San Diego Dentistry Blog

Dr. Daniel Vinograd Moves From Alpha Dental To Posh New Location

If you’ve been to see Dr. Daniel Vinograd, San Diego’s experienced and dedicated holistic dentist, there’s something you need to know: He’s moved from Alpha Dental to a beautiful new facility called Brighton Gentle Dental, located at 10450 Friars Road, Suite G in San Diego.

At the new place you’ll find state-of-the-art facilities, beautiful surroundings and some other important features that make it the right place for you to turn for your San Diego dentist:

  • more than enough FREE parking for everyone
  • easy freeway access
  • convenience of being just three miles from his previous office
  • easy access to your old patient file, moved securely from Alpha Dental.

The complete new address — including a new dedicated phone number — is:
Brighton Dental San Diego
10450 Friars Road Suite G
San Diego, CA 92120 (map)
(619) 346-7422


Put Dr. Vinograd To Work For You

Dr. Vinograd works hard for his patients, and if you aren’t already one of them you can be soon. Just contact the office for your first appointment. Our prices are affordable on most budgets. Plus, we accept most dental insurance, so please call to ask us if we accept yours.

With decades of experience and the latest tools at his disposal, Dr. Vinograd is 100 percent committed to pain-free, non-toxic dentistry, total safety and modern practices. This means he uses:

  • digital x-rays for complete convenience and the least possible exposure to radiation
  • diagnostic lasers for accurate diagnoses in moments
  • no-drill fillings whenever possible
  • injection-free dentistry when it can provide great results
  • mercury-free and nonmetallic fillings, bridges, onlays and crowns
  • invisible brace to help you avoid embarrassment when wearing braces at any age
  • and much more.

Dr. Vinograd Is No Longer At Alpha Dental

Don’t forget: Dr. Vinograd is no longer at Alpha Dental and now works for his patients at Brighton Gentle Dental. And his commitment to you is even stronger than ever. Plus, he’s even more committed to safe, non-toxic and biocompatible dentistry than ever. But that doesn’t limit the services he can provide. You can find all the services at Brighton that you’d find at any other dentist’s office — just with less pain, fewer toxins involved and more compassion from the doctor.

Procedures available include:

  • porcelain onlays, veneers, crowns
  • porclelain-fused metal bridges
  • tooth-colored fillings
  • implant services
  • treatment and removal of gingivitis
  • scaling and root planing
  • bone grafts
  • Invisalign braces
  • and many other services and procedures too.

Dr. Vinograd Serves You At Brighton Dental

Forget about parking hassles, difficult access and any other issues you may have had with Alpha Dental. Now Dr. Vinograd is pleased to serve you at his beautiful and modern new office, designed just for him.

When you visit Brighton Gentle Dental, you’ll soon see that Dr. Vinograd’s commitment to great services, personal attention and a friendly atmosphere extends to everyone who works with him. From the moment you step in the door, you’ll know that everything just seems right. The move from Alpha Dental to Brighton Gentle Dental is suiting him well.

Looking For The Best Toothpaste? Make Your Own Fluoride-Free Toothpaste

Ongoing exposure to hazardous chemicals like those found in many commercial toothpastes isn’t smart. Instead, turn to a fluoride-free toothpaste from a maker you can trust. Or better yet, make your own toothpaste using simple ingredients you can pick up today. Soon, you’ll see that the best toothpaste is one you make yourself and know you can trust.


Trusted Fluoride-Free Toothpaste Makers

It isn’t just fluoride you should be trying to avoid. Many commonly used chemicals have been shown to be toxic, including triclosan, PEG-12, FD&C Blue, propylene glycol, sodium hydroxide and BHT. In addition, you really don’t want to use toothpastes with sodium lauryl sulfate, sodium saccharin, carrageen, sorbitol or manganese gluconate.


A few brands make fluoride-free toothpastes that don’t have the chemicals above. But read labels. Formulas change all the time. Makers you may be able to trust include:

  • Tom’s of Maine, part of Colgate
  • Kiss My Face
  • The Natural Dentist
  • Jasons
  • Natures Gate
  • Spry

… and only a few others. Not sure you can trust the products from any company with your health? There’s a better way.


Your Own Homemade Toothpaste

The best toothpaste you’ll ever use is one you make yourself from a small and trusted list of ingredients. In fact, there are only FOUR ingredients in our toothpaste recipe, no chemicals and you can use it confidently. Here’s exactly how to make it:

Homemade Toothpaste: Melt a half cup of non-hydrogenised virgin coconut oil over low heat in a small pan. Once melted, add 2 or 3 tablespoons of baking soda or 1 tablespoon of fine pumice plus 15 to 20 drops of cinnamon or peppermint essential oil and some Xylitol to taste. That’s it. That’s all.

Cool this toothpaste before use, and store it in a glass jar.


Homemade Toothpaste: It Just Makes Sense

If you want to do something right, do it yourself. If you want a good fluoride-free toothpaste that will probably serve you well, consider one of the brands mentioned above. If you want the best toothpaste you’ve ever used that tastes good, feels good and works well, however, why not make your own?

Studies are inconclusive about just how bad for you some chemicals found in toothpaste are, but there’s no reason to take a chance when making your own is so easy. And with potential reproductive and developmental side effects as well as dry mouth symptoms and allergic reactions at stake, avoiding chemicals is the right thing to do.

It’s so simple, it just makes sense.

Protect your health and your family’s health by making a smart decision about your toothpaste. When combined with making intelligent decisions regarding food choices and other health and beauty products, it can make a real difference you’ll feel every day.

- written by

Original article:

Patient Review: Overcoming Dental Anxiety

original post and transcription:

Patient Review @ Brighton Dental

original post:

Free Teeth Cleanings – Gum Disease Awareness Week

“Along with non-toxic dentistry, and helping fearful patients, the awareness and prevention of Gum Disease is a priority in our practice. We invite you to sign up for a free cleaning during our awareness week.” – Dr. Daniel Vinograd, DDS

To schedule your free cleaning in our San Diego office, call (619) 550-4904

free teeth cleanings

Dr. Vinograd Lectures At The Gerson Institute

Regarding biocompatible dental materials:

How To Brush Your Gums Properly

post & transcription:

Developing a Paperless Practice P8

Dr Lavine:  Ok thank you. Next question, how do you recommend to convert loss and paper chart practise with digital imaging?  I guess it got cut out here but practise management software as well. As i said  i think the first  step  is  choosing the orates e management  software  because we find that pretty much any good practise  management  software  would be  good in that category  can ridge  with any  third  party image  program . So the  important decision here  is  the  practise  management  software and the best  thing that your can  do  is to get them a  copy of your  data , have them do a data  conversion and know  ahead of time what  to expect. Honestly, we have seen this with literally hundreds of offices sometimes the data just can’t be converted well. It’s the old garbage in, garbage out. If you got  data that  is not perfectly clean you are  going to find that it is really a challenge  to get that  clean the way  that you want it to be  so often times we  are recommend that  people  will keep the old  software  running on a   couple of  front desk  computers and as  patients come in you manually put in their name, you manually put in their  balances. Is it a pain in the rear? Yes but within 9 – 12 months you can get the bulk of your patient population in your software. Again if  you can convert it great  that always the first choice but when you do that  test  conversion that’s a way to find out  and  if there is problems what the test  conversations you are  probably going to have  problems with the  final version as well  and  at that point. I would never say don’t get a software just because that company cannot convert your data because it may be problem with the software.

Here’s a question for Sheryl, i don’t think we are balking up to the Maxident. How do we go about that? Is there a fee?

SHERYL: They would call me > that probably the easiest way of doing it. There is a minimal fee because they pay for the space that they use.

Dr Lavine:  We do online back up for a list of our clients as well and we use a data system as well and they don’t give away that space for free. Usually it’s not a major expense.

SHERYL: Well worth it.

Dr Lavine:  How much time would a new office need to get up and running? I work with a lot of practises that hare start up practises and it’s a process. We usually recommend that you start the process a good 2 – 3 months head of time. If you have ETA and when you plan to be in that space working with a practise all the time. Right now there is a good friend  of  mine up in Toronto right now and you ideally want to get  as much  free  time as you can because there is so  much  decision  that you have to make ,  not just the  practise management software , even  just the technology that we talked about  but everything  . The archetypal designs, the plumbing to the electrical. It just takes a long time. You’ve got the permit that has to be use. You have some state and provinces that are a lot better than others and you can get that together. Definitely start as early as you can.

I have medical companies that scan charts that cost very high, they charge per box.  Charts can be scanned in by third party. Our company found out what they do charge an armour. That why i wished that have the funds, the time to do something like this t make it low cost .What if someone can buck of a chart. A buck a chart would be a great idea for a business model.

Why is Debus a problem for Maxident? I can answer that  one because it’s not a problem with Maxident. It’s a problem with App Tricks. Sheryl in Canada can you use Dexus with Maxident scanner?

SHERYL: No and it’s a limitation of Dexus.

Dr Lavine:  Dexus is a very fine censor, please don’t get me   wrong. They are a great  censor .We’ve  got a lot of  people  using the  censor  but it tends to be a relatively i proprietary  system  so it’s  not going to work  with the Maxident software  directly or App Tricks or  pretty much any  third party software . It works really well with their software. It does work with the version of the Mac software in the States only in the military. I’m not sure I’m not sure if you are in the military. If you are not then that’s out of the question then you are out of luck.

We’ve got a couple of comments here. Any recommendations for a reasonable price digital panel? Absolutely, there’s a lot of good ones out there.  Probably my favourite right now j is the company that’s based into the US by 99%. You can get them out in Canada as well. It’s called Panoramic Corporation. What they have done is they have taken some of their used films and occasionally refurbished them and fit them with the censor. So the  image  quality  is as  good as  a  new Machine  because the censor  is  dictating image  quality . They also have get digitized existing pens as you already got that. The thing that I find most attractive about that is the prices. That most of the new digital pens out there are still in the $30 000- $35 000 range. The PC1000 requisite that we installed for a number of practises it comes with everything. The pen , the  computer, the software , shipping , installation , training , warranty , everything  for  $92 000.00 so  it’s a really great bargain . Certainly that my favourite system that we can recommend right now.

Other good ones that are out there. Gender 8500, the Plan Meca Pro 1, the instrument is a great unit. So ones are priced a little bit more but both of those are really good pieces. Any experience with I5 or reporting digital images to form your camera to your computer station. I played around with the I5 for those of you who aren’t familiar with it. Everyone cows with a digital camera you have like a little memory card and the way that you normally get that memory card to the computer is that you would put the mommy card into a reader and then copy that on. It’s basically seen as another hard drive   computer so you copy it over and then bring it to your software.

The I5 is memory card that would wirelessly transmit images right to your computer screen. Two reasons why I would not recommend is that it’s slow. You’re doing Wi-Fi___33 for some large image file. It’s going to be slow. They are probably not aware   of the I5 working with any dental image file. So you are going to have to put on your desktop first and then cut and paste it into the software. I think it’s just adding an extra step. So will not recommend something like that. Who knows what’s going to happen over the next few years.

Here’s another question. The dentist I work for say that all practises have to go paper less within a certain period of time. True there is a deadline. I know a number of you may not be on for the presentation for the first 5 minutes or so. In the US there is a schedule mandate that we need to be chartless or paperless by the end of the year 2014. Will that actually happen anyone can guess?  The reason that i am recommended it is two things. Number one I think insurance companies are probably ought to be the one that dictates what happens. At some point they are going to start taking film and stop taking paper claims.  I also think this is peer pressure. I mean more and more office are paperless and chartless and it’s an efficient standpoint. There a lot of reason to consider going towards a chartless or paperless environment. The reason why I would  be a lot more cautious  to this is if you have  sales  reps that comes in and say  you have to get  digital x rays  , you go to get  it And have to get it by 2014  that’s not 100% accurate. Don’t fall into some of these strong sale pitches.  I don’t necessarily believe in the case.

What’s a good imaging software and a good value for you money.  Certainly the one that Maxident sells with the app tricks software. It pretty much works with anyone out there. There is another one XDR. My god there is so many. I tend to be a  fan  of the  one that Maxident  uses , the  app tricks  , the XDR because  I really like  open ended image software. I think that people should have the ability to pick and choose their   censors, their cameras, their foster plate system, their scanners, their digital cameras and have them all working together.

So that’s why i tend to like those types of programs and that would be my recommendation.  Believe it or not we are out of time and pretty much out of question .We’ve got a few more here. What’s your   recommendation for your number and location of monitors to record in an operator?  I would say  probably  80%-85%  of the offices that we have set up in the  last  number of  years have gone  dual screen , two screens . One for the patient often time coming from the ceiling or a light bulb that   is going to show them images, show them patient education. If you want them to watch a DVD or TV fine. One that is going to be behind the patient. It’s for use by the dentist. I think you can pretty much do everything you want with   2 monitors.

We have more and more offices that we are working with that are going 3 monitors, 4 monitors. Honestly from an IT stand point they are a night mare. The quad carts that are out there that can handle three or four models are not easy to deal it. More often than that we get a call from the office on   regular basis that will say we can’t find out images on our monitor. I text them as say well do if you look on your other monitor’s get really confusing to kind of deal with multiple monitors. I typically recommend 2 monitors. I think that’s definitely fine.

What was the name of the Micro Tech? I think it was called the Media scanner. I am going to do a research on that and when I send the list I should have it on there. If I don’t for whatever reason and I’m going to put it on there to I will get to that. We are done. Sheryl is there anything else that you want to add at this point.

SHERYL: No not at this point.  If they have any questions on Maxi dents, conversion, it might be pricing option they can just give me a call directly. My number is … i don’t know if you are going to provide  that  but my number is 1800 -663-7199 and I’m extension 33 to  get my line direct .

Dr Lavine:  I don’t have that number. Do you want to go ahead and repeat that one more time?

SHERYL: 1800-633-7199 extension 33 or they can just email us at

Dr Lavine:  Ok. The other thing i should just mention to remind everybody as soon as you log out of the webinar you’re going to see a little skin that comes up. if you want me to  contact  youth any  additional question  or  just want to  set  up some time to talk . Again we don’t   change for that. if you definitely  want to hear  form Sheryl , for Maxident  sooner than later just  indicate that  on the  survey as well and  she will be in touch with you shortly . I want to thank everybody for joking. I think we had a great turn out, well over 100 people this evening. Some great question as well. We will send everybody more information about the upcoming webinars. The next one is in about 5 week on the infrastructure which i think is really critical. You can put computer software unless you got computer so that would be a god topic as well. Thank you everyone again for coming and the great questions and we will see you all again shortly.

Developing a Paperless Practice P7

SHERYL: For Ortho?

Dr Lavine:  Yes.

SHERYL: For Ortho contract filling or….

Dr Lavine:  Yes for imaging.

SHERYL: We penetrate orphan. Really any ortho imaging software that we can integrate with but for Ortha contracts and these other thing it’s already build in the software.

Dr Lavine:  Perfect. Thank you for that. I think I have already hint on this. What’s the best way to deal with people, charts and tons of data we have. It would take years to destroy them. It depends a little bit on your practise. Most of the practises that I work with really do not go into their progress notes on a regular basis. Maybe they want  to have the most recent  page of progress note but they the typically going back 5 or 6 years to remember what they did  or what their  progress  notes were. If you do practise like that then you are probably going to want to scan it in. As i said it’s not a fun job. I’ve always thought of great business model. I actually had a company that contacted me a couple of weeks ago.  Wouldn’t  it be great   if  you had  a company that had  like nan RV that went  around to the dental offices and come in on a Friday night and  would scan  all your charts for you over  the weekend, it would be an  hide  speed scanner and  by the time you came in  Monday morning it’s all done. I think you will see more and more companies doing that. What i would typically suggest is to scan in maybe the last page of progress notes. The other thing that you can do is to scan as patients are coming in. You don’t really want to scan an old chart from someone who hasn’t come in two years and you probably won’t see them for another 20 years. So what you can   do is the day before you can see the list of cases coming in and scanning those progress notes that you needed. It really just depends on your practise style. As  I said  you are going  to  find that it’s not just an  official  way to do things and  we’ve  had  people , office mangers tell them I would rather wait and do  something with that  so .

I got a recommendation here on another scanner that’s Xerox262 document. I’ve never even heard of that one so maybe you’ve got that. Thank you Doctor Bush for making that suggestions. Let’s go to the next one here.

Have I used any of the Anode smart pen system such as the deliria X paper or oxy paper? I’ve seen some of the trade shows. I have not used them yet. I think is an interesting concept. I don’t really want to comment on it at this point because i don’t know enough about them intelligently.

I think that purchasing iPad for patients so that they can vibe able to view their history forms prior to signature, do you know if iPad have it?  In Maxident Sheryl, do you guys work with the iPad yet?


Dr Lavine:  Actually where nay practise management software that can do that.  The  problem with an  iPad is that it’s basically like a iPhone on steroids because it  only  works with  applications that are  developed for an  apple  product . In our experience a number of practise management software companies are working on their iPad integration. I’m not even aware of any that have it yet.  Do you have anything else that you want to add Sheryl?

SHERYL: No, other than its coming. It’s been requested. So there is a plug in that apple has provided and that program is looking at integrating.

Dr Lavine:  Right. Ok here’s another question of you because we have one of your user on y here. I have Maxident already, shipped digital x-ray and [Inaudible] like a pen. How heard would it be to convert to completely paper?

SHERYL: Not hard at all. I guess that person can contact me directly.

Dr Lavine:  We have a 3 digital x-ray system with App Tricks but are not happy with the holes in the x-rays. What do you recommend as a replacement that works with App Tricks? There is a lot of good censors out there. One that we have had good luck with is one that is called E2V. Each of these are sold by a company called XDR and a few other companies. Many of you may not have heard of E2V because they in typically don’t sell directly to dentist, they sell it under other labels. So dentist in the past used to call it their image ray eye and Vere Tech used to call it their Accident Censors. Other companies like Mediadent haven’t sold that since. We’ve had really good luck with that one. There is another censor called the Amanda Censor that is available in Canada and the US. They have a brand new censor that is I believe they have one in Canada now called Vistio. It’s still going through FDA approval in the US so it’s not available yet but it has some promise as well. Again the beauty of the App Tricks system is that it works with every censor.  So really the best advice that I can  give you shopping for censors if  you already got the App Tricks software is have the rep come in and plug them in and take  all about  65 minutes of  both  drivers to get working and let your eyes help you to decide. Let them help you to tweak it and make sure that it’s you’re getting the best cost alignment. Have someone come in and if their censor can produce a better image quality then that may be the right cost for you.

If  i did  a start-up what’s  ball park I’m looking at in integrating the  various  technologies that  you have  presented  tonight ? Both initial cost and monthly. Now obviously this depends on number of factors. I can tell you that we work with a lot of start-up practises. The  typical practise that  we worked  with at getting practise management  software ,image  management , digital  x-ray , cameras, computers to grab all the apps, its not  a typical to have a  number  somewhere between  $40 000 kind  $ 55 000 .  That normal. We have some offices that are really going to be on as shoe string budget and that’s fine. We’ve also had large group practises that we’ve worked with that has gone beyond that. Solo practitioner if you budget for $50 000- $60 000 it probably won’t be a shock for you when you get the final deal. Obviously the ongoing monthly fees are going to depend on a number of factors. Whether  you  software  charges  a number of fees, whoever the  IT company is  going to offer  services as far  as maintenance and  networking monitoring and data  back up . All of that  have to  factored  in as well that’s why I would always recommend and  of Couse I am biased about this  but  i would  always  recommend working  with some  type  of technology consultant   that  you could  give you to the penny , here’s what  you are looking at  cost wise, the  initial cost is what you are looking at for a monthly cost  because that’s the way that you want to  go forward with  something like that .

Specific software for paediatric dentistry? Maxident can do mix dentistry cant it Sheryl?


Dr Lavine:  We found that there is not a lot out there that I would say is peso specific software.  We usually find that in most pedantic at least one that we are working with are getting their software in through general practise software and customise it for their patients.

So here’s another one. I recently purchased the Pedi scanner from MicroTech and i use it for dental x-rays. Well that’s great. I appreciate   giving me that feedback. There was a scanner from MicroTech years ago that we used to recommend called the MicroTech I800 and I900. One of the reasons why i loved that scanner is it was really inexpensive. It’s about $300 and the other ones we   are e looking at was   anywhere from $900 to $3000. MicroTech    the   less than North America market, a number of years but one of the attendees told me that they are back. That is another scanner that you can add. It’s called the Medi-Scanner and i will get more information about that as well.

There is another questions for Sheryl. How do your change incorrect default codes in Maxident chart? For ample MOD46 comes up as 2113.

SHERYL: I need to understand how old the charting program is. In the new charting program there is intelligence built not the system so it actually learns the dentistry that you do. If you do need to change a code there is one button called edit. Where you are able to go into there and edit the code. Once you set that it becomes your default all the time. Some are smart enough to reset itself based on the dentistry that your do in the office.

Dr Lavine:   So  if a program adds  features and  you already have a  third  party doing a separate data  base will that a problem? That’s really a challenge in decision. There is no easy answer here.  What  i understand the question to be is let’s  say that  you went out  and bought a third  party program because your current  management  software  didn’t have that feature and all of a sudden that software company now comes  up with  their  own module that’s integrated with  it . The questions is whether or not you should change. The answer is  in a lot  of  cases  I would  always  recommend  that there is  way to recommend it and  that’s  another reason why I am  a fan is that if there is a way to have the module  built  in, incorporated with the  practise management software its always going to be better. You don’t have to deal with bridges and it works fine .It just makes life a lot easier. The question is if you already had that information and third party program how easy will it be for the computer unit to get that stuff into the new module. In most cases it’s not that easy. What we normally suggest offices is just take a cut-off date. Here’s the day we are going to start using the model rather than the third party program. In some cases maybe you say that it can be converted in but in most cases it is not the case.

How many tablets do you recommend?  In most of your offices Sheryl how many tablets would you say to get. I assume they get them upfront and for sure but are people are putting in their operatory as well?

SHERYL: They are. If the dentistry is filling a prescriptions and he is using it to sign the prescription before he prints it or if he is electronically send it to a pharmacy he needs to have that. So the answer is it depends on that. Thetas not an easy answer I guess. But for sure reception. Sometimes you are planning a room and others in the operatory or the dentist office itself that’s always and issue with the prescription.

Developing a Paperless Practice P6

Really  every chart is different so what I recommend  if you are trying to figure out well how do I go chartless it’s  really not that hard. Go through your chart and take a list of every single system you got there. You’ve got your progress notes, your referral slips and patient in take forms. Less find a digital counterpart for them. I can help you with that, a lot of other people out there that do this for a living. As I said  it  sometimes can be a little bit overwhelming  especially when you are  dealing with some of these companies when they come and  say well if you are going to come in and get  our censors you got to get or practise name and   software  as well if you want to get an integrated solution.  You’re going to find that every system out there has pros and cons. What I normal recommend is that you take it one step at a time. There is always a way to get your image management software to work with your practise management software. We’ve not gotten any two systems that we couldn’t bridge one way or another. So make the decision based on that individual system and not try to do it all at once.

For the dentist on the webinar please involve your staff. Most of you do not have hands on day to day use of the software. They are  the ones who deal with it  every single day  so you are  if you are  going to look at a program like a Maxident,  if  your  are  going to  look at some other third  party program  that I talked about really make sure that the staff are part of that because  you want their  feedback because they hate  it. If they hate it you are just going to be miserable for years and it’s not worth it. Not that the staff should be the one to make the final  decision but they are a critical  part of the  practise and really should  be involve in that whole process as far  as I am concerned. As I said do things in stages. Sometimes it’s going to take a little bit of time. We work with offices all over the country who wants to go digital and get new practise management software and digital camera and all this stuff on day one and can’t figure out why their staff aren’t doing everything by day two. It’s really overwhelming. Do things in stages and everyone will be happy about that. As I said make sure you schedule in some time for this because it’s probably going to take you 12- 18 months to do something like this. So start doing it now, start the process whether it’s calling up a practise management software management company, whether it’s speaking with me or just doing it on your own. It’s available through email, You can got to my website  You can go to Facebook and search for me. You can go to twitter and search for me or you can go to LinkedIn probably about 2000 others. We have a toll free number that you can call if you want to set up a time. As I mentioned early up never charge a fee to talk to someone. If you just want my advice on a censor or practise management software I would never charge anyway. A lot of times it does require you to come into the office to do an in office evaluation. I am more than happy to do that. For new practise that wouldn’t be necessary because you have no building but I am happy to work with offices and if any capacity. We are going to open thing so up for questions right now.

What I’m going to do is give me second here. I’m going to open up my question pane. Start the questions as you think about them. Not a ton of questions yet which is great because usually what happens is people sort of fade more to the end. I’m not sure why. Let just get to the questions here. First, what’s the best standard to get rid of charts and x-ray? That is a really good question because aloft of times we are talking about 2 different scanners. The problem with  a scanner that you are  going to be using  for  film  is that for  most  part  they are pretty slow and they are  really not  designed for speed.  What my usual recommendation is to get 2 different scanners, one for paper, one for using for insurance forms.  One for film.

What do you use for paper?  The one that we normally recommend from paper are form a company called Fujitsu. They have two types of model, they have a lower cost one called the Snap Scan. I think S1500 is the model that i am currently recommend.  Like I said low cost, I’m saying relatively low cost. It’s still $4900 scanner. The probable with the Snap Scan is that it’s not  twain compatible .Twain is an  interface that  so used by  most software  programs  that allows the  to know how to interface with the  hardware . So  what that means is if you want to scan  the document that is not twain compatible you are  going to have to create a  PDF  file  first and then  import that into your  software. That’s fine, it’s an extra step. If you don’t want to do that then you are h probably going to want to get a twain compatible scanner.  Fujitsu has a model called the FI i think it’s the 6130. Now we are talking about $700-$900 scanner but it’s a great scanner for paper.

For film unfortunately your options are much smaller. The reason for that is in order for you to scan a film you are not going to want to take the PA and micro dental and so on. You are going to need something that has a large enough scanning surface and it also has what is called a CPU transparent unit. What that basically means is that there is a scanner or a light source in the lid. Usually when you are looking at X-rays if you want to see them you hold them up to the light and the light coming from behind the x-rays. That not the case with most scanners. Most scanners are like a copy machine where the light source is on the bottom. So a not a lot of great models for film.  The one that we normally recommend is the Epson V750M. They have one they called the V7000 but i heard that one is going to be discontinued.  The V750M is not an inexpensive scanner. About $800- $900 and the other limitation with that particular scanner is that it can only scan to about 10 inches maximum length which is fine for bite wing , which is fine for a  pan  but some  FMX mouths  are going to be a little bit longer  in here. Epson have another module called 10000XL which unfortunately is close to the price of it. You can scan the larger surface one beyond FMXD but that’s about a $3000 scanner. So  to  answer the  question I definitely recommend  getting both types of scanner because that’s  really what we do . I think there may be some questions about Maxident as well. I want to bring Sheryl on here so let me to just switch over to this for a second. Bear with me here.  I’ve got her muted which i am sure she is not opting to be happy about but I’m trying to get her to talk here. Sheryl can you hear me now?

SHERYL: I can.

Dr Lavine:  Perfect you’re great. So thanks for joining us and they are some Maxident questions here so great to have you on here. I’m going to go ahead and open up my questions again. So we got to the scanner questions. Does Egosoft software have all these criteria’s? In the states I’m not sure if Egosoft is available   in Canada or not. I think Egosoft is a very good program. You are going to find as you go through this   process there is a lot of good program out here. My goal is not to say well Maxident   is the only program you should look at and everything else is crap. I think Maxident is a great program… Egosoft has a number of features as well as they are going to  allow you to get close to the chartless and  paperless  but  as I said there is one  of many and I wouldn’t talk someone out of fi it fi they  are  sold on it but   certainly Maxident  is  one that  Would  definitely recommend.

What’s a good software for voice recognition that i can use to do period charting? There is not a lot of good stuff out there. I have been  telling people that  I believe  that  voice activated  software  is probably about  9- 12 months away from really being  state of the  art  and I have been saying that for  7  years .  The probably that I find is that if someone has an accent or if they have a cold that today of course you have to train it. It’s not as effective as i would like ti to be. The one that we have recommend for some offices is one that is called Perioral, its Again I will send the link to this. I believe it’s a web based  charting  which  is  kind of unique but  really nice system  that  is definitely   works  with  cove . That’s probably the only one that  have  seen  some of the practice management  programs  has it  built  in as  well and  I just haven’t found that its  really great  where i want  it to be  quite  yet.

Do you have any experience with Mogo? Yes i have experience with Mogo. I actually take was talking in my office last night. I wasn’t sure they were still in business. We have not heard much about Mogo in the last number of years. We had a number of offices that were on Mogo that used SQL database had a bunch of issues. Unfortunately a lot of users that we were working with jumped ship at that point. I don’t have a lot of current experiences with Mogo. I’ve worked with abou1600 offices over the years and i can count on one hand. That’s not necessarily a knock on them .I don’t know enough about their current software’s and the topic on them.

What are my thoughts on the future of online practise management software systems? I think web based is probably the future of all software. Not sure practise management   software, not just practise management software. We are heading in that direction. I think that you are  going to  find that  a lot  of companies and practise management  software companies are  going to  probably  head in that direction . I’m not sure Sheryl are you guys planning to do anything web based in a little while.

SHERYL: We are. It’s already in the plan. So its web based or computer based.

Dr Lavine:  Perfect. I think is great that you give people multiple options because they are so many practises out there who are living in east picking up a larger [Inaudible] or wherever. They have just no good consistent internet connection so I definitely think that for me is important. Which software for Orsoceptric is easy to use and easy to incorporate into Maxident? Do you guys have any specific software that you recommend Sheryl?

Developing a Paperless Practice P5

So a lot of reason why you should consider going chartless. The way that most of these systems work and in your practise management software you can clock on a little button and it’s going to take you right into the software and it will have. Of course you can customise it anyway you want  and you will  have read documents  that’s always need to  be signed and  if it hasn’t  been signed you  need to  make sure you got the  signature on there.  Customize the forms anyway you want. If you want that those to look like paper forms great if not you can use the ones come with their software.  They basically use sign and signature tabs like I showed you that basically you sign the signature tab that I showed you in the Maxident slide, your tablet PC. The dentist signs it and you now have a document that is perfectly legal and acceptable in every state every providence that I’ve ever been in.

The other cool thing about their software is that it’s online.  So  what a patient can do for example is  your patient calls up  in your practise you can  send it to your website where  there is link that they can go on to  a secure website, they fill out their paper work and that information gets uploaded to your  server a couple of time per day . So the whole premise behind this is that the information on the patient shows up long before they show up. The patent comes in for their first visit, they sign the signature tab and you are ready to go ahead and see them. That was always one of the things that I found annoying when I was in full time practise and send my patients the paper work, I would schedule in 10 or 15 minutes early just in case they forget it. They would forget it and come in on time and 35 minutes later they are still on their paperwork. So this should help to avoid a lot of the problems happening. This software is fully customizable. You can do all kinds of questions types, you can do statement things, and it can be done on a regular pc or a tablet or whatever you want. So that’s the Dent Form software. Depending  on the  package that you get you are  looking at  somewhere around  $3000  give or take  of the  software and  training and support and installation and the online and all that kind of  stuff as well.

What about online collaboration? This is an  area that really have not  taken off in dentistry  and  I’m surprised about that because as offices are becoming  more chartless, more paperless this is a  real hurdle . What do we do with those referral slips, how do we communicate another offices for using different to programs. How do we communicate with our labs? That’s important as well. If you are going to be chartless or paperless those forms are no longer going to be around. Is there a digital counterpart. There is not a lot of great options out there yet. The one that I’m most excited about. They are called Light Squid, they stared out in Calvary a few years ago. They are now in the US as well. They did their big coming out party in Chicago for the winter and February of this year. Expect to see a lot more about them. I’m just going  to show you a few slides of what they do  but basically it’s a  web based  online  platform for  multiple   people . The dentist, the lab, the referring office, the patient that you want them to have access to information and in real time.  Any of you who are  familiar with Facebook  are  probable  familiar with a screen  like the where  you can have a section for reading and  news blog,  this Facebook like  home page that  it keeps you updated on what’s  happening  with the cases. You’re got an area there where we can read comments for other people.

You basically have this online, ongoing dialogue with multiple offices. It   bridges to my knowledge with about 40 or 50 practise major programs. Pretty much every major one in Canada and the US so that’s not a problem. You can still enter in patients manually if you prefer as well. I think  there is this  really cool timeline feature as well that mouse over an area that you want ,  you mouse  over it and so you know when  something  happens or what’s  happening  at that particular  time . So really cool feature. You don’t have to use it if you want to just keep things chronologically as far as the other case that you have been working on.  Your can use a conventional system as well. You’ve got throw  online  lab prescription forms but  another really cool feature with this software you can take an  image on your  desktop , click and drag it to this white area and now your can upload it to  their  website. So really simple to click and drag and have access to images that your can share   with other offices. You’ve got this shipping check list, you have really nice view. You don’t need any special software. It’s all web based.

It also works with a lot of the cat canvases out there Catherine nitro and ND14 and Cirac. It actually has a built in 3D viewer as well.  So again someday who doesn’t have those machines can still take advantage of the products that you are sending to them. So great collaboration tools, security, manage your calling as far as who have access to what. You can certainly add calling as your feel you want to. That the Light Squid system. From my understanding  is  that the core system is going to run $129  ore  month  if you want  integration with the  Cad system  it’s going to be $199.

So keep your ears and eyes open for this. You are going to be hearing a lot more about it over the next few months. A few of the   things that i want to talk about in office communications. Certainly as you are going to have computers around the office does it really make sense especially for example for a  new office you really want to  go and  spend 5 or 6 thousand dollars on something that  is  older or light based , wired  systems. If you ‘vet got computers throughout the office why not use a software based system, software messaging systems. One that we recommended in the past is one called Soft Com a lot of practise management programs is built in as well. One we have recommended for a lot of practises is one that is called Bruno communicator. What I like about Bruno is that every person in the office has their own tone. So a lot of time you are trying to page someone you don’t know where they are. Are they in the staff lounge, in the operatory 3? As long as they can hear the page they can go to the nearest computer and reposed to that. So this is so really nice program. This m one runs around $800 for unlimited computers. So that’s one that i would recommend as well. We do get people who ask me about free programs like Yazd messenger and AOL messenger. I will be a little cautious about that. We are seeing more and more reports of spam and spyware and malware that affecting instant messaging programs. You wouldn’t necessarily want to put something like Ms Jones is here, sees a royal pain in the rear   that she usually is or something like this. Because when you are on this network Yazd messenger network you are on one that the whole world uses. So be a little careful about something like that. You tend to get what you pay off.

A  final program that I want to talk about and this is a n  area  that a lot of people  struggle with  as well is  progress note. If you are going to get chartless, get paperless how do you the progress note in there. The way  that  a lot of  practise  management progress notes  work is that u you will create h some type of  exploding code where you type this code  and  it’s  going to spit out the  procedure but then  you have to go back in there and  edit the tooth number and surfaces and the number of charpeals and anaesthetics . It’s just the pain. Often time you spend more time doing that then if you are typing from scratch. What if you can do the whole procedure with mouse click where all the setup is done ahead of time and you just click mouse, mouse, and mouse? We actually sat with offices that use this program and even to do a complex procedure takes them about 30 to 35 seconds.

So this is a program called Easy Notes Pro. It was created by a dentist, its Doctor David Burton in North Carolina. Just to show you some of their slides. This is the Easy Notes Pro software.  Works with pretty much any practise management rat software. I’m not going to spend too much time on this but basically this creates another tool bar for you can put on top of your practise management software.  Completely customizable. As I said most of the work that you do with this program is done ahead of time where you decide how you want the surface to be laid out in your software. For example most practises don’t have 30 different anaesthetics on a regular basis. It might be 3 or 4. Again I’m not going to spend too much time on the slides. If you have a really old practices management software that doesn’t have a place for progress note you can absolutely use something like this. It as standalone program. Most people don’t want that, they want the progress notes to go right in the software and that’s what this program can do. Again this is showing your how this works. Really slick software we have installed it in dozens of offices over the years. Works with pretty much any practise management software out there. Not an expensive program. Usually around $800- $1300 for everything. It just depends on what features you are adding to it. So you are trying to go chartless, you are trying to go paperless, what is the game plan? How do you go about if I could give you a summary of everything that we have gone through in the last 45 – 50 minutes? Really there is no magic bullet here. It’s not like I have information that no one on the planet has. I’ve done this for a number of years but the approach that I took is a systematic one. It’s a series of systems, look at it as a sequence of steps to take.  Try to do things in order.  You don’t necessarily want to go out and buy that really expensive digital pen if you don’t have digital software that it can work with or if your practise management software is outdated. So take the systematic approach to doing it.

Developing a Paperless Practice P4

As i mentioned a number of nice brochures and hand outs that you give to the patients as well. That’s Florida Pro system. Not an inexpensive system. You are looking at somewhere around $5,500 or so for single user system that’s going to be the hardware and the software and training and all of that. By the way the numbers that I am quoting here are retail prices. Usually companies like mine and other out there can probably get a better pricing. Around $5,500 for everything. I think that about $2,500 per operatory beyond that if you want   to do multiple operatory .Really nice system.  Not inexpensive.

What about patient education software? I think that’s really a great thing for people to be using. There is number of good systems out there. Most of you are probably familiar with Casey. Casey is the E hundred pound gorilla of patient education software. Unfortunately its $8000 patient education software. There are number of alternatives out there that are prices about third or a quarter of what Casey charge. There is nothing wrong with Casey, ‘m not trying to know them anyway. I just find that a number of offices that we work with say that we are looking for a little better   value for proposition or some think like this. One of the ones that I have recommend for lot of offices is called or sphere. You may have heard that it’s under a new name. Well i think they still sell the Orisphere but also Curbdental is now offering tips for free, it’s called Curb Ed. It’s completely free. It’s the exact software. I think its You can get more information about that. The Orisphere is the one that we have recommended for a lot of offices, very similar to what you would see with most patient education software’s. A series of libraries that you can stream together in a  playlist  For example if your want to show  patients something like an implant placement versus implant restoration that could be to a CD  or  DVD  to  take how with them. All the things that you would expect from modern software. Just to show you some their slides.  Really good graphics.

This is a thing we hear from some of our offices they don’t want to show patients anatomical things. For example something like an implant a verb going into the bone. They think that patients are going to be freaked out by it. I think you just have to gage with you patients. Some of them are not going to be comfortable with it and some of them couldn’t care less. So gage with your patients. The other thing with patients education software is that I always recommend to use it with a staff member hit a dentist chair site. Sticking that patient in chair and just having them listen to a little movie and then coming back and talking to them is a mistake. You have  to keep  in mind that the patient  is usually  not there to buy procedure, they are  there to  buy you  or  accurately  the  confidence that you can perform that  for them. So do a chair site don’t use the patient education software as a crotch. Again there are some of the slides that you would normally see with the Orisphere, they’ve got Cirac and all the latest and greatest stuff. Showing pocketing and build up. Again all the things that you would typically expect to see with   patient education software system. One that we have recommended for a number of offices is one that is called except. This is developed by a periodontist in Florida. What’s  unique  about  the Except system is that most  of the patient  education  software or programs  out there  is showing  you somebody wales  teeth , the patient  may  have a  little trouble  relating to  and  in my mind probably one of the most  effective ways that you can educate patient  is when  it  is   with their  own  images. So to call except a patient education software may be a bit of a miss nomer. I think it’s more accurate to call it a treatment playing software. So what i you want to be able to do is to take something like this where got the diasima, the central, and the latels could use a bit of crown lengthening. The cans can use a little tissue coverage there, perhaps cover things up. Ideally and under five minutes because truthfully I know the way dentist are. Its goings take  us more than 5 minutes we are  probably not  going to do  I but you can very easily simulate the  constitution graphs   on 6 and 11 or  Canadian  people  and 1-3 and 2-3,  crown lengthening  on the laterals, closing  up the black triangle with [Inaudible]and  of course doing some  whitening .

One [Inaudible] software like this. Be really sure that you can produce into his mouth what you are showing them in the screen. Usually they are going to want you to print this out for them, they are going to want to take it home and discuss with their response. When they come back  into that procedure  your know darn well that  they  probably have that with them  so what I always recommend doing is under promise and over deliver  and that way you’re going be a hero  in their eyes. For example don’t show them chicklet on the screen off you don’t know if product that. Show them maybe one or two shades lighter what they’ve got that way when you produces something better than they thought then you’re going to look golden in their eyes.

You can also do things with this program like numbering things or draining where are, showing how important would function. This is a really nice programs. I can’t give an example of what the cost is. Somewhere around $3000 give or take it.  We work with a number of companies using that one as well.

Confirmation and surveys. This is as I said a really hot area right now. I’m not sure if the market is really support  all the different ones that are out there but  Viewpoint want the first  one out there,  Smile Reminders is one that is  popular as well. My favourite one is one called the Man force. We installed it in a ton of offices. They are available in Canada and the US. Really great company, great product. There’s a lot of things that it can do. It was basically built initially as a way for confirming appointments but they went a lot beyond that. For example  lets say that you want to send out an  email  to every patient  that not  been in within  the last 6 months, offer them  some type of discount  on whitening or some kind of deal like that. The software does that automatically for you, just say go ahead and find everybody who hasn’t been in 6 months and send it automatically. You can track all this stuff which is critical because you want to know if it’s effective.

One of the things that i like about the Demand Force software is that they guarantee at least 3-1 return on investment or it’s free the next month. Most of these programs they cost somewhere around $200- $300 per month. So the  Demand Force is basically saying we can  track all this  stuff for  you  , you’re  going o see at least  $900  per month  in increased revenue or you  don’t pay within  the next  month . I am not aware of any other software program that does something like that. The core of the program  is that it sends out the confirmation  for the patient,  they click on that little confirm button that’s going to go back to the  dashboard that  the office manager has on their  screen  where you can keep a  running  total of whose coming in and who  is to be confirmed.

The other next  thing that they have  are these  surveys where you can customize this and  send the  survey out to  the patients after they have been into the office, try  to get  feedback  from hem and how you can a prove . Another really critical reason why I think the resurveys are important. This is just showing you that screen where you get that dashboard to the office manager where you they can monitor. The reason why those surveys are important demand force has a relationship with a little commonly called Google. To may have heard about them.  Basically no one is ever going to say that if you use a software you’re for sure going to get to the top of the list. When your do that, any of you who have familiar with what is called google local. You’re going to get get a little  map with 10 pins on it .You  are going to have  10 practises listed in the three, their website , their  phone number and you are  going to see reviews. Yes they are a number of companies that can give you reviews. At least for  San Francisco which is where the  Demand Force is based every single one of  those top ten if you click on the number of reviews it’s going to  review from Demand Force . So you are not necessarily guaranteed to get to the top. In our experience the more reviews that you have the more feedback that you have  from  patients  the higher you’re  going to rank with google searches and Demand Force definitely does that and that  including in that $300  per month fee that you are  paying them  besides the confirmation  and all that stuff. This is a great program, recommended for a lot of practise as well.

What about offices that are trying to go chartless and paperless that aren’t going to take my recommendations and look at a program like Maxident? How do you get those signatures into the practise management software? Probably my favourite program out there is Dent Form friend of mine and in the bay area. I’m just going to quickly go through some of their slides. I’m not here to sell you anything or to market anything like that. But the whole premise behind this and that and going chartless makes sense for a lot offices. You are going to save time, you are going to be a lot more effect as well. You are going to reduce the cost. I can’t think of anything that is more time consuming than scanning and charge. When lecture on this topic  people always  say  to me  what’s   your feeling on scanning and   charts and  whit I usually say  as the dentist in the group is that if you have  a staff member that you are  trying to get rid of  and you don’t want to fire them go ahead and give them  the  job of scanning and guaranteed h they  will portably  be gone  within a week . It’s a painful, time consuming job so. If there is a way that you can get all of that stuff electronically before paper. To  me  you are  going to  put  it on  paper and then scan  it in your are pretty much doubling your work  load. It so  way to get  you  digitally from  the get  go  and to me that is always the  best  way of  doing  it .

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