dental

A Dental Office Manager also referred to as a Dental Practice Manager is an administrative position commonly accommodated in dental practices or orthodontic facilities.

A Dental Office Manager is like an overall Administrator, also responsible for running the front offices of dental clinics and managing day-to-day operations to assist the dental faculties in propagating a smooth work environment. They accomplish a broad spectrum of duties in supervising the business aspect of the dental practice, sometimes even answering incoming calls, scheduling staff meetings, managing office budgets and payrolls, organizing charts, and admitting new patients. By skillfully maneuvering their orthodontic and billing terminology knowledge, they support and assist the dentist and their dental team attain a sustainable and convenient work routine.

Busy healthcare domains demand specific office management skills, well-blended with high regard for brilliant communication and a special type of individual to undertake these responsibilities. A Dental Office Manager usually holds a background in medical office processes and procedures and advances in the industry with their efficient management expertise. A high school diploma or equivalent degree is required to be considered for this position. This profession is an excellent opportunity for growth and development within the dental industry.

Responsibilities for Dental Office Manager

• Plan or map out dental office operations to ensure excellent patient service and support.
• Address any patient concerns.
• Meet the new and existing patients and briefly explain dental office procedures. Schedule patient appointments, both new and follow-up.
• Hire, train, and supervise newly added faculties.
• The manager may negotiate and manage contracts with suppliers, insurance companies, and other third-party service providers.
• They ensure that the office, including the waiting area and treatment rooms, is clean, comfortable, and appealing to patients.
• Evaluate employee performance, promotion, termination, and retention protocols.
• Assist in budget preparation and expense management activities
• Ensure appointment cancellations and last-minute appointment requests are appropriately dealt with.
• Efficiently review patient insurance documents to determine the procedures that will be covered in addition to required deductibles.
• Oversee daily office activities and support and assist the dental staff when required.
• Organize and maintain patient files and records, retrieve test results as needed for the dentist’s evaluation.
• Coordinate with the patients and other multidisciplinary specialists to schedule required x-rays, dental imagery, or consultations.
• Call patients to inform them of their upcoming appointments and reschedule as needed.
• Prepare patient files and charts before procedures are conducted and transfer to other physicians or departments.
• Perform marketing and public relations with professionals if need be.
• Oversee payment collections from patients and contact insurance offices for payment settlements.
• Perform timely payroll processing and organize employee records.
• Review and approve vacations, sick leaves, and unpaid leaves for staff.
• Improve inventory control and management to support initiatives for cost reduction.
• Check a patient’s insurance coverage, submit claims and follow up with insurance companies when needed.
• Implementing procedures and policies for the smooth operation of all departments.

Skills and Qualifications for Dental Office Manager

• Exceptional knowledge of medical and dental terminology and processes
• Expert knowledge of safety regulations and compliance, including Occupational Safety and Health Administration (OSHA) standards
• Secured written and communication skills when talking to patients and staff
• Strong leadership and motivation skills to meticulously guide and supervise others
• Experience working with data entry software such as Dentrix and maintaining reports
• Experience scheduling patient appointments depending on doctor availability
• Experience dealing with patients and providing clear instructions before procedures
• Excellent computer skills for email correspondence, financial transactions, and scheduling appointments
• Maintain and order office and medical supplies as requested by the attending staff
• Experience maintaining a professional level of confidentiality per HIPAA procedures
• Multitasking skills with experience working in a busy environment and managing staff calendars properly

Education and training requirements for a Dental Office Manager

• A high school diploma or equivalent degree is required
• A minimum of 2 years of dental administration experience

It is not uncommon for receptionists to eventually rise to the office manager position by demonstrating their capabilities and leadership skills.

Experience requirements for Dental Office Manager

Qualified candidates must have at least one year of experience in the medical or dental industry as a front office receptionist or dental assistant.  Depending on the requirements posed by the organization, supervisory and management experience may also be needed for evaluation.

Dental offices, particularly those that handle high-dollar orthodontics, often face difficulties with their accounts receivable (AR) management. AR is the portion of bills to patients and insurance companies that are outstanding. However, these challenges can be met with strong, enforceable policies and consistent collection procedures.

A good rule of thumb for dental offices is to keep AR from exceeding the practice’s average monthly income. That means if you generate $40,000 on average each month, you should keep your outstanding receivables below that amount.

Additionally, none of your receivables should be older than 30 days. The longer AR sits, the less recoverable it becomes. Getting a handle on your office’s AR improves its cash flow and makes sure it gets paid fairly for the services it renders.

The Best Medicine is Preventative

Putting policies and procedures in place to prevent accounts from becoming delinquent is the best way to manage a practice’s AR.

The process starts when a patient joins the practice. It’s critical that all of their information is entered correctly, and that services are properly coded when procedures are performed. Correct information avoids improper insurance company denials, which can present a roadblock to payment.

Submitting claims quickly, with all required documentation, is equally important. The longer it takes to start the process, the longer it will take to get paid. A significant portion of a practice’s AR comes from insurance company nonpayment. Anything you can do to reduce this amount will help your AR proportionally.

It’s also a good practice to overestimate when you pre-estimate patient insurance. It’s easier to send a refund than to demand payment the patient wasn’t expecting.

Have a Written Payment Policy and Payment Plans in Place

Nothing should be left to chance. You should have your patients read and sign a payment policy that details what they might owe, lets them know they’re legally obligated to pay any amounts not covered by insurance, and describes non-payment penalties.

Having established payment plans gives patients options that you already know your practice can manage. The alternative, working out payments on an individual basis, is difficult to manage and confusing for patients.

That said, it’s always better to collect upfront when you can. Office managers are often surprised how often people will pay what they owe at the time of service simply because they’re asked. They may assume they’ll be billed, and when they learn upfront payment is an option, they may take it.

How to Collect Existing Accounts Receivable

Unlike other businesses, healthy dental practices should be able to collect the lion’s share of their outstanding receivables. Some industry estimates say between 95 and 99% of a practice’s total production measured over a year, should be collectible. Let’s look at how you can accomplish this.

Tackle the Oldest and Largest Receivables First

This accomplishes two things. It removes the oldest AR on your books, getting you above the prescribed 30-day rule noted at the beginning of this article. It also chips away at the accounts that will have the most substantial impact on your total AR.

Insurance oversights, mistakes, and misunderstandings often account for a sizeable portion of large AR balances. These take effort, but they can generally be resolved with diligence. If the patient is required to pay, help them understand what they owe, and work with them to create a payment plan.

As we mentioned earlier, the older AR gets, the harder it is to collect. It’s essential to handle unpaid insurance claims if they’re older than 90 days because there are often rules against collecting after a certain period.

For the oldest receivables, you may consider forwarding the accounts to a collection agency or writing the amount off. If payment is unlikely, getting them off your books may be your best option.

Manage Claims Denials Quickly

Denied claims can dramatically slow insurance payments. When a denial happens, contact the insurance company immediately to determine the cause. Look for any documentation or coding errors that may have contributed.

Insurance companies are happy to delay payment as long as possible. By keeping them accountable, you can limit impediments to collecting.

Keep Collections Calls Friendly

It’s best to give patients the benefit of the doubt when calling to collect outstanding bills. The healthcare system can be confusing. The patient may have assumed their insurance company would be covering their bill. Financial difficulties may also be to blame.

Try to understand the patient’s position first. It may be that a simple explanation is all it takes to procure payment. Approaching collection calls with sympathy and compassion is much more helpful than using aggressive or combative language which puts people on the defensive.

Giving an incentive to patients who pay ahead of time will significantly reduce your AR.  Remember that healthy dental practices regularly collect nearly everything that’s owed them. The right methods make it possible.

As a dentist, you have chosen a fulfilling line of work that is constantly evolving. Dentistry has made rapid strides with innovation and advancements in technology over the years, so the learning curve of this professional always remains steep, fully engrossing you in the process. While being a dentist is an honorable profession, it is also highly competitive. Opening a dental practice can be an intimidating idea in itself especially when you are just starting your career as a certified dentist but it doesn’t have to be. Dentist demographic reports suggest that there are currently more than 200,000 practicing dentists (including dentists using their dental degree in some fashion) in the United States. This might give you cold feet to start your own practice but there is a loophole to building a successful dental practice by sufficiently being proactive with some significant steps.

If you are considering striking out on your own and starting a dental practice, you may have a lot to think about. Fortunately, we have identified ten easy steps any dental professional contemplating to start their own dental practice should know and implement.

1. Create a plan “after” talking with your dentist friends

Dental practices are known to have very high success rates but this may only be the case if you are doing intense research to skip out on all the mistakes made by experienced dental professionals that led them to their failures. By knowing challenges that other dental offices face and what steps do they take to address those challenges. May be you can do things differently. Now that you have made up your mind that you want to be a dentist and your own boss, you need to start exploring the unknown that lies ahead. Talk to dentist friends who are currently practicing and extract information about the complications and challenges you may face during the course of your dental venture.

Make a cohesive plan to overcome these barriers and prevail by asking them about what they would do differently today. It is utter madness for you to go into such a business pursuit blindfolded. Make sure you do your homework, considering all odds and setbacks.

2. Put your finances in order

The cost of starting a new dental practice is outrageously high, averaging well over $250,000. That’s a large sum capital for some people to access. Many banks are readily available to lend money to dentists considering the cost and funding allocation requirements for a start-up practice. It is crucial, however, to remember that you should not base your loan decision solely on the interest rate. Although the rate is important in keeping your payments lower, it should not be the lone factor in your decision-making process.

Explore the various loan features such as prepayment and lender service levels to allot the best loan for your practice. Estimate as best as you can the initial costs of getting your office up and running. You may also find it best to calculate the expenses that would accumulate for the day-to-day operations for the first few months. Most importantly, anticipate any unexpected costs to ensure there is financial aid available, just in case.

3. Develop an airtight business plan

Irrespective of whether you are a general dentist or a specialist, you should build a plan for your business that is clear-cut and organized. You should understand the importance of specific, comprehensive treatment plans for your patients. A solid business plan is instrumental to your success and can help build popularity for your dental practice. You can get a business plan template from the ADA Resource Center to help guide you into the right path of business development and flourishment.

4. Decide on the location

Have you thought about where you want to set up your dental practice? Maybe it’s near where you live or in an unknown neighborhood. Finding the right location for your dental practice is key in determining the number of patients that come into your clinic and further your business. Additionally, the right location of your dental practice will also help convert more prospects into loyal clients.

Before getting comfortable, it is a good idea to research the area to gain an understanding of the local patient market. Does the demographic align for your dental practice? Making your dental practice easily accessible, in proximity to your targeted patients, and within your budget. These factors can impact your potential consumer base and your revenue stream.

5. Secure licensing and legal

Get your hands on the dental license for your dental practice. Don’t wait until the last minute to take care of the legal aspects of owning a business. It can take anywhere from weeks to a few months for the private and government insurance establishments to provide you with the appropriate credentials. You will also need to be properly licensed in your state, have a national provider identifier number, are registered with the DEA, and comply with all other local regulations specific to your area. Check the type of dental malpractice insurance is best for you.

6. Hire competent staff

Leadership means that there will be people under your wing who will be looking at you for guidance. As soon as you lay out a blueprint of your dental office, you should consider employing diligent dental staff who can do your bidding and help you around your dental office. A growing business also signifies growing responsibilities and a growing dental team. It is important to start planning out your hiring process and strategies before you make a move into your new office. Coordinate with your town newspaper or blog to put out an ad for zealous dental professionals and assistants who are responsible and driven.

Make time in your schedule to properly screen and hire candidates. Beyond salary, you will also have to discuss and budget for health insurance, time off, and other employee benefits. Just as you are trained in your technical skills, you will also have to work on your leadership skills to lead your practice to success. Your attitude, decision-making, and initiatives will determine the company culture and the office environment. Employees only follow leaders who are capable and proficient. Your employees should not construe your leadership skills as inept and irresponsible. Rake as many leadership qualities as you can by looking into classes and conferences that specialize in teaching individuals to become good leaders.

7. Select a billing software

When you get into the nitty-gritty of dental appointments, you will realize that it has a lot of components. Billing, for instance, can be equally as complicated to process as it is necessary. Dental billing software is specifically designed for dental claims billing. If you disregard integrating an efficient dental billing software into your practice management system, you are risking increased chances for errors, missed claims, or denied payments. Traditional dental claims filing through postal service or fax can take weeks to process, leaving a physical paper trail that requires additional service and shipping expenses. Dental software like Dentrix or Apex EDI helps your practice get paid quicker with significant cost savings.

8. Create your dental website

As a dentist and business owner, you should never underestimate the power of social media. Creating a structured and coherent dental website for your practice can help you gain more patients. Build a professional website with clear directions for setting up an appointment for new and recurring patients to easily access. You can also drive traffic to your website by incorporating backlinks and registering with dental directories that can help promote your dental practice. Effective blogging with engaging articles can also help you gain social media following and in turn bringing in more patients to your practice. You should also make sure that your blog content is SEO optimized by adding appropriate links and keywords.

9. Engage in search engine marketing

One of the biggest mistakes beginner dentists make is not putting adequate effort into marketing. Word of mouth and referrals from your current patients can only take you so far. It has been statistically reported that there are six times as many dental clinics today as there were ten years ago. That means that your neighborhood now consists of more dentists that can threaten the viability of your practice. Complete SEO optimization and implementation can take about six months to a year. Until your website gets optimized, you cannot let your business run its course. You need to generate leads right away! For this purpose, a lead generating tool can be your savior. Invest in Google Advertising for managing your search engine optimization.

Once your dental practice is registered to Google Ads, whenever a potential patient searches the word ‘dentist’, your dental practice will be spotlighted and your website will begin to generate clicks and increase the conversion rate. It is also wise to drive traffic to your website by registering for a free Google My Business listing. An optimized Google My Business listing has been found to get seven times more visits than an unregistered one! Try Yelp or Yellow pages directories to help your patients find you easier.

10. Attract patients

Your practice needs patients to run. Attracting patients is the most important part of owning a practice. Make sure you advertise your practice well through local marketing agencies who can put together a comprehensive team to run campaigns for your dental practice all year round. This ensures a steady and consistent flow of patients without seasonal droughts. Also, you can consider implementing a social media marketing plan through ads on Facebook. Local prints, TV, and radio stations will also be able to widen your reach.

Dental practices may be a challenge to build from the ground up but it is also a thing of great pride to be your own boss! Setting up dental practices with the help of professional advisors can also make your experience much easier. Let go of all rues by implementing these helpful tips before getting handsy with your dental practice. Good planning can help you build a better business module and bring in patients who match your audience type.

In retrospective dental clinical cases, restorations have played a rather unique role in alleviating pain and discomfort for the patients. A standard restoration may take up to a few appointments to complete which is the first major flaw that overshadows traditional restorative dentistry. As dentists, it gets exhausting to work on complex dental restorations as it would the patient to keep booking appointments to see their dentists every other day. Surprisingly, however, studies indicate that about 1.2 billion restorations need to get replaced every 10 years or so. This never-ending dental loop of monotonous push-and-pull interferes with the efficacy and convenience of the patients. As a result, in September 1985, at the Zurich Dental School, the first chairside ceramic restoration was placed with the CEREC 1 system using CAD/CAM technology. Many dentists critically acclaim this concept of restorative dentistry and have implemented it into their practice.

CEREC crowns last between 5 and 15 years, like a traditional crown. If a patient has dental insurance, the CEREC crowns typically range between $500 and $1,700.

What is CEREC?

CEREC stands for “Chairside Economical Restoration of Esthetic Ceramics” and essentially is a computer-aided design and manufacturing (CAD/CAM) system for dentists to take impressions quicker and be able to generate an accurate, well-fitted ceramic restoration. CEREC subtly combines a computer, a camera, and a milling system all in one unit to create a machine that works methodically in perfect synchrony to deliver quality dental restorations to the patients. The CEREC system that is in use today has progressed mostly thorough a series of software and hardware upgrades since its introduction. Over the course of 35 years, this revolutionary concept for restorative dentistry has evolved from a 2D design program to a three-dimensional speed with a leveling guide to increase the memory of the computers that saw a massive improvement.

The implementation of the 3D software substantially improved the functional load of the CEREC system, making it easier for dentists to view the designs in a way similar to what they are used to seeing with stone models. The 3D design of CEREC has also improved the clinical workflow, making it a comprehensive dental process to generate data and deliver restorations all on the same day. CEREC’s unique feature in dental CAD/CAM technology enables the dentist to capture the tooth preparation in the patient’s mouth and at the same time create and seat a ceramic restoration in a single appointment. CEREC technology has become an integral part of the dental industry.

When is the CEREC system indicated?

The CEREC system helps dentists fix unsightly teeth by incorporating an easy restorative program that works for a majority of dental restorations. According to a review in the Journal of Dentistry and Oral Care, there are three common restoration profiles that the CEREC system accomplishes:

• Crowns: A crown is a dental “cap” placed over the entire tooth to restore the shape, size, and appearance of a broken or chipped tooth or to support a tooth with a large filling.
• Veneers: A veneer is an ultra-thin dental shell placed on the front of the tooth to improve appearance. It works for teeth that are discolored, misaligned, or irregularly shaped. Veneers can also restore minor chips in teeth.
• Inlays and Onlays: Teeth that are too weak to support a dental filling may be treated with inlays and onlays. An onlay is a restoration that covers the cusps of the teeth whereas an inlay covers the space between the cusps.

How are CEREC restorations fabricated?

CEREC in collaboration with CAD/CAM digital system is a cutting-edge technology used to reconstruct tooth restorations and to offer single-day restorations for the patients. The process of dental restoration fabrication involves the following steps:

• Exam and preparation: Initially, the dentist determines whether the CEREC system is appropriate for the particular patient. The prognosis for dental restoration is dependent on the teeth structures available. Depending on the amount of remaining healthy tooth structure, the dentist decides one either a simple filling, dental crown, bridge, or an onlay/inlay. After analyzing the options, the dentist begins the process by administering anesthetic and preparing the tooth for restoration. Decay material and weakened tooth structures are removed.
• The optical Impression: In order to accomplish the desired restoration, a 3D image of the tooth is pertinent to visualize the areas of hard and soft tissue compressions. A 3D image is created from a digital scan of the tooth. In order to replicate the dentition of the patient, a CEREC Omni-cam is used. By simply gliding this intraoral camera over the teeth, a full-color 3D model of the teeth is generated. Because of the slim design of the camera, scanning even the rear molars becomes very convenient.
• The design: The CEREC Acquisition Unit houses a medical grade computer and the CEREC camera. By using the CEREC software, an accurate restoration for the teeth can be designed. The dentist receives a high-quality life-like draft of the restoration that allows them to rework or even directly transfer them to the milling unit. Therefore the dentist is able to design the restoration easier and quicker without compromising precision and aesthetics.
• The milling process: Following the design process, the dentist simply fabricates the restoration by placing a ceramic block in the milling unit. The CEREC software and the milling unit work closely with each other. Even the smallest fissures or alterations are worked perfectly by the finest CEREC milling tools.
• The seating: After finalizing the restoration, it is seated into the patient’s mouth to ensure a proper fit and bite. When ready, the restoration is polished and bonded onto the patient’s teeth. There is no need for temporaries while the patient awaits the final dental restoration. Try-in is done the same day as the final seating.

Benefits of CEREC restorations

The CEREC system is a technological marvel that is superior to the traditional methods of restorative dental procedures in numerous ways. This comprehensive system allows the dentist to eliminate tedious and time-consuming steps in the restorative process. According to the Journal of Dentistry and Oral Care review, the CEREC system is a vital part of advanced dentistry and offers many tantalizing benefits.

• Quick delivery: One of the most important reasons for the rapid popularity of this particular restoration style is its one-day delivery convenience. Within just two hours, the entire process can be done and the patient can go home with their new teeth. There is no need to return for try-ins or final restoration fit.
• Stronger material: CEREC restorations are favored for being truly long-term. The all-ceramic material used for these restorations has high strength properties and is durable. A study in the International Journal of Computerized Dentistry showed that 87.5% of CEREC inlays and onlays lasted over 27 years of use.
• Biocompatible material: The ceramic used in these CEREC restorations is biocompatible with the mouth, which means it is non-toxic and non-allergic.
• Better fit and comfort: With the help of the intraoral camera and the CEREC software, it allows for precision and accuracy in restoring the details of the mouth and enables the crown to be well-fitted and exact. As indicated by a study in the Journal of Prosthetic Dentistry, CAD/CAM restorations exhibited clinically acceptable marginal discrepancy ranges.
• No need for temporaries: Using the CEREC system, the final restorations can be delivered in a single day and there is thus no need for temporaries that are often weak and can easily fall off.
• Superior esthetics: The look of the CEREC restorations makes it the best option for restoring damaged or clinically undesirable teeth. The all-ceramic design makes for a natural-looking tooth that can boost the confidence of the patients.
• Reduced manpower: The dentist can eliminate the expenses associated with outsourcing to a dental laboratory for the fabrication of each restoration. This technology reduces the need for extra work and can be fabricated from start to finish in the dentist’s office.

With over 250 scientific studies confirming the reliability of this state-of-the-art technology, and over a million positive testimonials from first-hand recipients and dentists who have used and approved of this dental miracle, the CEREC system remains one of the best ways for the dentist to fabricate stunning smiles for their patients. In fact, this futuristic design is so popular and convenient that about 91% of patients recommend their dentist!

 

During the past decade, prosthetic dentistry has positively been shaped and impacted by computer-driven technologies that situate a level of desirable comfort and efficacy for the dentist and patients alike. Among many biometric systems implemented in the two cardinal fields of prosthodontics and implantology, rehabilitation of partially or fully edentulous patients has become substantially easier and precise. Fabrication of dentures and other prostheses by means of computer-aided design (CAD) and computer-aided manufacture (CAM) has not only proven to be possible but may have readily revolutionized the world of dental prosthetics. With the rapid integration of technology for prosthetic marketing, dentists have been adopting a high-yielding system of immediate dental restorations based on digital impressions and workflow that prioritizes patient control and convenience. 

What is a dental impression?

A conventional dental impression is a negative imprint of the hard and soft tissues in the mouth, recording of which can generate a positive reproduction (cast or model). It is a preliminary step in which a stock or custom dental impression tray is loaded with appropriate material (commonly used hydrocolloids like agar or alginate) that is specially designed to roughly engage the oral structures and fit over the dental arches. This impression is then aptly coerced into the fabrication of necessary dental appliances that fulfill a patient’s dental needs.

The principle of impression-taking abides by either of these two theories of denture appliance fabrication- the mucostatic theory and the mucocompressive theory. Mucostatic theory follows the impression being taken of the mucosa when in its normal resting position. Although these impressions are generally affiliated with great fit and accuracy, the denture is more likely to pivot around compressive areas such as the torus palatinus, during chewing. Mucocompressive theory, on the other hand, is related to taking impressions when the mucosa is subject to compression. As a result, a denture most stable at function but not at rest is accomplished. Another type of impression technique, known as the select pressure technique is focused on delivering relief to stress relief areas and compression to the stress-bearing areas. This guarantees the benefits of both the theories; the best of both worlds.

What are digital impressions?

A digital impression is a virtual scan that creates a map of the oral cavity. Digital impressions optimize cutting-edge technology that allows dentists to create a computer-generated virtual replica of the hard and soft tissues of the oral cavity using lasers and other optical scanning devices. The digital technology captures a coherent and structured impression of the oral tissues that can then be transmitted to computer software. This analyzes the data and lets the dentist implement modifications to create dental appliances that have superior fit and precision. A milling unit or fabrication plant will then fabricate a physical model of the crowns, bridges, dentures, or other restorations that would be given to the patient.

A majority of patients seeking prosthodontic rehabilitation have edentulous ridges, whether partial or complete. Digital impressions ensure a better fit for the underlying (potentially resorbed) tissues and the CAD/CAM system substitutes many of the steps of a conventional denture production chain. For instance, occlusal rims (OR) and functional impression with border moldings can be digitized, with the help of intraoral scanners, thus reducing the number of appointments for the patient till a final denture delivery.

Types of digital impressions technology

The innovative technology incorporated in digital impression-taking can be availed of by the dentist in two major ways. One type captures the images as digital photographs, and the other captures images as digital video. Since the images can be readily produced in a matter of seconds, it allows dentists and laboratory technicians to view and modify a series of images to create a denture fit that is accurate to the particular patients.

The images can be captured either using lasers or digital scanning. Laser scanners use concentrated light to capture all the details of the teeth and gums. They are safe and highly precise and will help eliminate the patient’s need to hold distasteful material in his or her mouth as would with the conventional method of impression-taking. An intraoral scanner is a handy device that works by projecting a light source onto the object to be scanned (in this case, the alveolar ridges or prepared teeth). They may, however, require powder-coating before scanning to ensure complete inclusion of the oral structures, although some modern-day scanners work without powder use.

How is a digital impression created?

Contrary to popular belief, the digitization of impression-taking is not relevant in all cases, and most commonly may only be “partially digital”. Prior to a digital outcome, a preliminary impression through conventional methods is crucial. This is because although digital scanners are great at recording precise readings of hard tissues, they are not accurate in recording the compressed and relaxed states of soft tissues. Some clinical cases have shown the pathway until the delivery of prosthetic appliances utilizing only digital intraoral scans in a fully digital workflow (mostly without the introduction of border molding).

Studies have demonstrated that in such techniques, the denture is able to provide sufficient retention, however, the plica intermedia is usually overextended and the denture is not secured with the functional movements of the mouth, giving substandard results. Since they marginalize the functional mucosa movements, the reliability and reproducibility of some of these techniques are questionable. For this reason, end-to-end digital fabrications are usually foreshadowed by conventional impressions.

A denture prototype can be fabricated by additive manufacturing (AM) for the chairside try-in sessions. A final denture is manufactured using subtractive or additive manufacturing methods.

• The dentist prepares the patient’s tissues for scan by suctioning out any blood and saliva that may coat the teeth and other soft tissues with specially formulated titanium dioxide powder. Some scanners are powder-free.
• Using the intraoral scanner wand, the dentist captures a series of 3D digital images or videos that can be viewed on the monitor by the patient and the dentist.
• The affected area is shown attention by gliding the scanner to the site. The dentist inspects the area for resorbed tissues, uneven dental ridges, any early signs of oral trauma, oral lesions, and other anomalies that can deter the process of impression-taking.
• The buccal-occlusal-palatinal (BOP) and “zig-zag” techniques are mainly used to digitally scan the edentulous jaws. Using special markers on the jaws, the dentist is able to avoid “overlapping effects” of the scanned image or video.
• On the chairside screen, the dentist is able to view the impression data in image or video format that has been compiled by the software.
• The dentist then reviews the digital images and verifies the accuracy of the scan.
• The digital impressions are sent to the dental laboratory where the patient’s restorations are fabricated, finished, polished, and sent back to the patient. Some clinics may also choose to 3D print the dentures with the relevant data from the digital scans.

Benefits of digital impressions

The process of digital impression-taking and denture fabrication is ridden with amazing benefits:

• Supreme patient convenience: The process of impression-taking becomes powderless and seamless with the digital intraoral scanning technique.
• Impressive speed: No longer do you have to wait around for the impression to dry. With incredible scanning algorithm, the Medit i500 ensures time-efficiency.
• Enhanced accuracy: They can scan oral tissues to a T, irrespective of the most minute of oral structures or any oddities. They are brilliant equipment for taking measurements.
• Simplified dental procedures: In cases of multiple dental implants or complex undercuts, dental procedures are simplified with the Medit i500.
• Superior predictability: The implementation of facial scanning into the workflow along with intraoral scanning allows the dentist to provide a virtual try-in session. The patient is able to see how the outcome is mostly to look like.
• Improved patient communication: Patients are more satisfied with intraoral scanning as they feel more involved in their procedures

Patients receiving digitally fabricated dentures may be able to transition from a traditional denture to an immediate denture quicker and easier, with the likeness of brilliant precision, accuracy, and patient comfort. Furthermore, the facial scans using this digital prototype can be obtained for the virtual esthetic evaluation (by the dentist and the patient) and digital try-in session. Many patients find digital impressions to be more comfortable than traditional impression-taking, which consequently helps the dentist build a strong rapport and grow their practice extensively.

Digital technology for restorative, cosmetic, and corrective dentistry has changed significantly over the years, allowing patients to receive modern dental solutions for their traditional dental problems. With the critical need for accuracy and precision in the scope of diagnosis and further treatment planning, digital intraoral scanners have been seeing massive popularity, alongside stand-alone equipment for computer-assisted design (CAD) and computer-aided manufacturing (CAM). Whether you are new to digital dentistry or looking for a fresh approach to treatment planning, according to the FDI World Dental Federation, adding an intraoral scanner to your practice will let you design and manufacture a “custom dental device, or a patient-specific dental device from an industrialized product, with the aid of a computer.”

What are intraoral scanners?

Intraoral optic scanners (IOS) are devices used to capture direct optic impressions by producing accurate and realistic images of the teeth and surrounding structures. They readily recreate the tooth’s anatomy and the dental appliance’s tridimensional position. Digital tooth maps can be created to provide an accurate color analysis for determining the shade and custom characteristics of cosmetic restorations.

The process of impression-taking is relevant for a number of dental cosmetic and restorative procedures and acts as a blueprint for the fabrication of respective appliances and devices. A dental impression is a negative imprint of the oral structures used in the fabrication of restorative prosthetics and orthodontic appliances for the recuperation of deficient or damaged tissues and the restoration of oral functions. However, with the problems accompanying conventional alginate impressions, a digital-analog comes in handy.

The current intraoral optic scanners are sufficiently accurate to capture impressions with much precision and detail and replicate the bone structure and tissue placements inside the mouth. Digital data of the oral tissues when displayed on the monitor can allow for endless modifications for superior fit and stability without having to take impressions of the patient’s mouth over and over again.

Popular manufacturers of intraoral scanners of 2019 include 3Shape TRIOS, 3M True Definition, Sirona Omnicam, Dental Wings DWOS, Medit i500, iTero, and CareStream.

Where are intraoral scanners used?

• Prosthodontic procedures: They are used for fabricating inlays/onlays, copings, and frameworks, single crowns and fixed partial dentures on both natural teeth and implants.

• Cosmetic procedures: They can be used for smile design and makeovers, and to fabricate posts and cores, removable partial prostheses, and obturators.

• Implantology procedures: Intraoral optic scanners can be integrated into implant dentistry for guided surgery and for the fabrication of custom abutments or screw-retained crowns and surgical guides for accurate placement of the roots of implants.

• Orthodontic procedures: In orthodontics, intraoral scanners are used for digital storage and on-demand model production in 3D printers, digital impressions, and 3D aligner treatment plans. They are effectively used in the fabrication of restorations, crowns, and surface coverage appliances used for aligning malaligned or crooked teeth (aligners and custom-made devices).

• Diagnostic purpose: They play a significant role in the diagnosis of specific dental ailments and aid in the customization of appropriate treatment plans for them. This ensures that the patient receives treatment sooner.

How do intraoral scanners work?

Similar to other 3D-scanners, they work by projecting a light source (laser, or more recently, structured light) onto the object to be scanned (in this case, dental arches and prepared teeth). Various name brands now have altered technology to create intraoral scanners that work for special dental conditions and are relative to the field of clinical use.

For example, the CEREC system makes use of the CEREC OmniCams to perfectly recreate the dental impression of the mouth. Since surfaces with uneven light dispersion can reduce the accuracy of the scans, these systems make use of opaque powder coating of titanium oxide to prevent such problems with scanning. One of the latest innovations of CEREC scanners called the CEREC ACBluecam uses LED blue diode as its light source.

The need for powder and opacification is typical of first-generation intraoral scanners (IOS). The more recently introduced devices can detect optical impressions without the use of powder. Technically, a scanner that works without opacification by powder is preferrable for clinicians and patients alike.

Differences between Intraoral scanning and Classic impression

1. The mode of operation

Conventional impressions accurately represent and replicate the oral environment for the fabrication of orthodontic and prosthodontic appliances.

• Dental materials like alginate and elastomers are mixed into a putty-like consistency and loaded onto trays (the fit of which coincides with the alveolar ridges).
• Following the insertion of these trays into the patient’s mouth, the patient is expected to apply normal biting force on the dental trays.
• An impression is successfully created and a die stone or dental plaster material is poured on the impressions to create a 3D representation of the oral structures. These impressions act as guides to create onto them custom-fit dental appliances.

Digital technology now offers a new easier approach to recreate 3D models that best depict the oral environment. An intraoral scanner comes with a disposable tip that can be used for individual patients.

• The scanners are simply glided over the alveolar crests and a full-color 3D model image of the oral structures is generated and can be visualized on the monitor in real-time. This allows for effective treatment planning and creating accurate dental appliances.
• After applying relevant modifications, the 3D data can be sent to the fabrication plant or milling unit to build the final dental prostheses and is handed over to the patients.

2. Precision and accuracy

Intraoral scanners work by digital technology that articulate and relay even minute details of the oral structures and can realistically replicate the entire oral habitat and all of its minuscule lines and ridges. This ensures that they convey flawless precision and accuracy which can be utilized to recreate the closest replication of the internal structures for the fabrication of a prosthesis. Accuracy is one of the key benefits of intraoral scanners that promote its use.

Traditional impression-making involves an unacceptable extent of leeway for errors and may not be as easy to perform as would be an intraoral scanner. While classic alginate impressions are excellent at recreating the details of oral structures, they may not be as reliable as intraoral scanners as they can miss microscopic nooks and crannies which may be vital in the adherence and fit of the final prosthesis which would be based on the initial impression taken.

3. Room for errors

The use of dual-arch trays in the conventional impression techniques poses numerous risks for potential laboratory errors such as shrinkage, irregular thickness, or detachment of the impression material and distortion of the impression. Human errors during physical impression-taking are inevitable and repetition would be inconvenient for the patients. Additional problems are dimensional changes caused by the expansion of the dental stone. Studies have reported that a mean deviation of about 10µm occurs when taking impressions and fabricating a cast, although considered negligible.

Although digital scanning eliminates the errors caused by humans and dental materials, technology-related errors are more evident with intraoral scanners. Since intraoral scanners lack fixed references and the first image acts as the reference scan body, even minor tampering with this impression can cause overlap images. Despite minor technical errors which are quite rare, intraoral scanners assist in the fabrication of crisp and well-fabricated dental prostheses with accurate fit.

4. Time-efficiency

Working with an optical intraoral scanner takes only a few minutes to operate and finalize the 3D model of the impression, significantly reducing the chair time, in turn reducing cost overturns. This enables the dentist to see many patients at a certain period of time to generate a digital workflow that is much more reliable and practical in performance. In cases where the digital data has not turned out as expected, another optical impression can be taken with much ease and speed.

With conventional impressions, there is a delay and wait for the impression material to dry, and takes more time to pour the impressions with dental material. Not only do patients need to wait and schedule another appointment for the finished impression, but it is also messy to take the impression.

5. Patient satisfaction

Traditional impressions cause inconveniences because they are unpleasant-tasting, bulky, and consist of cumbersome trays that make the patient experience unpleasant and disappointing. Furthermore, patients with poor gag reflexes can be easily triggered with the trays that impinge on the read-ends of their mouths and induces strong gagging sensations. With intraoral scanning, these inconveniences are eliminated. Not only is rear molar scanning easy with the intraoral scanners due to its slim design, but they also show the 3D model of the impression on the monitor that lets the patient visualize their treatment and be more involved with the procedure.

The takeaway

This cutting-edge technology used in intraoral scanners comes with a multitude of benefits that create opportunities and employs great patient and dentist satisfaction. With a strong learning curve associated with the IOS technology, dentists and patients can stay motivated and invested in the treatment.