Putting Out Fires

Posted on March 12, 2015 by The Dental Warrior

Some days, I feel like I’m the dental version of a fireman. On Monday, I saw a new patient who had been referred to me by a colleague in Ohio (who knows me through the Dentaltown message boards). The patient is a “snow bird” who spends his winters in Florida. It happens a lot, as it seems there is a rule that most patients up North eventually end up in Florida. I share many patients with my northern colleagues.

First Fire

The patient, a 75 y.o. male with a history of multiple myeloma, had a chief complaint of a loose bridge. It was implant-supported with abutments in the position of #9 and #13. Interestingly, rather than pontics, there were crowns on natural teeth in the positions of #10 and #11. There is a pontic #12. So, it was combining natural teeth and implants. Except, the natural teeth were no longer really part of the equation (as you’ll see below)

The patient was planning to return home to Ohio in a couple of weeks. Normally, I’d recommend replacing the screws with new screws (and I told him so). The old screws have been stressed cyclically and are prone to breakage. But, he wanted a quick fix, and I thought I’d just tighten the existing screws enough to get him home to Ohio. And, so that’s what I did. I recommended that he see his dentist ASAP when he gets home. I also mentioned that the entire bridge may need replacement.

He’s baaaaack

Yesterday, the patient called to tell us the bridge came out completely. Rut-roh! I knew the screws did not likely loosen themselves all the way out in a couple of days. And, I was right. Both screws broke off in the implants. Oh, crap. I saw him this morning, and this is what I found.

Here's what was under the four splinted crowns.

Here’s what was under the bridge.

Continue reading →

Posted in Case Presentation, Practice Management, What Happened Today | Tagged broken implant screws, CAD/CAM, cerec, single central incisor, under the bus | 24 Comments

Are You A Dentist or THE Dentist?

Posted on February 13, 2015 by The Dental Warrior

Seems like a strange question at best and an ego-driven rhetorical question at worst, right?

Mandelbaum! Mandelbaum! Mandelbaum!

“So, you think you’re better than me?”

I couldn’t help working in a Seinfeld reference!

A meeting of the “dental minds” in Las Vegas. Can you name them? 🙂

What do I mean by the title of this article? I was thinking about how most of my new patients referred by my website end up on my website and then in my chair. I often ask those patients if they remember which search terms they used. Often, they tell me they were looking for something specific… a specific service or a specific type of dentist. They weren’t looking for A dentist. They weren’t looking for ANY dentist. They were looking for THE dentist (who met some specific criteria).

Who are you? Who, who? Who, who?

Yes, there are many prospective patients looking for A dentist who: Continue reading →

Posted in Editorial, Marketing, Practice Management | Tagged long tail, search engine optimization, website marketing | 4 Comments

How Do You Tell a Patient Her New Crown Must Be Replaced?

Posted on February 11, 2015 by The Dental Warrior

A family that was in my practice moved out of state (Iowa) several years ago. They recently returned and became patients in my practice again. First, the husband came in, as a tooth was bothering him, and he had been told it needed treatment back in Iowa. The tooth needed a crown, and he asked, “Can you do it it one visit?” I replied, “Did you get a one-day crown back in Iowa?”

My wife did. Do you do them?

No. I’m very familiar with the technology, but it’s just not right for my practice.

Why not?

It has its place in dentistry. But, I prefer lab-fabricated restorations.

And, he seemed satisfied with that. We proceeded with his new crown.

Along came Sally (not really her name)

Yesterday, his wife returned to my office for an exam and to get back into the hygiene recall system. We got her recent x-rays from Iowa by email. I noticed the new crown on tooth #18. She told me it’s been sensitive ever since it was placed (less than a year ago). She also asked, “There’s a dark line at the bottom. Is that a problem?” I replied, “That could be a number of things, let’s take a look.” Continue reading →

Posted in Practice Management, What Happened Today | Tagged cerec, crown, dental do-overs | 20 Comments

Do You Have the Balls to Be Great?

Posted on February 7, 2015 by The Dental Warrior

balls This is another quick and dirty post inspired by a discussion in a Facebook group. The group is based on the idea of having a FFS (fee for service) practice by design. One member was concerned about the FFS business model, because she is surrounded by a lot of practices competing on price….

Our demographics: office is surrounded by chains and PPO driven practices all marketing free X-rays, dirt cheap cleanings, Saturday hours. The local patient base shops for fees. The local dental chains (2 of them within 2 miles) will do anything for a buck, regardless of the long term outcome for the patient. This is the kind of competition that we have to live with. I am not throwing in the towel, just sharing some of our reality.

And those patients that do go to the chains, often end up in our office paying the higher fees. But the tide of mediocrity, the Walmart culture, is formidable. We are outnumbered.

Being “outnumbered by mediocrity” is a HUGE opportunity…. IF you aren’t mediocre. Instead of competing with them, “hit’em where they ain’t!”

Now, of course, just as everyone THINKS they he or she is an excellent driver, most dentists claim to be “excellent dentists.” But, ARE YOU?

Time for a reality check:

Continue reading →

Posted in Editor's Favorites, Editorial, Practice Management | Tagged FFS vs managed care | 22 Comments

Random Thoughts of the Day

Posted on February 4, 2015 by The Dental Warrior

It’s been an interesting couple of weeks. This will be a quick and dirty blog article. No pictures. No fancy editing. Just what happened this week and what I’m thinking. GO!

Thought #1:

It all started with a seminar…

Last week, I attended a local 3-hour presentation by my friends from New Patients Inc (Howie Horrocks and Mark Dilatush). I’ve known these guys for around 15 years, or so. I’ve also used New Patients Inc (NPI) for various marketing projects. They are my “go to” guys for marketing expertise.

At the presentation (to a small group), Mark and Howie remarked that I had heard their material before. I said, “Yeah… but, I’m stubborn, and sometimes you have to beat me over the head to get through. So repetition is good for me!” And, yeah… I HAD heard it all before. But, I still get something from it, and I invariably walk away with an idea to implement.

Just one “pearl” is all I need.

One of the things they talked about was website marketing – one of MY areas of “expertise.” A hallmark trait of NPI is that they have DATA to back up their assertions. They studied which factors or things interest consumers when it comes to choosing a dental office. I won’t go through the list here, but one of the highest ranking factors was “technology.” Consumers like to know about the use of technology in a dental office.

One of the most common “technologies” that are featured by dental offices is digital x-rays. I do not use digital x-rays in my office (for a number of reasons). So, it did not really occur to me (until my epiphany at the NPI presentation) that there is more to “technology” than digital x-rays. So, I went home and immediately went to work on crafting a new page for my website just about the technology I do use. I came up with the list and then expounded on each technology in terms of PATIENT BENEFITS. Patients don’t care about why WE like technology. They only want to know “what’s in it for me?” That’s a VERY important point! Remember who the audience is.

They don’t care which technology you have… just that you have SOME technology. And, we ALL do! So, make your list and begin writing about how it BENEFITS patients.

Along came an 87 year old…

On Monday, I had a new patient Continue reading →

Posted in Marketing, Websites, What Happened Today | Tagged dental technology, just say yes, website marketing | 4 Comments

Happy Anniversary-ish TDW!

Posted on January 17, 2015 by The Dental Warrior

This month marks the beginning of the FIFTH year of The Dental Warrior Blog! Holy crap, time is flying. I began writing TDW, in earnest, in January of 2011.

I want to THANK YOU, my audience, for indulging my rants, raves, and rabble-rousing. Really… It means a lot to me that my writing resonates with so many (and pisses off a few). I also enjoy the creative (and cathartic) process of writing!

I thought I’d share some blog stats with you.

In the last four years, I’ve posted 277 articles (not including this one). That comes to an average of 5.8 articles per month. When I started this blog, I worried that I would not be able to come up with enough “material” to keep it going. I do have occasional dry spells. So far, so good!

From January 1st, 2011 to now, the blog has had: Continue reading →

Posted in Dental Warrior Announcements | Tagged The Dental Warrior anniversary | 3 Comments

“That’s Very Expensive, Doctor!”

Posted on January 14, 2015 by The Dental Warrior

I treat patients from all walks of life. Contrary to a reputation that mysteriously precedes me, I don’t have a practice full of wealthy people with bad teeth and open wallets. I wish! But, my patients do span the spectrum. A significant portion of the “big cases” I do (which have been few and far between since 2008) are for patients that are very much middle class.

I understand that times are tough for many people, and I’ve kept my fees steady for the good part of this “recession.” Furthermore, about a year ago, I implemented an in-house membership-based dental savings plan called, “Quality Dental Plan” or QDP.

For a tooth?? That’s too much money!

I am occasionally frustrated by those patients who “cry poor” when it’s quite obvious they’re not. I am not at all bothered by the fact that some people just don’t value their teeth or the services of a good dentist. Really… they’re not MY teeth. I’ve “matured” to the point of being very comfortable presenting treatment options and letting the patient decide. They can do:

All of what I suggest.
Some of what I suggest.
None of what I suggest.

I present the advantages and disadvantages of each. In the Navy, we used to say, “Run it up the flagpole and see if anyone salutes.” It’s all good. I’ll be here when you’re ready. Dr. Bill Blatchford once said, “Some will. Some won’t. Some wait. So what? Next!“

But, I’m on a fixed income!

This week, I had two patients who Continue reading →

Posted in Practice Management, What Happened Today | Tagged patient objections, treatment planning | 19 Comments

Who They Gonna Call?

Posted on January 12, 2015 by The Dental Warrior

Who will your patients call? Who will they think of when a friend needs a dentist? Why will they think of you? It could be that they love your hygienist. It could be that they love your front desk or your chairside assistant. It might even be because they think you’re the greatest clinician ever. It could happen!

WILL they think of YOU when the topic of dentistry comes up? Are you memorable? How ENTHUSIASTIC will their recommendation be?

Hopefully, your practice is firing on all eight cylinders and the answer is “all the above.” But, what ELSE can you do to be memorable? I’ve posted numerous articles on the value of photography in this blog. Of course, dental photography has value in terms of documenting clinical conditions and results… lab communications… publications… marketing… and so on. But, it’s also an unexpected and MEMORABLE value-added service for patients. Several months ago, I wrote about a young woman with Down’s Syndrome. We provided some cosmetic dental care for her and had a ball doing a “glamor photo shoot.” Click the link to see the case and the glamor shoot!

We just got a very nice “Happy New Year” photo greeting card from her family. The photo of Lisa on the right is one from her photo shoot here at the office. How’s that for a compliment?

A short blog article to kick off the year! Happy 2015! Let’s make it a great one!

Posted in Photography, What Happened Today | Tagged dental photography, glamor shoots, happy new year, photography | Leave a comment

Higher MPG Cars = Higher Costs! What??

Posted on January 1, 2015 by The Dental Warrior

Happy New Year!

And, now for something completely different on the first day of 2015. I just LOVE (I really do) blowing widely-held “conventional wisdom” out of the water with FACTS. I write mostly about dentistry and firearms on this blog. I’ve written one other article about cars – Tire Safety – before this one.

My wife and I were talking about a friend’s new car (and how proud he is of the fuel efficiency). He got a Volkswagen Passat with the diesel engine. A lot of Americans who drive fuel-efficient cars enjoy the bragging rights. And, that’s OK. But, some take it to the point of disdain towards those who prefer less efficient cars to serve their purposes. It’s become a political high-horse to some. This is not the case with my friend, by the way.

Though I’ve never owned a diesel, based on what I knew about cars, I have long contended that they are a better way to go than the “hybrids” that gained sudden popularity thanks, in part, to Hollywood elites prancing about in their Priuses. Yeah, that sentence runs on a bit, but breaking it up just wouldn’t have the same impact!

(Edit to add: Prius owners need not get butt-hurt. I was having some fun with alliteration while making the point that celebrities played a significant role in the popularization of hybrid cars, and that began with their endorsement of the Prius. Brilliant marketing!)

If you like your car, you need not justify it. Enjoy it! This article is focused only on dissecting the oft-reported economic advantages of driving a diesel or hybrid.

Diesels have long suffered a stigma in the United States. Many Americans still believe that diesels are the dirty, slow, weak, and noisy smoke machines of the 1970s. Meanwhile, Audi’s racing team has been winning in the Le Mans Series (endurance racing) for well over a decade… in DIESEL-powered race cars.

Tonight, I got a wild hair and decided to parse the actual economics of diesel and hybrid cars vs their gas-powered counterparts. I wanted to see if the widely-held belief that hybrids and diesels are more economical in the long run was true. I’m just weird that way (among others). Continue reading →

Posted in Current Events, Editorial | Tagged car ownership costs, cars, diesel, fuel efficiency, hybrid | 15 Comments

REAL Dental Warrior – Dr. McBadAss, WW2 Medal of Honor Recipient!

Posted on December 10, 2014 by The Dental Warrior

I just learned about U.S. Army dentist, Captain Ben L. Salomon. And, wow! What a story!

Dr. Ben L. Salomon was drafted into the Army in World War II. He ended up as a front-line surgeon. That’s right… in war time, military dentists become trauma surgeons… then and now. Before I was deployed on an aircraft carrier (which ended up in “Operation Desert Shield”), I had to go through “C4 – Combat Casualty Care Course.”

In the Battle of Saipan, Captain Salomon was running a battlefield aid station (only 50 yards behind the first foxhole line) tending to the wounded. It was overrun by the Japanese enemy. After killing several Japanese soldiers with a rifle and hand-to-hand combat, he realized the four men manning a machine gun were killed. So Salomon took over the machine gun and ordered the wounded to be evacuated. The next day, Salomon was found dead, slumped over his machine gun. He suffered SEVENTY-SIX bullet wounds and multiple bayonet wounds. His finger was still on the trigger! But, before him lay NINETY-EIGHT dead enemy soldiers.

Here is his Medal of Honor citation. Read it! The details are amazing! Continue reading →

Posted in Editorial | Tagged Captain Ben L. Salomon, medal of honor, world war 2 | 19 Comments

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