Dental Equipment

The decision to bring computers into the operatory is a big one, and it raises many questions. Some of the most common are: Where do I start? What do I need to buy? Where will the computer go?

There has been an explosion of dental offices adding computers in recent years, but there are still many clinics that need to incorporate technology better. One of the main reasons for delay is simply not knowing what to do.

In my experience, the best way for a technologically timid clinic to move towards computers is to begin by digitizing your intra-oral cameras. Why? Simply because they are non-essential systems. As you go through the process of learning to deal with computers in the operatory, you are bound to make mistakes. Messing up a few images is no big deal, but having to retake a full mouth series of x-rays is.

Once the decision to move forward has been made, the basic steps are:

1. Talk to your sales rep/technology rep and decide which camera you will use. Will it be a new USB camera, or will you be capturing images from an existing analog camera? What hardware do you need to accomplish this?

2. Decide where everything will go. Is there room for a computer and peripherals in your operatory? On the chair? In the cabinet? There are even wall mount brackets that can hold a CPU, monitor, keyboard and mouse.

3. Decide what software you will use. Choose something that you will be able to use long term. Don’t simply go with the cheap software that comes with the camera- buy full featured software that you will use later on. The reason is that you want to become comfortable with the entire system before making a move to digital radiography. Learning the software now will ease the transition later.

4. Reevaluate your hardware requirements. Double check the specs and requirements of your software and peripherals. Don’t skimp. Running image management software with the minimum amount of memory is an exercise in frustration. Ensure you have lots of memory and storage.

5. Evaluate your backup up and security systems. All images and records should be backed up regularly and preferably off site. Also, set up a bomb proof file security system. Free media coverage is great, but you don’t want to be in the news because someone stole your server and got their hands on confidential patient information.

Computer and networking costs can easily equal the price of digital x-ray sensors. Taking a baby step now will ease your ultimate transition down the road, save you money now, and make you more comfortable with the software and computer when the time comes.

computers in operatory, Dental Equipment, digital x ray sensors, Intra Oral Cameras

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Intra Oral Cameras

In a recent post I compared AC and DC x-ray machines, and focused in on one of the differences – consistency at short exposure times. Of course, consistency isn’t only important in short exposure times, but also in long exposure times.

As a dental office grows and ages, x-ray machines are often added and replaced; the new x-rays are usually not the same type as the existing machines. Over time, dental clinics end up with a wide variety of x-ray machines, and often, image inconsistencies from operatory to operatory. Thankfully, this is easy to fix.

Your service technician likely has access to a few x-ray test tools, such as an exposure timer, kVp meter, and mR meter. I will spare you the detailed technical discussion of the process; but your technician can actually go from room to room, recording data about your x-ray exposures, and make adjustments to the machines to ensure consistent radiation entrance dosages from room to room.

Sometimes, adjustments can be made internally to the machines, while sometimes the timer will simply have to be adjusted. This may mean different timer settings in each room: for example, Op 1 might have a bitewing setting of .18s, Op 2 .20 seconds, and Op 3 .25 seconds.

In my experience, this isn’t much of an inconvenience; most people seem to use one timer setting for the vast majority of their exposures anyway. For those who do change timer settings frequently, a simple printed label stuck on the front of the x-ray will tell you the proper setting for that room. And of course, a machine with a programmable timer makes this all automatic.

An entire 5 operatory practice can likely have this work performed in anywhere from 1 to 3 hours, depending on the type of x-ray machines in the clinic. For a relatively small cost, you can make dramatic improvements in the diagnostic capability of your office.

Posted by Ryan

Dental Equipment, dental imaging and x ray, maintaining x ray machines

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Dental Imaging and X-Ray

This writer recently had a discussion with a Dentist who was faced with a hefty service bill. An x-ray head had failed in his office, and the cost of the replacement head was $3500.00. He had inquired about the cost of a new machine, and was given a quote of $5000. What should he do?

Many factors play into the decision of whether to replace or repair damaged equipment; the age of the machine, condition, service history, etc. These factors should be considered before any repair, but x-rays pose a special consideration because they are generally so long-lived, and the repair bills are usually so high.

In my opinion, if the x-ray machine is out of warranty, and the tube head fails, the entire machine should be replaced. Note that many x-ray machines have an extended, pro-rated warranty on the x-ray tube head. This tube head warranty varies greatly from manufacturer to manufacturer, but 5 years is a general guideline.

Now, it’s true that x-ray generator technology hasn’t changed much in the last 5 years, but ultimately replacement is probably the best use of your money. There is no telling what kind of strain a tube head failure may have placed on the x-ray’s circuit board and power supply, and a failure of either of these components at a later date is likely to push the cost of repair past the cost of replacement.

Replacement also gives you the opportunity to lease the new machine, something you can’t do with a repair. In addition, the new machine will come with a new warranty. Generally, it’s better to repair than replace, but not when it comes to tube heads.

Posted by Ryan

Dental Equipment, dental imaging and x ray, tube head, x ray machine, x ray

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Dental Imaging and X-Ray

CADI 6 is the latest version of a dental imaging program developed and distributed by Synca Direct. It is one of the finest dental image management products on the market today.

Synca has designed CADI very well; the layout is crisp and simple, with easy to understand icons and very few clicks required to do what you want to do. Even new users will have no problem capturing and editing images because of the intuitive interface.

CADI is not a patient management system; however, it integrates very well with the vast majority of patient management systems on the market today. Of course, CADI also includes a very capable patient database, so if you aren’t running patient management software, CADI will be able to organize all of the images for you (Actually, CADI always organizes the images for you; when linked to your PMS it simply recognizes the patient’s name, and then opens up the correct file within its own database).

CADI is compatible with virtually all intra-oral cameras, extra-oral camera, intra-oral x-ray, and extra-oral x-ray systems. In addition, CADI can also launch external programs such as patient education files or treatment planning programs.

Many manufacturers of imaging equipment will provide imaging software for free, or at a reduced cost. This software usually works adequately, but only for the equipment that it was designed for. Using third-party software, such as CADI, for your image management provides several advantages. For example, if you are using a DenOptix machine (and VixWin) to capture digital radiographs, and want to upgrade to Schick sensors in the future, you will need to go through a complicated process to convert your old images into the new database. With CADI, you only need to install the Schick drivers onto the computer. Also, because you are paying for the software, it is designed to a higher standard than software that is given away at no charge. This means a better initial product, and better customer service when help is required.

For more information on CADI 6, visit the website at www.cadi.net. If not for anything else, check the wacky videos they have introducing the product.

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With the rise of digital radiography, equipment manufacturers have been releasing DC x-ray machines and touting them as the ‘best x-ray’ machine for digital radiography.

‘Best’ is of course, often a sales strategy. So what is a DC x-ray, and is it really better?

AC x-ray machines use an alternating current to drive the tube head to produce x-rays. This is usually the same 120v AC supply that powers our home; the voltage alternates from +60 to -60 volts, giving 120v of potential across two wires. The tube head produces x-rays for only about 1/2 of the total exposure time, as radiation is produced only during the positive alternation of the AC waveform. This method has been used to produce dental x-rays since their inception. It is a relatively simple technology and works very well.

DC x-rays are actually high frequency AC machines – rather than a 60 Hz waveform like an AC x-ray, they produce a very high frequency (often around 70 kHz) waveform, and only produce positive pulses. The end result is a much more constant output of radiation from the tube head.

What this means to the user is that during very short exposure times, the DC x-ray will produce more consistent radiation than the AC unit, by as much as 1/3 on a .04 sec exposure. As a result, images taken with a DC x-ray tend to be more consistent from image to image. However, this advantage disappears rapidly as the exposure time increases. Someone taking standard film-based bitewings at .25 seconds would not see the difference.

DC x-ray machines can provide more consistent images from low exposure time settings, but there is no need to replace x-ray machines just to go digital. The AC x-ray generator that currently hangs on your wall is more than capable of producing high quality, diagnostic images, even with digital radiography. However, if you are building a new practice or looking to replace an x-ray machine in the near future, it is worth taking a closer look at a DC unit.

If you are looking dental x ray machines check the listings of  new or used dental x ray machines on our site.

Dental Equipment, dental imaging and x ray, dental x rays, digital radiography, radiography equipment

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Dental Imaging and X-Ray

Most dental offices are familiar with the Pentamix 2 mixing machine. It is a wonderful time saver in a dental office, allowing almost any material to be mixed and dispensed into a tray with the simple push of a button. The large size of the cartridges means that you don’t need to be fiddling with syringes and mixing guns all the time, and when purchasing materials, you get a bulk discount.

3M has been very successful with the previous product, but still managed to find a way to develop a new and improved version.

The Pentamix 3 has several advantages over the previous machine; most notable is speed. The Pentamix 3 is twice as fast as the Pentamix 2, which will allow for the use of even faster setting materials.

The exterior of the unit has also been redesigned. The new Pentamix 3 has a much smaller footprint than even the Pentamix 2; it actually has the smallest footprint of any automatic mixing machine on the market today, saving you valuable counter space.

The automatic mixing capabilities of the machine mean that the end product is the same every time, with no voids. This results in better, more accurate impressions time after time.

There are also asepsis benefits with the Pentamix 3; traditional guns are clunky and difficult to clean. Because the Pentamix 3 is operated by a single button, cleanup is easy. The dispensing tips are disposable and simple to change.

Pentamix 3 also keeps you informed of its working status. A window on the front of the machine tells you what material is loaded, what the working time of the product is, and what the set time of the product is. In addition, there is a gauge on the left side of the machine that tells you how much material is remaining in the cartridge.

3M has made a marked improvement upon an already great product. For more information, visit www.3m.com.

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Dental Equipment,
Dental delivery units

Many dental offices wisely choose to purchase mechanical room equipment, such as compressors and suction machines, with dual heads. The theory behind this is when one compressor head or vacuum motor fails, the other motor has enough power to keep the office running while waiting for service or parts. It’s a great idea, but for some offices it just isn’t enough.

As your clinic grows past approximately eight operatories, the demands placed on your mechanical room equipment begin to grow exponentially. I have seen many 10 room clinics run on an MC-202 suction machine with good success – but when one suction motor fails, the office slows to a crawl. An old Copeland headed MDT compressor can easily run a clinic of this size – until one of the heads locks up. When that occurs, the compressor runs continuously, trying to keep up with the demand placed upon it.

Having major equipment breakdowns are costly, not just due to the repair cost, but also because of lost productivity in the office. To mitigate some of the risk of failed equipment, many large dental offices are now doubling up equipment in the mechanical room. Two compressors, two suctions, plumbed independently of each other, with a crossover valve in between them. This works best in a dental office with divided operatories. For example, an office with operatories on each side of a long hallway could plumb each side into its own suction machine. This effectively reduces the demand on the suction by one half. In the event of failure, you can simply turn a valve, and restore full vacuum to the clinic.

This is easiest to accomplish during the construction phase, but most offices can be refitted in some manner at a minimal cost. Spending twice as much money on equipment isn’t appealing to everybody, but compared to the cost of having a large practice sit idle for a day due to breakdown, it just might be one of the best investments you can make.

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Dental Equipment

As computers become more common in the dental operatory, issues concerning the cleaning and disinfecting of computer equipment are becoming more prevalent. Hospitals have been dealing with these issues for some time, and they have great, albeit expensive methods for dealing with them.

One example is that hospital monitors are often designed to be disinfected, and come with flat glass screens which are impervious to chemicals. Hospital keyboards in patient care areas are often either flat with no ridges, or use a touch screen interface to simplify cleaning.

Since most dental offices choose to use standard computer equipment, many of the hospital’s methods do not apply. There are a few things that I have seen used in the past that I thought I would share with you today. You will have to judge the effectiveness of these methods yourself, as I am not a medical professional. However, hopefully these ideas will either agree with you, or will spark your imagination and help you come up with your own solution.

Mice and keyboards pose the most common problems. A computer keyboard is often a cleaning & disinfecting nightmare, with all the individual buttons, complex shapes, ridges and gaps. It goes without saying that the mouse and keyboard should be wireless; cords would add a whole extra level of complexity, and would be a nightmare to keep clean.

Bluetooth mice and keyboard sets are widely available, have great range, and can be configured to not interfere with other computers in close proximity.

The most common solution I have seen for keeping the mouse clean is simply to use a stick on barrier film. This allows the buttons to be pressed freely, and cleaning the mouse is as simple as replacing the barrier. This assumes that the mouse is being used on a clean surface, and that there is no chance of the bottom of the mouse becoming contaminated.

Another solution is to use a Ziploc style bag. This could cause some problems with tracking if the bag were to get bunched up under the mouse, but cleaning the mouse is as simple as replacing the baggie.

Keyboards have several options available. There are plastic, roll up keyboards available – these still have the problem of a varied surface, but can be sprayed down with disinfectant and left to soak.

Many companies make plastic keyboard covers to prevent dust and crumbs from getting into the inner workings of the keyboard. These covers could also work in a dental office by allowing you to remove the cover and spray it down, or spray the keyboard with the cover in place. The downside to this method is that the covers do not last very long, since they are not designed to be exposed to harsh chemical.

The most common method that I see?

Simply wrapping the keyboard with Saran Wrap, and replacing the plastic between each patient.

What do you think of the methods described above? Have you used some or all of them in the past? Do you have an idea that works better? Leave a comment below, and share your ideas with your fellow readers.

Dentist with computer

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Dental Equipment,
Dental Imaging and X-Ray,
dental lab equipment

In recent blog entries, we talked about ways to attract patients to your practice. If you have missed them, here is a link to the articles.

The first article was on how to attract new patients to your dental practice.

The second article focuses on more ways to attract patients to your dental practice.

However, as a business owner it is not just enough to attract new patients, you also need to keep them. Luckily, this isn’t rocket science; you can use the same methods that any other business uses to retain customers.

1. Staff – Having a competent staff is a no brainer. Equally important is making sure that your staff is friendly. I am in dozens of offices each week, and I am constantly amazed at how RUDE some of the staff are. Nobody likes coming to the dentist to have procedures performed, but everybody likes coming to a friendly business. If your business isn’t friendly, and people don’t want to have the procedure done – why would they come to you?

2. Contact – Keep in touch with your patients. Send out holiday cards (Christmas can be a touchy subject, but Valentines Day, Thanksgiving, Independence Day or New Years are all pretty safe bets). Also, make sure to send out appointment reminders. When contacting patients, remember that there is a hierarchy of contact. Face to face contact is best, followed by voice, and finally mail. When dealing with voice calls don’t use automated message dialers – spend the money for a warm friendly staff person to make the calls for you.

3. Book Recalls And Future Hygiene Appointments Now – Never, repeat never, let a patient out of your office without booking a follow-up appointment. Even if the patient has to move the appointment at a later date, book a tentative date now. Ideally I like to have the hygienist or assistant book the appointment from a computer right in the operatory, but if that isn’t possible, make sure the receptionist does it.

4. Personalized Service – You should always do your best to remember personal details about your patients. If you have a memory like mine, this isn’t always easy – but it’s ok to cheat. I keep reminders of personal details in my BlackBerry, but you can write notes about patients on their chart. During the procedure, have they mentioned that they are moving, expecting a baby, or going on a vacation? Make a note about it and ask them about it the next time they come in. Nothing tugs at our heartstrings like being remembered. A good dentist asks their patients if they are having any problems with their teeth; a great dentist says “Hello Richard, how is that new house treating you?”

Follow these 4 simple steps for a start & you will be well on your way to developing a long lasting, mutually beneficial relationship with your patients.

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Dental Equipment

I recently stumbled upon a fantastic piece of equipment in a dental office. The Cadent iTero is a digital impression system that completely replaces traditional impression materials, trays, and models. The machine is quite large, a bit wider than a Cerec scanner. It has a monitor on top, a full-size keyboard, and a camera wand built into it. Essentially, the entire machine is a rolling computer with an intraoral camera built in.

When you start the machine, it asks you for several pieces of information about the patient and the impression you are taking (including the shade of the tooth). When the proper data has been entered, you begin taking scans. The camera is really just an intraoral camera, but the software has you take several photos of the same tooth, from varying angles, all guided by the on screen instructions.

Once you have captured enough images, they are compiled to form a 3D map, and an extremely accurate 3D model is generated. This digital model can then be sent to a Cerec machine to have a restoration milled, or to the company’s headquarters. At Cadent they create a model for you to send to your lab. The quality of the models made by the company is very high. The detail is like nothing I have ever seen before.

The benefits of this machine are numerous.

First and most obvious – you never need to buy impression material again, and there is no need to make the patient sit with a loaded tray of impression material in their mouth, gagging, while you wait for the putty to set to just the right consistency. Retaking the impression is free – just rescan the image.

Of course, the machine looks cool and high-tech, so the patient is impressed, and it’s likely that they will tell their friends and family about you. In addition, this is exactly the type of tool that would make a great media story, as we discussed in a previous post (link to old post).

The Cadent iTero is what technology should be all about in a dental office; save time, save money, and get better results. You can find out more about the Cadent iTero, including watching videos of the machine in use, by visiting http://www.cadentitero.com.

Dental Equipment, Intra Oral Cameras

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Intra Oral Cameras