Click here to enlarge imageArticaine is considered to be the best–selling local anesthetic in the world. And for good reason. Despite some studies, most dentists have found that it provides deeper anesthesia, with far fewer missed blocks, than other anesthetics. It also exhibits superior diffusion properties, so blocks are not needed for lower premolars forward, only lower molars. Moreover, you only need half a carpule. So you also deliver less epinephrine and produce less trauma. For compromised patients, consider 1:200,000 carpules for even safer injections. (Brands: Zorcaine, Cooke/Waite–Kodak; Septocaine, Septodont)
2) Chairside sandblaster
Do you have a micro–etcher in each operatory? Get one today! Sandblasting internal surfaces of crowns will double their retention. Bonding to old resin requires sandblasting for new composite to adhere. Intraoral porcelain repairs also require micro–etching.
One–step bonding agents bond poorly to uncut enamel margins. A quick blast from a microetcher roughens enamel to produce longer–lasting restorations. Do the same for no–prep Class Vs over abrasions or abfractions.
Use your sandblaster to remove old cements, clean preps (including those for posts), or remove stains. Blast out grooves before applying sealants to improve retention. Prep incipient lesions without anesthetic. Call your rep to install an extra air line in each operatory. (Brands: Danville; Parkell. Cost: approximately $200)
3) Payment plans
Why do many people avoid dentistry? Cost! Dental financing cards offer an answer, but many patients who need them are rejected. What do you do? Try the “Enhance” and “Help” cards. They separate patients into several tiers to provide programs for even marginal patients. To cut your discount rate, ask for a down payment (accept it on a credit card for 100% financing). (Enhance Patient Financing (877) 436–4262; HELPcard (888) 750–6793)
4) Better antibiotics
Are you still using the same antibiotics we were taught to use in school? Here are some alternatives to consider:
→ To increase compliance and build your practice, make antibiotics easy for patients. Consider the Zithromax “Z–Pak.” It's taken once a day for five days, yet provides 10 days of coverage. For perio infections, try doxycycline (Rx: 100 mg once per day).
→ What should you do when the antibiotic does not work after two or three days? If you've prescribed penicillin, amoxicillin, or Zithromax, add Flagyl (metronidazole) to get more anaerobes. (Rx: 250–500 mg x 20 Q6H.) Or switch to clindamycin. This medication is effective against anaerobes, will kill penicillin–resistant organisms, eliminates worries of allergic reaction, and is inexpensive. Colitis is extremely rare (virtually negligible) for dental regimens. (Rx: Cleocin 150 mg x 20 TID).
→ For more about amoxicillin, Keflex (why you shouldn't use either), erythromycin (critical update), Augmentin, and key antibiotics, see the “Anesthesia” guide at our Web site.
5) Dental insurance tips
Are you sending electronic claims? Sixty percent of dentists are not. What a mistake! Call your software support people or National Electronic Attachment (NEA) today. Electronic claims are cheaper to send. They are also typically paid in only five days for easier collection of co–pays. [NEA: (800) 782–5150]
Did you know that 40% of dental claims are denied due to clerical errors or missing information? Electronic claims automatically flag such claims before problems occur. They also stop mistakes and “lost claims” by eliminating manual data entry by distracted clerks.
You do not need digital X–rays or high–tech equipment to send X–rays, narratives, and photos electronically. Just get a scanner with a Transparency Materials Adapter (TMA, from $250 to $1,000). For how to do this, see our free newsletter (sign up at www.HundredsofPearls.com).
6) Sedation explosion
Sedation allows you to help fearful patients who may have avoided the dentist for years. It also allows you to do longer, more productive procedures all in one visit.
Halcion (Triazolam) oral tablets have a duration of only three to four hours, followed by a speedy recovery. Patients often fall asleep during treatment. This drug has a wonderful amnesia effect, so people commonly remember little of their visit.