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Tooth-Colored Inlays and Onlays
inch disk drives. While this m easure will certainly result in lost dates, com puter downtime and costly repairs, it should also prevent viral replication and transm ission. M ich ael A. S ieg el, D.D.S. U n iv e r sity o f M aryland at B altim ore A u th o r ’s com m en t: Dr. Seigel’s tongue in cheek analysis of the tre a tm e n t for com puter viruses m ay indeed have some validity. T hom D u m sha, D.D.S. U n iv e r sity o f M aryland at B altim ore TOOTH-COLORED INLAYS AND ONLAYS
There is a contention th a t fracture rate s for tooth-colored inlays go up when they are over 2 m illim eters in thickness. While we have had num erous problems w ith lab-prepared inlays including fracture, m arginal breakdow n and sensitivity, our experience with more th a n 200 restorations placed via the Cerec CAD-CAM system shows a considerably better performance. M any of these inlays/onlays were designed over 2 mm thick, and we have observed not one fracture in more th a n a year of use so far. If therm al sensitivity is not a factor, I still would prefer to use gold casting etch-bonded after internal tin plating. Cerec restorations are quite tricky to m anufacture and deliver. T here’s a serious learning curve. B ut for e sth e t ics, abrasivity and therm al insulation, the m achined 12
JADA, Vol. 123, November 1992
ceramic seems very promising. W illiam C. D om b, D.M.D. U p land , Calif. SEPTEMBER EDITORIAL
In reply to your Septem ber editorial, here’s a simple solution th a t has worked for me. W hatever we do, as businesspeople, we should realize the m ost im portant aspect of a long-term successful dental practice is the recall dental hygiene portion of our practice. The more patients we exam ine every day through the hygiene system , the more operative and prosthetic procedures we will have. We m ust first recognize this and then react accordingly. The hygienist, dentist, tech nician and others can be m otivated only by increased income over the long haul. As professionals we m ust have incentives to produce and the best incentive is money. Hygienists today who are on a fixed salary will eventually process only a m inim um num ber of recall p atients per day. Why should they do more? Their enthusiasm will eventu ally subside even further, and they will either burn out or drop out of the profession. We all lose. The hygiene profession should be promoted as a prim ary wage earner. In today’s single parent family situations, a hygienist should be able to support a family alone. W hat two-year tech college graduate can m ake th a t statem ent? As dentists we m ust not be so selfish or narrow m inded as to recognize th is fact. How? Very simple. O ur hygienist receives 35 percent of
all her gross production. She can develop h er own destiny, her income levels and her success. She has no sick leave or vacation pay, no bonuses. She sim ply ru n s a profes sional h ealth service under the supervision of my dental practice, m uch like an independent contractor. If a patien t doesn’t like her attitude, she loses. She has the opportunity to hire and tra in assistan ts to m ake h er work load easier as well as to increase her production levels. The hygienist m akes case presentations and sells the office to our patients. She relishes the fact th a t she m akes a lot of money as well as deciding her work schedule. Her nam e and title are an integral p a rt of our building signs. She promotes our public education program s and has been averag ing about 20 new p atients per week in a practice th a t is 32 years old. H er rapport w ith the medical profession is fantastic as she and I exam ine and find m any medical problems in patients every day. As a team , we save lives as well as promote a dental service. O ur hygienist will earn about $65,000 this year. W hen I lecture to dental study clubs about staff m anagem ent, they wince and voice objections about paying anyone th a t kind of salary. “You can hire a dentist associate for less th a n th a t,” is a common reply. T heir fears and apprehen sions are lessened, however, w hen I rem ind them she has m ade $13,000 additional income for the practice. This does not take into account the m any
There is a contention th a t fracture rate s for tooth-colored inlays go up when they are over 2 m illim eters in thickness. While we have had num erous problems w ith lab-prepared inlays including fracture, m arginal breakdow n and sensitivity, our experience with more th a n 200 restorations placed via the Cerec CAD-CAM system shows a considerably better performance. M any of these inlays/onlays were designed over 2 mm thick, and we have observed not one fracture in more th a n a year of use so far. If therm al sensitivity is not a factor, I still would prefer to use gold casting etch-bonded after internal tin plating. Cerec restorations are quite tricky to m anufacture and deliver. T here’s a serious learning curve. B ut for e sth e t ics, abrasivity and therm al insulation, the m achined 12
JADA, Vol. 123, November 1992
ceramic seems very promising. W illiam C. D om b, D.M.D. U p land , Calif. SEPTEMBER EDITORIAL
In reply to your Septem ber editorial, here’s a simple solution th a t has worked for me. W hatever we do, as businesspeople, we should realize the m ost im portant aspect of a long-term successful dental practice is the recall dental hygiene portion of our practice. The more patients we exam ine every day through the hygiene system , the more operative and prosthetic procedures we will have. We m ust first recognize this and then react accordingly. The hygienist, dentist, tech nician and others can be m otivated only by increased income over the long haul. As professionals we m ust have incentives to produce and the best incentive is money. Hygienists today who are on a fixed salary will eventually process only a m inim um num ber of recall p atients per day. Why should they do more? Their enthusiasm will eventu ally subside even further, and they will either burn out or drop out of the profession. We all lose. The hygiene profession should be promoted as a prim ary wage earner. In today’s single parent family situations, a hygienist should be able to support a family alone. W hat two-year tech college graduate can m ake th a t statem ent? As dentists we m ust not be so selfish or narrow m inded as to recognize th is fact. How? Very simple. O ur hygienist receives 35 percent of
all her gross production. She can develop h er own destiny, her income levels and her success. She has no sick leave or vacation pay, no bonuses. She sim ply ru n s a profes sional h ealth service under the supervision of my dental practice, m uch like an independent contractor. If a patien t doesn’t like her attitude, she loses. She has the opportunity to hire and tra in assistan ts to m ake h er work load easier as well as to increase her production levels. The hygienist m akes case presentations and sells the office to our patients. She relishes the fact th a t she m akes a lot of money as well as deciding her work schedule. Her nam e and title are an integral p a rt of our building signs. She promotes our public education program s and has been averag ing about 20 new p atients per week in a practice th a t is 32 years old. H er rapport w ith the medical profession is fantastic as she and I exam ine and find m any medical problems in patients every day. As a team , we save lives as well as promote a dental service. O ur hygienist will earn about $65,000 this year. W hen I lecture to dental study clubs about staff m anagem ent, they wince and voice objections about paying anyone th a t kind of salary. “You can hire a dentist associate for less th a n th a t,” is a common reply. T heir fears and apprehen sions are lessened, however, w hen I rem ind them she has m ade $13,000 additional income for the practice. This does not take into account the m any