Hammer and Nail

Author: Dr. David Dickerhoff, DDS, MAGD, FOCOI

Have you ever heard the saying, “if you are a hammer, everything looks like a nail”?

I fear that some of the technology that has inserted itself into our profession might be driving some of the decision making in recommendations for treatment. Our technology has become so expensive to both purchase as well as to maintain, that getting a return on your investment drives some of our marketing and influences our recommendations to our patients.  This is a dangerous temptation and has been one of the reasons that corporate dentistry has become so big in the profession. Recent graduates from dental school are saddled with significant debt in the repayment of their school loans and do not want to go into further debt as they establish their practices. Often, committing to these high cost technology driven improvements is done at a time in their business growth life where a return on the investment is paramount in the mind of the business owner, whether it be a dentist or a corporate entity.

In the 23 years that Spring Lake Dental Group has been in existence, my thought process of when to invest in new technology has relied solely on being able to meet the needs of my patients.  Reinvesting profits back into the business allows us to stay current but having state of the art technology is not the engine that drives the bus.

Back in 2000, Spring Lake Dental Group invested in implant technology. We did this not because we wanted to market expensive, high end dentistry. But I envisioned the day when one of my patients would come in with a broken front tooth from trauma and had to have it extracted. What options could I offer my patient that would address their current crisis that would satisfy them both functionally and esthetically? I did not want us to become an implant practice, but I did want to have another effective tool to satisfy the demands of my patients.

This is the way that I look at a recent technology upgrade that we made, where we are able to scan digital impressions for production of milled out crowns onsite. The advantage of this technology is marketed as having the capability of providing same day crowns for your patients. Spring Lake Dental Group did not purchase this technology as a tool to produce more crowns or faster crowns.  But we watched this technology, initially developed by Siemens, until it got to the point that scientific data proved that crowns manufactured by this technology was equal to or superior to the crowns that we were producing through laboratory techniques.  Because we service a large military population and many soldiers come to our office stating that they are on orders to depart for their jobs and need a dental restoration quickly, we thought that this technology might fill a need for our patient population.  There are some patients as well that do not prefer to be in temporary restoration for a three week period of time while their case is in the lab.

The digital scanning technology is housed on two scanning workstations and is produced by PlanScan E4D utilizing Romexis software. The compatible milling unit and glazing oven are also owned by Spring Lake Dental Group and allow us to produce lithium disilicate (Emaxx) crowns from digital scans taken directly from our patient’s mouths. Done to our standards, these crowns are hard to differentiate from virgin teeth and have the capability to function without any special treatment other than what you would do for normal oral hygiene.

Since we have purchased this technology, you would think that we would be producing lots of Emaxx crowns, but that is not the case. Here’s where the saying at the start of this blog comes into play. Treatment planning this technique and this material is very patient specific. It is specific to their needs, desires, social and financial calendar. One size does not fit all.

If you are a patient of record with Spring Lake Dental Group, have a conversation with your providing dentist or hygienist about whether this technology is right for you.  We are always glad to discuss your specific situation and why this “hammer” may or may not be right for your “nail”.