When my receptionist told me that Woman Dentist Journal had called about doing an article on technology, I asked her if she laughed. I am not known by family or friends as being very techno-savvy. I just want to know which buttons to push to make things work. When we got new computer equipment, the standard joke was that I would ask my 9-year-old son for help if I couldn't figure it out. But, reflecting back on the advances that have been made in my practice, I realized I'm not as techno-challenged as I thought. I just have a love-hate relationship with technology.
When I entered dental school in l977, only 3 percent of practicing dentists were women. That started me on a course as a trendsetter early in my career. Technology and gender have both been advantages that set my practice apart. Although I am not techno-savvy, you wouldn't know that by my public image. For the last 22 years, being on the "cutting edge" has been a hallmark of my practice. The problem with that precarious distinction is the risk of getting "cut." Forward thinkers used to be burned at the stake. Giordano Bruno was burned in 1600 because he said the world revolved around the sun. Two hundred years ahead of the rest of the world and he was toast! As a successful woman dentist, I call myself the "Joan of Arch," because others who wish to stay in the dark ages would rather cry heretic than try progress. (One of the charges against the real Joan of Arc was that she wore men's clothes — as we all do now.) The amalgam war should be a lesson to us professionals of the changing tides of dental practice.
My foray into technology began my first year in practice. The year was 1981, and computers were making their way into the business world. I decided to buy a computer to do the accounting and business end of the dental practice. Fortunately, my husband Mike enjoys computers, but he struggled with setting it up. He tried to make it work, with no luck. We returned the computer, but continued to look for technical support. Then, I implemented the Sargenti Technique for endodontics, which was used successfully in Europe but quickly banned in the United States. So much for quick, easy, successful root canals.
We explored laser technology and committed to a YAG laser, and we were the first dental office in the Midwest to have a laser in 1989. That launched our public image as a high-tech office. We subsequently introduced the CO2 laser and the Argon, and became a three-laser office in the early 1990s. However, maintenance support and development did not advance to meet our demands, so we eventually phased out the use of lasers in our office.
Then came intraoral cameras, dental software to run the office, fax machines, high speeds with light in the handpiece, and tooth-whitening systems. The offerings were endless, so we prioritized our technology for patient treatment, not just "sales." Functional orthopedic/orthodontics courses offered the European technology for treating crowding without extractions, a practice shunned in the United States when I started, but now implemented in many orthodontists' offices. Posterior composites still are not used by many dentists, but we have been mercury-free since l989. Of all the things we tried, many failed either due to lack of motivation on our part or lack of performance on the part of the product. Many of my patients work at software companies, so I've learned that the industry standard is to sell the technology before it is fully developed — there's where the "cut" of cutting edge happens.
null
null
Using CAESY patient-education program
null
Undaunted by the percentages of success and failure, we made plans to build our dream practice. We planned to open the doors of our ultimate achievement on Sept. 15, 2001, but due to world events delayed the opening until Oct. 1. My husband had joined my practice five years after I started. We "job-shared" for 15 years while raising three children. We worked in one office, each of us there two-and-a-half days and at home two-and-a-half days. Then we decided to open a new office. Mike is the technology person; I am the marketing person. What he sees as a great new tool, I see as a way to let patients know they are receiving the most advanced treatments available. Our new office has all the bells and whistles. And our patients love it!
Our new office is 2 years old now, and I can finally use most of the equipment. I still don't know how to process digital radiographs, but maybe next year. We are a paperless office — no charts, all computers. Mike said that was important because my handwriting was so bad no one could read it anymore. He forgot I don't type well either, but spell-check takes care of that! We electronically file insurance claims and use email to communicate with patients who request it. Our Web site has online forms patients can fill out to reduce paperwork before appointments.
We have monitors on the ceiling — not for patients to watch videos, but to display their digital radiographs. Larger-than-life X-rays speak for themselves. And the ability to zoom in on a problem area, print a copy to take to a referral, and even email a copy of the radiograph is wonderful.
We also use CAESY, the patient-education program that has a library of most procedures available to show patients. This is one of the best ways to use technology to educate patients about their options.
null
Setting up pulseoximeter for sedation
null
I designed our new office as a dental spa. A massage therapist does chair massages while patients wait for anesthesia or procedures. We use aromatherapy, relaxation CDs on our sound system, oxygen therapy, headphones, and sunglasses to help patients relax. They can have routine dental work done with the latest technology in a relaxed setting.
One of the simplest things we implemented is walkie-talkies that we carry in our pockets. They have a receiver for the ear and a microphone, so all we have to do is speak into the microphone and all employees can hear what we say. The second day I wore mine, a PhD came in for a consultation for Invisalign. I sat down and called for an assistant with my microphone. His first words were, "You guys have all the latest." Was it easy to help him believe we can deliver the care he wanted? You bet!
BriteSmile and Invisalign are the two most requested procedures we offer. Once again, these companies have combined technology with marketing that brings dentistry to the patient. I am Invisalign-certified, and patients love that technology. To see their own orthodontic case morphed on software and be able to email their treatment software is a great advantage.
I also developed ToothArt, the fun stickers and jewels for teeth. I conduct all of my international business on the Internet and have sales in countries around the world, and do 98 percent of my business online. Before the Internet, this business would have had to be done with sales calls. Now, I sit at home and work on the computer.
Having just come back from a dental mission trip in Peru, I now know that the greatest technologies in dentistry are high-speed suction and four-handed dentistry. We worked in a dental school with an amalgamator that used separate mercury and powder, and each chair still had a "spit-bowl." The high-speed handpieces used water, and every two minutes the patient had to sit up and spit. I don't take for granted all that we have available to us, but our technological wealth is glaringly apparent after working in a country that has very little.
In the early 1900s, the director of the U.S. Patent Office told the President that he should close the patent office because everything had already been invented! He wasn't much of a forward thinker! Dentistry continues to advance, and patients and doctors continue to benefit, with more people seeking dental care than ever before. Technology makes both the patients and the doctors look good.
Maria Kunstadter, DDS
Dr. Kunstadter, a registered dietician, practices dentistry with her husband, Dr. Michael Sigler. A busy mother of three, she has spoken both locally and internationally. Dr. Kunstadter is on staff at North Kansas City Hospital. You may contact her at [email protected].
