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What do dental teams REALLY think of digital impressions?


Experts weigh in on the pros and cons of using this technology.

We spoke to our experts from different parts of the dental team to find out what they actually think about digital impressions and how they're impacting the dental industry.

What does this clinician really think?

Dr. Mark Hyman has been taking digital impressions for nearly 20 years. He uses them as part of his suite of digital dentistry services. He loves them. His team loves them. And his patients? Well, they love it the most-or at least they love the treatment they get. As a result, his practice in North Carolina has more than 1,200 5-Star reviews.

Dr. Hyman frames his use of digital impressions and related digital dentistry suite to patients in a unique way.

“I'll say 'have you ever heard of this?' Almost always they'll say, 'no, what's that?' and I’ll respond, ‘Remember when you had your crown before, it was three or four visits and the temporary came off, and the crown didn't fit, and you had re-impress it and you gagged on the impression? And the tray cut your gum? We don't do any of that anymore. Instead of three weeks, your crown will be made in eight minutes. How's that strike you?’ And they go nuts,” Dr. Hyman says.

Patients aren’t the only ones who appreciate digital impressions. Dr. Hyman’s dental assistant team likes digital impressions also. Dr. Hyman believes in training his staff members and then getting out of their way.

“I do the preparation for a CEREC unit for a CAD/CAM, and I walk out of the room. I leave them to place the cord, scan, mill it, try it in and do the pre-cementation radiograph. Often, I come in and it’s already etched and bonded, and I place it. I'll adjust the occlusions and take a final post-cementation radiograph to confirm all cement has been taken out.”

His lead assistant has been with him for 18 years. Dr. Hyman attributes his staff members’ happiness and willingness to be part of the team to the fact that they are challenging themselves as dental professionals.

“It's because instead of just sitting there, sucking spit, they get to play with a $100,000 CAD/CAM machine. So, from a self-esteem point of view, they're using their talents,” Dr. Hyman explains.

Dr. Hyman especially appreciates the exactitude a digital impression facilitates. Many moments in a traditional process present opportunities for errors, from the handling of the materials while taking the impression to the shrinkage or expansion that occurs during the casting process.

“There are so many errors introduced in the process of using an impression, so when you scan it, the precision skyrockets,” Dr. Hyman says.

Dr. Hyman and his team handle a lot of the crowns in-house with their CEREC CAD/CAM system. However, he does still use his lab. His Master Ceramist Mark Whitaker,and he have worked together for over a decade. It all started when Whitaker sent back Dr. Hyman’s first scan. Dr. Hyman joked with him, saying, ‘Do you know who I am?’ to which Whitaker replied, “Yeah, that’s why I sent it back!” Dr. Hyman appreciates having a trusting relationship with the lab.

“I said 'Wait a minute. So, here's the deal, anything I send you that's not perfect, send it back. I promise I'll redo it, no questions. And anything you send me that isn't perfect, I ain't paying for it,'” Dr. Hyman recounts, laughing. “And we've worked together 11 years. The work I show in my seminars nationally and internationally is his work.”

Ultimately, Dr. Hyman puts patient care first in his practice. His digital impressions and related CAD/CAM dentistry allow him to provide it. Not only that, but everybody wins.

“The patients get a superior restoration. You feel good as a professional and practitioner. You don't have to pay for that second visit where there's no change. You don't have to pay for temporary material, impression material and temporary cement. The lab gets a finer scan to do better work if you don't mill in-house. The teammates are a dynamic, active part of the restorative team. Just everybody benefits.”

What does this lab technician really think?

Lars Hansson is a certified dental technician and senior vice president for digital implant solutions at Valley Dental Arts in Minnesota. He has worked with digital dentistry for almost 20 years but felt that digital impressions had been missing something in the past-at least from a communication and accuracy standpoint. However, in the last five years, the industry has accelerated its success in both areas.

“Digital impressions have simplified the way we're going to work in the future. Now that the data transfers are quicker, we can evaluate it not only chairside immediately, but also in communication with each other digitally,” he says.

Hansson finds both standard impressions and digital impressions have comparable accuracy, although both have their drawbacks. For standard impressions, more areas exist where flaws could occur, from expansion in the material to distortion in the casting. On the other hand, digital impressions have a learning curve and require clinicians to be more accurate with the impression wand, without any gaps in the image.

“There have been some frustrations that some of the doctors have there, and it's more the learning of doing this than it is the machine or technology or the accuracy,” he explains.

The transition to digital impressions follows generational lines, Hansson says. He finds senior doctors more reluctant to let go of traditional impressions since they have been doing it that way for many years. Younger, more tech-savvy doctors prefer digital impressions. The same lines exist in the lab industry, too.

“The older generation of laboratory owners or those who've been working with it for a while are a little hesitant to jump in on the digital side when it comes to accepting that this is going to be the way it is,” he says. “Digital impressions are the way to go. It's just a matter of the learning curve from the office to get into it.”

In addition to the learning curve, Hansson believes some doctors are hesitant to transition to digital because they aren’t sure where to invest their money. He sees the biggest advantages in open-system technology over closed-system technology. He believes new scanners will be smaller, more accurate and, most importantly, open system.

“Closed systems are usually the bigger companies that acquired these companies early on because they want in on it and they've closed systems. And that presents its own problems as you merge data in other areas, from other laboratories,” Hansson explains. “Where we're going is tools to open data files, and that's what's probably the most important.”

What do these dental assistants really think?

Tina Calloway is a Certified Dental Assistant (CDA) and has been a treatment coordinator in Dr. Hyman’s practice since 1999. With 21 years in dental assisting, she finds that the introduction of digital impressions contributes to her sense of achievement and accomplishment. She finds satisfaction in applying new technology, and that happiness carries over to her patients.

“What's cool is that your patients get excited that you're excited about something new and that you have this technology in your office that you can use,” Calloway explains. “Science is changing every single day, and I'm glad that I went to a progressive practice changing along with it. It's super exciting.”

Tija Hunter, a dental assistant for 36 years and also a certified Expanded Function Dental Assistant (EFDA) in Missouri, agrees that digital impressions make dental assisting more rewarding.

“We don’t just want to clean rooms. We want to be involved in the treatment process,” she says.

Patients experience significant benefit from digital impressions, particularly if they happen to have a sensitive gag reflex. For example, in early March a patient needed a bite splint fitted, but the dental assistant came to Calloway for advice because the patient “was a gagger.” Calloway suggested using the Omnicam instead of taking a traditional impression, much to the other assistant’s relief.

“Sometimes when you're in the heat of the moment, you forget about what tools you have available,” Calloway says. “They went ahead and made a digital impression for that, and the same thing occurred for a partial in that case as well.”

Hunter’s practice mills their abutments and surgical guides. They collaborate as a rule because no two crowns are alike.

“There is always a different scenario in every single design and every single patient. There is always going to be something different or an obstacle to overcome. It’s very important that everyone collaborate on that. It makes it fun because you’re learning at the same time,” she says.

Hunter practices in a state where expanded function is approved. However, she thinks the benefits of digital impressions are still significant for dental assistants in states where expanded function isn’t legal.

“It is so much cleaner, as far as the impressions go. So, even if you aren’t a part of the process, with digital impressions you don’t have to get out the material, you don’t have to fit the tray, and you don’t have to wait three minutes wondering does it come out okay? Does it have a bubble in it? Did we get it seated right? Did the patient bite down enough? The whole gamut of what-ifs,” she said. “Whether you can take the digital scan or not, for the team member, digital impressions are just a whole better situation.”

Calloway has been a regular on the lecture circuit for the past 10 years, addressing motivation and problem-solving for her audiences. She finds that dental assistants are a mixed bag about adopting digital technology. Some that have never used it are afraid to try while others that can’t wait to use it.

“It comes down to your comfort zone. What are you comfortable with and are you willing to stretch to achieve your highest potential?” she explains.

However, Calloway thinks it isn’t assistants who are reluctant to adopt digital impressions. More often it is the doctor who is the obstacle to taking digital impressions. When she consults, she asks the doctor why he or she doesn’t take digital impressions. The doctors often admit they are more comfortable with traditional impressions. Sometimes she discovers they want to keep a lab relationship they have built over the years.

“You have to help them break away from that relationship and say, ‘Are they really servicing you? If you have this technology, you might ask them to step up their game as well, or they're going to be losing some business,’” she says.

Hunter thinks competency with digital impressions makes dental assistants more valuable to the practice. Getting proper training is essential to ensure success, as well as knowing the laws for the state in which they practice. However, the involvement in the treatment process and greater satisfaction with their career is worth it.

“They are learning something new. They are growing in their profession. And, gosh, who doesn’t love that?” Hunter says.

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