Archive for the ‘Clinical’ Category

Strength in Numbers

Monday, December 4th, 2017

Guest post by Dawn Christodoulou, President/Owner of XLDent

The modern dental office is becoming fully integrated into the digital age, with the ability to capture and analyze much of the data it generates on a weekly basis. Close monitoring can guide the Practice Owner to reflect on which marketing methods are generating the most leads, how successful collection efforts are, and production trends.

In a matter of seconds, a KPI (Key Performance Indicator) should tell you whether your practice is growing, maintaining, or starting to decline. XLDent offers a brand new KPI Dashboard feature to help you gather this data quickly, and formXLDent.TND.Blog.Dec.2017.Dashboard2 (002)at it into easy-to-read graphs, giving you a window to the health of your dental practice. This Dashboard is mobile-friendly and accessible from anywhere, anytime.

An analysis of your Clinical team can tell you several things:

-Production is the most basic building block of your business, so these daily, weekly, and monthly totals are a great place to start looking for trends, peaks and valleys. They can be useful to determine whether you should think about adding more staff to manage your patient care without delays or protracted schedules.

-Is the hygiene team making sure to schedule the next recall appointment with the patients before they leave the treatment room? Recall metrics need to be clearly visible, concise, and up to date.

-Are your recommended treatment plans being accepted, scheduled, and followed through or are patients not feeling confident in your team? Perhaps you will need to add education for patients who are unsure if planned treatment is truly needed.

-Are overhead costs crippling your ability to run a successful business? The materials and equipment you choose (and the method they are deployed) should be reviewed periodically, so that modifications can be made, where appropriate.

An analysis of your Administrative Team will point out the following areas:

-The number of new patients coming into the practice each month. Are they referred from satisfied patients, calling you because of a successful marketing campaign, and is your office creating the best experience once they come in?

-Are your Collections being handled in a timely manner? Not everyone is comfortable asking patients to pay their balances, so it’s a good idea to seek out the right staff person to tackle this roll.

With all this information at your fingertips, performance goals can be set and achieved. Practice growth decisions should include clear expectations of what your team is capable of, and what systems and positions may need to be modified going forward. Keeping track of your practice’s growth, and potential, doesn’t need to be a major time commitment. The new XLDent KPI Dashboard can provide a window into where you’re headed in just minutes.

To connect with XLDent, call 800-328-2925 or email xldentinfo@xldent.comDawn

Dawn Christodoulou is the President/Owner of XLDent. She has more than 25 years of experience computerizing dental offices and helping both new and established practices streamline electronic workflows for increased efficiency, improve patient engagement, and achieve maximum profitability. Dawn is also a member of ADA SCDI Working Groups 11.1 Standard Clinical Architecture and 11.9 Core Reference Data Set.

A Smart Start to Practice Growth

Tuesday, August 1st, 2017

Guest post by Dawn Christodoulou, President/Owner of XLDent

As the owner of a practice starting out or a stagnant one trying to grow, you are faced with figuring out what impacts practice growth the most. When properly planned, three areas can help to maximize growth from day one.

  1. Systems

You’re likely not thinking about efficiency or productivity during your first days or weeks in business. With a handful of patients each day, you’re not faced with bottlenecks, communication gaps, or duplication of processes. Alas, you soon will be. Systems minimize gaps or overlaps in your daily processes. They are needed for productive workflows and profitability.

Create standard operating procedures (SOPs) early on. Doing so sets the stage for staff expectations, accountability measures, and helps you measure areas of success or needs for improvement. Early on, you are likely running your practice without a full team. You have an assistant also taking on the front desk role, because you’re simply not busy enough yet to hire a full-time admin team member. As you bring on new staff, a written set of SOPs will ensure each team member is prepared and knows their responsibilities. Systems should be created knowing they will evolve as your practice grows and staff roles change. XLDent provides each practice, whether just starting out or transitioning from another PMS, a core set of SOPs to start with. They are a fantastic starting point for those new to establishing systems, and are customized by each practice as needed.

  1. XLDent blog photo Mockup-12-19-16Reviews and Referrals

I doubt there’s a practice starting out today that doesn’t have an online presence from day one. From the day you open your doors, focus on creating a process for reviews and referrals. Nothing attracts new patients more than a healthy online rating and patients who aren’t afraid to tell others about their great experience. After a visit, ask your patient if they were happy with their experience and funnel them right over to do that 5-star review. Lighthouse 360 helps you automate this. Emails. are automatically sent post-visit, and good reviews are posted right to your website and social media pages.

  1.  Patient Experience

It’s no surprise that convenience and consumer experience are priorities when a new patient chooses a dentist. They are especially significant in gaining one who is loyal. Don’t discount the importance of electronic reminders, online access, and paperless forms, to a patient. A busy mom doesn’t want to be faced with a stack of forms to complete that you’re going to scan and shred anyway. Consider a system that embraces all aspects of a streamlined paperless system, so you’re not left with the task of finding disconnected solutions that leave you with clumsy systems.

To connect with someone from XLDent, call 800-328-2925 or email

DawnDawn Christodoulou is the President/Owner of XLDent. She has more than 25 years of experience computerizing dental offices and helping both new and established practices streamline electronic workflows for increased efficiency, improve patient engagement, and achieve maximum profitability. Dawn is also a member of ADA SCDI Working Groups 11.1 Standard Clinical Architecture and 11.9 Core Reference Data Set.


Sex, Drugs & Oral Cancer

Thursday, June 1st, 2017

Sex, Drugs & Oral Cancer…what does this mean? Let’s take a closer look at oral cancer to see how sex and drugs play a role in the development. The risk factors for oral cancer are not only the traditional risk factors of tobacco, alcohol, and age, but now there is an increasing prevalence being caused from a sexually transmitted virus, HPV 16. With the new risk factor of HPV, oral cancer is not only affecting older patients, but now younger patients without the traditional risk factors. This means that everyone who walks into your office potentially has a significant risk factor. Just as with other cancers, early diagnosis of oral cancer provides a markedly improved prognosis for the patient. Knowing that early discovery for cancer saves lives, our goal should be to screen every patient. With the changing trends, it is important to have a tool in your arsenal for early discovery. OralID™ is the perfect solution and is being used in some of the top clinics and cancer centers across the nation.

OralID™ is an FDA Cleared medical device for oral cancer (and pre-cancer) screening. Without the need for any rinses, dyes or other consumables, OralID™ uses fluorescence technology that when shined in the mouth causes healthy tissue to fluoresce an apple-green color and suspicious tissue appears dark. If a dark lesion is found, the recommended protocol for screening is to have the patient back in two weeks to reassess the lesion. Normally these lesions will have healed in the follow-up period. If the lesion is still present, then performing an advanced cytology swab (CytID™) or a biopsy (PathID™) is recommended at that point.

In addition to the OralID™, Forward Science provides complimentary diagnostic tests designed for early discovery. The company offers an all-inclusive program, called the ID For Life Program™, that provides not only the OralID™ device for each office, but diagnostic tests, unlimited support, marketing materials, a lifetime warranty, and more. The ID For Life Program™ helps to ensure success in implementing an oral cancer screening protocol in each office.

As oral cancer has continued to rise over the past eight years along with the risk factors now affecting all demographics, we encourage you to join Forward Science and commit to screening each of your patients. By working together, we may play a crucial part in reversing oral cancer trends through early detection. Learn more by visiting

FSForward Science is a privately held biotechnology company based in Houston, Texas. OralID, Forward Science’s flagship product, is an award winning oral cancer screening device that allows clinicians to Shine Light. Save Lives.™ by identifying abnormalities that may not be seen under traditional white light examinations. Forward Science quickly expanded its product portfolio in efforts to provide clinicians with a complete program to battle the rising trends of oral cancer. With the launch of the ID For Life™ Program, Forward Science has evolved into the industry leader for oral oncology. The ID For Life™ Program includes the following in an effort to change the trends for oral cancer: screening device (OralID), diagnostic tests (CytID, PathID, hpvID, phID), and treatment options (SalivaMAX). SalivaMAX is Forward Science’s latest product offering, which is an FDA Cleared prescription strength rinse for all ranges of xerostomia.

Building a Better Practice: Bone Grafting

Wednesday, March 16th, 2016

Guest post by  Gregory Snevel, DDS

New dentists often ask me how start building an implant program in their practices. They wish to expand the services currently offer in their practice, and ask me where the best place to start is. Successful implant therapy begins and ends with proper management of the pre-existing condition through diagnosis, extraction, and socket preservation (i.e. bone and tissue grafting) of non-restorable teeth. Managing a case in this manner generally leads to favorable and predictable outcomes, allowing for maximum experience gained, and inspiring confidence in the growing implantologist.


Even if you don’t plan to branch out into implantology, if you currently offer extractions in your practice, bone grafting is: simple, safe, and profitable. In my opinion, it is standard of care. Dystrophic changes in the alveolar architecture following non-grafted extractions can mar esthetic and functional results of both fixed and removable prosthetics, not just implants. Root denouement can occur during the removal of terminal molars, often resulting in attachment loss adjacent to the tooth in question. It’s time we did better.

A review of techniques and materials is beyond the scope of this article, but I will give you 4 steps you need to take to begin building a better practice with bone grafting.

  • Take a course. Bone grafting courses are affordable, informative, and convenient. Learn about what you do.
  • Invest in Time. By far the most common mistake made is not giving yourself enough time to adequately complete the procedure. This compromises results frustrating both dentist and patient. Materials are inexpensive. If you currently extract teeth, you most likely already have all the surgical tools necessary. Book yourself enough time. Consider the temporary loss of production as an investment. It will pay dividends.
  • Fundamentals. No material, suture, device, or forcep, will ever contribute as much to a successful outcome as solid surgical technique.  Know what you are doing, and know why you are doing it.
  • Practice. The key to proficiency in any task is practice. If you have given yourself the time to put into effect what you have learned, your confidence will grow and you will be well on your way.

As a parting piece of advice, find a mentor. It could be a specialist referral, a former classmate, or a person you met at CE. Share your cases with them. Ask for advice. Offer advice. While it is true that all knowledge is earned, wisdom can only be shared.

Advisory Board_GregSnevelGregory Snevel, DDS, 2011 graduate of Ohio State University, is a member of The New Dentist Magazine Advisory Board.

He is a part time clinical instructor at a local Community College and a 3rd generation dentist running a general dentistry practice in a suburb of Cleveland, Ohio. He took over his father’s existing general dentistry practice after working there as an Associate.

5 Steps for Patient Referral Success

Monday, February 15th, 2016

Guest post by Dr. Lindsay Goss, DMD, MPH

As a general dentist I work with specialists every day in order to provide exceptional comprehensive patient care. I used to think that when I referred a patient to a dental specialist that they would take over from there with the patient’s care. They would diagnose the patient, treat the patient and the patient would return to my office only when they have improvement. But what I soon realized is that I would wonder what was happening? When is the patient returning to my office? What was their diagnosis? What is the prognosis? Once I referred the patient out of my office, I felt that I could no longer be in control of my patient care. However, with a few changes to our office protocol on how we make a referral, I remain a part of my patient’s continuation of care with the specialist.

Here is my office protocol:

1. Determine the patient needs a referral to a specialist.

2. Define what specialist can provide a Diagnosis, Prognosis and Treatment recommendations (DPT).
   a. What type of specialist should the patient see?
      Does gender of the doctor or the location matter?
      Does insurance coverage make a difference for this patient?

3. Offer patient a pre-scheduled appointment with the specialist prior to leaving your office.
   a. This step is important because it commits the patient to the care they need.
   b. Our patient coordinator gives insurance information to the referring office.

4. Write the pre-scheduled appointment day/time on the referral slip.
   a. Make a copy of the referral slip for your patient records.
   b. Inform patient their records will be sent over and ready for their consult appt.

5. Compliment the specialist and inform the patient that we will look forward to hearing the results from the consult appointment.
   a. Ask your specialist for a pre-treatment letter which states the DPT.
   b. I always review the DPT from the specialist prior to treatment with the patient.

I would encourage any New Dentist to get to know their specialists and develop a clear relationship on how you want to manage patient care. Call and invite your specialists to meet over lunch! When I work with a specialist I am inviting the specialist into a relationship of trust I have built with my patients. The patient knows that I am going to follow their case and I expect the patient to follow through with the recommended treatment/care. For these reasons it is important to make working with specialists an easy and routine process.


Dr. Lindsay Goss is an esteemed member of The New Dentist Magazine Advisory Board. She graduated from the Arizona School of Dentistry and Oral Health and AT Still School of Health Management.  Dr. Goss also completed an Advanced Education in General Dentistry program through the Lutheran Medical Center before she worked with four different types of practice settings, and prior to starting up a solo “space share” in Chandler, AZ.


Common Scheduling Mistakes ( 1 of 3)

Thursday, January 15th, 2015

Maintaining a productive schedule isn’t easy. It takes commitment and the willingness to implement measurable systems that will bring about real change in your practice. The person in charge of your schedule must be properly trained and have a clear understanding of the difference between scheduling to keep the team busy, and scheduling to keep the team productive.

When you finally start scheduling to meet productivity objectives rather than just to fill the day, you’ll notice a huge difference in your practice, as will your patients. Stress levels will go down, patients won’t wait as long to see you, and instead of just reacting to what’s thrown your direction, you will be prepared for every appointment. All this, plus you’ll start meeting your practice’s financial goals.

Yes, managing the schedule can be tricky business, but it’s vital to your practice’s success. You may be overwhelmed by the thought of nixing your old system and designing one that actually works, but I’m here to help you through it. I’m about to share with you three of the most common scheduling mistakes dental practices make, along with tips on how you can avoid them. Read on, then start making the necessary changes.

Mistake #1:
You’re Not Communicating with your Scheduling Coordinator
You expect your coordinator to fill in procedure times but are you communicating how long the procedures take? Instead of making your coordinator play the guessing game, let him or her know exactly how long it will take you to perform a scheduled procedure, as well as how long it will take the assistant. The coordinator should then mark the times in different colors on the schedule. Just like that, you’ve saved yourself and your team some unnecessary frustration and aggravation, and you’ve ensured you’re not double-booked.

Whether it comes directly from you or from a hygienist after you’ve provided the time break down, I can’t stress enough how important it is to clearly communicate procedure times with your scheduling coordinator.

Controlling the schedule is vital to your practice’s success. The schedule determines the level of care you provide, how stressful your day is and how much money you bring in. Avoiding these common pitfalls and making a commitment to properly manage the schedule will help ensure that you meet daily production objectives, allowing you and your team to focus on what’s most important—providing the best patient care possible.

The Profitable Associate

Wednesday, October 1st, 2014

Can an associate generate a profit? The answer is in the size of your patient base. If you have a saturated practice with an abundance of patients, you can keep your associate busy and generate a 30-35% profit margin.

The first step after accurately measuring the size of your patient base is to perform a cost benefit analysis to determine the likelihood of profitability, as well as to gauge the non-monetary benefits such as improved quality of life, which may be equally important. The following steps will help you analyze the economic sense of hiring an associate, and will help you set realistic expectations about the return on investment you are likely to attain.

Step 1: Determine Production Goals

Step 2: Assign Direct Expenses to the Associate

Step 3: Apply the Formula and Get the Answer

Associate Profit Analysis Summary

Daily Collection – $950
(Assume 95% Collection/Production Ratio on Daily Production Goal of $1000)
# Days Worked Per Year X 196
Projected Annual Revenue $186,200

(Assume 34% Collections) Associate Compensation – $63,608
(6% Dental Supplies) Associate Payroll Taxes – $4,843
(8% Lab Expenses) Associate Lab Expense – $14,896
Associate Supplies – $11,172
Assistant Salary (inc P/R tax) – $21,620
Uniforms – $200
CDE Allowance + $1,100

Projected Annual Revenue: $186,200
Less TOTAL EXPENSES – $117,439
Associate Profit: $68,761

($68,761 PROFIT / $186,200 ANNUAL REVENUE)

Once you’ve assured yourself that the economics make sense for your associate, proper planning is key. Most importantly, if this associate is a candidate for your long term transition plans, make sure that you properly think about your exit strategy so that once you begin interviewing candidates, you clearly spell your vision for a successful relationship.

To read the original article in its entirety please visit: The Dentist’s Network Newsletter #100

Dr. Thomas L. Snyder, Director, Practice Transitions for The Snyder Group, a division of Henry Schein Professional Practice Transitions.

Job Opportunities and Resources for New Dentists

Wednesday, September 17th, 2014

Perhaps you have considered looking for a new job as an Associate but haven’t found the time or don’t know where to start. Job-hunting can be time-consuming and often fraught with anxiety.

So often it is easier to get swept up in the daily routine and go with the flow -not to mention that most of us are hard-wired to resist change! Regardless of how good or bad your current situation may be, we owe it to ourselves in this “new age of technology and information” to explore options for the lives we want to lead. Other possibilities exist. We know this.

What are you waiting for? Take a few minutes out of your day today to dedicate some small amount of thought – even for just a few minutes – to focus on how you might prefer to live…the type of practice you wish to have or where you would prefer to work. You could be ready for a chance to make a change.

Start your job search process by talking to some of the professional resources available to you on the New Dentist Website Resources page – this link will get you right to it –

Several opportunities are listed and they are not all the same. Where there is an opening, there is a caring professional on the other end waiting to talk to you and to explore the factors that are most important to you to determine if there is a better fit for you elsewhere.

Should you decide that owning your own practice is the way to go…we also have resources available for you on that too!


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1 of 3 Steps to Establish Performance Expectations

Friday, May 30th, 2014

It stands to reason that most dental practice team members are far more likely to succeed when they know what is expected of them, when there are goals they can seek to achieve, when they are part of an overall effort to attain a common objective, and when they know what path to follow. It seems so profoundly simple and obvious, as fundamental as turning on the lights, unlocking the doors, and opening the practice for business each morning.

Yet this simple concept is often lost on dental practice owners. Commonly, the assumption is that employees “instinctively know” what is expected of them, particularly if they have worked in another practice. The doctor can’t understand why employees don’t just “do their jobs,” and employees can’t understand why the doctor “won’t tell them what s/he wants.” Consistently, the culprit is lack of or weak performance measurement systems. Successfully measuring employee performance requires a clear and well defined strategy, and it starts with three key steps:

Step #1 – Create Specific Job Descriptions
Define the job that each staff member is responsible for performing. Specify the skills the person in the position should have. Outline the specific duties and responsibilities of the job. Include the job title, a summary of the position, and a list of job duties. This can be the ideal tool to explain to employees exactly what is expected of them.

For example, your dental assistant’s job description should include points such as attending beginning of the day meetings, completing case presentations, reinforcing to patients the quality of care delivered in the practice, directing the doctor to check hygiene patients, completing post treatment care calls, converting emergency patients to new patients, turning the treatment room around promptly, etc.

Avoid the common yet dangerous pitfall of overlapping job duties. Instead, cross-train so that each area has coverage when the point person is out ill or is unavailable. If you overlap duties, employees are given tasks but not responsibility. Consequently, the team member quickly becomes frustrated. S/he wants to take ownership for a particular system, but can’t because it’s not “her/his system” to oversee. It’s simply not in the practice’s best interest to have multiple people responsible for areas such as collections or scheduling.

Interested in speaking to Sally about your practice concerns? Email her at


Perio Considerations

Wednesday, May 14th, 2014

From Guest Blog Contributor: Dr. Michael Rethman

I concur that 80% (or more) of perio therapy can and should occur in the GPs office: the trick is knowing what should occur where and when — in other words when to refer and why. Chronic periodontitis is usually site-specific and often progresses slowly which can trap GPs in situations where they fear referring later on because things went downhill early-on. Furthermore, most dentists (me included, and I’m a perio) aren’t good at blind scaling and root planing, many RDHs aren’t either. So assuming that you or your RDH are somehow good at this is foolish — unless, of course, you are using an endoscope or surgical access, the latter of which may be overkill.


As noted by Dr. Fazio, sites that show no plaque yet persist with BoP suggest strongly for getting help. One trick to a happy practice is to establish a good relationship with a nearby periodontist or two and ask them to help you refine your treatment skills and referral paradigms as well as be involved in multi-disciplinary treatment planning and execution — that may include optimal periodontal or implant placement/maintenance skills that you simply don’t have. (Not all perios are stars either, but they have nearly double the formal dental education of most GPs and if the ones you contact don’t want to help or don’t seem all that informed, find others.) Also, there exists a publication entitled Management of Patients with the Chronic Periodontal Diseases that may help you too, I think it’s available at Finally, remember that your state grants you a license to practice dentistry and patients consent to your “touching” because both the state and your patients expect that you will always hold their interests paramount — over yours especially. Part of that responsibility entails not only doing what you think is ethical and correct but also learning more and more over the years so you get better and better at doing knowing what’s “right” — and I’m not talking about your practice gross income here… I am talking more about sleeping well at night…. Aloha all and have fun!

Screenshot 2014-05-14 14.51.46

Dr. Rethman is a board-certified periodontist with over five years of general practice experience. He is also a dental research scientist and a former Director of the U.S. Army Institute of Dental Research, as well as a past-President of the American Academy of Periodontology. Dr. Rethman also recently chaired the ADA’s Council on Scientific Affairs for an unprecedented three years and has recently chaired and/or served on numerous expert panels that systematically assessed the scientific literature to provide up-to-date information regarding a variety of important clinical topics.