Dental Cyberweb/Dentists: As the Molar Crumbles
Each month Doc Doty attempts to shatter myths common in the dental profession, and present ideas and practices he's discovered as truths in his years of practice. If you've got a myth to bust or a truth to proclaim, please contact us at the Dental Cyberweb! We'd love to hear it and will credit your submission.
- September 1996 MYTH: Accountants will look out for your business success!
I want to say initially that I have no grudge to bear with the accounting profession! I was led to believe by others (not accountants), that a good accountant would help me manage the financial affairs of my business. I started my dental career with a fairly inexpensive accountant. He prepared my quarterly reports and gave me my financial statements. At year end he helped me put together my taxes and answered my tax questions. He really didn't offer much of any tax strategy ideas or business advice.
Well I thought maybe I need a high priced accountant. I found the hot shot, high priced accountant in my local town. While his offices were impressive and his computer printed out gobs of information (mainly useless to me), any ideas for my business as far as taxes and financial planning were contributed mostly by me.
The bottom line is--don't expect accountants to be really helpful in forming your financial security. They for the most part are good bookkeepers that know little about the business of dentistry. You need one to answer tax questions. (You will have to think of the questions.) You should rely on yourself to compile your business numbers in a format that will be meaningful to you as you attempt to manage a profitable dental practice. Financial planning matters are something you should research yourself and have a working knowledge. Then you can ask the right questions and make the proper decisions.
PS: You need to know how your business is doing monthly and soon after the end of the month. If you have an accountant do all your business numbers, they usually compile them quarterly and you get the report a month or so after the quarter is over. Not having the numbers immediately will cost you literally thousands of dollars a year. You will be way too late correcting problems with your overhead, etc. with numbers that are not current. Get yourself one of the many computer accounting programs and you will be on top of your practice numbers.
- July 1996 MYTH: Peer to Peer Networking is a Bad Thing.
A current myth perpetrated by computer salesman selling to dentists, can be a very expensive lesson. They intimidate many dentists based on the dentist's lack of knowledge about computer networking and computer software when it comes to networking computers. Many give the impression that a peer to peer network, i.e., Windows for Workgroups or Windows 95 is not capable of handling a dental office with several computers. I personally have 11 computers networked and working fine on a peer to peer network based currently on Windows for Workgroups eventually converting to Windows 95.
I have to qualify my statements somewhat. Some computer software designed for dental offices does require Netware to run correctly. That necessity is built into the software and is not a result of the limitations of peer to peer networking. I am not putting down the merits of Netware, I am sure it is a fine program. I am saying it adds unnecessary complication and expense to a dental office computer network.
- May 1996: To extract or not extract that is the question!
One of the truly great controversies in dentistry is our subject this month. I took the liberty of slightly plagiarizing a great author's prose for my own purposes. I have seen more dogma written, lectured, argued over etc. on this subject than well even TMJ or occlusion. Most "experts" on the subject seem to be on one side of the fence or the other almost condemning the other point of view totally. Any time I see so much disagreement and polarization it sends up that little "one eyed dentist" flag to examine the dogma carefully!
For those not into ortho as much as I am, I am talking about whether to extract teeth for orthodontic purposes. Without getting into a lengthy discussion the only myth I would attempt to expose is that anyone who states either I always extract teeth or I never extract teeth should probably have their concepts of treatment looked at with extreme caution.
- April 1996: Anybody Out There?
Come on all you closet critics out there! You all know of some whoppers you were told by supposed experts during your dental careers. Let us all know. Some contributions would be appreciated! I promise I won't use your name if you don't wish to be identified. I will be glad to take the heat for you.
- March 1996 MYTH: BITE PLANES DO NOT NECESSARILY CAUSE BITE OPENING
For those patients with TMJ muscle problems, we dentists can argue till the occlusion freezes over about what appliance is needed to give the patient relief. At the risk of being burned at the stake I would suggest that MOST (note I do not say all) patients would do much better with simple moist heat applied to the muscles and/or a short term of muscle relaxants, with us keeping our hands and our pieces of plastic out of their faces. For the more tense and tougher muscle cases a simple anterior bite plane can usually relieve symptoms.
Now I know I will have to dispel still another myth of dentistry BITE PLANES DO NOT NECESSARILY CAUSE BITE OPENING. Read my lips. If the patient is instructed to wear the appliance only at night no bite opening problems will result!
I am braced for all of the hate mail I will receive!!! Hopefully a few love letters will be mixed in!
- February 1996: TMJ Appliances
TMJ appliances! Oh about 50 or so different types come to mind! Yes, we all remember when we were told by supposedly outstanding clinicians that muscle strength and all other bodily ills could be righted by just having the teeth occluding in perfect balance. We all wanted to believe. What a bonanza in patient care. Why, nearly all of our patients had some occlusal imbalance! If we could justify adjusting everyone's occlusion our overpopulated profession would have tons of work for eons. Well I hate to dispel the myth. (It still crops up it's ugly head even today.) Plenty of people make it quite nicely through life with the most messed up occlusions. Many having no dental or muscle problems with jaws etc. Next month: What therapy to use if patients do present symptoms that need treatment!
- December 1995 MYTH: You can take a good partial denture impression with alginate as long as you make a custom tray!
Yes, I was taught this in dental school and wondered for years why my partials "almost" fit, exactly. Must be that lab can't quite make a good casting. Boy was I wrong. One day I used that same custom tray with Impregum and had a devil of a time getting the impression out of the patient's mouth, but low and behold that partial fit perfectly! I have since switched to Reprosil which is not quite as stiff and I am able to remove that perfect impression from the patient's mouth with greater ease.