Cliff's Notes

The Business of Dentistry

Dental Handpiece Maintenance?

Why are some dental handpieces so expensive? That’s like asking why some cars are so expensive. I was talking to a dentist last week who mentioned that a friend of his buys $35.00 handpieces from China and when they break down after 3-4 months he just throws them away.

What is the difference between that $35.00 high speed and a $1200.00 one? A lot! A craftsman does their best work with the best tools. As a dentist you are a craftsman, you restore human anatomy.

High Speed Handpieces … Carbide burs and diamond stones preform best when used with a quality tool. High Speed handpieces spin at 350,000 rpms, faster than a jet engine. Quality tools are laser balanced, will maintain their centricity under load and minimize or eliminate chatter. Internal components regulate air flow to maintain true cutting speed and torque for predictable performance. Quality pieces are designed ergonomically to be hand held and have a much lower decibel level offering personal health benefits to the user. Everyone has different views about high speeds but just remember, you get what you pay for. Regardless of what you spend, proper care & maintenance will increase the life of the turbine cartridge.

The High Speed Turbine … This is one of the most misunderstood piece of dental equipment. Stainless steel or ceramic bearings ride inside a race (track) that is attached to a cylinder with blades (fins) that capture the air to spin the turbine. Sounds simple, but it is not. The detail engineering and specifications require a regular maintenance plan that will not reduce the life span of this little jet engine and please, keep them away for Disinfectants.

Disinfection & Sterilization … If you are not using an automatic handpiece purge unit the chances are that you are not cleaning or lubricating properly. Handpieces need to be cleaned and lubricated before sterilization. Forced pressure lubrication is always better because it will clean the turbine cartridge at the same time it lubricates and by using an autoclavable lubricant you will help protect the moving components from the repeated sterilizer heat. Never use disinfectants of any kind to wipe clean a handpiece. Use plane water, they are made to get wet, and a hand scrub brush if needed. Remove the handpiece from the room before spraying or wiping counters and equipment. The disinfectants release a vapor into the air. This vapor will settle on the handpiece and degrade the metal.

The Metal … Dental handpieces are made of titanium or stainless steel. Titanium is better (and more expensive) because it is lighter in weight and more resistant to sterilization but most are made of stainless steel. However, stainless steel is just that, it stains less. There are different qualities of stainless steel so you will get what you pay for.

Your #1 Tool … A baseball player always uses the best glove, some even sleep with there bats. A Photographer will use the best camera available and a painter will use only the best brushes. Your high speed, low speed, air driven or electric’s are your #1 tools. You use a handpiece of some type on 99.98% of you patients. Quality tools will help you be the best you can be, they are your brushes! You can save money in a lot of places but there are three, where money should not be an issue. (1) Your overhead light (2) The stool you sit on (3) Your handpiece. Please feel free to contact me at any time with any questions or concerns.


January 21, 2018 Posted by | Uncategorized | Leave a comment

“A Picture is Worth a Thousand Words” … Napoleon Bonaparte

A treatment plan presentation begins when the patient calls for an appointment and walks through the front door into your reception room. Your office doesn’t have a waiting room because your patients don’t wait.

A treatment plan presentation is all about communication and that begins with the patient’s perception of you, your team and the physical environment. If the office looks old how does that effect the patients perception of care?

Napoleon Bonaparte was known as the Little General. He really wasn’t that short but he surrounded himself with tall bodyguards. That image also helped hide his military genius from his enemies and retain the loyalty of armies. What professional image does your practice portray?

The Professional Image … When you get to the office do you walk in the front door or the back? When I visit my clients I always use the front door and sometimes I am shocked at what I see. My business background is marketing and operations and Stu Leonard was one of my marketing heroes, he once said “Retail is Detail” and the detail is what you need to pay attention to. I can’t tell you how many times I have picked up wet newspapers and brought them to the front desk or, while I was waiting, picked up a magazine that was 10 months old. It’s so interesting reading about baseball spring training after the season is over. It looks and feels old and competes with your success.

Competing with yourself … This is not good and it is so avoidable. What magazines are in your reception area? What is playing on the flat screen (I hope it’s a flat screen)? Think about this, your 35-45 year old patient is reading about a great newly designed putter or an outrageous hand bag that sell for $250.00. Then you tell that patient that they “should” have an old restoration replaced. What do think they will do? I think they will say “maybe next time”. If they are watching the travel channel in the reception area, what are they thinking about? It’s not veneers or aligners. Keep the focus on oral and systemic health.

Systemic health … This is the core of the patient experience and the picture you want to portray. Your patients don’t understand that you are a physician and part of their health care team. Your reception area should have heath related magazines and oral health related videos on the flat screen. Keeping the patient focused on health will help them better understand your clinical suggestions. The average patient also respects technology and dental imaging because now you can show them pictures and a picture is worth a thousand words.

The Picture … several years ago I started working with client in an affluent New Jersey town. It was a million dollar location but the practice had not been updated in over 20 years. The dentist is an excellent practitioner with a great personality but the new patient count and re-care system was struggling. Reluctantly, the dentist invested over $100k and renovated the practice (with no down time). They scripted the team, focused them on the patient experience and enjoyed meeting over 100 new patients (that all re-appointed) over a 9 month span. The picture is only getting brighter.

Keep Making it brighter … Gandhi once said “we are the language we speak”. New diagnostic tools are becoming more available to dentists. To remain part of the healthcare revolution that is well underway you need to consider utilizing some of these tools. Technology now allows you to use digital imaging along with your words to explain clinical issues. Technology also allows you to offer your patients an analysis of systemic abnormalities and probabilities. You are not “just” a dentist, you are a physician and a key part of your patient’s healthcare team. Stay current, stay relevant and keep making that picture brighter.

January 17, 2018 Posted by | Uncategorized | Leave a comment

Time, Technology, Money … 2018(Not Necessarily in That Order)

Many of my clients know my feelings about getting up in the morning. We all get up for one of three reasons, fortune, glory, or the betterment of humanity. Well, it all starts with fortune. Unfortunately there is another saying “it takes money to make money” and that is what prevents most people from trying to reach out and grab the gold ring.

Reaching Out for the Gold Ring … Developing a business plan and trusting yourself with the implementation and the financial investment required is the hardest part. Most of us don’t have the ability to do it all so the investment in a quality team is the first thing to be addressed. Another old saying is “pay peanuts, get monkeys” and that means you will pay more for quality. Most dental practices that have difficulty expanding don’t look at the business foundation and how well it is supported. Without the blocks to build on you will not be able to keep up with the changes over the next decade. The longer you wait to engage, the more expensive it will be. You need to factor in the “learning curve”.

The Learning Curve … It takes a certain amount of time to learn and master a technique or a software program. The new world of dentistry is all about the network and how diagnostic and business management systems integrate. Understanding and utilizing this integration is very important and that means quality in-office training and support.

Training and Support … Yes, it can be expensive but it is essential for your ROI. Unfortunately most dental offices do not realize that some technology integrates better with certain other technologies. Buying a digital radiography system that needs a software bridge to your practice management system creates another step for information to transfer. The Digital trainer may not be familiar with the bridge and that could be a week spot in your production chain. Popular brands usually work well together but a smooth implementation depends on quality training and continued support. Now you have come full circle and need the team to train.

The Team … You need to choose a team leader that could be in command with regard to procedure and protocol. Operational systems need to be maintained for a healthy work flow and maintaining consistency is hard. You can’t keep an eye on everything while you caring for your patients. Morning huddles and monthly team meetings are necessary to keep your team focused and involved.

Focused & Involved … “Involved” is the key word. Always keep your team involved with any changes you plan on making. Before you implement something new (i.e. an impression scanner or software) explain your plan to your team and ask their opinion. Your decision may have been already been made and the order placed, but by consulting (not informing) with your team you can address any fears and concerns that could derail a smooth integration. People don’t like change and some are afraid of a challenge for fear of failing. Bonus systems should be considered as rewards for team performance, that gives everyone a common goal. You can’t keep giving raises, we’ll discuss that next week. Please feel free to contact me at any time with any questions or concerns.


January 7, 2018 Posted by | Uncategorized | Leave a comment