How do you find good dental staff members?

Although I have tried a number of methods, currently Craig's List seems to be an extremely affordable and productive source. I used to place expensive classified advertisements in the New York Times, but Craig's list has a better response rate, at one tenth the cost. My office manager calls the most promising candidates. She arranges interviews and 'working interviews' for the best candidates. Usually, I am looking for 'nice' employees. I can not train someone to be nice. Skills can be trained, but personality can not!

Usually over the course of a normal work day we can gauge how well a potential candidate will fit into our office and we ask our patients whether they like the candidate. Patient input is extremely helpful when evaluating a hygienist or receptionist, since these two positions interact independently and directly with patients.

Are discount dental plans worthwhile?

Dentists have overheads of 60% or more and asking them to reduce fees by 25%-50% or more can make it difficult for them to make a profit. In what probably is the best case scenario, a patient can be fortunate and find a dentist whose practice is not busy enough to keep his appointment book full and is using the discount plan to fill his empty appointment slots. In this case, the dentist is using the plan as an advertisement of his or her practice and as a way of recruiting new patients. Treating patients from the plan may not be highly profitable, but may help a dentist cover his fixed overhead.

From a patient's point of view these plans may seem like a huge bargain and are tempting to patients in search of affordable dentistry. The obvious problem is that choosing a dentist from a list of "low bidders" is probably not the best way of choosing a dentist,contractor or any type of service provider. Also, all the value of any savings will be negated, if this choice leads to dental treatments or restorations that do not work out well.

A far better method of choosing a dentist is "word of mouth" (pardon this corny pun). Getting a recommendation from a satisfied patient, or another doctor is more likely to lead to a positive dental experience than choosing from a list of discount dentists.

What should a Dentist be prepared to do while waiting for a 911 ambulance?

Medical emergencies occasionally take place in dental offices and can result in a 911 call being placed. What should the dentist do while waiting for an ambulance crew to arrive? The following is a guest post by Jon Bloomberg, EMT and a respected and certified AED/CPR trainer in the New York area who will provide an answer to this question.The short answer is that New York State dentists are required to hold a current AED /CPR card to maintain a their license. The requirements may differ for other states. This implies that Dentists should be able to recognize and respond appropriately to sudden cardiac arrest, heart attack; syncope, choking, stroke and allergic reactions. Other situations may arise but these are the most frequent life-threatening situations that dentists may see in a practice.

It’s not expected that a dentist will be as proficient or knowledgeable as an EMT or ER physician. Dentists should act within the guidelines and treatments that they feel comfortable with and for which they have been trained. However, repeated group and staff training will facilitate a proper and effective response by the team.

Although New York State regulations do not require everyone in a dental office to be trained, it is a good idea for all staff members to receive training. In my experience the easiest ways to accomplish this training is to have it done in the office. Accordingly, for the past four years, I have been providing training for dentists at their convenience in their own offices. I find that when the group is cohesive (namely an office) that people learn better and are more likely to retain the learning. It is my hope that when people learn as a team that they will be better prepared to handle a medical emergency as a team.

How do I eliminate sensitivity from my posterior composites?

This is a question posed by a dentist regarding her patients complaining about sensitivity after having white fillings placed.

Most often sensitivity after having a filling is due to the technique use in preparing and placing the fillings. Most of my patients are not complaining of sensitivity after having a posterior composite placed. I will attempt to explain my technique.

When preparing a filling I usually use a 330 bur with out cross cuts . This bur is rounded at the end and doesn't usually create internal cross cuts or micro cracks. When using it I use gentle hand pressure and plenty of water coolant from my hand piece. Most of the time I place vitrabond over the deepest portion of the cavity preparation. I use a 15 second all etch technique and wash off the acid solution for 10 seconds or more. I dry the cavity preparation passively by waving my high speed suction tip over the preparation. My intention is to leave the preparation 'wet'. The surface should be glistening. If I have inadvertently over dried the preparation, I will re-wet the prep using a micro brush and water.

I use prime and bond and apply at least three times. I assume this is enough times to allow the acetone in the formulation to chase away the water in the prep. Then I air dry and cure as recommended by the manufacturer.

At this point I apply Flow it (flowable composite)sparingly to cover most dentin surfaces. I use an endodontic explorer to disperse it in the prep and use a micro brush to remove any of the flowable that inadvertently was applied to the cavosurface. I cure this for twenty seconds. Then I use a hybrid composite that I have previously placed on my bracket table. This composite has been prepared in to little balls of varying sizes and stored under an amber dappen dish (so that it won't set prematurely). I place small amounts into the prep and adapt each addition carefully and set it with my curing light. after the preparation is filled completely I am ready to finish always using water while removing the excess composite and smoothing the filling.

Of course there are other excellent techniques for preparing, placing and finishing composites, but I thought it might be helpful for me to share my technique.

When are you going to get Ida a new computer?

I am embarrassed to say that this is a question I get asked at least once per month. Ida is my office manager/receptionist and she has been using a Power Mac (circa 1996) to run our out dated office management Dental Mac software. I am not really as cheap as it sounds, since buying a new computer was not the issue. What was I waiting for???? I was waiting for the right time to invest in a new dental management system and in networking my office. This is a necessary, but fairly costly investment.

I am happy to report that we had the office wired yesterday and Ida has a brand new Dell computer! We purchased the Dentrix G4 management system and will be receiving our training shortly. This program, when used in conjunction with the Dexis digital X-ray system we installed in 2009, allows our office management system to be fully digital. If we choose, we can go paperless and use the system for maintaining all of our patients records, as well as submitting dental insurance claims electronically.