Cliff's Notes

The Business of Dentistry

NHII Part 2 & a Review on Carries Detection Systems

Cliff’s Notes for February 27, 2011

….. E-Blast…..

 Cliff Marsh, Henry Schein ……Cell: 201-321-7494……Fax: 201-262-2210…..E-mail:


There are no constraints on the human mind, no walls around the human spirit, and no barriers to our progress except those we ourselves erect. 

Ronald Reagan


In This Week’s Issue

  • The NHII (National Health Information Infrastructure) Continued!
  • The Good, The Bad & The Ugly!
  • Product Review – Carries Detection Systems!


NHII – National Health Information Infrastructure – Continued! 

The ADA says that every stakeholder in dentistry that is involved in developing, maintaining or accessing patient information should participate in the National Health Information Infrastructure. The ADA information can be accessed by logging on to the following link and then click on the “Dentist Version”.

 Dr. Robert Ahlstrom, a practicing dentist who serves on the NHII Task Force and also serves on the ADA Standards Committee on Dental Informatics and the Council on Dental Practice, on Jan. 5, 2007, told a group of new council chairs the following:

“As the evidence of crossover between medical and dental conditions continues to emerge, an electronic patient record will be essential in determining treatment and evaluating outcomes. When up and running, it’ll be like accessing a web page on the internet. Dentists will participate through their practice management systems, accessing technology from a main database. If a patient has already been to a dental or medical practitioner it will be easy to obtain information about that patient from his or her EHR through the standards established by the NHII.” 

Ask yourself these questions:

  1. Are my radiographs in a high quality digital format?
  2. Is my charting digital and can I go paperless?
  3. Are there networked work stations in all of  my op’s?
  4. Is my practice management software updated and capable of NHII integration?
  5. Do I know how to use my software & integrate?

Do not try to create or integrate on your own!

  1. Ask for advice from a healthcare technology integration specialist and not your IT group. There is a difference! IT groups builds the highway; an integration specialist helps you drive it.
  2. Keep your staff focused & committed.
  3. Become informed, involved & committed.
  4. Go into the project, consulting with your financial advisors. When projected and funded correctly, it’s amazing what they can do. In just 2-3 years you can recover your investment. Then it’s “retained earnings”, there’s that phrase again, ya got to love it.

“The first rule of any technology used in a business is that automation applied to an efficient operation will magnify the efficiency. The second is that automation applied to an inefficient operation will magnify the inefficiency.”                                                                Bill Gates


The Good, The Bad & The Ugly!…………………………

Yes, it’s a cult movie classic. Yes I watch it every time it’s on. It is The Classic American Spaghetti Western, but maybe it’s also your office. It’s time to walk in the front door and take an objective look at what your patients see.

When was the last time you put down new carpeting? When was the last time you changed the colors of the office? Now you may think that your patients are coming for you and most are, however, everyone else is going to the office down the street. Why? The office down the street provides an enhanced patient experience.

We’re not talking about expensive technology; we’re talking about simple housekeeping. Basic hospitality enhances the healthcare environment and is an important part of your marketing program. With all the money you spend on your re-care system, website, mailings, promotions, write-off’s, etc., it all comes down to the patient in the office, their experience and willingness to come back. It’s called “value added services”.

The first thing you need to do is probably the hardest. You need to stop using the term “waiting room”, in your office nobody waits. It gets a new name, “Reception Area”. Now I know it sounds corny to think of a phrase as a starting point, but it establishes a mind set and a standard. So, what should a reception area be like?

  1. Comfortable Seating.
  2. Current magazine issues (After 3 months, get rid of them).
  3. Soft lighting.
  4. Flat Screen TV.
  5. Refreshments.
  6. Aroma Therapy. 

The list goes on. I just love it when I walk into an office and there are pleasant sights, sounds and smells. So, now let’s look at the “furnishings”. Have disinfectants taken a toll on you chair upholstery? Is the finish coming off your delivery unit? Are your counters or furnishings scratched or chipped? Now let’s face it, if your coach at home was torn would replace it, or at the very least, fix it? Your patients would. What are they thinking after seeing a taped up chair and your BMW in the parking lot?  Then there is Spa Dentistry and I’ll leave that discussion for another time.

My Father, who was my hero, had some great sayings. One was “I’m going talk to you like a Dutch Uncle”. A Dutch uncle tells the hard truth even if it hurts. So, you want the truth? Can you handle the truth? When patients see your office looking warn and tiered, it reflects on you. Marketing 101, Packaging is 95% of the Sale.” Some of you may remember a brand called “No Frills Foods”, everything from cereal to soap, all in plain white boxes. No Frills had lower prices because they saved money on expensive packaging and advertising. Well, people still wanted Tony the Tiger. No Frills went out of business. I don’t care how small or old the space is, you can make it up to provide a better patient experience. 

You’re a Good dentist; don’t get beaten by the Bad & the Ugly. I hope you enjoy this clip. I thought it would be fun on the last Sunday morning in February.


The trailer to the film “The Good, the Bad, and the Ugly” the greatest spaghetti western ever made.


 Product Review: Automated Carries Detection…….

Carries detection is what you do. I always said that a sharp, high quality explorer finds a lot more “issues” than a dull one. However, in today’s world of technological advancement, there are better ways.

About 8-10 years ago Kavo America introduced the Diagnodent. Once calibrated correctly the small hand held unit used laser technologies to identify color changes within virgin tooth structure. Great concept and every pediatric dentist should have one. By finding carries that are forming below an apparently healthy tooth surface, minimally invasive procedures can be incorporated to eliminate the decay. The system has a street price of around $2500.00 and, when used correctly, will raise your standard of care and pay for its self in about 120 days. Unfortunately, the Diagnodent is not effective on restored teeth, so technology needed to advance.

Introduction to DIAGNOdent

Integration of DIAGNOdent in your practice

Several years ago Kodak introduced a visual caries detection system as part of their digital radiography software program. Great idea, but you needed to use your x-ray unit to utilize the format. Unless you specifically target an area, you won’t get full arch diagnosis. This method is a little impractical on routine exams due to radiation concerns.

Two years ago, we were introduced what may be the Holy Grail of carries detection, or at least the pathway to it. Intraoral cameras now use “blue light” to detect carries and project them on your monitor and your software will capture the diagnosis and store it in the patients history (NHII 1/1/2015). The blue light technology is similar to how the Velscope Oral Cancer Detection System identifies abnormal tissue.

A picture is worth a thousand words and an intraoral digital image taken during a hygiene exam will dramatically change your practice by improving diagnosis and patient acceptance. The cameras work on restored teeth and a full arch exam is fast, informative and requires no unnecessary exposure to radiation.

There are two systems on the market that I like. Yes, I personally prefer one over the other, but that’s a personal decision. They are both excellent pieces of equipment. In-office demonstrations are available and are recommended. I can arrange these for you at any time. The street price is around $5k – $5500.00 and that investment should be recovered in less than 60 days if incorporated correctly into your exam procedures. This is a proven fact.

Below are informative videos on the 2 units I recommend. For more information please feel free to contact me at any time (201-321-7494).

Sopro Life by Acteon.

Polaris/Spectra by Air Techniques

Air Techniques | Spectra caries detector| Dental Product

Sunday February 27, 2011……………………

Today is Sunday, February 27th. It looks like we’ll make it through the winter. As we enter the change of season, remember to “Beware the Ides of March”, be safe and take some time to enjoy your family. They are the reason we do what we do.

Cliff Marsh

Henry Schein Dental

P.O. Box 663 / 45 Rt. 46 East, Suite 605

Pine Brook, NJ 07058

Cell: 201-321-7494

Fax: 201-262-2210




February 27, 2011 - Posted by | Uncategorized

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