Practice Management

The Increasing Impact of Technology on Everyday Dental Practice


Ron Weintraub


April 16, 2014

April 16, 2014

Many years ago, technological innovations began to gain some recognition within dental circles.  As always, the starting point was with the curious early adopters that pictured the application of each new technological breakthrough into their particular practices while the majority of us hung back. We allowed the steep learning curve to be experienced by others. After considerable trial and error and many years of testing, we often timidly stepped up to incorporate these modalities into our own daily regimen. We learned we had to keep up with progress if we wanted to grow.

Some of our confreres had difficulty adapting to the changes and applied the “if it isn’t broken, don’t fix it” philosophy. They laboured on for quite a while in a state of denial. At that time, patients had only a moderate focus on what their dental office afforded in the way of innovation; therefore, few negative consequences of this lack of patient perception existed.

Today, however, patients are acutely aware of and demanding of the latest and greatest technological breakthroughs modern dentistry has to offer. If their practitioner does not provide this learning inclination, they would probably not leave the practice as they have established a relationship. They might refrain, however, from referring family and friends to a facility that does not have all the “toys” that, in their opinion, a contemporary practice should offer. They often mistakenly group the latest technology with excellent treatment outcomes even though we know that one is certainly no guarantee of the other.


Many innovations have contributed to progress in dental offices. Among them are the following:

1. The airotor hand piece:  Yes, there was dentistry before the advent of the airotor. Some practitioners were late in adopting what was then considered a revolutionary modality.  Some academic programs in the late 1950s -1960s prohibited the use of the high-speed hand piece in the pediatric training program. Today, we cannot conceive of modern practice without it.

2. Multiple x-ray heads:  Another early innovation was to have x-ray heads for conventional analog radiography in each operatory to enable a patient to remain in the operatory. Early adaptors later augmented it with the introduction of analog Panorex radiography, which went a long way to elicit significant radiographic information with a minimal amount of radiation exposure.  In the last 15 years, digital radiography including digital Panorex allows for instant transport of images to patients and dental colleagues.

3. CAD/CAM technology: Another milestone invention was the application of CAD/CAM technology to the fabrication of crowns and veneers at the dental office and dental laboratory facilities.  The push for this emanated in Europe and made its way slowly to North America.


AdministrationAfter timid introductions of the computer system and the Internet to the administration department and its acceptance by the dental administrator of the day, many didn’t trust the computer.  Some resorted to use parallel hard copy appointment books.  Today the computer system is the heart of the operation, and, in many cases, it is used in each operatory as well as other areas of the office.

Short list of Administrative Applications

1. Appointment Scheduling:  Instant access to next available appropriate appointments2. Charting:  Clinical findings and notes3. Paperless documentation: Time savings can occur in real time as patient is being treated by the dentist or hygienist dictation to an auxiliary for permanent recording purposes4. Accounting System: Allows for instant allocation of expenses and fees for payment5. Electronic Communication: Able to interface with confreres and patients6. Electronic Surveys: Patient initiated automated appointment request7. Automated response to Frequently Asked Questions8. Pre-scheduled patient communication9. Automated analysis and reporting on practice performance metrics10. Workflow software that guides staff through pre-defined processes

Clinical Applications of Technologies Currently Available

1. Digital radiography and photography:  The ability to manipulate and enhance images is diagnostically valuable and helps patients understand the proposed treatment plan.2. CAD/CAM3. Digital impressions transmitted online to laboratory:  Online transmission is a great time saver and ameliorates one of the more unpleasant steps in prosthetic rehabilitation.4. 3D Cone Beam CT technologya. Detection of pathologyb. Virtual planning visualization and placement of implantsc. Correlations of X-ray data with surface scan data to allow accurate flapless placement of implants.

One of the most recent innovations currently in clinical basic testing after many years of development locally is WizarDDS that performs by being superimposed on an existing dental software program. It is designed to guide staff through predefined processes to improve efficiency and accuracy.

The list of innovations is perhaps overwhelming and very few practices can avail themselves of all of them, so we must choose judiciously. The unstoppable move towards more technology should give us pause to think about consolidating and engaging in more group practice in order to have a critical mass to allow us to afford the technology hardware that contemporary patients expect.

Let’s ride the wave of innovation rather than being submerged by it.