We are able to prep teeth, remove the pulps of teeth, replace missing teeth, scale teeth, remineralize teeth, remove teeth, repair teeth and some dentists involved in research are even able to grow teeth! But, an ability that is lacking for most is the ability to move teeth.

One of the most frustrating things for many general dentists is that they have to develop a treatment plan based on the current position of the teeth. Since the vast majority of adult patients will not seriously consider traditional orthodontics, most dentists don’t seriously consider discussing this option with their patients. Sure, dentists and hygienists will oftentimes mention traditional braces as a possibility, but the conversation quickly ends when the adult patient rolls their eyes at the mere thought of having a mouth full of metal for two years.

How do you deal with tooth position problems? Do you offer up a referral to the orthodontist and when the patient says no, you succumb to the idea that your treatment plan will need to be based on the existing position of the teeth and gingiva? Have you tried using aligners for your patients with crooked teeth, only to find that the level of control and predictability you have with aligners is very much lacking? This is the plight of many dentists around the world.

This is the situation we find ourselves in, because as long as dental schools have existed the focus has been on training dentists how to deal with dental disease. Mal-positioned teeth have not, for the most part, been considered disease. Furthermore, orthodontia has historically been a complicated field that involved precise wire bending, fitting and seating bands, and multiple years of treatment. Ortho started outside the realm of general dentistry and has predominantly remained there. My experience shows me that we are all keenly aware of the fact that even as orthodontics has become remarkably simpler with the invention of super-elastic wires and pre-programed brackets, orthodontists have aimed to keep general dentists out of the business of moving teeth.

When aligner systems like Invisalign® entered the market about twelve years ago, everything changed. GPs now had an easy way to learn and implement orthodontics in their practices. We were all thrilled. Adults now had an attractive alternative to traditional braces and we, as general dentists, could provide this to them. The promise that aligners provided almost seemed too good to be true. In many ways, that has proven to be accurate. The limitations of aligners have created many frustrations for patients, orthodontists and general dentists. The lab fees are high, there is little control over specific tooth movements and compliance can be a problem. Aligners offer very restricted practitioner control over achieving the tooth movement that is desired. Rotations and extrusions are particularly difficult. Aligners can work well for some types of cases, but have proven to not be the panacea that was hoped for.

We practice in an era where there is no clear line between health and beauty in dentistry. Patients desire teeth that look great and function comfortably. The ability to move teeth to a more ideal position greatly enhances a dentist’s ability to help their patients with both cosmetic and functional issues. Short-Term Orthodontics is a relatively new field within dentistry that has exploded because dentists understand the opportunities associated with being able to predictably move teeth in a short period of time.

Short-Term Orthodontics involves the use of tooth-colored brackets and wires to gently straighten teeth in less than nine months. Systems such as The Six Month Smiles Short-Term Ortho System allow general dentists to predictably and safely provide an attractive orthodontic option to the adult patients in their practices. The short treatment times (six month average) are achievable because treatment goals are more cosmetically focused and the brackets are uniquely designed for this purpose. Goals of treatment are very similar to most aligner cases. Crowding is corrected, deep bites are improved and spaces are closed but Angle Class is not usually changed.

As dentistry evolves, dentists who can provide tooth movement in a manner that patients will actually say yes to, have an advantage. I believe that within the next few decades, Short-Term Orthodontics will be a part of the vast majority of dental practices. It’s a great service for patients, the demand is high and dentists can get started with minimal training and low costs. The growth in this field over the last five years speaks to a future in which dentists can include moving teeth on the growing list of things that they can do. It’s exciting for everyone, especially our patients.

You most likely pay your team members at the same hourly rate each week, but the performance of some team members undoubtedly fluctuates from week to week. Is this fair? Is this what you want? I would answer with a resounding NO to both of these questions. In this article, I’ll explain why and I’ll provide 3 shifts you can make that can yield success and prevent an entitlement attitude within your team.

Employment is an exchange. It is the exchange of time and effort for money. A poisonous mindset can start to take over members of your team if they realize that they get paid the same amount from week to week even if their focus and performance drops from time to time. If the paycheck is the same each week but the performance oscillates, people tend to quickly forget that each week, there is supposed to be a fair exchange of output for money. When this happens, the paycheck is seen as an entitlement rather than something that must be earned each week.

Imagine how your team members would respond if each week their paycheck was written randomly for a different amount. Do you think they would accept this pattern? Then why do some of us accept varying levels of employee performance, attitude and output from week to week? The culture and energy in your office can completely change, for the better, if you make some slight shifts. These shifts will help ensure that YOU are in charge of your business, rather than allowing the often-present negative attitudes and moods of your team running the show.

Here are my suggested 3 shifts for increasing accountability and eliminating an entitlement mentality:

1. Know and Communicate Your Team’s “Deliverables”
I focused exclusively on this in my last article. For each position, you are best off if you know what you want in terms of deliverables for each position on your team. I recommend writing down 5-10 deliverables for each position and communicating these clearly to the team member in each position. Deliverables for various positions could be things such as: All patients confirmed the day before their appointment, $XXXX in production scheduled each day, XX new patients per month, a professional and positive attitude at all times, no whining, oral hygiene instructions and risk factors discussed with each hygiene patient, or all models poured with no blebs and no voids. You put yourself in a fantastic situation if each team member has a written list of deliverables and has acknowledged that they understand they are getting paid to deliver these things.

2. Personally Hand Out Pay Checks Each Week
This may sound strange, but this by itself is a total game-changer. If you know what you want delivered from each team member, this knowledge should allow you to know how you feel about each team member’s performance. As you deliver a paycheck or pay stub to each employee, let them know how comfortable or uncomfortable you feel in regards to their performance for that pay period and the amount of money they are receiving. Any concerns you have about performance should be addressed. And any praise due should be given as well! This creates a clear and direct connection between your view of their performance and their pay. If your front desk manager isn’t confirming appointments, let him/her know that it is unacceptable and that you are not comfortable paying him/her if that trend continues. Would you feel comfortable paying your waiter for the entire amount of the bill if you didn’t get all the food you ordered?

3. Let People Go If They Are Not Delivering
Most of us hate letting people go. It’s not easy. But if your goal is to have the most successful dental practice possible, the best way to ensure that you DON’T reach your goal is to keep people on board who aren’t delivering. If a team member isn’t performing to the level that you expect, it can really hurt you in two ways. First, the exchange is unfair. You are paying for something that you are not receiving. Also, it communicates to the rest of the team that it is acceptable to perform in a fashion that is less than excellent. Why would other team members strive for excellence if Jennifer continues to get paid while not doing the same?

Businesses tend to be most successful when team members understand that not everyone can work there. If you are willing and able to make the three shifts listed above, you can turn your practice into a magnet for all-star performers. If you know what you want, keep your expectations tied to the paychecks and let go of the non-performers, you can create a fantastic team with a vibrant culture. Pay top dollar to the all-stars who are performing, treat them with respect, and go after what you want with fervor. Hire slowly and fire quickly. Everyone achieves more when they know what is expected of them, they’re paid well to deliver results, and they clearly see that not everyone can be a part of your great team!

You’re probably stressed while running your dental practice. Whether you are an owner or an associate, the way you lead your team can greatly affect the amount of stress you feel from day to day. Many dentists that I talk to are overwhelmed with trying to run and grow their practices because although everyone is working hard, the dentist is shouldering most of the responsibility regarding success or failure of the organization. There is a way that you can turn it all around and start being happy and more successful. Everyone on your team will be happier too.

If you want to be a great leader and also empower your team members to be great, you need to have clear deliverables for each position on the team. By clear deliverables, I mean that each team member should know what they are getting paid to “deliver” to you, the dentist. “I’m paying you X to deliver Y to me.” If you hire a painter to paint your house, the deliverable is pretty simple… “I will pay you X to paint my house blue and the quality of the paint needs to meet my standards.”

We all know that people most often thrive and succeed when they know exactly what is expected of them. In my experience, most dentists do it exactly the wrong way. They hire people and tell them what activities to perform – “bring the patient to the chair, assist me during treatment, get the room ready for the next patient and then do it all again.” Then, when the team member does something “wrong” the dentist “zaps” them and tells them that they should do it different, better or faster. This completely limits the potential of everyone in the office, including the dentist. It also keeps the burden of success on the dentist and the stress starts to build, permeating through the office.

I was recently talking to a dentist named “Evan” who was dealing with this exact situation. He has an incredibly busy and successful practice, but he is completely stressed out and feels like the future success of the organization is sitting squarely on his shoulders. As opposed to giving his team members clear deliverables, he told me about all the rules and policies that he and his partner had developed over the years in order to help keep the team members doing things “correctly.” He described how all 100 team members (yes, a big practice!) always got further and further “out of policy” and then he would finally have a big team meeting each year, in which he and his partner would tell the staff that they were failing to follow the policies correctly.

He would say things like “today we’ll forgive everyone for past mistakes but going forward you all need to be better at following the policies.” Evan realized that this same pattern was repeating year after year and that everyone was miserable and felt like slaves to the policies. Evan and his partner felt responsible to create more rules and policies to keep things in check, and all of the team members felt that they had no freedom to perform and innovate. The problem is that they were all getting paid to “follow policy” rather than being empowered to use their talents, skills, creativity and abilities to deliver results.

The amazing thing is that when we give team members a clear picture of what results we want delivered, they will oftentimes deliver results that are bigger, better, faster and easier than we could have imagined. That is the power of the human spirit when it has the freedom to soar. When people are slaves to rules, policies, and “should haves,” they cannot truly take ownership of the end result, and the burden of success or failure stays completely with the person who is making up the policies. In Evan’s case, he felt all the stress because he was the only one free to dream, innovate, come up with new ideas and think about the “big picture.” He was driving himself crazy and making everyone around him miserable at the same time.

Here is how Evan, and you, can reduce stress and completely flip this situation on its head. If done right, everyone will be empowered and the whole practice can thrive. Take some time to think and imagine that you have a time machine. Imagine that you step out of your time machine, one year from now, and the practice is hugely successful and just the way that you want it to be. What things are happening in the office that make it such a success? What does the balance sheet look like? What is the patient experience like? Did you grow by 10%? Are you running on time? Are you taking more time out of the office? Are team members thinking about new and creative ways to grow the practice and make things easier for everyone? Are team members spending some of their time in the evenings thinking about how to get more patients into the office?

You can make all of these things a reality by creating and describing clear deliverables for each position on the team. Describe the destination you want to see one year from now and NOT the day to day activities and policies. That’s their job! Figure out what you want and task your team with figuring out how to get there. If communicated with clarity, grace and passion, they will thank you for it. Set the captives free to succeed. They just need to know what success is. Only you can define it.

“There’s infighting within my team!” “I can’t seem to motivate my staff!” “I have a moody employee whose moods affect the whole office!” “I get tired of all the gossip in the office!”

Do any of these concerns seem familiar to you?

Every dental office has its own culture. Some cultures are healthier than others. The culture that exists in each office is a direct reflection of the leader of that particular office. Whether conscious of it or not, the dentist sets the tone of the dental office with his/her attitude and behaviors. Does the team communicate openly and honestly with each other? Do members of the team confront each other directly when they have a concern? Do members of the team manipulate people and situations to avoid working as hard as others? The answers to these questions are determined by the office culture, which is primarily fostered by the dentist.

Whether we like it or not and whether we know it or not, when we run a dental practice we create the “rules of engagement” within the office. In my experience, many dentists don’t enjoy dealing with the negative consequences that their leadership creates. Also, many of us are unwilling to take personal responsibility for these consequences. Instead, we have a natural tendency to blame others when conflict and tension arises. However, we can make enormously positive changes when we take personal responsibility for what goes on in our offices. We may have not actively created certain situations (like a team that constantly gossips about each other), but we probably allowed the situation to develop. Like most problems we face, we can’t solve them until we own them.

My experience has shown me that the number one change a dentist can make in his/her practice in order to take control of the office culture is to create a team of truth tellers. By “truth telling,” I’m referring to a communication style that involves addressing concerns as soon as they are recognized.

Most of us want to be nice, and we believe that it is “nicer” to avoid conflict with someone than directly raise our concerns. It may feel “nice” to ignore things that bother you, but it ultimately can do a tremendous amount of harm as this approach will absolutely limit your ability to reach your goals.

When another person’s words or actions make us uncomfortable (like when an employee’s moods control the atmosphere in the office), we usually have four choices:

1. We can try to ignore it by “bottling it up”
2. We can get frustrated and send indirect signals to communicate our frustration (like giving someone the “cold shoulder”)
3. We can get agitated and speak our minds in a harsh tone
4. We can raise the concern directly, but with a productive and professional tone

Out of these four options, raising concerns directly with a productive and professional tone is the only one that works. If we “bottle up” our concern, it only makes us resentful and we usually have to deal with worse ramifications later on. Communicating frustration through indirect means such as “the cold shoulder” or moping will only build resentment within others and speaking our minds out of anger always pushes people away.

I don’t know about you, but I want to work within a culture of “truth tellers.” It’s not for everyone because as the old saying goes, “the truth hurts.” This is true, even when truth is delivered in a graceful manner. Some people just can’t deal with the truth. These are the people that we don’t want in our offices. These are the people that hurt office morale, make the lives of others in the office more difficult and create a whole array of problems that are detrimental to reaching our goals.

An office full of “truth tellers” is an office with unlimited potential for success in every aspect of the word. If that sounds appealing to you, it’s time to take responsibility for the problems that exist in your office. Stop blaming others. It’s impossible to create a culture of “truth tellers” if the leader is not one. Are you a truth teller? Change can be difficult, but at any point in time we can shift direction and start walking down the path that leads to our desired destination. What’s YOUR next step?

Short Term Orthodontics (STO) is typically thought of as a cosmetic procedure. Similar to treatment with aligners, most patients pursue STO primarily for cosmetic reasons, but changes to tooth position can greatly benefit function and help to preserve tooth structure and TMJ integrity. For these reasons, restorative dentists have found STO to be an essential part of their offerings.

In our practices, we oftentimes see patients who have constricted chewing patterns. Also described as a constricted envelope of function, these people have premature contacts on their anterior teeth and various forms of adaptation occur to allow for posterior teeth to contact. In other words, the brain and body adapt to allow for a maximum intercuspal position that includes posterior occlusal contacts. Adaptive changes that occur to help establish these posterior occlusal contacts generally include: muscular retrusion of the mandible with distalization of the condyles, anterior tooth wear, anterior fremitus and/or anterior spacing. In essence, the maxillary anterior teeth are simply “in the way” of the lower anterior teeth and are an obstacle that makes normal and healthy function of the stomatognathic system more difficult.

When a constricted envelope exists, it is challenging for restorative dentists to address because the etiology stems from non-ideal tooth positions. Many dentists will suggest a referral to an orthodontist, but the acceptance rate for conventional orthodontics among adults is extremely low. Typically, many dentists would then plan a restorative process aimed at altering the dentition and alleviating the constricted envelope. Unfortunately, because of the significant additive changes that need to be made, a restorative treatment plan that can effectively eliminate the constriction is usually a costly endeavor and can involve the preparation of multiple teeth. Similar to conventional orthodontics, many patients are unable or unwilling to pursue an extensive and costly restorative option.

Short Term Orthodontics has proven to be a highly desirable cosmetic procedure and the most practical and effective method for treating some occlusal discrepancies such as a constricted chewing pattern. It is a cost effective, minimally invasive and time-sensitive solution. Also, it is a procedure that general dentists can easily learn and implement. General dentists who have a treatment modality that can alter tooth position in a timeframe that is feasible for adults are able to greatly expand the scope and effectiveness of their clinical offerings. The treatment planning process completely changes when alterations to tooth position, gingival margin location and interocclusal relationships can be made predictably and in a manner that adults will actually say yes to.

The Six Month Smiles System is a GP friendly cosmetic braces system that provides for impressive orthodontic changes to be achieved in an average of six months. The attractive treatment times are achieved by a combination of unique orthodontic brackets and a shift in treatment goals compared to conventional orthodontic treatment. When adult patients refuse traditional orthodontic treatment, the Six Month Smiles System provides general dentists with the ability to offer an orthodontic option that is more practical for most adults. The system includes easy one step seating of pre-positioned brackets and shape memory wires work in conjunction with the unique brackets to safely achieve the desired results.

The goals of treatment are very similar to those associated with aligner cases. In most cases, angle class is not altered and bucco-lingual root movement is minimal. However, with very light forces, significant changes can be made in 4-9 months. The arches are rounded out and leveled, crowding is eliminated, spaces are closed and visual symmetry is achieved. Cosmetically, the changes are life-changing and the control over the occlusal scheme that is afforded is significant. As the arches are leveled and aligned, constricted chewing patterns are very easily alleviated. Also, occlusal improvements can be achieved that allow for cessation of occlusal dysfunction that can occur when the existing occlusion prevents the central pattern generator (in the central nervous system) and the muscles from establishing a healthy and regular maximum intercuspal position.

The inability to orthodontically move teeth in a way that adult patients will accept greatly limits the treatment opportunities that dentists can provide to their patients. When non-ideal tooth position is the source of a problem like a constricted chewing pattern, the most appropriate and conservative solution is one that favorably changes the position of the teeth. Short Term Orthodontics gives restorative dentists a powerful tool that greatly expands their treatment options and broadens their capacity to help their patients. Whether used to achieve cosmetic goals, occlusal changes, or a combination of both, STO is firmly being ensconced in the dental profession as a minimally invasive and necessary tool in the tool belt of the well-rounded restorative dentist.

This case was treated in six months and demonstrates the ability to alleviate a constricted envelope of function with a short-term orthodontic approach. Carious lesions on the laterals were also exposed during treatment to facilitate easy restoration.

By Ryan Swain DMD

At our monthly Six Month Smiles seminars, I get the opportunity to meet and talk with many different types of dentists from around the world. I’m able to glean a lot from these conversations, and it gives me the ability to clearly see what separates the highly successful dentists from the ones that aren’t. Without a doubt, the number one thing that the highly successful dentists have in common is that they all work with consultants who have helped them achieve and continue to achieve success. For me personally, working with consultants has been one of the key things that has helped me reach my goals and has opened my eyes to many things that I had been completely unaware of.

At least once per month, I get asked the question “Should I hire a consultant or not?!” My answer is a very simple “yes…but find a good one.” Every dentist has a different definition of success but the right consultant can absolutely help a dentist achieve their goal, whether it is less stress, practice growth, easier team management, working fewer days, better record keeping, or all of the above. As you’re reading this article, if you aren’t already successfully working with a consultant, I would encourage you to strongly consider it. It can change everything for you.

The number one obstacle for most dentists considering a consultant is of course the cost involved. Many dentists look at the yearly fee associated with hiring a consultant and they can’t pull the trigger because they are unsure of what the results will be. I agree that it is difficult to commit to a fairly significant monthly payment if there is no certainty about what the return on that investment will be. The good news for us is that we can definitely find out, by doing some investigation, which consultants have proven track records – and this allows us to minimize our risk.

We all would happily participate in an investment opportunity if the potential risk was very minimal and the potential reward was large. We must look at a consultant as an investment opportunity. By talking with other dentists and finding out which consultants have proven their worth, we can almost guarantee a successful investment.

There are 3 main questions to ask when considering working with a consultant:

1. Can I afford it?
When we’re considering buying something, we first need to determine if we can afford it. However, unlike buying a house or a car, which end up being “cash drains,” a consultant is an asset and can be a boon to cash flow. So, look at what the monthly payment is, and if possible, re-arrange monthly spending as needed to accommodate this new payment. If you could afford a rare piece of art that was almost certain to appreciate, you’d do it right? If handled properly, a consultant relationship can function similarly and should yield a strong return on investment and increase cash as the months go on.

2. Will there be a return on my investment?
One of the keys to ensuring that there is a strong return on investment is to investigate consultants you are considering. Interview the consultants; call their references, and talk to as many dentists as possible. The right choice for you should become abundantly clear. Remember that we typically ‘get what we pay for’ – so do not shop based on price alone. A consultant that commands a higher fee oftentimes demonstrates a higher level of success and a larger return on your investment.

3. Are you able to take advice?
I’ve talked with many consultants and they tell me that the biggest barrier to success is dentists who are unwilling to change and unwilling to actually follow their lead. Dentists are used to “running their own show” so it is absolutely critical to recognize that we are not the experts in everything. If you’re going to hire a consultant, you have to be willing to follow their advice or you will kill your chance for success. Why hire someone to help you change your practice if you aren’t flexible enough to change?

Especially during tough economic times, all of us need to be smart about where we spend our money. As much as possible, money should be spent with purpose and care. Resources should be spent on things that will specifically help us achieve our goals. We can’t just look at the price tag; we must think about the potential return and then minimize our risks in the process. You can walk beside the train and get left behind, or carefully jump on and go to places you never dreamed. I say jump!

Occlusion is a topic that is seemingly shrouded in mystery and oftentimes challenging to discuss. It’s like discussing politics or religion; many people have strong beliefs while others don’t even believe in it at all. It seems that the topic of occlusion has challenged many dentists because it has typically been taught, both in dental schools and at CE courses, in a way that is overly complicated.

Most of us were instilled with some dogmatic principles in dental school but weren’t provided with an appropriate level of context from which to analyze these principles. For example, we were taught that we should aim to achieve canine guidance and protrusive guidance for all patients. One of the biggest disservices done in dental school is that dental students don’t seem to be encouraged to ask one simple question: When do teeth actually occlude with significant force? This question is incredibly important to consider as it leads us down a pragmatic path to investigating “what really matters” in regard to occlusion.

For the large majority of people, maxillary and mandibular teeth do not come into contact with each other during normal mastication. To put it simply, teeth do not normally touch during chewing. So, this begs the following questions:

• How does tooth wear occur if teeth don’t touch during normal function?
• When are canine and protrusive guidances used if not during normal function?
• What aspects of an occlusal scheme are most important if teeth don’t occlude during normal function?

When we recognize that teeth don’t touch with significant force during normal chewing, we can then focus on the two main culprits that contribute to tooth wear and restoration breakage: parafunction and constricted chewing envelopes. As we all know, some patients do strange things with their teeth and muscles while they are sleeping. They clench, grind and unknowingly work very hard to destroy their dentition. Canine and protrusive guidances can be beneficial for patients who clench and grind because these features can help minimize the muscle activity and bite force during parafunctional events, thus increasing protection for the teeth and joints. Properly fabricated night guards can also reduce muscle activity and force. Night guards can be an effective and easy way to immediately provide protection against parafunctional forces, especially for patients whose current schemes make it impossible to achieve immediate disclusion of the posterior teeth when the mandible shifts from maximum intercuspation. Of course, the success of a night guard is dependent on patient compliance.

The aspect of occlusion that seems to get very little attention but is one of the most important to consider is the envelope of chewing (often called the envelope of function). In my experience, when anterior restorations chip or break, it is oftentimes due to a constriction in the envelope of chewing. The upper anterior teeth are simply “in the way” of the route that the mandible wants to follow during chewing. Our muscles of mastication are usually intelligent enough to prevent an incisor collision during normal function, but during sleep, all bets are off. We all see patients who have severely worn the lingual surfaces of their upper incisors and the incisal edges of the lower incisors. These are the tell-tale signs of a constricted envelope.

The solution for a constricted chewing envelope is to provide more overjet or less overbite. Historically, it has been hard for dentists to significantly alter overjet or overbite without traditional orthodontics or opening the bite restoratively with full mouth rehabilitation. One of the many benefits afforded to general dentists who are treating patients with short-term orthodontics ( www.SixMonthSmiles.com) is that we have the ability to quickly and easily improve the occlusal scheme and eliminate any constrictions that exist. This allows us to set up restorative and cosmetic cases for maximum longevity and success.

This case was treated by Dr. Anoop Maini using the Six Month Smiles System and demonstrates how a constricted envelope of function was eliminated in just six months with short-term orthodontic treatment. Here, the maxillary wire was “piggybacked” to encourage intrusion.

The key to success with regard to protecting teeth from wear and breakage is to be keenly aware of when and how damage can occur. Patients who show signs of parafunctional activity need to be educated and can best be treated by achieving smooth guidances that provide posterior disclusion, a night guard, or a combination of these things. Anterior wear and breakage often occurs because the maxillary teeth are in a perilous position with regard to the mandibular envelope of function. Short-term orthodontics provides us with an ability to alter this relationship in a manner that many patients will accept. Whether you hold passionate beliefs about occlusion or you don’t think a lot about it, I think we can all agree that if we minimize muscle forces and get the teeth out of the way of themselves, we can improve our patients’ chances for dental health and longevity.

Imagine playing football on a field with no end zones, no yard markers and no scoreboard. It wouldn’t be much of a game. Your football team would run plays but would never know if they were succeeding or failing. When you were finished playing you wouldn’t even know who won the game! Should you celebrate? Should the team feel disappointed? Should you be looking for better players? Who knows?!

Many dental offices are set up to function just like this hypothetical (and ridiculous) football field. If the dental team does not clearly know what the practice goals are or how to measure success or failure for their own positions, it makes it very difficult to “win the game.” Individual dental team members oftentimes do not know if they are succeeding or failing, or if the practice is succeeding or failing. Most team members just assume they are doing a great job if they aren’t equipped with clear knowledge about how to gauge their own performance. Just like the football team playing on a field with no end zones, a dental team without clear indicators of success/failure will most likely miss the mark. After all, it’s hard to hit the mark if the team doesn’t know what it is!

Here are three critical steps you can take that will completely “change the game” for your practice and your team:

1. Know What Success Means for You
What does “winning the game” look like for you as the owner? In other words, what do you want? A high percentage of growth in revenue? Happy patients that like you and your team? The highest possible level of restorative care with very few failures? Ultra high efficiency? A combination of all of these things? Take a few minutes to think about what you want to achieve and write it down. Your team can’t possibly know how to help you win the game if you don’t clearly know what success means for your practice.

2. Know What Success Means for Each Person on Your Team
For each position on your team, you need to know what your expectations are. Write down a description, in your view, of what success looks like for each position on your team. In other words, write down what a person in each position should be doing in order to help ensure that you reach your practice goals. Be as specific as possible. You essentially want to develop a “stats list” for each of the players on your team, including yourself. This provides objective criteria in which performance can be measured against. If each player on the team knows what “stats” they need to deliver on in order to achieve success, they should be able to push themselves appropriately to reach these goals. Do you want your hygienists to see a certain amount of patients per week? Do you want your assistants to be able to turn over a room in a certain amount of time? Do you want your front office to schedule a certain amount of production each day? Once you’ve clearly defined, in your own mind, what success is for each position, you have the ability to change the entire dynamic in the office…for the better!

3. Use a Questionnaire to Find Out What Each Team Member Currently Thinks
This is when things get really interesting! You will be amazed at the things you learn about the mindset of your team (ask me how I know). Hand out a short questionnaire to each team member that will allow you to gain insight about what each person thinks success looks like for their position and for the practice in general. It should include some questions like: Week to week, how do you know if you are succeeding within your role? Would you say that, within your role, you are wildly successful, moderately successful or unsuccessful? (If you want a copy of my form, just email me at Drswain@thedentistsnetwork.net)

What you’ll most likely see right away is that your team has very little awareness of your specific practice goals or how to gauge their own level of success. If this is the case, it means that your expectations aren’t clear and this is usually due to the fact that you don’t really know what your own expectations are! (see Step 1)

Once you’ve read each questionnaire (and taken some Pepto-Bismol), you now have the ability to go back to each team member and clarify your expectations. Using the questionnaire as a reference point, define your goals for the practice and your expectations for their position. Explain the “stats list” that you’ve put together for their position and how both you and they can use this to gauge their performance. Even though you may feel like your team will be resistant to this, most will not be. People like to have clear expectations and to know whether or not they are doing a good job. You’ll find that this arrangement (clear expectations and clear goals) significantly changes the culture in your office and will yield positive results. Once your team knows what winning is, you’ll do a lot more of just that…winning.

Dr. Ryan Swain is a graduate of the University of Florida College of Dentistry. He practices in Rochester, NY and focuses on Short Term Ortho and other conservative cosmetic dental procedures. He is president and chief clinical instructor for Six Month Smiles. Dr. Swain is a pioneer in the field of Short Term Ortho and constantly on the forefront of GP orthodontics. He has trained dentists internationally.

There’s a common myth in the dental world that says cosmetic dental procedures are the first ones to decline in a recession. The opposite is actually true. As dental professionals, we know that the following topics of conversation become more difficult when money is tight:

1. “This molar has some cracks in it and really should have a crown.”
2. “This tooth has a spot on the x-ray and the root canal needs to be re-treated.”
3. “Your wisdom teeth are impacted and really should be taken out.”

We’ve all seen the blank stares and heard the giant sighs that sometimes happen after we inform patients about these dental needs. The tough part for us is that as the economy continues to falter, our ability to influence and persuade people to take action with their teeth is increasingly challenged as people tend to hold onto their dollars with a firmer grip.

Human DNA is much more influential in driving behavior than even the most verbally skilled dental professional. Whether we like it or not, humans love symmetry and beauty. We’re just wired that way. We are attracted to things and people that exhibit symmetry and harmony. These things make us feel good. To some it may seem shallow, but it is a truth that we can either tap into or ignore – to our detriment. Mal-positioned teeth are not esthetically pleasing. In other words, crooked teeth are UGLY. Please forgive me for being blunt, but let’s cut to the chase. Adults who are living with the “disease” we call crooked teeth know how it affects their life and their self-image. Laughter is oftentimes less joyous. An interaction with a new person can be less successful. Every photograph taken is a potential disaster. Every smile is restrained. Take a minute to think about how much a completely new smile would be worth to these people. How valuable is it to receive a new smile that looks attractive, is confidence boosting, and that will positively affect every day of the rest of your life? What is the value associated with “curing the disease of crooked teeth?”

About four years ago I treated a patient named Linda.  The first time I saw Linda she was grumpy and a bit confrontational. She told me that she hated her crooked teeth and hated the way they made her feel about herself.  Like most adults, Linda didn’t consider traditional orthodontics a viable option because of the lengthy treatment times and metal braces typically associated with the procedure. However, Linda had found out that I provided Short-Term Orthodontics and came to my office because she was excited to learn more.

Linda was a great candidate for Short-Term Orthodontic treatment and we were able to straighten her teeth in just six months. The process is simple and general dentists are able to straighten teeth safely and predictably in an average of six months. With unique clear orthodontic brackets and a slight shift in treatment goals, adults are able to say goodbye to their crooked teeth and have an attractive new smile in a reasonable amount of time. The goals of treatment are similar to those of veneers: to dramatically improve the appearance of the smile without completely revamping the occlusal scheme.

Linda’s treatment was routine. She was in and out of braces quickly and we watched her blossom into a new person. She was friendlier, warmer and exuded a newfound confidence that she had never experienced before. Linda had lived 55 years with crooked teeth, but now she was cured. There was no need to explain to Linda that getting a beautiful symmetrical smile was a good investment. Her DNA had already convinced her. When she came in for a final check, she gave me a big bear hug and told me something I’ll never forget. She said, “Dr. Swain, when I die and they lower me into my coffin, I don’t care what my hair looks like or what clothes I have on… as long as they prop my mouth open so that everyone can see my beautiful smile!”

CariFree has recently launched two new products, HA Nano Gel and pHluorigel HA Nano, the first in a new generation of patent pending nano hydroxyapatite remineralization technology.  These gels are combining bioavailable nano hydroxyapatite crystallites with unique pH+ technology and xylitol, as well as the proven anti-caries benefits of 5000ppm sodium fluoride in the pHluorigel.

Q&A

Today’s Topic: HA Nano

Dr. Swain: “Dr. Kutsch, can you tell us how the hydroxyapatite nano particles aid in remineralization?”

Dr. Kutsch: “Well, according to the science over the last seven years of remineralization research, natural remineralization doesn’t occur because of incorporation of ions… the saliva actually forms nano particles of hydroxyapatite crystal, and it is these pre-formed crystals that act to build into the existing HA crystals in enamel.  To put it simply, the demin-remin process of enamel behaves within a pH sensitive nano sized crystal system, and the addition of nano crystallites of hydroxyapatite in an elevated pH gel mimics the natural remineralization process.

Dr. Swain: “So what is the difference between your two new gels?”

Dr. Kutsch: “The HA Nano Geldoesn’t contain fluoride, and is an ideal saliva substitute with an elevated pH and infusion of nano particle hydroxyapatite.  The pHluorigel HA Nano contains 1.1% neutral sodium fluoride, an elevated pH of 9, and an infusion of nano particle hydroxyapatite, making it an excellent toothpaste replacement.  Both products also contain high concentrations of xylitol.”

Dr. Swain: “So what are the indications for these products?”

Dr. Kutsch: “Patients with cavities, post whitening, patients with moderate or high caries risk, dry mouth/poor saliva flow, or white spot lesions, patients who experience sensitivity, patients who present with acid erosion, any patient in orthodontic appliances or braces, or any patient that is tested with a high bacterial challenge.”

Dr. Swain: “How often are the products used?”

Dr. Kutsch: “The HA Nano Gel can be used as often as needed, any time of the day without restriction.  It can be applied with the tip of the finger, brushed on with a toothbrush, or placed in whitening trays for extended exposure (for example, overnight for dry mouth, high caries risk, and post whitening patients).”

“The pHluorigel HA Nano can be prescribed for use once or twice daily as a toothpaste replacement, based on the severity of the patient indication.”

Interested in reading further?  Contact CariFree at 866.928.4445 or info@carifree.com.