CAD/CAM integration: a team sport

Of all the technology advantages introduced to dentistry during the past 25 years, nothing has created more of a stir in team training than CAD/CAM dentistry. Getting the team to communicate effectively about this exciting way of delivering dentistry is truly a total team sport — your practice will not win the CEREC game without it.

By Linda Miles, CSP, CMC

Of all the technology advantages introduced to dentistry during the past 25 years, nothing has created more of a stir in team training than CAD/CAM dentistry. The entire team must be on board in order to have total success and patient acceptance. Dentists who are proficient in CEREC one-visit crowns, who have overcome the learning curve, must realize that the battle is only half won at that point. Getting the team to communicate effectively about this exciting way of delivering dentistry is truly a total team sport. Your practice will not win the CEREC game without it.

In most practices, hygienists have patients as a captive audience for an hour. This is a great time to share their excitement about CAD/CAM dentistry. Even if a particular patient is not a good candidate for posterior or anterior crowns, inlays, or onlays, that person more than likely knows someone who is. Educating each patient about the benefits of this type of dentistry can make a huge difference in how many units are completed each month. Hygienists and clinical assistants can talk margins, materials, and the convenience of one-visit crown appointments. They can also brag about the doctor, and how few other dentists make this type of a monetary investment or spend the time in training to achieve clinical excellence.

While consulting hundreds of dental practices over the past 30 years, it is amazing to me how many practices spend more hours talking socially vs. talking about dentistry. Asking questions such as, "How do you feel about keeping your natural teeth for life?" or "Have you heard about one-visit crowns? No more temporaries or waiting three to four weeks to get your crown from the laboratory." These questions or comments create conversations that lead to higher interest and higher case acceptance. Patients enjoy learning about new procedures and techniques. They also like knowing their dentist and team stay on the forefront of modern dentistry.

At the first point of contact (the phone), scheduling coordinators who answer the phone have an opportunity to build the practice through proper communication. Rather than viewing the telephone as an interruption, each call should be looked upon as an opportunity to help patients and build the practice. The phone is the practice's lifeline to the outside world. A dentist can spend tens of thousands of marketing dollars to make the phone ring, yet in the first 30 seconds of that call those dollars are thrown to the wind if the scheduling coordinator is not proficient in answering the phone.

There should be four distinct voice tones woven into each call — friendly, knowledgeable, enthusiastic, and empathetic. Being rushed or anxious to end the call leaves patients feeling this is how the dentistry is done — quickly and incompletely. If the voice tone is bored, the caller assumes this is a boring practice and that he or she is just another patient. If the scheduling coordinator seems uninformed about the clinical procedures and what makes the practice unique and special, the message cannot be conveyed to patients or prospective patients. Finally, if the person answering the phone is unable to put him or herself in the shoes of each caller by displaying empathy, the practice is totally anti-marketed.

What would it mean to your practice to hear some of the following conversations?

"Thank you for calling Dr. Jennings’ practice. This is Karen. How may I help you? Yes, Mr. Freeman, this is the practice that designs and delivers crowns in a single visit. I'm so happy Valerie referred you to us. Our satisfied patients like Valerie who have received their one-visit crowns are spreading the good word. In order for Dr. Jennings to discuss your particular needs, I'd like to reserve a time on his schedule for your initial visit. Are mornings or afternoons best for you?"

Another example:

"Thank you for calling Green Hills Dental Practice. This is Jill. How may I assist you? Yes, Mrs. Davis, we are taking new patients. Who may we thank for referring you to our practice? I'm not sure how much Susan told you about our practice but if you have a moment I'd like to tell you what to expect on your first visit. Your first visit will consist of your necessary radiographs and a complete oral health exam by Dr. Ferguson. At the end of your first visit the doctor likes to spend quality time with new patients discussing their dental concerns and answering any questions they may have. Do mornings or afternoons work best for you?”

The goal of the scheduler is to be cordial, inviting, and thorough on the first encounter. Dentists would be astounded if they knew how many potential patients have been turned away by the lack of customer service, knowledge, or compassion when they make the initial call. If it's an emergency caller, such as a patient who just broke off half of a tooth at lunchtime, this is a great opportunity to introduce the person to a one-visit crown. CEREC has the highest level of perfection in single-visit tooth restorations. Your case numbers can double with knowledge, confidence, enthusiasm, and a well-trained staff.

I've discovered many times that the excitement from the dentist about CEREC or any new technology/procedure/material/technique is transferred to the team, and the team in turn transfers that excitement to patients. Patients can't wait to have the procedure completed. In other words, enthusiasm filters from the top down!

Investing in new technology and not involving the entire team in the training is like buying a Mercedes and taking it to Jiffy Lube for maintenance. The return on investment will not be there or will be short-lived. There are countless dentists who bought a CEREC, went to one or two courses (alone), and then expected to automatically increase their number of crown units each month. If their case presentation skills were weak before, they will not automatically increase with new technology. I've also noticed that dentists enjoy looking and feeling smart and confident. If they try something new and feel they are fumbling due to a lack of perfecting that skill, they will back away from it and give up in some cases.

We all know that a large percentage of case acceptance fall apart in the financial discussion. Having a financial coordinator who is confident, believes in the doctor's dentistry, believes in the fees, and has great success in collections is worth his or her weight in gold to the practice. Patient financing has been one of the best management tools in the past 25 years.

Presenting fees at the time of service in positive terms means there will be positive results. Examples include: "Your fee for today's visit is $1,350. Will that be cash, check, or bank card?" Three yes answers. Or, "Mrs. Bailey, the fee for those four crowns will be $5,400. I know you discussed that your budget may not be able to handle all four of them at one time. If I can secure for you a 12-month no-interest payment plan, how does $450 per month sound?" And in one practice the verbiage is: "Mr. Jackson, our doctors are so concerned about patients in need of ideal dentistry who feel they can't afford it that the practice is willing to pay their interest for 12 months so that they can start treatment right away."

Then there are patients who want to use insurance as their "crutch." They often say, "I can only do this if my insurance covers it." These patients learned to use insurance as a crutch because the practice said all the wrong things! Stop saying,"I'll have our financial coordinator check with your insurance company to see what they'll cover."Instead say,"Mrs. Phillips, you are one of our fortunate patients with a benefit plan that covers part of your basic care. How we wish ALL patients had a benefit plan because many patients pay the entire dental fee themselves." Letting them know the true definition of dental insurance is a must — it is a partial reimbursement for basic care, and 95% of all adults need more than basic dentistry. CEREC is not basic care, it is ideal care, and ideal care in most cases is not covered on benefit plans, and if it’s covered partially that's a plus. Remember not to call it INSURANCE. Instead say,"The BENEFIT PLAN your employer has chosen for you has strict limitations."

Improved CEREC usage is a result of:

  • Proper telephone techniques
  • Improved chairside communication
  • Patient financing options
  • Enthusiastic dentists and team members
  • Enhanced case presentation skills
  • Happy patients who refer


Grade yourself and your practice on a scale of 1 to 10 on the above six points. How close to 60 are you?

The most exciting part of being a CAD/CAM practice is that it sets your practice apart from others in the community. But with that uniqueness, the soft skills that go along with the technology — such as communication and enthusiasm — are a must. The other good news is that from a management standpoint, CEREC is the only piece of equipment that is paid for by existing expenses in the form of lab costs.

Make a commitment today to get the entire team on board with CAD/CAM integration. Invest in Wiltrace, the only firm in dentistry that specializes in CEREC integration, which includes not only the clinical training aspects, but also each person's distinct role of bringing the CEREC integration to a winning score.

Author bio
Linda Miles, CSP, CMC, Virginia Beach, Va., is an internationally recognized consultant, speaker, and author on dental practice and staff development. Linda is a successful businesswoman who in 1978 not only founded LLM&A, a leading INC 500 dental management consulting firm, but also founded the Speaking Consulting Network in 1997. Linda is known as the speaker who instinctively understands and loves to share the business side of practicing dentistry with dentists and teams.

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