The Importance of Team Training When Implementing a New Practice Management System

Today, there are very few dental practices that do not have a practice management system installed. The days of front office staff flicking through a paper diary and shuffling notes from dentist to hygienist are long gone for most. Owners and practice managers spend hours researching the best system to suit their practice’s needs; perhaps they are a multi-site practice and so need a system that can cope with different locations, or maybe they require a piece of their existing equipment to integrate seamlessly with the software. The decision is an important one, as a lot of time and money is being invested. Sometimes, the area that can get overlooked due to resource constraints is the dental team’s involvement. Their inclusion and motivation for the practice management system is essential in its long-term success and full utilization.

Training the Team

If you are about to install a new system—or you are changing to alternative software—the initial training and ongoing support of the whole dental team is pivotal in its success. Even if there are members of the team who will use it to a lesser degree than others, their understanding of how the program works and where they can find certain information might prove beneficial in the future. Suppliers of practice management systems should offer comprehensive guidance and support for all members of staff; this should also be part of the decision maker’s criteria when assessing which system to purchase. Often, the training provided is an assortment of face-to-face teaching, self paced online training and written instructions, and then—when needed post-launch—webinars, telephone interactions and online forum support as appropriate. Continue reading

Interpreting Advanced Imaging: It’s Best to Know Nothing

by John Khademi, D.D.S, M.S.

Interpreting advanced imaging, such as CBCT imaging, is tricky. Evidence of just how tricky becomes apparent during lectures I give on the subject. I will show a study to the audience and discuss it for several minutes. When I take it down, I ask them which side was buccal? Which side was palatal? Was it tooth number 14 or number 3?

The audience will start guessing, because they really don’t know—even after looking at the tooth for 5-10 minutes. They would never mistake buccal for palatal, or the tooth numbers, with 2D radiography. But with 3D radiography, it happens all too often. I’ve been evaluating 3D imaging everyday in my endodontic practice for eight years now, and I can still make this kind of mistake. The issue is this: we don’t have that same set of skills with 3D radiography that we do with 2D radiography, but we think we do.

In medical radiology, however, they’re well aware of the complexities that go along with interpreting imaging. That’s why medical radiology is a four-year specialty after medical school—with sub-specialties after that. You don’t want a mammographer evaluating the CT of your head or a thoracic radiologist reading your mammogram.

The need for specialization is clear: interpreting 3D imaging calls for a well-trained eye. That’s why we have to be very careful when we interpret with CBCT. For this reason, I’ve developed a strategy for interpreting 3D imaging based on what has been learning in medical radiology.

It’s important to note that I don’t automatically order an imaging on every patient. Whenever possible, my staff provides me with the minimum information necessary to determine if an advanced imaging study should be prescribed.  This very counter-intuitive finding is captured in the title of a 2002 paper in Radiology from noted radiologist Dr. Thorn Griscom: A Suggestion: Look at the Images First, Before you Read the History.”

Whenever possible, the preferred method involves doing two reads—first, without looking at the projection radiograph, doing a clinical exam or talking to the patient first about their symptoms or getting the history. My goal is to not have any preconceived notions about what the findings may be, let alone the diagnosis. Of course, with CBCT—especially with the focused field—if it’s an upper left side, I have a pretty good idea of where the problem is. But that’s all I really want to know.

I evaluate the study through that lens. I then get the history, look at the projection radiograph, review all the clinical information and perform the clinical exam. After that, I go back and look at the CBCT study again. This approach is very counterintuitive and not widely appreciated.  Current recommendations for approaching are as follows: conduct a thorough clinical exam and radiographic exam before prescribing imaging. In my opinion, that’s backwards, and not based on what has been learned about the interpretive process through careful research in medical radiology. Continue reading

CBCT at Its Best: Get Involved

Dr. Kunal Shah is the Principal of a new practice in Hendon, London – LeoDental. With a state-of-the-art CBCT installed, the practice is receiving referrals for implant planning cases. Completing his series of articles looking at the use and benefits of CBCT in implant treatment, Kunal explores where dentists can start when getting involved with implantology, highlighting the importance of mentorship.

Unlike other areas of dentistry, there is no clear path to follow when looking to get involved in implantology. It is often down to the individual to seek the appropriate training through courses and postgraduate qualifications that satisfy the GDC’s requirement for implant dentists to be competent in the field.

When looking for an initial training course, I would recommend asking the following questions in order to overcome some of the hurdles I faced:

  • What does the course entail? What do you gain at the end of it? – You need to establish whether you’re looking for a qualification or clinical experience, as this will determine what type of training you chose. The qualification courses tend to be the MScs and Diplomas, which are heavily theory-based, while others are more clinical and practical-based. I personally preferred the clinical element – as a dentist, you already have knowledge of the anatomy, so implantology is simply building on this. I also believe you need practical experience to develop your skills, learn from your mistakes and understand the different scenarios that can occur in practice. Continue reading

CBCT at Its Best: In Practice

Dr. Kunal Shah is the Principal of a brand new practice in Hendon, London – LeoDental. With a state-of-the-art CBCT installed, the practice is receiving referrals for implant planning cases. In the second instalment of his three-part series, Kunal demonstrates a clinical case study where CBCT scanning was integral for predictable treatment and the very best outcome for the patient.


A female 52-year-old patient was referred to me from a local practice for implant surgery. I had developed a good rapport with the referring dentist, who was looking for mentorship through this case. The patient had had missing teeth for several years (15-20), although this had only recently begun affecting her lifestyle as she had issues eating – the problem was therefore functional rather than aesthetic.

The patient was fit and healthy, with no relevant medical background or allergies, a non-smoker, social drinker, moderate previous dental restorations and generally good oral hygiene. The LL6, LL7 and LR6 were missing, having been extracted many years ago. The adjacent teeth had started to drift and the opposing teeth on the other side were erupting.

The treatment options were discussed with the referring dentist and the patient, which included no treatment, bridges, dentures and implants. The patient wished to proceed with implants and consent was obtained. Continue reading

CBCT at Its Best: The Perks

Dr. Kunal Shah is the Principal of a new practice in Hendon, London – LeoDental. With a state-of-the-art CBCT installed, the practice is receiving referrals for implant planning cases. As part of a three-part series, Kunal begins by considering the treatment pathway for implant treatment and how CBCT imaging improves the process for a more predictable outcome.

As implant dentistry continues to increase in popularity among the profession and patients, it’s important to establish a protocol for consistently safe and effective treatment. The quality and type of imaging used during the assessment and planning phases has a huge influence on this. In particular, the cutting-edge CBCT scanners now available offer unprecedented visualisation of each patient’s anatomy for precise planning and predictable outcomes.

For dentists new to dental implantology, the standard treatment pathway is as follows: Continue reading

2018 Predictions: Leveraging Technology to Impress Patients

The desire for convenient treatment is nothing new, but now more than ever patients want to have the benefits of the latest technology with minimal steps. Dentistry’s Image Expert, Janice Hurley, advises practices to continue to embrace tech-savvy patients in the year to come.

How do you help patients understand how dental technology improves their overall care?

The opinions expressed on the blog are a reflection of the author and not an endorsement from Carestream Dental.

2018 Predictions: Riding the Wave of Digital Transformation

Advancements in intraoral scanner and 2D panoramic equipment technology along with the increased use of CBCT systems are key indicators that the analog to digital transition will continue to intensify in 2018. Carestream Dental’s chief dental officer, Edward Shellard, D.M.D., shares his vision for the future of digital dentistry.


Which digital tool has made the biggest difference in efficiency for your practice?

2018 Predictions: Disrupting the Oral Health Industry

Offering innovative technology paired with responsive support is a critical requirement modern oral health practitioners expect leading dental companies to fulfill. Bart Silverman, D.M.D., reveals more business necessities essential to the evolving industry.


How have the broader possibilities in the oral health industry changed the way you purchase equipment and software for your practice?

The opinions expressed on the blog are a reflection of the author and not an endorsement from Carestream Dental.

2018 Predictions: Faster and More Predictable Implant Planning

Eliminating the guesswork of implant planning by utilizing cone beam computed tomography in conjunction with an intraoral scanner is one trend Ara Nazarian, DDS, believes will influence dentistry in 2018.

How do you think technology will change implant planning and placement in 2018?

The opinions expressed on the blog are a reflection of the author and not an endorsement from Carestream Dental.

Trends for 2018 Are Timeless!

What will be the biggest dental trends in the New Year? Carestream Dental asked industry leaders for their thoughts and Lisa Moler, publisher, MedMark Media, came back with her predictions.*

As publisher of Implant Practice US, Orthodontic Practice US, Endodontic Practice US, and Dental Sleep Practice, I get to be involved with an amazing profession. With all of the new procedures, techniques and equipment being developed on a global scale—it takes time and effort for clinicians to keep current on the latest opportunities to treat patients faster, more comfortably and more effectively. Luckily, by reading print and digital publications and attending webinars, dental professionals can have that information at their fingertips!

One of the most prevalent changes in dental practices is the race to “go digital.” Electronic medical records systems, electronic insurance billing, digital X-rays and patient portals are becoming expected for an efficient office.

3D imaging continues to revolutionize oral healthcare by giving clinicians the opportunity to have a “surgical view” without even picking up a scalpel.  The options for low-dose imaging have been a boon to clinicians who place implants. Seeing dental anatomy in 3D, plus obtaining all of the possible measurements related to bone density and other data, all help to avoid possible complications before and during surgery. Continue reading