost (both in time and money) of maintenance care. Unfortunately, most orthodontists may not stress the importance of retention at the beginning of treatment and most don’t want to have a long-term relationships with their patients. Their business model is based on case starts, whereas a general dentist’s business model is based on life-long recall and dental maintenance.

It’s somewhat unlikely to find an orthodontist who actively encourages patients to return long after treatment ends. This is perfectly fine because patients like it that way. Orthodontists might want to discuss their retention protocol with you and referred patients (before treatment) because they have a vested interest in the maintenance of treatment results. The patient is a compelling advertisement for their skills as long as the quality of the work is retained. On the other hand, it isn’t always possible for the patient to see the orthodontist again and vice versa due to long distance moves or retirement.

In short, get to know the orthodontist(s) you refer to so that you can better understand what patients expect of retention maintenance after orthodontic treatment.

Do you find it valuable to see things from the perspective of doctors you refer to? We’d love to hear your thoughts in the comments!

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Lee Ann Brady DMD

Dr. Lee Ann Brady is passionate about dentistry, her family and making a difference. She is a general dentist and owns a practice in Glendale, AZ limited to restorative dentistry. Lee’s passion for dental education began as a CE junkie herself, pursuing lots of advanced continuing education focused on Restorative and Occlusion. In 2005, she became a full time resident faculty member for The Pankey Institute, and was promoted to Clinical Director in 2006. Lee joined Spear Education as Executive VP of Education in the fall of 2008 to teach and coordinate the educational curriculum. In June of 2011, she left Spear Education, founded leeannbrady.com and joined the dental practice she now owns as an associate. Today, she teaches at dental meetings and study clubs both nationally and internationally, continues to write for dental journals and her website, sits on the editorial board of the Journal of Cosmetic Dentistry, Inside Dentistry and DentalTown Magazines and is the Director of Education for The Pankey Institute.

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Shift Case Acceptance Odds in Your Favor

August 27, 2017 Mark Murphy DDS

Struggling to move your desired amount of dental work off the charts and increase your case acceptance? Usually, the issue isn’t that not enough of your patients need treatment, it’s that they have been ineffectively diagnosed or haven’t accepted procedures for a multitude of reasons.

I’m here to show you three painless methods that will get more patients to say ‘yes’ so you can provide the best care possible.

3 Case Acceptance Methods to Increase the Odds

1. Emphasize a Patient’s Wants Over Needs

Focus on helping patients want better dentistry and a more complete solution. Humans inherently spend money on their wants over their needs. Americans spend much more on alcohol, tobacco, and gambling than on dentistry. Help transform their perspective of dentistry from a necessary evil to a desirable solution. Be patient. Allow them the space to understand the consequences of inaction. At some point, they will “want” to know a solution.

2. Develop Curiosity Over Passivity

Ask about the problem and stay in the question. Many patients will begin to come to their own conclusions if we develop their curiosity. Let them co-discover and view things using the intraoral camera or hand mirror. This gives them the chance to really learn about their mouth. Telling them what you see is passive education. Helping them figure it out is more active and creates ownership. Avoid discussing solutions or talking about problems excessively unless they ask.

3. Help Patients Take Ownership

Here’s the honest truth: Patients are not aware, concerned, or interested in the long term consequences of not seeking treatment. They mistakenly believe that having no pain or dysfunction equates to health. If all we do is give them an exam, develop a treatment plan, and tell them what they need, we will fail to convey the value of a procedure to their life. We have to continue to probe by asking questions about the problem and its progression. When they recognize the ultimate untoward outcome, finally taking ownership, we know case acceptance is on the table. A telling sign is when they ask, “what can I do about that?”

How do you increase case acceptance? We’d love to hear from you in the comments!  

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Mark Murphy DDS

Mark is the Lead Faculty for Clinical Education at ProSomnus Sleep Technologies, Principal of Funktional Consulting, serves on the Guest Faculty at the University of Detroit Mercy School of Dentistry and is a Regular Presenter on Business Development, Practice Management and Leadership at The Pankey Institute. He has served on the Boards of Directors of The Pankey Institute, National Association of Dental Laboratories, the Identalloy Council, the Foundation for Dental Laboratory Technology, St. Vincent DePaul's Dental Center and the Dental Advisor. He lectures internationally on Leadership, Practice Management, Communication, Case Acceptance, Planning, Occlusion, Sleep and TMD. He has a knack for presenting pertinent information in an entertaining manner. mtmurphydds@gmail.com

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Exquisite Alginate Impressions

August 26, 2017 Jeff Baggett DDS

Improving the quality of alginate impressions for diagnostic models requires a fine-tuned technique based on specific materials. These materials are used in conjunction with clever steps that lead to a minimization of voids and bubbles.

Dr. Baggett explains his exact procedure for achieving drastically improved alginate impressions. With these recommendations, you’ll find your confidence and efficiency soaring. Impressions are one part of the treatment puzzle that must be as precise as possible to avoid problems down the road.

How to Improve Alginate Impressions for Diagnostic Models

At my practice, we still use alginate impressions as our main impression material for diagnostic models. I generally take them. A very helpful tip to improve the quality of your impressions is to use a 35 ml monoject plastic syringe (from your local dental supplier) and Ivoclar Accudent XD Pre-Sure Tip applicators (Ivoclar Reorder number 67891 Soft Flex Tips).  

By placing the flexible tips on the end of the 35 ml plastic syringes, you are able to squirt excess alginate loaded into the syringe onto the teeth at a 90 degree angle starting at the distals of the second molars. You can do this instead of wiping alginate on the teeth with your fingers before you seat the alginate loaded tray.

This technique results in a lot less bubbles and minimizes the chance for voids distal to the most posterior teeth. The flexible tips are autoclavable, the monoject syringes can be cold sterilized, and petroleum jelly can be applied to the rubber plungers so they can be used again.   

This tip – combined with the use of 1-inch medical tape along the posteriors of our maxillary trays as a post-dam seal – has improved the impressions taken at my practice tremendously.

What aspect of impressions do you find the most challenging and why? We’d love to hear from you in the comments!

 

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Jeff Baggett DDS

Dr. Jeff D. Baggett attended Oklahoma State University where he received his undergraduate degree and attended professional school at the University of Oklahoma College of Dentistry. After obtaining his Doctorate of Dental Surgery degree, Dr. Baggett received postgraduate training at the L.D. Pankey Institute, recognized worldwide for its excellence in advanced technical dentistry. He was accredited as a Pankey Scholar. Practicing for over 30 years, Dr. Baggett is also a visiting faculty member at the L.D. Pankey Institute. He lectures various dental study clubs and dental meetings. He is a guest speaker of the Victim's Impact Panel Against Drunk Driving. A published author, Dr. Baggett wrote sections in the book Photoshop CS3 and PowerPoint 2007 for the Dental Professional. Dr. Baggett is also the team dentist for the Oklahoma City Thunder with his partner, Dr. Lembke. An esteemed member of the dental community, Dr. Baggett is a member of many professional organizations including the American Dental Association, the Oklahoma Dental Association, the Oklahoma County Dental Society, the Southwest Academy of Restorative Dentistry, the McGarry Study Club, the University Oklahoma College of Dentistry Alumni Association and the Oklahoma State University Alumni Association. He also served on the Board of Directors of the Oklahoma County Dental Society.

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3 Things Your Team Expects After a Dental CE Course

August 25, 2017 Pankey Gram

Our team – the people that form the basis of our dental practices – often have a few key expectations about our behavior post dental CE course. While we’re away, they flit through daydreams of the turmoil soon to inhabit their lives, wondering what fresh torment will arrive in the form of a drastic change to the way things are run.

Disrupting the status quo is fine and dandy if you understand the passion behind it, but this is not the case for most dental staff. We dentists get impassioned by our new learning and rush to implement it, forgetting our team is many steps behind us in the motivation department.

3 Things Your Team Has to Deal With After You Complete Dental CE

1. Tons of New Materials to Buy

You arrive home from a weekend of intense clinical discussions where you were surrounded by advancements in materials and technology. These ‘shiny new things’ may very well improve how you practice, but in your excitement to order them you forget to explain the ‘why’ to your staff.

Your staff now has to learn a whole new set of instructions and all new inventory control. They also have to deal with the possibility that you’ll try the materials and realize you’re not really going to use them. To you, this was useful experimentation. To them, it was a hectic couple of work weeks.

2. Changing Everything but the Kitchen Sink

Beyond the materials and tech, you also imbibed a heavy dose of alternate thought processes and clinical techniques. Your staff expects a variety of potential changes: how to answer the phone, new patient scheduling, chairside assistance, and on and on. This creates a lot of stress.

3. All Bets Are Off

Sometimes, the expectation of change is taken to the extreme. A common ‘myth’ in dentistry is that of the dentist who called and fired their entire staff from a CE course. This may or may not have actually happened and is unlikely in most cases. Still, it exemplifies the upset caused by your return. From your staff’s perspective, it’s more work and adjustments for them. If they don’t understand that these change will be better for them, patients, and the office, they see it all as another load on their shoulders.

There is a way to avoid this problem. When you complete a CE course, you should set aside time to share what you learned with your team. Share your excitement so they feel it too. Many times dentists start enforcing the implementations without an explanation. This hinders their staff’s ability to successfully apply what was learned.

As always in dentistry, come up with a system that makes your communication more effective.

How do you motivate your staff to enjoy and appreciate change? We’d love to hear from you in the comments!

Related Course

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DATE: June 22 2025 @ 8:00 am - June 26 2025 @ 2:30 pm

Location: The Pankey Institute

CE HOURS: 44

Dentist Tuition: $ 7400

Single Occupancy with Ensuite Private Bath (per night): $ 345

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Digital Bite Splints: Part 2

August 24, 2017 Daren Becker DMD

(Link to Digital Bite Splints: Part 1)

If you’re hesitant to start testing out digital bite splints in your practice, read on to learn why one dentist prefers them for improved efficiency and accuracy.

In Part 1 of my thoughts on this topic, I explained the features I love when working with a lab to create digital bite splints. These bite splints have an incredible fit and allow for customizable retention. Below, I round out the rest of my perspective on why they’re a great option for many dentists.

Occlusal Schemes and Adjusting the Digital Bite Splint Design

I’ve played with different occlusal schemes for digital bite splints. I have utilized:

1. A universal flat plane appliance (upper or lower).

2. An anatomic retainer-type appliance we designed to have a little more detail.

3. One anterior repositioning appliance. It was created for a patient who had some recent trauma. We were trying to keep them from seating all the way for a short period of time.

The idea is that you can design the occlusal scheme any way you want. After we send the scan in and the lab does the initial design, they can send us back screenshots that show us what the design is.

When we look at those screenshots, we can make comments on them. If there’s a lot of change – if we want to shallow the guidance, steepen the guidance, or make it thicker/thinner – we can actually go online live with the lab as they enact the changes. We can watch it happen in real time.

Increasing Efficiency by Reducing Chair, Lab, and Adjustments Time

Digital bite splints are a nice, new way to do things. Personally, I think we’re getting a better result. It’s certainly saving us a ton of time, both in terms of lab time (model work time) and chair time because the patient doesn’t need a lot of reline time. Of course, keeping the nasty acrylic out of the mouth is another significant benefit.

You don’t have to spend a lot of time adjusting. The occlusal adjustments are nominal. If we get the records right with the scan, there is very little in terms of adjustments. In fact, that might be the downfall for some of us because we lose a portion of time for the patient to experience things. Sometimes, I’ll spend more time adjusting than I need to. I ensure the patient is engaged and experiencing what an even bite might feel like relative to their natural occlusion. But, in this case, I wouldn’t have to devote that time if I didn’t need to.

Digital bite splints are also really dense. Breakage is going to be a minor problem. They’re going to hold up and last a long time.

What technology are you considering using in your practice? Please leave your thoughts in the comments!

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DATE: November 21 2024 @ 8:00 am - November 24 2024 @ 12:00 pm

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night with private bath: $ 290

This course is sold out Aesthetic dentistry is where artistic form meets functional restorative dentistry. Where patients, clinicians, specialists and laboratory technicians communicate with each other in an effective way…

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Daren Becker DMD

Dr. Becker earned his Bachelors of Science Degree in Computer Science from American International College and Doctor of Dental Medicine from the University of Florida College of Dentistry. He practices full time in Atlanta, GA with an emphasis on comprehensive restorative, implant and aesthetic dentistry. Daren began his advanced studies at the Pankey Institute in 1998 and was invited to be a guest facilitator in 2006 and has been on the visiting faculty since 2009. In addition, in 2006 he began spending time facilitating dental students from Medical College of Georgia College of Dentistry at the Ben Massell Clinic (treating indigent patients) as an adjunct clinical faculty. In 2011 he was invited to be a part time faculty in the Graduate Prosthodontics Residency at the Center for Aesthetic and Implant Dentistry at Georgia Health Sciences University, now Georgia Regents University College of Dental Medicine (formerly Medical College of Georgia). Dr. Becker has been involved in organized dentistry and has chaired and/or served on numerous state and local committees. Currently he is a delegate to the Georgia Dental Association. He has lectured at the Academy of General Dentistry annual meeting, is a regular presenter at ITI study clubs as well as numerous other study clubs. He is a regular contributor at Red Sky Dental Seminars.

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Digital Bite Splints: Part 1

August 23, 2017 Daren Becker DMD

The future of dentistry is here: digital bite splints. I’ve used bite splint therapy in my practice successfully for years. I was comfortable with my preferred traditional process until I learned I could work more efficiently and more accurately with the latest technology.

There is no reason to fear implementation of a digital workflow in your practice. In this two part series, I’m going to lay out the reasons why I’ve chosen to switch to digital bite splints for goals like protecting teeth and restorations, deprogramming muscles, and treating TMD.

They’re the productivity solution you didn’t realize you needed.

Less Effective Splint Fabrication Methods

My past process for fabricating occlusal splints (bite splints) was traditional. It included making records, alginate impressions, facebow, mounting, and several bite records (protrusive and centric). We would design and fabricate with cold cure acrylic that we would make by hand, then adjust and modify as needed.

That process works great, which is why most dentists use it. Alternately, some dentists send them off to the lab and have the same process done, possibly in a cured acrylic. But the outstanding process we have transitioned to in my practice is a completely digital designed and fabricated bite splint.

Why I Love the Digital Bite Splint Fabrication Process

The first step for a digital bite splint is to do an intraoral scan of the patient’s dentition. Any scanner can be used. We then send the scans to a restorative lab, where a software package specifically made for appliance design is utilized. The lab designs the appliances to our specifications and then they are milled out of a solid block of acrylic. This leads to an amazingly dense result that polishes unbelievably well.

The fit is incredible because we can get such an accurate scan with no distortion. With an impression, we usually have distortion of the alginate, distortion of the stone, or distortion of the acrylic as it sets, which is why we have to reline them. I have only had to reline two CAD/CAM designed and milled splints since we’ve been doing them. These bite splints are easy to adjust and it’s easy to read the dots on them. They just drop right in with almost no adjustment needed.

You can also dial in the retention on the software, so we’ve played with it a little bit to figure out what we want in terms of retention. We’ve got it just about right where they’re not too loose and not too tight. They have a nice snug fit that’s stable and retentive enough, but doesn’t squeeze the teeth too much.

Keep your eye out for Part 2 of this digital bite splint blog series. Next week, I’ll describe how we play with different occlusal schemes and work with the lab on customization in real time.

What advancements in dental technology are you hesitant to implement in your practice and why? We’d love to hear your thoughts in the comments!

(Link to Digital Bite Splints: Part 2)

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DATE: September 26 2024 @ 6:00 pm - September 28 2024 @ 2:00 pm

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Daren Becker DMD

Dr. Becker earned his Bachelors of Science Degree in Computer Science from American International College and Doctor of Dental Medicine from the University of Florida College of Dentistry. He practices full time in Atlanta, GA with an emphasis on comprehensive restorative, implant and aesthetic dentistry. Daren began his advanced studies at the Pankey Institute in 1998 and was invited to be a guest facilitator in 2006 and has been on the visiting faculty since 2009. In addition, in 2006 he began spending time facilitating dental students from Medical College of Georgia College of Dentistry at the Ben Massell Clinic (treating indigent patients) as an adjunct clinical faculty. In 2011 he was invited to be a part time faculty in the Graduate Prosthodontics Residency at the Center for Aesthetic and Implant Dentistry at Georgia Health Sciences University, now Georgia Regents University College of Dental Medicine (formerly Medical College of Georgia). Dr. Becker has been involved in organized dentistry and has chaired and/or served on numerous state and local committees. Currently he is a delegate to the Georgia Dental Association. He has lectured at the Academy of General Dentistry annual meeting, is a regular presenter at ITI study clubs as well as numerous other study clubs. He is a regular contributor at Red Sky Dental Seminars.

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6-Handed Bonding

August 22, 2017 Mike Crete DDS

How an Extra Dental Assistant Can Improve Your Protocol for Restorations

Restorations and adhesive dentistry have rapidly advanced over the past few decades. Changes in materials necessitate corresponding changes in protocol. Read on to learn the adjustment that drastically improved Dr. Mike Crete’s bonding process.

30 Years of Significant Advances in Clinical Dentistry

I have been practicing for a little over 30 years and often find myself looking back amazed at how many advances have occurred in clinical dentistry. Dental school requirements were focused on metal restorations that were either: (1) condensed into place (amalgam and gold foil) with “retention form” the key to success, or (2) cemented with the likes of zinc phosphate. Ah, the good ‘ol days of mixing on a cool glass slab!

My favorite general advancement over the years has been the concept of adhesive dentistry.  Not a day goes by in my practice where I don’t either bond a direct composite, bond a crown or two, or place an entire arch of bonded porcelain veneers.

Why 4-Handed Dentistry Fell Short for My Restorations

I must admit when I first started placing bonded restorations I was gun shy and felt like I would never be as adept as I was at carving amalgams or burnishing exquisite gold margins. I fumbled through bonded porcelain and composite like it was the same as metal restorations. I had mastered working with one chairside assistant. I could almost do dentistry blindfolded and 4-handed dentistry made me look great.

After about 3 years of really not liking treatment that involved bonding and finding myself justifying in my head how amalgam and gold were better, I finally had an aha moment when a mentor told me, ”You can’t do something new the old way.” I was a bit puzzled and asked, ”Why not?” My colleague then introduced me to the concept of 6-handed bonding.

6-Handed Dentistry Makes For a Better Bonding Protocol

Every time I do either a single unit or multiple indirect bonded restorations, I utilize both a chairside assistant and a “tray-side” or tertiary dental assistant. The tertiary assistant has the 5th and 6th hands.

The tertiary assistant helps by efficiently preparing the restorations for bonding (cleaning, silane, etch, prime, bond, resin adhesive, etc.) while the chairside assistant helps me keep the teeth isolated, etch the teeth, and place the restorations with precision and a very high level of accuracy. The chairside assistant can be totally focused on me and the patient, while the tertiary assistant prepares and hands me the indirect restorations.

Consider modifying your protocol to include a 3rd pair of hands and make 6-handed bonding part of your daily routine.

What is the most significant change in clinical dentistry you’ve noticed over the years? We’d love to hear from you in the comments!

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About Author

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Mike Crete DDS

Dr. Mike Crete lives and practices in Grand Rapids, MI. He graduated from the University of Michigan dental school over 30 years ago. He has always been an avid learner and dedicated to advanced continuing education., After completing the entire curriculum at The Pankey Institute, Mike returned to join the visiting faculty. Mike is an active member of the Pankey Board of Directors, teaches in essentials one and runs two local Pankey Learning Groups in Grand Rapids.

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