<a href="http://www.linkedin.com/profile/view?authToken=0fg_&authType=name&locale=en_US&id=33105187" rel="author">Dr. Larry Emmott </a>is one of the most entertaining speakers in dentistry and he is considered the leading dental high tech authority in the country. He has over thirty years of experience as a practicing general dentist in Phoenix, AZ. He will have you laughing while you are learning. Check out his site at <a href="http://emmottontechnology.com" rel="author">Emmott on Technology</a>

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Replacing Desktop PC with Zero-Client

They used to be called “dumb terminals” but of course nobody wanted a computer that was dumb. So the name was changed to “thin client”. Much nicer, after all according to fashion you can never be too thin. However maybe they are too thin because the new name is “zero client”.

With zero-client computing, what’s old is new again. The whole idea is to move computing back to the data center and away from the desktop. A zero-client environment is often less expensive and easier to deploy (via Replacing Desktop PCs with Zero-Client Solutions – Networking news from Channel Insider).

The thin or zero client is not really a computer but a terminal that allows the user to enter and retrieve digital data. All the computing is done at the server. This is the way all computers networks worked in the pre-PC days. Then personal computers sprouted up on desktops everywhere and networks were developed to connect them and allow multiple PCs to share data. This is what drove the PC computing revolution and is what really brought computing to clinical dentistry.

Now new technology is pushing things in the other direction. The latest trend is to create a virtual desktop machine on a server and distribute it to thin client terminals throughout the office. The server can be a machine in the office or a machine in the cloud. There are some definite advantages to this, especially for the IT service provider.  On the other hand at this time most dental software is not designed to work optimally in a zero client environment. In fact most dental software vendors will tell you their software will not run as a thin or zero client.

Never the less I have spoken with several advanced dental IT service providers who have set up virtual desktops with thin client services for dentists and they claim they are working fine.

Simple data transfer like chart notes lends itself well to thin client computing.  Images are another story. It is easy to transfer images from server to terminal but image capture and manipulation takes lots of computing capacity that most zero client applications are not designed to handle.

I do not suggest you run out and demand your computer IT provider switch everything out to zero client. There is a real difference between leading edge and bleeding edge and at this time zero client is somewhere in between. However it is good to be aware of these changes and to look to the future.

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282% More Dentistry

I have been a big fan of Care Credit for many years. It has always seemed obvious to me that if a patient had credit available he or she would select better dentistry. That “obvious” assumption has been validated with a study from the ADCPA (Academy of Dental CPAs).

The study demonstrated that patients with a Care Credit account not only get more dentistry done they get a lot more dentistry and they continue to have more and better care for years.

Here are the key findings; households with a Care Credit account were compared to similar households without Care Credit.

In the first year after an account is opened, households with an account:

Made 62% more dental appointments
And had 282% more dentistry done (By dollar value)
That is expected however the amount of the increase is a lot more than I would have guessed. Increases in the first year make sense but here is the finding I did not expect; five years after the account is opened households with Care Credit:

Made 25% more dental appointments
And accepted 44% more dentistry.

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The Average Referral


Dentists are extremely dependent on powerful word of mouth referrals. Why should we expect anyone to refer us if we are just average? To be noticed we have to be noticeable; provide an experience that is not average.

Over time what was exceptional becomes average and expected. It isn’t good enough to be friendly, on time and accept insurance. Everybody does that!

Technology can be seen by patients as an exceptional above average practice feature. If the technology is exciting and the patient is invited to participate then they will be more likely to mention it to others. For example if a patient can fill out forms online before coming to a first appointment that is the type of experience they will remember and tell others about. If they are then given an opportunity to mention it on a social media platform they end up telling not just one friend but hundreds.

See it on Emmot On Technology >

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Digital Sensor Warranty and Replacement

Every digital sensor comes with a warranty. However the warranties vary significantly and they are always being changed by the vendors. Comparing warranties is one way to compare the relative quality of different sensors. On the other hand don’t get too carried away with this, there are ways to hide extra costs and confuse the buyer.

Terms: The sensors all come with an initial warranty; these vary from one to five years. After that the buyer can purchase an extended warranty or service contract. Extension contracts are usually for one year at a time and some companies will not offer extensions after a certain time.

A great long term warranty is worthless if the company offering it goes out of business.

Cost: The initial warranty is part of the purchase price. The vendor could choose to lower the price and shorten the warranty or the vendor could increase the price and extend the warranty.

Extension contracts are usually priced at so much per sensor per year. They vary significantly from $800 to $1200 in price. Some only charge the full warranty cost for the first sensor and then less for additional sensors. When buying get the details this could make a big difference in your ongoing costs.

Coverage: Some cover the sensors and provide software upgrades and support. Some just cover the sensors. Some cover everything including accidental damage. Some just cover a limited number of problems. The primary failure point in most sensors is the connection of the cord top the sensor.

Although the coverage is different with each vendor the leading vendors have shown themselves to be extremely reliable and consistent when called upon to provide service. Users in need of help report consistently that the company has provided replacement sensors for next day delivery.

For most dentists the extended service contract is a good investment.

Digital radiography sensors are expensive. They are expensive to make, they are expensive to sell, they are expensive to support, and they are expensive to service. As with so many other things looking for the cheapest option does not always provide the lowest cost in the long run.

More Information

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When Impressions go Wrong

Consider the lowly impression and the number of times there is a chance for an impression to go wrong. That is for it to distort or in some other way betray us from the moment it is taken until the restoration is ready to deliver.

Each of these materials; the impression materials, the stone, the wax, the investment and finally the metal has some sort of setting and shape change with time, temperature and moisture. Then there could be mechanical distortion if the tray bends, the die is abraded, the material compresses or is pulled slightly from the tray. And of course there are bubbles, contamination and tears.

Any one of these errors, lurking like little gremlins, can easily go undetected for at least a portion of the restoration fabrication process. The result…remake.

When you take a digital impression you eliminate all of those chemical and mechanical gremlins. The result is better and more reliable restorations with almost no remakes. In fact a study from iTero shows a remake rate of 0.3%.

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