Prepping for the Digital Workflow

You're listening to The Dr. Phil Klein Dental Podcast from Viva Learning.com. Welcome to the show. I'm Dr. Phil Klein. The digital workflow has arrived and it's here to stay. In fact, it influences every aspect of our practices. Today, we'll be discussing current operatory equipment and other technologies within the digital workflow that promote efficiency, comfort, and ergonomics. Our guest is Dr. Lori Trost, who maintains a full-time practice in Redbud, Illinois. Dr. Trost focuses on aesthetic dentistry with a wellness approach to patient care. She lectures extensively throughout North America, is a clinical evaluator for many dental manufacturers, and she translates her knowledge and experience into authoring a wide variety of professional articles. And we're lucky at VivaLearning.com to have her do many CE webinars and podcasts. So before we get started, I would like to say Dr. Trost had a webinar which did extremely well. as far as attendance, a live one that was last week called Prepping for the Digital Workflow. It was really, truly fantastic. For those of you who missed it, you can visit VivaLearning.com, type in Trost, T-R-O-S-T in the search box, and then you can watch the on-demand version of that webinar. Dr. Trost, it's a pleasure to have you on the show. Thank you, Dr. Klein. Happy to be here and happy to talk with you today. We're really happy to have you. So tell us about some of the technologies and equipment. that we should be thinking about when it comes to developing and optimizing our digital workflow? Well, I come by this kind of recommendation firsthand because a couple of years ago, I got back into just kind of reinventing a different kind of style practice. And I made the decision by virtue of literally what's out there by comparison, talking to many colleagues, talking to many manufacturers, doing some research, doing my homework. And I've always loved technology. I've always liked to be out on the front end of that dinosaur, they call that, right? But I really sought after what I found to be, I think, the most cutting-edge technology because as we push more for this digital workflow, which is everything from... how we do exams now, because that's changing in the hygiene realm, when a new patient comes in, all the data we're gathering. I don't care if it's an intro scanner, if it's intro cameras, caries detection, CBCTs. You're really looking at a whole encompassing experience for the patient in a new way. I think that just really is such a great marketing tool as well for your practice. So I kind of went at that approach to make some selections that way. really it comes down to fine-tuning what you use in technology too and for the digital workflow you have to have really excellent and durable operatory equipment that you can rely on because you practice long enough you understand when your handpiece goes down or something's not working right that really can really throw a wrench in the plans in your schedule for the day so durable equipment you can rely on. I don't care if it's your chairs, your operatory lights, your hand pieces, you've got to really have really solid choices there. Yeah, and there's a lot that goes into the routine practice of a dentist. Even though it's digital workflow, there's physical demands on the operator, which means ergonomics is a big factor with the chair, the lighting. Now, you mentioned hand pieces. All of us have a collection of high-speed hand pieces in our office. So tell us... how a high-speed handpiece can materially affect the digital workflow. Well, high-speed handpieces, I think, have enormous impact. You want to make sure that that handpiece is not only ergonomic and balanced well in your hand, whereby you don't have to lean hard into the tooth with the burr. Honestly, that's going to be felt by the patient. So they have a handpiece that runs smoothly. to have a hand piece that can really go through the rigors because we use our hand pieces really a lot to cut through crowns prep teeth remove amalgam i mean a decay is going to usually be soft but we go through a lot of really tough hard materials so a hand piece that has to be able to feel and have that tactility. It's kind of like, to me, an artist's brush. You know, you do different strokes with it for different things. You need it to go through zirconia, but you also need it to go through soft decay. So it has an up and a down. It has a lot of RPMs. It has fewer RPMs. So you have to have a range there. But more importantly, it's got to really feel good in your hand to express your tactility and to really have that sense to create a beautiful margin, an ideal margin that you can pick up. And again, make them efficiently work within that digital workflow. So it reflects really the choice of your handpiece ultimately plays out to what your digital workflow is going to be because then that scan can be seen better and pick it up. You've been doing dentistry for a while. You've probably evaluated quite a few handpieces in your day. What are some of the key things that they should be looking for when purchasing a high-speed handpiece? So, you know, speed is one thing. Torque is another. But power really is ultimately what you have to have in your handpiece to cut through a zirconia or cut through an old PFM, for example. So you want to have a handpiece like the Aries handpiece from Dental Ease. I mean, that's a wonderful handpiece. It's got incredible fiber optics. So like up on a maxillary number two, you can see so well. It has three ports of water that are coming out. So the clarity is there. The power is there. I think it's actually that it offers the most. power of any handpiece right now on the market today without really going over into the electric handpiece selection side. So comparably, you can really work with that handpiece nicely and it can function very well throughout any kind of procedure or quadrant dentistry within the mouth. Do most dentists use a combination of air and electric now, or could you survive with just one good quality air-driven handpiece like the Aeris that you just mentioned? I absolutely believe that you could survive just with the Aris. I think that that can really broad spectrum every procedure you need to do and be ergonomic as well as efficient too. Yeah. And Dental Ease has been making hand pieces for a long time now. They're not new at this. The Aris, is that a relatively new product line of hand pieces? Yes, it is. And it honestly has been out for about two years now. And I've been able and fortunate enough to work with it. I've used it in every dental procedure. Available and I can tell you satisfactorily that it works and it works very well works great in my hand I think it won't work well in a small hand I wear it like a size 6 glove But I also look at my colleagues who maybe have a size 10 or 11 hand And it's very balanced as well there. So it can withstand the rigors of cutting through those difficult materials that we have to, as well as slowing down and maybe polish or tactility to create that beautiful margin. So it answers, I think, to a broad spectrum. So therefore, you don't have to go into those other hand pieces. You can function solely with that in your operatories. I think it's a great choice. Can you give us some recommendations on how we can improve the longevity of our hand piece? Maybe things that dentists are not currently doing. uh longevity is huge because like you said you know you've got a drawer full of hand pieces so do i right so our first thought is that our turbine has shot craps and we have to get a new turbine well the beauty of having one of these heiress hand pieces uh first of all is that you're able to do any kind of maintenance really and if you need to change out the turbine you can do that chair side that's number one Handpiece is going to go through about 500 sterilization cycles and then it needs to be outfitted again, probably with a new turban. But they have technology. They have some interesting technology now that's tracking infection control. It's tracking where the handpiece is at within the old practice. So I think those are really amazing. uh possibilities that we need to start considering because maintenance and you really want to keep the focus on the patient if maintenance can be kind of taken care of by itself that's a great thing but to keep that handpiece rolling you want to use fresh burrs all the time and i really believe for infection control purposes use a one and done burr because if you don't you're really you're chasing tail you're really wasting time having an assistant try to clean that burr and it just is not as effective or as efficient so many times Again, we're working with maybe a burr that the diamond particles will flecked off. You're reusing it. You don't know how many times you reused it. And the quality of that burr is just really translating back up into the turbine. And so that's not spinning as well. The water flow maybe is cut down on it. And that all factors into what we think is wear and tear on that hampus. And effectively, it's really just the burr itself. Yeah, I think that's a really good point about the burrs. I think the more podcasts I do with the KOLs that are discussing this, a lot of them are saying economically, infection control wise. The one and done burr is really here to stay. And I never really heard the concept about how a new burr is actually, and it makes total sense that it's much more gentle on the handpiece. So you're getting more handpiece longevity out of using a new burr because you're not getting as much friction and pushback into the turbine. Do most companies sell single-use burrs? Many companies are out there doing that. And I think you just need to... Find a product line in a manufacturer that fits what your style of practice is and ask for samples to see what they have and see which ones you find to perform the best and what works best in your hand. Again, it's about let's go back to being the artist in the brush choice and taking that paintbrush in your hand and really just really crafting and creating with that and how you use your handpiece and the strokes that you rigor that through. So there's some great quality burrs that are out there. They need to be good enough for the one and the... they need to be also be mindful of just you know economics and practice management yeah is the prep design significantly different based on the digital scanner technique versus using traditional impression materials Absolutely. And here's the thing. I think if you have a really good handpiece and you use those one and done burrs, you make wise choices. And when you're prepping, you have to understand that digital scanners cannot allow and more so they can pick up an undercut. But the problem is with the milling machines now today, because that's what we're doing primarily, right? The labs are milling all these beautiful restorations. So you cannot have undercuts and they will not mill an undercut. That restoration will not fit. again if you have jagged edges if you have any j hooks on your margins none of that is successfully milled and you're going to have a crown or a restoration that's just not going to fit so you need to make sure that you're prepping correctly you have no undercuts you have the proper taper not over taper but proper taper of degree and you have a you know just a good clear solid margins for whatever ceramics or material that you're going to restore that with so you feel that it's less forgiving working with a digital scanner than working with traditional materials and therefore it's so important to focus on a handpiece that provides smoothness reliability and then most likely you would recommend using the one and done burrs Absolutely. And really, it's the milling process that can't be forgiving just because of how it mills. And that intake of surface has to be as smooth and pristine as possible and properly prep without undercuts or undulations and really sharp transitions. It has to be very smooth, rounded, and very clear on the margins. So we really appreciate that, Dr. Trost. I know you have some more webinars coming up and podcasts on Viva Learning. We appreciate all your time with us. So those of you, again, who missed Dr. Trost's webinar. Last week, the title of it is Prepping for the Digital Workflow. And that was kind of like a play on words. I think she meant prepping by being prepared, but also prepping the tooth in its literal way. I love the title when I first heard it, Dr. Trost. And the webinar was really, as I said, fantastic. Visit vivalearning.com. Look up Trost, T-R-O-S-T. We thank Dentalese for sponsoring this podcast and look forward to Dr. Trost on future podcasts. Great. Thank you so much. It's been great talking with you.