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Looking back: What were dental fees in 1993?

Ah, yes, the good old days. What do you remember about 1993? Bill Clinton was president. The median household income was $31,241. Unforgiven won the Oscar for Best Picture. The Chicago Bulls won their third straight NBA title before Michael Jordan announced his sudden (and short-lived) retirement.

In the dental world in 1993, a periodic exam checkup (D0120) was $18 (nationwide average). In our most recent fee analysis (courtesy of Sikka Software), the same checkup in 2012 was a little less than $90 (nationwide average).

RELATED ARTICLE: Our dental fee report for 2011
RELATED VIDEO: Tracking dental Key Performance Indicators (KPIs) in November, 2012
RELATED LINK: Use our FREE dental fee analyzer to find what other dentists are charging in your zip code

So, as head into 2013, how were dental fees 20 years ago? Take a look below at what the dentists told Dental Economics for the 1993 dental fee survey.

1993 dental fees reported by dentists around the country to Dental Economics
Initial oral exam, adult-excluding radiographs -- $26
Emergency oral exam -- $27
Panoramic film -- $46
Intraoral X-rays, complete series including BWX -- $54
BWX four films -- $25
Intraoral, periapical, first film -- $10
Intraoral, periapical, each additional film -- $7
Prophlaxis, adult -- $39
Diagnostic casts -- $37
Initial oral exam, child -- $22
Prophlaxis, child -- $28
Fluoride child, including prophylaxis -- $16
Periodic oral exam, child -- $17
Pit and fissure sealant, per tooth -- $21
Periodic oral exam, adult -- $18
Amalgam restoration, 1 surface, permanent -- $45
Amalgam restoration, 2 surfaces, permanent -- $59
Amalgam restoration, 3 surfaces, permanent -- $72
Complete resin restoration, 1 surface, anterior -- $55
Complete resin restoration, 1 surface, posterior, permanent -- $61
Inlay, metallic, 1 surface -- $307
Full-cast, high-noble metal gold crown -- $485
Porcelain fused to high-noble metal crown -- $486
Prefabricated stainless steel crown, permanent tooth -- $127
Cast post and core, in addition to crown -- $34
Crown buildup, including any pins -- $97
Recement crown -- $36
Labial veneer, laminate -- $212
Labial veneer, porcelain laminate, lab -- $366
Complete upper denture -- $622
Complete lower denture -- $624
Upper denture reline, chairside -- $136
Lower denture reline, chairside -- $136
Extraction, single tooth -- $55
One root canal, exclusive of restoration -- $262
Two root canals, exclusive of restoration -- $322
Three root canal, exclusive of restoration -- $407
Periodontal scaling with gingival inflammation -- $76
Gingival curettage, per quadrant -- $114
Periodontal root planning, per quadrant – $94
Periodontal root planning, entire mouth – $286
Teeth whitening, per arch -- $186
Infection control fee -- $7

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Communicating shade to dental labs

Chris Salierno, DDS 12/04/2014

Dr. Salierno offers four practical tips that will help all dentists communicate more clearly with their dental labs for succes, and it invovles more effort than just writing a letter and a number on a lab script. I used to just wrtie “A2″ in a box on a lab sheet and hope that the lab would figure it out.  That was pretty dumb.

Unfortunately (or fortunately) our teeth are not identical to the VITA shade guide tabs.  There is far more complexity that exists in our dentin and enamel, so if we are to hope to acheive a higer level of replication we must put in some more effort than just writing a letter and a number on a lab script.

The good news is that you don’t need a masters degree in the fine arts to be able to take a good shade.  Here are some simple steps I use:

(1) Buy a damn digital SLR camera with flash and macro lens

I promise you that getting a professional camera will bring you to another level of dentistry.  There are a number of reasons, which our friend, Dr. Albert Yoo, is writing about in this month’s issue of Dental Economics.  But for now let’s be concerned with the fact that shade communication is far better with a proper camera set up than with your smart phone.  Two popular palces to get the whole package are Lester Dine and PhotoMed.

(2) Pick a few shades that look good

Don’t just pick one shade for your photo; pick a few.  Chances are that there’s more than one shade tab that will offer insight into the teeth of interest.  Giving more than one tab will also give the lab technician some variety and the ability to compare elements of color between photographs.  Don’t forget to give the lab a stump shade (shade of the prepared tooth) if you are using all-ceramic restorations.

(3) Take a proper photograph with the shade tab

Make sure the tab identifier is visable (e.g. A2, C4, etc).  Make sure the tab is held at a similar orientation as the teeth of interest so that the light plays off of it similarly.  Take a few photographs under different lights and not just your treatment room.

The orientation of the shade tab is a bit off, thus giving us a reflection that is not present on the teeth of interest.  This photo isn't terrible, but we lose an opportunity communicate some information to the lab.
The orientation of the shade tab is a bit off, thus giving us a reflection that is not present on the teeth of interest. This photo isn’t terrible, but we lose an opportunity communicate some information to the lab.

These photos are more accurate.  We have good orientation of the tabs, we can see the tab identifiers, and the lab has two photos for comparison.
These photos are more accurate. We have good orientation of the tabs, we can see the tab identifiers, and the lab has two photos for comparison.

(4) There’s more than just shade to communicate

But of course we’re not ONLY interested in communicating shade, are we?  There is also characterization and texture; what are the nuances of how the shade is distributed on the surfaces and what tiny lumps and bumps are to be found?  For these bits I like to take an extreme close-up photo, which can really only be done with a camera with a proper macro lens.  This can be separate from your shade tab photos so you’ll have a free hand to use a cool toy like a contrastor.

- See more at: http://thecuriousdentist.com/communicating-shade-to-labs/#sthash.iInTcl6F.dpuf 

Championship communication with your dental lab: Part III

David Rice, DDS 12/04/2014

Dentists and lab technicians both want to experience success, and communication is a key part of that success.

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