New whitening and fluoride treatment products from oral health developer OrVance® are described as the first to leverage clear retainers and aligner trays as an effective delivery device. The company says the 2 products were developed with the support of orthodontic and dental practices and are designed to provide the most effective, most convenient, and best value options for the growing population in clear retainers and aligner treatment.

Both of these OrVance products are formulated to provide safe and effective treatment with clear retainer and aligner trays, which already provide a custom fit and are worn with regularity.

The OrVance Whitening Treatment offers 10 applications per package and will be available to orthodontic and dental practices and to consumers from major online retailers. The company says there are plans to launch with brick and mortar retailers next year. The OrVance Fluoride Treatment will initially be sold primarily to orthodontic and dental practices and provides 3 applications formulated to strengthen tooth enamel and reduce sensitivity.

The 2 new products support OrVance’s goal of improving the orthodontic patient experience and to provide solutions to support longer-term compliance for smile retention. Clear aligner treatment is an attractive long-term growth segment driven by not only the growth of orthodontic treatment but also the improvement of longer-term compliance to retainers after treatment, according to the company. Whitening solutions during and after orthodontic treatment is the perfect time to introduce a long-term whitening option, says OrVance, and during the development of the OrVance Fluoride Treatment, company colleagues strongly agreed that a more convenient and cost-effective fluoride delivery system within orthodontics is also an important innovation to retain/strengthen tooth enamel and reduce sensitivity during and after treatment.

Articles

Two products developed with the support of orthodontists and dentists designed to be cost-effective options for the growing population in clear retainers and aligner treatment.

New Whitening, Fluoride Products Will Leverage Clear Retainers, Aligner Trays As Delivery Methods

Dr. Lorne Lavine, founder and president of The Digital Dentist, has more than 30 years invested in the dental and dental technology fields. A graduate of USC, he earned his DMD from Boston University and completed his residency at the Eastman Dental Center in Rochester, N.Y. He received his specialty training at the University of Washington and went into private practice in Vermont until moving to California in 2002 to establish TDD, a company that focuses on the specialized technological and HIPAA needs of the dental community. He can be reached at drlavine@thedigitaldentists.com or 866-204-3398.

The last 3 articles have focused on cybersecurity best practices. Although Health Insurance Portability and Accountability Act (HIPAA) compliance is still a critical issue for many offices, in recent years I have been emphasizing the need for dental practices to up their cybersecurity game. The biggest threat to dental offices is ransomware, the class of viruses that lock your files and demand you pay a ransom to get the unlock key. A ransomware infection would be devastating to most offices. Not only would you have days of downtime and have to pay a large sum of money to (hopefully) get your data back, but a ransomware infection is considered a breach and you would have to report it to your patients and the US Department of Health & Human Services.

Previous articles looked at ways to keep ransomware out of your network or to minimize damage by encrypting the data. In this article, I want to again examine the best way to recover from a ransomware attack without paying the ransom: having a solid backup and disaster recovery system.

If a patient goes to 10 dental offices, they will likely get 10 different treatment plans. If you ask information technology (IT) providers to recommend a good, HIPAA-compliant backup system, you are going to get different opinions. Below is the system that I have developed over 21 years of providing this service for our clients. It consists of 2 main components:

1. In almost all cases, your local backup will be the first line of defense. 

It resides in your office and will allow for the speediest recovery. The challenge for many dental offices is that although they may have thought through the process of backing up data, they have not planned for how to quickly recover the information. Many practices just back up the data, but this is a mistake. If your server goes down and you need to be up and running, what do you do? It would often require getting another server into the office (they are not sold at the local Best Buy), reinstalling all your program files, reconfiguring the network, then downloading the backed-up data to the new server. This is at best a 1- or 2-day process, likely longer. What I recommend is taking an “image” of the server, basically a snapshot of the entire server: data, programs, network settings, everything. Put that image on a local device and virtualize it. Now, if your server goes down, you fire up that virtual copy of the server and within minutes, not days, the rest of the computers will think the server is up and running again; you will be able to pull up the practice management system data, take x-rays, etc, while the main server is being repaired.

2. Notice I said almost all cases use the local backup to recover. You are going to need an offsite backup as well. 

There are, however, instances where that is not true: fire, flood, theft, anything that destroys the server and the local backup. You are going to need an offsite backup as well. This also happens to be a HIPAA requirement. In the past, many practices used external hard drives; they are inexpensive and easy to run. However, I recommend a cloud backup instead—the more you can minimize hands-on management of your backup by you and your staff, the better. Although there are some cheap options, you tend to get what you pay for. Many are not HIPAA compliant, do not offer monitoring and alerts to backup problems, or cannot get you the data quickly.

While many dentists do have the ability to do backups, when you consider how important they are, I usually suggest that you have an IT professional specializing in health care handle this for you.

Part 4 of our Cybersecurity Series looks at how backup data can save money and your practice’s reputation. 


Ransom Recovery

Ian McNickle leads WEO Media’s sales, marketing, consulting, and business development teams (

). He brings more than 20 years’ combined experience in technology, business development, sales, marketing, and operations. He lectures extensively throughout North America on all aspects of dental marketing and practice growth at dental conferences, study clubs, and continuing education events. In 2019, Ian published his first book, 

Mastering Practice Growth: The Definitive Guide for Growing Your Dental Practice or Dental Group

. In addition, he writes articles on a wide range of marketing and growth-related topics for publications such as 

Dental Economics, The Progressive Dentist

Cory Roletto leads the operations team at WEO Media, an award-winning dental marketing and web development agency (

). He brings more than 20 years’ combined experience in technology, business consulting, marketing, and operations. Cory began his career at Intel, where he served as a key member of the competitive marketing team. He received 12 awards at the divisional level or higher while at Intel and many of his engineering and marketing innovations are still used at Intel today. Cory has a BS in chemical engineering and an MBA from the University of Washington.

What is Google’s Mobile First Initiative?

Mobile First is a multiyear series of ranking algorithm changes to shift focus from desktop computers to mobile devices. For the past 5 years the volume of search on mobile devices has exceeded desktop traffic, so this move does make sense. The final transition is called Mobile First Indexing, which will be completed in March 2021. This will complete the transition from desktop to mobile algorithms.

Desktop Algorithm > Desktop Algorithm & Mobile Algorithm > Mobile Algorithm (March 2021)

At the highest level, Google’s intent is 2-fold:

Google split mobile and desktop search into 2 algorithms in 2016. This rewarded those who spent time to customize the user experience on desktop and mobile separately. Although good in theory, it took significant effort to maintain. Consolidating to 1 algorithm is less work.

With mobile search volume exceeding desktop, and the desire to move to 1 algorithm, shifting to the mobile algorithm made the most sense.

This is a departure from past algorithm changes, which primarily focused on improving user experience. Mobile First indexing is more about efficiency and reduced complexity for Google’s operations.

Website design technology and code change significantly about every 2 years, with much of it driven by screen size and resolution of devices as well as Google’s agenda.

Since April 21, 2015, when Google introduced “Mobile Friendly” tests into its algorithm,

 dedicated mobile websites have proven the best for user experience and conversion.

 They were concise, easier to navigate, quicker, and more readily provided information a person searching on a mobile device desired.

Google’s Mobile First initiative is massive. It is a total reversal from the original preference for dedicated mobile sites. Website designers and SEO agencies will need to ensure their sites do not fall into irrelevance by meeting Google’s mobile expectations.

According to Google, by March 2021 its algorithm will only consider content on the mobile website for ranking. It will ignore any content that only shows up on the desktop version of a website.

 However, content is still king, so the more unique content on a website the better. Gone are the days of being more concise or customizing content for a better mobile experience. Now you need to show everything on mobile.

If you have a fully responsive website with no customization for mobile visitors, then you will probably be fine. If there has been customization on your website, you may need to remove media calls that exclude content on mobile versus desktop and confirm the website still formats correctly.

If you have a dedicated mobile website, you probably will need to rebuild the entire website as soon as possible. If you have a desktop-only website, then it will be completely dropped from Google’s index.

 So if you care about being found in a Google search, you will need to build a new website as early as possible.

If you do not know the details of your mobile website, ask your website designer or SEO agency. Hopefully they have already contacted you about making sure your site is ready for Google’s search update. Any high quality website designer should be well-prepared for this change, just as they should have been prepared for the launch of the original Google mobile algorithm and then made the adjustment to responsive sites in recent years. Time is of the essence if changes need to be made, especially if you need to move away from a dedicated mobile or desktop only website.

Makino T, Phan D. Rolling out the mobile-friendly update. 

https://developers.google.com/search/blog/2015/04/rolling-out-mobile-friendly-update

Responsive web design, dedicated mobile site or mobile app—how to choose? 

https://www.digivate.com/blog/mobile/responsive-web-design-dedicated-mobile-site-or-mobile-app/

Montti R. Google Mobile First Index—zero desktop content March 2021. 

https://www.searchenginejournal.com/google-mobile-index-news-from-pubcon-virtual-2020/384111/

Starting in March, Google search rankings will index websites based on their appearance and performance on mobile devices.

Is Your Website Ready for Google’s Mobile First Initiative?

Bruce Bryen is a certified public accountant with over 45 years of experience and is a part of Baratz & Associates CPAs. He specializes in deferred compensation, such as retirement planning design; income and estate tax planning; determination of the proper organizational business structure; asset protection and structuring loan packages for presentation to financial institutions. He is experienced in providing litigation support services to dentists with Valuation and Expert Witness testimony in matrimonial and partnership dispute cases. He is also a financial writer for several dental journals. You may contact him at 609-502-0691 or at 

There are many states where their legislatures have passed laws that prohibit anyone not licensed as a professional dentist to be able to own a dental practice either directly or indirectly. The dental service organization (DSO) organizational structure typically has a licensed dentist or dentists owning and operating the clinical side of the DSO.

The management service side of the DSO may or may not have licensed dentists owning that part of it but may also have hedge funds, venture capital firms, investment bankers or other private investors within the ownership group. Sometimes the DSO employs 2 company structures so that the clinical side and the management side of the DSO are separate businesses.

The struggle for the DSO is to convince the state board of dentistry where they want to operate that their structure is legitimate with non-licensed dentists being part of the organization and they comply with the law. There is an incredible amount of money involved for the DSO in the short and long term where inevitably, an initial public offering may take place. The founders and early investors will earn an enormous amount of money when the final transition occurs, and they can “cash out.” One can be sure that the best attorneys and expert advisors will be retained by the DSO to present their case to the state board of dental examiners. They will attempt to convince the state board to allow their organizational structure to be acceptable. The designs and models used by these experts will attempt to circumvent what they see as glitches that may vary from the actual terminology in the legislative act of the state that may be denying access to the DSO.

What Are Some of the Problems and Potential Solutions?


There may be a myriad of problems potentially with some solutions but the basic rule is that the state boards of dentistry resisting the DSOs do not want non-licensed dentists to be owners. To overcome this problem, some of the DSOs will appoint a licensed dentist to be the owner with compensation and effectively offer that dentist a minimal role in the operations just so that he or she is designated as the owner. In an attempt to circumvent the specific guidelines of the legislative act, the model used by many of the DSOs is similar.

The DSOs want their MBAs and monied people to run the organization. The problem for the DSO occurs when the state does not want it this way and is willing to go to court to keep the DSO out. The state may feel as if the DSO has unlimited money to go to court and to stay in court until they prevail with a judge who may be willing to listen to business verbiage that legally overrides the law’s intent. The DSO will attempt to use a factual presentation that does comply with the law but not the intent of the statute. The attorneys representing the board of dentistry probably have a budgeted amount to spend and also a time frame to resolve the issues and to keep the DSO out of the state. Unfortunately for the state, the DSO will probably continue returning to it even if they incur losses in court until they eventually do win or the state’s dentists push their board to accept the DSO concept. The individual dentists may join after a marketing campaign by the DSO targeting them and describing their earnings potential. They may urge their board to allow the DSO to join the state and the state may feel that they will eventually lose the battle to keep them out anyway.


The typical dentist’s biggest source of aggravation is the management side of the practice. When they see that administration and management are mostly dispensed with by employing the DSO concept, many states see their dentists fall in line and start supporting the DSO. They then pressure their state legislature to adopt amendments to the current law so that by using certain guideline models, the DSO can operate in the state previously trying to keep them out. As mostly offered in any type of debate, it’s almost always about the money. DSOs are big business. Once the wining and dining of the local dentists begins, there is not much a state government can do to stop them. The attorneys and experts hired by the states will use the law as it is written to delay the DSOs from coming into the state. When the amendments take place to the legislative acts, the state’s attorneys don’t have that power on their side to support the previous arguments that were used successfully to retain the individual local concepts of dentistry and big business then takes over.

Reasons for Acceptance by the State and the Local Dentists of the DSO


Because the DSO concept offers excellent current income and no management headaches, the individual dentist sees a great invitation to continuing his or her career and working where the patient is, rather than with the attorney, accountant and other administrative advisors. The model includes a great exit strategy built into the organization and a transition agreement without the worry of finding a buyer. It isn’t long before the state concedes and the dentist practices dentistry and not economics and personnel management by joining the DSO.


Regulatory difficulties can create obstacles for DSOs when attempting to get access to operate in certain states.

Dentists Need to Be Aware of State Regulations When It Comes to DSOs

Lisa Newburger, a master's level social worker supervisor, helps audiences find humor in talking about tough topics. Her "in-your-face" style of presentations and writing will make you smile or just shock you into taking some action. Either way, she is very effective at empowering others to reach their goals and feel better about themselves. Her entertaining workshops are available for national and international audiences. Writing for the dental industry since 2010, she uses an alterego (Diana Directive) to illustrate her points in a sarcastic but effective way. Presentations can be scheduled by contacting Lisa at www.discussdirectives.com/dental.html.

We all want it. We all need it. And many feel like we never have enough of it. For most of us, that is SO true. I know this, because of you. My articles about money issues … asking for a raise … literally get the most hits. Why? Because this is how we are wired. This is what we think about. There is no shame in that, right? So, let us talk about it.

Is it the elephant in the room? When you were a little kid, did you know how much things cost? How much was the rent? How much did your family spend on groceries? When I was growing up, no one EVER talked about money. One of the rare times we ate in a restaurant, my dad refused to let us see the bill. Why? I know it costs money to go out to eat. But what is the big secret? It makes me wonder how we teach our kids about how much things cost. Why not have your kids figure out the tip and show them the bill? This can be a teachable moment on many levels.

What does this have to do with the dental office? Most employees working in a dental office have no idea what it costs to run the practice. They know how much procedures cost but do not have the total picture. I just spent $170 for 15 minutes with a TMJ specialist. He is booked up for months and yet, there are no other patients in his office when I am there. Yet, his 3 employees are hard at work. He has payroll, benefits, rent, insurance, equipment, and the list goes on and on.

For some of us who are not paid so well, the money boggles our minds. We see the dentist driving a nice car and living in an affluent community. You need to remember that the dentist is taking all the risk. She/he may have big debt from dental school tuition or large loans that seeded their practice. Unfortunately, there is a real tension in a practice between the haves (dentists, dental hygienists, etc.…) and the have-nots (front office staff, dental assistants, etc...) Do not get me wrong. I am not taking sides. I am just pointing out that sometimes, a low paid employee resents seeing others have financial success. (Oh, come on…this is not the first time you have heard of this.)

I am pointing out that there can be underlying tension in a practice … and it is over money. In a perfect world, we want our employees to be able to speak honestly about problems that are going on. But do we really want to hear it? There is a difference in education and services that different employees provide. I am not a big fan of upselling and the financial incentive of that for an employee. When you incentivize someone to sell more, it makes me wonder who is going to benefit. Will it be the patient? Or the employee and practice?

Last month, a friend shared how she had gone to a corporate dental practice as she had a gap in her mouth and was unhappy with how it looked. When she asked about braces, it was recommended that she have 6 healthy teeth removed instead. They would make her a bridge and quoted a price of $16,000. This stressed her terribly before she approached me. When I heard her story, I sent her to a dentist to evaluate her. His recommendation was to send her to an orthodontist and felt repulsed that a recommendation had been given to remove healthy teeth.

This is a danger of upselling. When you incentivize employees this way, it can be morally and ethically wrong. This patient did not need 6 healthy teeth removed. She needed someone to evaluate her and make recommendations without taking advantage of her. I share this story to have you think about the patient when it comes to upselling. We are not asking if you want “Fries with your burger.” We are talking about someone’s health and well-being.

Address the elephant in the room. Get comfortable talking about money and expenses. I am not telling you to share what your salary is with your staff. But, I am saying address the concerns. Let them know that you know what is important to them. That is money.

 if you have witnessed issues of upselling in your office that make you uncomfortable. I also like to hear the success stories that make you proud of where you work.

Is money the elephant in your room? It’s important to talk dollars, incentives and the risks of upselling with your staff.

Money and Upselling in the Dental Practice

The recently introduced Perma Sharp PTFE sutures from HuFriedyGroup were created to provide an additional option for clinicians performing implant surgery, oral surgery, periodontal surgery, and other related dental procedures.

The sutures are designed specifically for use in dental procedures and feature 300 series stainless steel needles designed to retain sharpness through the tissue closure process. Available in multiple sizes, the non-absorbable sutures provide moderate to high tensile strength and feature reverse cutting needles. 

The new PTFE sutures include the same features as other Perma Sharp sutures.

HuFriedyGroup Adds PTFE Options to Perma Sharp Suture Line

It was not until January 2021 that I finally got up the courage to make an appointment for 3-month periodontal maintenance. I was now almost a 2-hour drive away from my favorite hygienist, Lori, but it was worth the trip to receive excellent supportive therapy in a periodontal practice. It is also embarrassing to report that it had been about 12 months since I last saw Lori. Most of the procrastination was because of a trimalleolar ankle fracture that kept me preoccupied and in physical therapy. Lori offered me a 1% hydrogen peroxide preprocedural rinse before treatment and mentioned that it was being used in most dental practices during the coronavirus disease 2019 (COVID-19) pandemic. Being a scientific skeptic, which most of the time I am proud of, I knew right then that a column on the topic was forthcoming.

Let me also mention that I am a member of several dental hygiene chat groups on Facebook and am always curious to read questions/answers on various topics. Over the course of a year, I have read questions about COVID-19 oral prerinsing and they usually go something like this: “What is everyone using as a COVID-19 prerinse for hygiene appointments? Which one is your favorite and why?”

Preprocedural rinsing has been suggested by some sources (authors/speakers/dental practices, and other commercial interests) as a way to reduce the SARS-CoV-2 viral load, so I would like to explore the literature on the subject and ask the following question: Is there evidence to support the use of antimicrobial mouth rinses to reduce the viral load of SARS-CoV-2 and protect dental health care workers and patients?

Cochrane is always my first go-to when looking for objective evidence; years ago, I visited their editorial-based team at the University of Manchester, Division of Dentistry, in Manchester, England. This large review group publishes summaries of quality research to assist practitioners in making informed decisions.

Cochrane reviewed the evidence on antimicrobial mouthwashes and nasal sprays for individuals with COVID-19 as a way to fight the transmission and prevent them from infecting health care workers who treat them.

 They also were interested in determining whether these measures would protect health care workers, especially before undertaking aerosol-generating procedures.

The Cochrane team searched the medical literature for studies comparing effects of any antimicrobial mouth rinses or nasal sprays administered to patients or health care workers against no treatment or water or even a salt solution.

 The team investigated benefits and risks for patients and health care workers and effects of these medicaments on:

Patient deaths and health care situations like the need for hospitalization, artificial breathing support, dialysis, or hemofiltration (treatment required when kidneys are not working properly)

New COVID-19 infections and health care workers

Change in patients’ COVID-19 viral load

Results were as follows: there were no completed studies to include in this review. Cochrane found 16 studies underway investigating mouthwashes and nasal sprays, but none had been completed or published.

When examining another aspect of antimicrobial mouthwashes and nasal sprays to protect health care workers when undertaking aerosol-generating procedures on patients without suspected or confirmed COVID-19 infection, Cochrane again found no completed or ongoing studies to include in this review.

A third aspect of the assignment was to review evidence pertaining to the use of antimicrobial mouthwashes and nasal sprays by health care workers to protect themselves while treating patients with suspected or confirmed COVID-19 infection. Again, Cochrane found no evidence concerning benefit or risk to health care workers who used antimicrobial mouthwashes or nasal sprays to protect themselves while treating these patients.

The Cochrane review group did find 2 randomized controlled trials and 1 nonrandomized study that are underway. Until these clinical trials are analyzed, and reviews are updated based on available evidence, we do not know whether there are any benefits (or risks) of antimicrobial rinses and nasal sprays regarding risk mitigation.

In March 2020, the American Dental Association recommended having patients rinse with a 1% hydrogen peroxide solution before each appointment.

 No reference was given for this recommendation.

The Centers for Disease Control and Prevention reports no published evidence of antimicrobial mouth rinses regarding clinical effectiveness in reducing SARS-CoV-2 viral loads or in preventing transmission.

 Even so, they cite preprocedural mouth rinses with antimicrobial products like chlorhexidine gluconate, essential oils, povidone-iodine, or cetylpyridinium chloride as a possible means of reducing the level of oral microorganisms in aerosols and spatter generated during dental procedures

When there is no evidence, what do we do? We need to be aware and not dupe ourselves and patients into thinking there is. Therefore, until we have some evidence, whatever antimicrobial rinse we are administering during the pandemic might or might not be of benefit to ourselves or to our patients. Should you choose to use an OTC rinse like one of your favorites with licorice root extract or a more expensive antimicrobial rinse like chlorhexidine gluconate, do your homework and do not rely on a Facebook group to give you the answer you are looking for.

Without looking at the evidence from a reliable source like Cochrane, it is easy to be duped or “educated” by marketers to champion their products. Professional associations are not always a reliable source of evidence, either, even though we have come to expect a culture of integrity for every organization and business.

When there is no evidence, what do we do? In committing to a high standard of integrity in everything we do, always mitigate the risk of wrongdoing by following published research guidelines to the best of our ability. If I am offering a chlorhexidine prerinse, for example, I will tell the patient that chlorhexidine is the gold standard in plaque control. When there is no evidence to support a product, don’t cherry-pick it to support your or a particular group’s point of view.

Antimicrobial mouthrinses and nasal sprays to protect healthcare workers and patients at risk of COVID-19. Cochrane Oral Health. Accessed February 2021. 

https://oralhealth.cochrane.org/news/antimicrobial-mouthrinses-and-nasal-sprays-protect-healthcare-workers-and-patients-risk-covid

Versaci, MB. ADA adds frequently asked questions from dentists to coronavirus resources. American Dental Association. March 12, 2020. Accessed February 2021. 

https://www.ada.org/en/publications/ada-news/2020-archive/march/ada-adds-frequently-asked-questions-from-dentists-to-coronavirus-resources

Guidance for dental settings. Centers for Disease Control and Prevention. Updated December 4, 2020. Accessed February 2021.

 https://www.cdc.gov/coronavirus/2019-ncov/hcp/dental-settings.html

It's important to find objective, evidence-based science before determining whether to use preprocedural rinses in practice.

Becoming Scientifically Objective About COVID-19 Preprocedural Rinsing

DGSHAPE Americas has expanded the capacity of its DWX-42W Wet Dental Mill with the introduction of a new 6-Pin Adapter, which is designed to increase the dimensions of the milling unit.

The new adapter will enable the DWX-42W to mill up to six 14 mm material blocks, which is twice the total allowed by the standard adapter. In addition, the 6-Pin Adapter base can be used with DGSHAPE’s AK-1 Abutment Kit.

“This innovative 6-pin adapter is another great accessory developed to further expand the functionality and productivity of our state-of-the-art DWX series milling machines,” said Roland DGA Product Manager of Dental Solutions, Lisa Aguirre. “Simple to install and easy to use, it significantly increases the DWX-42W’s milling capacity, saving clinicians and dental lab technicians time and money.”

The DWX-42W is a wet dental mill that is designed for the milling of glass ceramics, nano-composites, inlays, onlays, veneers, and custom titanium abutments using the AK-1 Abutment Kit. It’s an open architecture unit that features a 6-station Automatic Tool Changer, Virtual Machine Panel, and new grinding burs.

Both the DWX-42W and the 6-Pin Adapter are available from authorized Roland DGA dealers. For more information, visit 

The new 6-Pin Adapter increases the capacity of the company's wet mill system.

DGSHAPE Expands DWX-42W Mill Capacity With New Adapter

RevenueWell recently completed its acquisition of PBHS, adding that company's expertise in digital marketing and web development for dental practices to it's own platforms for patient relationship management and communications.

The addition of PBHS's dental website design, practice branding, SEO, online advertising, video marketing, and social media campaigns to RevenueWell's existing platforms will help create a unified solution to help dental practices of all sizes grow, acquire new patients, and retain existing patients. 

Both companies have focused their innovations and services around the dental industry and each offers a wide range of services tailored to meet the needs of general and specialty dental practices. PBHS is exclusively endorsed by ADA Member Advantage, the American Association of Endodontists, and the American College of Prosthodontists along with 30 state associations.

The newly integrated company serves a current customer base of more than 13,000 dental practices. Plans are in place to roll out new products and packages of existing solutions over the next few months, according to a press release.

The addition of PBHS's digital marketing and web development capabilities are an optimal complement to RevenueWell's communications and relationship management solutions.

RevenueWell Expands Into Digital Marketing With Acquisition of PBHS

Mike Uretz is a nationally-recognized Dental software and Electronic Health Records (EHR) expert. Mike has helped hundreds of individual practices and multi-clinic groups properly evaluate and select software vendors and solutions, structure and negotiate pricing and contracts, provide implementation oversight and vendor management. Mike was a member of the Certification Commission for Health Information Technology EHR vendor certification workgroup, and has been a member of various federal and state working committees for EHR business practices and policy. Having been involved with the EHR Incentive program from day one, Mike has helped a number of states, to evaluate and select EHR vendors, structure contracts and agreements, and manage vendor issues. As co-chairman of the Best practices advisory committee for EHR Contracts, Mike has been instrumental in developing standards for structuring vendor contracts and pricing for use by state programs nationwide He is the founder and editorial director of DentalSoftwareAdvisor.com, a trusted and objective online resource on all matters related to dental software. He is also the point person for Advanstar’s coverage of dental EHRs and their evolving role in the dental industry and can be reached by e-mail at mikeu@dentalsoftwareadvisor.com.

We are in a very exciting world today in which dental providers and medical providers are increasingly collaborating on their patients’ care. Telehealth is a technology helping to lead the way. The following are excerpts from a conversation with Maria Kunstadter, DDS, who is founder and the chief dental officer of The TeleDentists, a popular teledentistry platform, and Jonathan Wiesen, MD, founder and chief medical officer of MediOrbis, a fast-growing telemedicine platform. Both The TeleDentists and MediOrbis offer respective virtual dental and medical provider networks.

Maria, Jonathan, I know your respective telehealth companies, The TeleDentists and MediOrbis, have recently announced a partnership to work together to help medical providers and dental providers collaborate using telehealth technology. Can you talk a little bit about how your partnership came about?

 For years, medicine has been calling for an integration of oral health, and medical health. And with teledentistry as a subspecialty of telehealth, it was a logical choice to bring them together on the same platform. I’ve heard from medical specialists that they know oral health is important, but they don’t know what to do about it, so they don’t mention it to their patients. That was the driving force to bringing MediOrbis together with The TeleDentists. Now patients at the tip of their fingers, can have access to either your physician or your dentist, real time. That’s a great opportunity that brought us to work together on this exciting collaborative project moving forward.

The emphasis in medicine today is really on collaboration—working together with different specialties, different individuals with different skills, and it was in that spirit that this partnership just seemed to make a lot of sense. In clinical medicine I work in the intensive care unit in critical care, and we’re always consulting specialists and getting opinions, and in internal medicine and general medicine, we do the same. So it just made a lot of sense to bring as many different subsets of health care together, to be able to provide a more comprehensive solution.

Maria, I saw a presentation that you gave with a very interesting slide really struck me. It talked about how a lot of people go to dentists, but they might not go to their medical provider, and then conversely, a lot of folks go to physicians, but they might not go to their dentist. Can you talk about this chasm and what’s going on here and the problems we have with this?

The graphic you were talking about, Mike, is that 180 million individuals, before COVID-19 [coronavirus disease 2019], saw a physician but did not see a dentist in a year, and 28 million people saw a dentist but didn’t have a physician. For practicing dentists they were recommending we do blood sugars checks. But I kept thinking, why would I do that when I can’t do anything about it except tell my patient to go see a doctor? We have now introduced this platform to have in dental offices where … if the patient has high blood sugar, they can push a button and talk to one of MediOrbis’ virtual physicians and start being treated and maintained for diabetes or whatever they need to. If you send somebody to go see a doctor, sometimes they never do. So if you’re right there and say, “Let’s get you connected to a doctor that can maintain and monitor this condition and get you healthy,” that’s such a service to be able to offer to patients, and the convenience is everything now.

So, Jonathan, having been in medical software and technology myself for a number of years, including work in health information interoperability, I’m really interested… Are you an outlier out there in medicine talking about the need to collaborate with dental counterparts or is this a movement happening? What’s going on in medicine in terms of oral health care awareness and working with the dental community?

I think it’s hard to look around in today’s environment and not see that digital health, telehealth, and remote access are words that are being thrown around in a way that they never have been in the past. And I’ve seen everything from telemedicine for neonatology to telemedicine for seizure management and the management of refractory epilepsy to transplant medicine being managed by a remote health and telemedicine platform. The list goes on and on and it’s literally endless. This partnership with The TeleDentists is an amazing program, an opportunity to be able to provide remote dental care. Honestly, I would be shocked if there’s anyone that’s around in health care today that if you told them, “Hey, you know, I’d like to bring a dentist remotely,” would give you a funny look, because it’s almost an assumption at this point that almost any type of clinical care can be provided remotely.

Maria, talk to me a little bit about where you think dentistry and dentists in general are today in the awareness of the need to collaborate with medical counterparts.

I can tell you that since 2000, the surgeon general called for an integration of oral health and primary care. The Academy of Family Practitioners, the Academy of Pediatrics and the American Dental Association and the CDC…all of these organizations have been saying for 21 years…, “This needs to be done to improve patient health.” So, it is finally happening. It is not yet what I would call mainstream. Every time a blood pressure is taken in a dental office, which is actually required by many state dental boards, there needs to be the next step if there is unrelenting hypertension in that patient, even during that visit, because dentists aren’t supposed to treat the patient with high blood pressure for any injections or anything along that line. So rather than say, “OK, I’m going to have to send you out”, now we can have a virtual tool that we haven’t had before. I think the adoption will happen much more rapidly by making it easy and simple and straightforward. In the past, I would send them out and hope they come back and then you don’t see them again. Now that you can have it in the office when they go on their way home, they can pick up any hypertension medication that the doctor may say they needed to start. The patient has been value added, dental and medical care right there on the spot.

When I am helping my dental service organization (DSO), group, and practice clients evaluate and select software solutions, I am always talking workflow, workflow, workflow, when we look at various products. So, I am really interested. Can you get into a little detail of the actual virtual workflow between physicians and dentists? How is the patient involved?

When the dentist has a need for a physician, they will just hand the patient a tablet or go to the computer right behind them. In this case, they click on MediOrbis and, for example, say, something like, “Hey, I’m in Dr Jones’ office and they can’t get my blood pressure down. I’ve had this problem for a while.” Then the patient can have a telehealth consult right in the cubicle in a few minutes. They can actually speak to the physician, get on the road to some sort of mediation of their condition, and then they’ll turn to the dentist and say “Thanks, because I wouldn’t have gone to a doctor in the first place.” So, the same can happen when they go to a physician connected with MediOrbis capability … they can click on The TeleDentists if they have a dental concern.

It is so important to meet patients where they are and not to demand things of them to meet your expectations. Being able to provide simple, streamlined solutions, being able to make things more accessible and more available allows patients to get the care that they need in the manner in which they need it, rather than trying to make them conform to a very strict, rigorous, and confined infrastructure, which is what we were unfortunately relegated to for many, many years

Well, this is really exciting and what I consider somewhat of a groundbreaking partnership in the world of telehealth, and I really wish you both success. I expect to see a lot of case studies coming out in the coming months that will help drive this movement toward using telehealth for collaboration between dental and medical providers for the benefit of their patients.

The TeleDentists, MediOrbis work together to advance telehealth and improve care for patients of dental, medical providers.

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