Dentaltown May 2013 - (Page 14)

howard speaks column » Is Dentistry Getting Too Easy? by Howard Farran, DDS, MBA, Publisher, Dentaltown Magazine This year I celebrated my 25th year of practicing dentistry and looking back over the last quarter century, sometimes I wonder if dentistry is just getting too darn easy. The first five years I practiced, I had a 24-houra-day, 7-day a week, callous on my thumb and index finger from carefully moving stainless steel endofiles up and down all the time. When I graduated from dental school, it literally took me two hour-anda-half appointments to manually clean out a tooth. Dentists today are so lucky! Now we have 300RPM nickel-titanium files that takes care of business in less than half the time – and in a single appointment, no less. Radiology is also undergoing a complete revolution right now, and endodontics has become so much easier because of it. There is a high percentage of American dentists who use two-dimensional X-rays and it’s so surprising to me how few have moved over to the new 3D technologies. I have still not met a single dentist who’s gone from 2D to 3D and will ever go back. So many skeptics who still use 2D ask: “Well does insurance cover it? Will I have to charge extra?” Yet every single dentist I know who uses 3D says they don’t even care. It’s just amazing what you can see with the new technology. I mean, look at endo again. For years, every time a root canal failed we just assumed we did something wrong. Like, maybe we were just short of the apex and we didn’t get it all cleaned out. When you use 3D imaging, you can plainly see the root is fractured. If you can see that, just imagine how much more dentistry you can diagnose and treatment plan! I predict, within a few years, general dentists will not refer to endodontists who don’t have 3D X-rays – how would the endodontist even know if the tooth had a vertical fracture if she can’t even see it? Root canal failure is why so many endodontists warranty their work. If it fails in the first year, the patient will get 3/4 of their money back; if it fails in two years, the patient will get half of their money back and so on. If the root canal lasts four years, it’s good enough. The best endodontists, on the other hand, outright refuse to warranty their work. They’re good at what they do, and if they’re using 3D imaging, they can see everything! You’re telling me you’re OK with taking $1,500 of someone’s hard-earned money to perform a root canal that’s not going to last a year and you don’t feel any shame or guilt about it? That ruins endo and root canals for everyone! What sort of connotation does it carry when someone tells you: “I don’t want a root canal. Just pull the tooth. My cousin got a root canal and they had to pull the tooth a year later anyhow. What a waste of money.” The American Dental Association was way ahead of the curve when they granted specialty status to oral radiologists. In the future, the dentist isn’t going to be the person reading X-rays. Oral radiology is going to explode – not just in the United States but internationally. That’s all thanks to the Internet! I see practices taking 3D X-rays and e-mailing them to an oral radiologist somewhere else on the planet, and within a few minutes, the oral radiologist reads the X-ray and tells you what you’ve got. The best endodontists in the profession use 3D cone beam computed tomography (CBCT), and they have the ability to place implants. I want my retreats to go to an endodontist who can take an accurate 3D X-ray and if she decides that the tooth isn’t salvageable, the money isn’t an issue because she can either make $1,500 doing the retreat or she can make $1,500 pulling the tooth and placing the implant right then and there. That is outstanding customer service to the patient! You’d have to agree with me; dentistry is getting so much easier! Look at CAD/CAM. Since I’ve been a dentist all the best labs that I know will tell you that all the best dentists have about a six percent remake rate (couple that with the dentists who say they have never had a remake in 25 years, you know the truth is somewhere in the middle). Now with impressions going digital with optical scanning, those same labs continued on page 16 14 MAY 2013 » dentaltown.com http://www.dentaltown.com

Table of Contents for the Digital Edition of Dentaltown May 2013

Dentaltown.com Highlights
Howard Speaks: Is Dentistry Getting Too Easy?
Professional Courtesy: High Tide for High Tech
Continuing Education Update
Industry News
Second Opinion: The Stainless-Steel Crown for Primary Molars
Special Second Opinion: Prevent a Tulsa Repeat
Simple Two-implant CT Guided Case
Does Your Staff Ask for Referrals?
Your 2013 Website Optimization Starts Today
I Attended Your CE and All I Got Was This Crappy Notebook
Dentaltown Research: CAD/CAM
New Products
DIY Finance, Part VI: Red Flags and Scams
Employee Working Interviews: They’re Legal, Aren’t They?
The Sleeping Giant in Your Practice
What’s on My Tray? Prep and Impression, Crown and Bridge
Continuing Education: Articaine and Paresthesia in Dental Anesthesia: Neurotoxicity or Procedural Trauma?
Concentric Circles Dentaltown’s annual focus on the charitable side of dentistry
All the Things Money Can’t Buy
Taking on Pro-bono Cases
Doing Good and Doing Well
Global Dental Relief
Giving Thanks, One Smile at a Time
Big Help on a Local Level
Oral Health America
You Should Know: Climb for a Cause
In This Issue: Where Should Prevention Begin?
Perio Reports
Ad Index
Profile in Oral Health Prada or Prevention: A Look at Public Health and Oral Health
Dentally Incorrect

Dentaltown May 2013