Clayton Davis, DMD 

Hint: It wasn’t because I was cold. 

A First Impression I Will Not Forget 

One of the activities my family enjoyed on our vacation to Ireland 25 years ago was visiting the famous McGee tweed factory in Donegal. They had a loom set up so visitors could pick out threads, weave with the shuttlecock, and make a pattern. My children were at an age when that was very entertaining. 

On our last day in Ireland, we walked the main street of Sligo and stopped in the Mullaney Brothers haberdashery. While my wife looked for a few things, I waited with no intention of buying. An elderly gentleman walked up behind me, and with a charming Irish brogue asked, “I say, sir, are those your children over there?” I said, “Yes.” And he said, “Oh, they’re fine looking  children. They are a credit to you, well behaved.”  

As the conversation proceeded, he introduced himself as Mr. Johnny Mullaney. He inquired about where I lived and what we had done while in Ireland. He mentioned how he enjoyed watching the Olympics in my hometown of Atlanta. He knew a lot about Markree Castle, our accommodation for the week, and Rosses Point, a golf course I played at. He enthusiastically shared his opinion of its famous 18th hole. He was immensely proud of the golf course. Then he mentioned the pride they had in their tweed jackets made from tweed from the McGee tweed factory.  

He pointed to the jackets and asked which of the tweeds I liked best. I pointed to one and he said I appeared to be size 41L (exactly right), and before I knew it, he had slipped the jacket over my shoulders. As he brushed his hands over my shoulders and down the sleeves and tugged at the cuffs and bottom of the jacket, it felt tailor-made for me. I told him I liked the way it fit, but our luggage would be tightly packed for our trip home. I expressed my concern the jacket would end up badly wrinkled. He said, “Oh, it’s tweed, sir. We can fold it very nicely and have it ready for you to pack and it will unfold without wrinkles when you get home.” 

I liked the look of the jacket, yes, and I appreciated the quality of McGee tweed. But ultimately, what I appreciated most, what made me want the jacket, was Johnny Mullaney, himself; the consummate haberdasher, a master at his craft, who won me over by becoming my friend in a mere five minutes.  

I thought, “I don’t have a memento of this trip. This jacket will always remind me of our wonderful trip, our day at McGee factory, and this endearing Irish businessman.” I said, “Mr. Mullaney, I will take the jacket.” 

What I Learned from that Lasting Impression 

There are four elements from meeting Johnny Mullaney that I apply to meeting every new patient in a preclinical interview: 

1. Make a friend. (How can you trust each other if you don’t become friends?) 

1. Make an invitation. (Accepting an offer to be examined makes co-discovery exams flow.) 

1. Make it easy. (Find out their concerns, and address them.) 

1. Connect the feeling to the choice. (People do business with people they like.) 

You see, we always make choices based on our feelings. The preclinical conversation allows the new patient to feel good about my desire to genuinely help them and understand their feelings and needs. This is how we can move forward toward optimal care.  

A Series of Invitations Lead to the Treatment “Yes” 

When dentists ask me how they can do more cosmetic and restorative cases, they are usually surprised when I tell them it begins with doing pre-clinical conversations at the first visit.  

• You can’t do comprehensive cosmetic and restorative treatment until you’ve presented a treatment plan.  

• You can’t produce a treatment plan until you’ve done a good diagnosis.  
• You can’t produce a diagnosis until you’ve done a thorough exam. 
• And that thorough exam is incomplete when it doesn’t start as a good preclinical conversation with the new patient. 

The preclinical conversation sets the tone for trust and healthy open communication. It is the essential first step in creating a lasting good impression that leads to the first “yes” in a series of invitations on the way to treatment.  

Charlie Ward, DDS

In this article, I’ll share how I save my Dental DSLR photos and choose between the file formats of RAW versus JPEG. There are specific reasons why we might need one format or the other, or perhaps both. I’ll also share how I store and protect my ever-growing collection of images. 

The Difference Between RAW and JPEG Format 

We have a choice when we’re shooting with our DSLR about how we want to save our files. On the menu of our camera, we see that we can choose between RAW and JPEG, and the quality of JPEG. When RAW is selected, all data that hits the camera sensor is saved. A JPEG is a processed image resulting in a compressed (smaller) file size.  

The data stored in RAW images can be 3 to 4 times more than in JPEG images, depending on the quality of JPEG you select on the camera menu. The processor in your DSLR camera will remove data from a JPEG image that it perceives to be imperceptible to the human eye. The greatly smaller size of JPEGS makes them universally preferred, not only for storage but for quick upload, download, and opening for viewing online. I routinely shoot high-quality JPEGs for diagnostics and routine lab communication.  

(If you are wondering what JPEG stands for, it’s for Joint Photographic Experts Group. Once JPEG images are in your computer, they can be saved as different file formats ending in different extensions such as .eps, .pdf, .jpg, .jpeg, .bmp, .tif, and .tiff.) 

If I take an image in both RAW and JPEG format, at first glance, the JPEG and RAW images may look the same, but on closer inspection, I may see that the stain on a tooth’s enamel or surrounding skin tones appear lighter in the RAW image. The camera itself has processed the image and determined that some of that data is unnecessary.  

When to Shoot RAW Images 

For most of what dentists do with our DSLR cameras, JPEGS are fine. There are three situations when we should choose to shoot RAW images. 

1. When we want to edit images like a professional photographer. 

1. When we shoot images for accreditation for the American Academy of Cosmetic Dentistry. The Academy requires images in raw format so they can tell that the images have not been edited.  

1. When we are using a digital shade matching system like eLab or Matisse that requires RAW input. 

Why Shoot Both Versions When You Want RAW 

If you are storing CBCT and RAW images on your server, a lot of data can accumulate quickly. I shoot JPEG versions of the images I shoot in RAW format so I can delete the RAW files from my server when they are no longer needed and still have a case record with the JPEG files. 

Storage Tip: In my practice, we download the patient’s or the day’s images from the SD card on to our server in a patient folder. We have one main folder and within it a subfolder for each letter of the alphabet. Inside each alphabet letter’s folder is another subfolder labeled with the patient’s name for each patient whose last name begins with that alphabet letter. Inside each patient’s folder are appropriate subfolders, labeled for example, “Name-Prep-Date.” 

Charlie Ward, DDS  

Whether you want to use a digital SLR camera for documentation, patient education, lab communication, making presentations at dental events, dental publications, or accreditation in the American Academy of Cosmetic Dentistry, you have choices to consider in multiple price ranges.  

Dentists can spend $1,800 and get a good system for documenting cases, patient education and lab communication. Dentists can easily spend $3,800 or more on a setup to equip themselves to take higher quality images. 

Camera Body: Most dentists shoot with a Nikon or Cannon DSLR camera. These are comparable brands. My experience is with Canon but my lab technician uses Nikon and gets wonderful results. I am shooting with the Canon EOS 90D. The comparable Nikon is the D7500. More entry-level models are the Nikon 3500 and the Canon Rebel T8i. 

Lenses: We can get a third-party Sigma 105mm or a Tokina 105mm lens that gives us decent quality, or we can purchase the Canon 100mm or Nikon 105mm version at twice the price. When I upgraded to the finer Canon lens, I noticed a huge difference in image quality. I recommend an upgraded lens for the highest-quality images you need for accreditation. 

Flashes: The ring flash is a great entry-level option and significantly less expensive but there are limitations to what you can do to control your light. I’ve been using a dual point flash for some time. I can pull a flash off and shoot from a different angle. By changing where the light is coming from, I can accentuate the angle lines for more depth and visual clarity.  

Sometimes, I’ll take one of my flashes off, hold it on the opposite side of what I am shooting, and shoot the flash back into the lens of the camera. When I do this, I get an ethereal-appearing image or an image with a white background. I appreciate the versatility of using the dual point system.  

For my best-looking images and portraits, I’ll use softboxes. This gives smoother, more diffuse light and a beautiful appearance. These are necessary for everyday dentistry but make a huge difference in showcasing aesthetic cases.  

Consider the Long Term: When dentists invest in cameras and lenses, they typically use them for a long time. If you are on the fence about how much you want to invest, my own experience might be helpful. I honestly wish that I had upgraded sooner than I did with the Canon EOS 90D and the Canon 100mm lens. After taking photos for 12 years, the upgraded equipment has only increased the joy I have for photography and pushed me to take more pictures! 

Dental Sleep Medicine in Restorative Practice Part 9: Marketing Dental Sleep Medicine 

By Todd Sander DDS 

How do you start reaching out to physicians and other providers to build a dental sleep medicine practice? Start with the ones you know. Start with your own personal physician and start a conversation. If your dental patient is on CPAP, get permission to converse with their doctor. I spend time contacting many primary care doctors and find they are the ones who know patients are non-compliant with their CPAP therapy. They help me get patients re-evaluated by a sleep specialist. 

This may not be true in your community, but in Charleston, SC, where I practice, many primary care doctors don’t know what to do with their non-compliant CPAP patients. They are thrilled to have someone to refer them to try alternative therapy. 

Years ago, I reached out to sleep testing centers to communicate my services. Both independent sleep labs and hospital-based sleep labs have been great sources of referrals. For many years, I was the dental advisor to a sleep lab. A great conversation starter with sleep physicians, is the potential of combining CPAP and an oral appliance. This often allows the CPAP air pressure to be turned down so their patients be more comfortable and compliant. 

When you screen your dental patients for airway issues such as sleep apnea and snoring, the next step is referring your patients with issues for a sleep study. When the patient discusses their symptoms with their primary care physician or a sleep physician, you are mentioned and often documented as making the referral. Over time, physicians come to know you as a go-to provider of dental sleep appliance therapy. This process is sped up when you take the time and initiative to contact your patient’s primary care physician with your patient’s permission. You can guide physicians and remind them of the recommended standards-of-care, including appliance therapy in place of or in combination with CPAP therapy. 

Some patients self-refer to me, as friends and family talk about their experiences in my office, but I am not spending money on digital advertising to bring in dental sleep medicine patients. Mostly, they are referred to me by physicians, dentists, and other patients.  This is the same for my dental practice. 

As mentioned in a previous part of this series, our hygienists have attended dental sleep medicine courses with me and screen for airway issues. They adeptly educate and guide patients who have signs and symptoms to schedule an examination and consultation with me. 

Note: When patients are referred to me for dental sleep medicine, I never encourage them to become dental patients in our practice. This is a choice they might make but I am extremely careful to refer patients referred by a dentist back to their referring dentist for all dental needs. I am an adjunct to help other dentists’ patients fulfill a prescription for a dental appliance. 

If a patient comes in for sleep-disordered breathing but is also experiencing facial pain or TMD, I understand that this patient’s two issues are likely connected and I will not be able to successfully treat one without treating the other. This is an opportunity to communicate in depth with the referring dentists and let them know I plan to treat the patient for both issues simultaneously. This has been easier for me to do because I have had years of experience in treating facial pain and TMD issues in my dental practice, as well as sleep apnea and snoring. 

Seth Godin recently asked, “What are the symptoms of a marketing problem?” and continued… 

We have a ‘marketing problem’ when: 

• There are people who would benefit from your work who aren’t engaging with you. 
• There’s a change you seek to make in the culture, but it’s not happening. 
• You’re having difficulty persuading other people of your point of view. 
• The service or product you make isn’t resonating with those you seek to serve. 
• You’re fighting in a race to the bottom, and it’s wearing you out. 

If you have a marketing problem, how much time are you spending working on a marketing solution? …You can’t solve your marketing problem tomorrow by simply repeating what you did yesterday. 

At the Root of Your Problem

Broaden your thinking and consider what is at the root of why you aren’t doing more of the dentistry you want to do and building a larger base of patients you enjoy. There are two primary reasons why dentists fail at meeting their desired practice goals: 

1. They’re not very good at delivering on the promise, and therefore aren’t getting very many internal referrals and excellent digital reviews. (Marketing doesn’t solve this. Other things do. This isn’t really a marketing problem, is it?) 
2. They are not well known in their community for being the genuinely caring and “honest” type of dentist that patients crave most. And they are not well known for being the perfect fit to compassionately and predictably solve complex oral health problems to significantly improve quality of life.  (Marketing can help solve this, but how?) 

Resolving Your Problem

Most dentists naturally focus on developing their skills and then struggle in the shadows with an amazing skill set that few people seem to appreciate. How do you best approach resolving issue #2? That depends on what it is that you’re trying to achieve. What is your purpose? And what are the principles and philosophy that stands behind that purpose? Because it’s your principles and philosophy that you need to be promoting and projecting out into the public sphere, not just the flash…not just the “how to”…and certainly not the doctor dancing around the office and bragging about how great he or she is.  

Patients need to be genuinely impressed and more than satisfied so they spread high praise in your community. You and your entire care team need to give them things to talk about…what it is different about your approach….the relationship they have with you…the experience they have in your office…how well they are informed…the excellent results they enjoy…  

Clearly speak about your principles and philosophy in mindful, emotionally intelligent conversations with patients. Clearly write about your principles and philosophy of practice on your website. Listen and read “well” what patients say about you. What do they love? This is significant content for your website, blog and other external marketing.  

It comes down to: What is it that you can do that is deeply significant to your target audience, and how can you best convey that information and feeling to them on a consistent enough basis that they want your care?  

The foundational, solid relationship you build with them using highly attuned emotional skills will support treatment acceptance congruent with what they value and congruent with what you explain is in their best interest to meet their oral health and smile objectives. 

That’s what marketing is about, and it is both an internal and external process that must be constantly fine-tuned and consistently evolving within yourself, within your interactions, and within your messaging inside and outside of your practice walls. 

Lin-Manuel Miranda concludes his iconic musical Hamilton with a piece titled, “Who Lives, Who Dies, Who Tells Your Story.” The song causes the audience to reflect on why certain people in history are remembered, while others are forgotten. It draws them in and includes them in the drama to discover personal meaning through the experience.

L.D. Pankey knew and told his story. Others told it too.

One of my favorite quotes from Peter Drucker is, “The aim of marketing is to know and understand the customer so well the product or service fits him and sells itself… The aim of marketing is to make selling superfluous.” When I first read Drucker, is was a true “a-ha” moment for me; it completely shifted my paradigm about marketing while simultaneously connecting it to L.D. Pankey.

The light came on. L.D. Pankey was one of the greatest marketers in the history of dentistry. And he achieved it by first knowing who he was, and then clearly and consistently communicating it to the world. In other words, he was very good at telling his story, and it was through that narrative that others learned, grew, and our entire profession benefited.

Clarify your story to tell it well.

If we are to thrive in this rapidly-changing marketplace, our own compelling story must be known. Our story must be told by ourselves, by our care team, by our patients, and others. It’s ultimately up to us who will tell our story and what they will say. So, how do we go about telling our story? First, we must clarify our philosophy and vision to the point that they are “in our tissues” … to the point that we can’t NOT talk about them. Put your story out there with enthusiasm. The rest will follow.

In my last post on SEO and Google, we talked about the first two steps to get found online by the people who need you most – those in your community. We went over the age, authority, and quality of your website. Not to mention the importance of staking your claim in all of the directories.

At this point, you’ve got a secure, responsive website and hundreds of citations of extremely consistent NAP data. Now what?

With the first two steps completed, search engines need proof that you exist and that you’re worth recommending to their users. How does this happen?

Local SEO Domination in Dentistry

Step 3: Social Engagement and Reviews

Consistency in social media is key. If you’re never going to tweet, don’t get a twitter account. You need to be active where your patients are active. For most of us, that’s going to be Facebook, Instagram, Google, and Yelp.

Pediatric and orthodontic offices should strongly consider putting content out on Musical.ly and Snapchat.  Twitter and LinkedIn are wonderful for connecting with other professionals. Participate in conversations on social media and search engines will know you’re a real live business.

They don’t, however, have any idea how good you are until you get reviews. Again, consistency is key. Don’t get too hung up on volume.

A consistent stream of reviews, as little as one per week, will do better than a brief campaign that produces the same end volume in a month’s time and quits. Native reviews direct to sites like Google, Yelp, etc. have more weight than those acquired by aggregation software like DemandForce, SolutionReach, or RateABiz.

Also, because of geo-location enabled devices, you can look forward to reviews written away from the office being ranked higher. Ask for them consistently, especially when a patient offers a compliment, and you will see results.

Step 4: Go Forth and Create!

The last step is simple but probably the hardest. Be active!

Build your library of content, whether it’s in the form of blog posts, podcasts, or vlogs. Steady streams of updates send the signal that you are a living breathing organization that deserves to be noticed and recommended.

Always keep the subject focused on what benefits your patients experience. I like to divide my content in equal parts – personal interests, professional interests, office updates, industry updates, and local news. This simple post I wrote in 2017 on conservative dental therapies gets as many views as our “about us” page.

Now go and share with the world how awesome you are and crush the competition while doing it!

Gone are the days of feeling good that everyone in your community can find you because you paid a single fee for an ad in the yellow pages.  

Today, you need your dental practice to be visible when people in your area are looking for services like yours. More and more people are using their phones and computers to do this.

Growth should be the primary goal of every dental practice. No matter how well things are going, planning for and promoting growth ensures that any setbacks do not completely derail you. Growth is also valuable because it keeps your practice lively with new patient energy and ensures your team stays engaged.

In Part 1 of this series, I discussed my first two tips for 2018 that encouraged developing a marketing plan and increasing whitening services. Keep reading for my final two pieces of advice:

Thrive in 2018: Patient Education and Experience

Use Digital Photos for Patient Education

Take the following series of six digital photos on all new patients:

1. Natural smile
2. Close up retracted view
3. Upper occlusal view
4. Lower occlusal view
5. Left buccal corridor
6. Right buccal corridor

Load the photos onto an iPad or tablet for patient viewing. This will convert the process from passive to active for the patient. Be prepared to hear two frequent comments from patients: (1) “Wow, I have never seen my teeth like this before!” and (2) “Yuck!”

Provide a Remarkable New Patient Experience

The first visit to your practice should be an awesome experience that helps new patients become more interested in their oral health. Take some time with your team and design a new patient experience that is more ideal.

Consider beginning with a simple office tour that shows the patient some services that are available. Include a new patient interview where a team member takes the time to get to know your patient and understand their ‘dental story.’ Make it a ‘wow’ experience where patients leave saying, “I have never been treated so thoroughly before!”

The four tips presented in Part 1 and 2 of this series are an excellent way to develop a thriving practice in 2018 and beyond.

As you begin to implement these recommendations, think of the following axiom: To achieve what you have never achieved, you must do what you have never done. Here’s to your success!

It’s my strong opinion that dental practices are either growing or they are in decline. A case could be made that there is a third option, staying the same, but with ever-rising overhead, staying the same is just another form of decline.  

In Part 1 and Part 2 of this series, I’ll share 4 specific tips that will help you thrive in 2018 and beyond.

Thrive in 2018: Marketing and Whitening

Develop a Comprehensive Marketing Plan

New patients are necessary for a growing practice. Oftentimes the difference between a good practice and a thriving practice is the volume of quality new patients.

Spend some time crafting a comprehensive marketing plan that includes internal, external, and digital marketing activities. In my own practice, our most effective internal marketing strategy is the dentist calling all new patients and any patient who receives an injection on the evening of treatment.

An effective external marketing strategy for us is making NFL-quality mouth guards for our local high school football team. Also, one very effective digital marketing strategy has been getting online patient reviews. An appropriate marketing budget for a growing practice is 4-5% of revenue.

Embrace Whitening

Growing your whitening business is a great way to attract patients. Here are 3 simple things you can do to increase the amount of whitening treatments you perform:

1. Take a shade match at the beginning of the hygiene appointment. Then show the patient their current tooth shade on a shade guide organized chromatically from dark to light.
2. Value-price whitening. Consider value-pricing as a means of making it more affordable and accessible for your patients. The real economic benefit is the restorative and elective treatment that results from increasing your whitening.
3. Offer lifetime whitening. Consider offering free gel to your whitening patients, provided they keep their recommended hygiene appointments. This is a win/win strategy that patients love!

To be continued …